Common Period Problems
Your top questions about irregular menstrual cycles answered
Could I Be Pregnant?
My period isn’t late yet, but I really feel like I’m pregnant. Am I crazy? How early can I do a home pregnancy test?
Early pregnancy often feels just like a period about to start, but some women notice the effects of the early rise in hCG levels, which can result in breast tenderness. A pregnancy test is the best way to determine if you are pregnant, and a blood test is the most accurate, particularly in early pregnancy. Home tests are accurate when used according to package instructions, usually not until the first day of your missed period. Some brands now offer results up to five days sooner, although with decreased accuracy. (Read more about the early signs of pregnancy.)
My periods are usually very regular, but the last one was late. Could that mean I was pregnant and miscarried?
It is possible. Ten to 25 percent of all pregnancies end in miscarriage, including many pregnancies that women aren’t even aware of because they occur very early. You would not experience more cramping with an early miscarriage, and the only way to know that you were pregnant and miscarried would be with a blood test. Having a late period one or two times a year is in fact normal and often due to stress, travel, exercise, or illness.
Is it possible to have a normal period after conception?
After conception, some people have a small amount of spotting around the time of their period called implantation bleeding, but it is not like a normal period. Spotting is very light bleeding (usually brown) and lasts only one to two days. This is different from a period which lasts four to five days and is heavier in flow. Women may spot during the first trimester, but you cannot be pregnant and get a true period.
Other Menstrual Problems
I have painful periods. I have heard about endometriosis, but what is it really?
In brief, endometriosis is the presence of viable endometrial cells in places other than the uterine cavity. Every month when a woman has a period, the cells that line the uterus, known as the endometrium, are shed in the menstrual flow. Some small portion of this combination of blood and endometrial cells may also pass out through the fallopian tubes into the abdominal cavity. Most of the time, the body’s natural defense systems attack and destroy these cells before they can begin to grow. However, this is not always the case. In some individuals, these endometrial cells actually implant on structures in the abdominal cavity and begin to grow. Then, each month when the normal hormonal changes bring on a menstrual period, much the same occurs in the endometriosis. A small amount of bleeding occurs from the endometriosis cells. This is very irritating to the body, and as a result of this, scarring occurs around the endometriosis. Most often this is a progressive process, with a small additional amount of bleeding and scarring occurring every month. It definitely has implications for future fertility, so check out the article Fertility and Endometriosis.
I’m only 39, but feel like my cycles—which have been regular all my life—are now going a little haywire. I seem to have PMS when I never did before, and huge variation in flow (sometimes nothing, sometimes I go through the “super” tampons in no time). I hope this isn’t the start of menopause already! What do you think?
Not to be confused with menopause, a distinct stage in a woman’s life where she has stopped producing estrogen and progesterone, and no longer menstruates, or even early menopause (defined by the cessation of a menstrual period for more than 12 consecutive months before age 45), perimenopause is a transitional phase—occurring up to a decade before menopause—defined by fluctuating hormone levels. With little or no progesterone (due to a non-ovulating cycle, or anovulation) to balance the effect, unopposed estrogen—up one day, down the next—causes many women to experience a myriad of symptoms from irregular menstrual cycles to changes in memory and mood. One big misconception about perimenopause is that what women are experiencing is all in their heads. It is not, and perimenopause may be one of today’s most misdiagnosed conditions. Physicians have begun to realize that there is a definable entity prior to the onset of menopause. Read more about perimenopause.
More Period & Ovulation Resources
Six weeks ago I had a dilatation and curettage (D&C) after a miscarriage at 10 weeks. Now my doctor has discovered via ultrasound that my ovaries are polycystic. Is this common after miscarriage or D & C? Is this the same as PCOS? And will this effect future attempts to conceive?
If the ultrasound was done soon after your miscarriage, it may just be the ovaries trying to start back up. Blood work can usually nail down the diagnosis of polycystic ovarian syndrome (PCOS), specifically, a measure of your glucose/insulin ratio, follicle stimulating hormone, luteinizing hormone, and serum testosterone. Your doctor may want to order these if a repeat ultrasound again demonstrates a multicystic picture. That you got pregnant already is a good sign against PCOS.
With PCOS, women suffer irregular—usually rare—periods, hair growth, and varying degrees of infertility. Its most general definition is a syndrome in which there is too much male-type hormone (androgen) produced by the ovaries (and sometimes the adrenal glands) with associated disruption of the normal cycle. Its exact cause is unknown, but it seems to be hereditary. Almost one in 20 women of reproductive age has it, and it is one of the most common causes of infertility. It is also one of the most underdiagnosed conditions in women. Now that other health consequences have been implicated in association with PCOS, a lot of attention has been given to making the diagnosis in women who otherwise would have been overlooked.
We hope these questions and answers have provided you with some insight, or links to other helpful information. For further reading, check out:
Physicians who contributed answers:
- Gerard M. DiLeo, a board certified obstetrician-gynecologist who has been in private practice since 1981 and has served as Chief of the Medical Staff at Lakeview Regional Medical Center in greater New Orleans. He has written a book called The Anxious Parents’ Guide to Pregnancy.
- Steven R. Goldstein, professor at New York University School of Medicine, and author of Could It Be…Perimenopause?: How Women 35-50 Can Overcome Forgetfulness, Mood Swings, Insomnia, Weight Gain, Sexual Dysfunction and Other Telltale Signs of Hormonal Imbalance.
- Marie O’Sullivan, registered nurse.
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