Life

Ask the Expert: Should I be worried about my irregular periods?

Missed a period this month? Menstrual health expert Anna Druet explains when and if you should be concerned

Your period should generally be about the same length and volume each cycle
Your period should generally be about the same length and volume each cycle Your period should generally be about the same length and volume each cycle

PERIODS are painful and irritating to endure, but it's really important to keep an eye on them – because prolonged irregularity could be a major warning sign of a bigger health issue.

So how do you know when something's amiss with your monthly cycle? We asked Anna Druet, chief science researcher at ovulation tracking app Clue, to advise.

She says: "Firstly, it's important to define what exactly is 'normal' and what is 'irregular' when it comes to periods.

"A 'normal' period usually refers to a period that typically happens every 24 to 38 days for adults, and lasts between four to eight days. In that time, you can shed anything between 5-80ml of blood (that's up to six tablespoons). An average period sheds two to three tablespoons (35-40ml) of blood and tissue. People who are in the upper five to six tablespoons are considered to have heavy menstrual bleeding.

"The typical 5-80ml amount would use between three to 16 regular absorbency tampons or pads per cycle, but you can also measure your period flow by using a menstrual cup. It's easy to overestimate how much blood you shed each period, so a menstrual cup can come in handy if you're unsure. Talk to your doctor if your period is so heavy or painful that it interferes with your daily activities, because prolonged heavy menstrual bleeding can lead to anaemia.

"Noticing some clots or clumps, especially on the heaviest days, is completely normal, as is noticing changes in the colour of your menstrual blood over your period (darker colours are usually common when your flow is light)."

So why can your period change?

"Periods fluctuate for a while after they first start, but if you've had your period for a few years, it should generally be about the same length and volume each cycle. You may still notice changes from time to time, though – the heaviness and length of your period depends on your hormones, which can fluctuate. Hormones can change temporarily because of things like stress, over-exercising, not getting enough calories and other diet changes. It can also be affected by taking an emergency contraception pill.

"Your period will also be different than usual if you don't ovulate each cycle – you may miss a period, or it may come later than usual, and/or be heavier or lighter and shorter or longer than your norm. Not ovulating regularly (anovulation) is common during adolescence and perimenopause, and is a common cause of temporarily absent or heavy menstrual periods.

"Periods can also fluctuate because of certain health conditions, like uterine polyps, fibroids, or PCOS – these should be addressed with your doctor."

When should I be concerned?

"Having a menstrual cycle is like gaining another vital sign – like your blood pressure or pulse. Your cycle can let you know when everything is working as usual, or if something else might be going on. This is why it's important to track your cycles, which you can easily do using an app like Clue.

"An irregular cycle may be the first noticeable symptom of a treatable hormonal condition. Common conditions that sometimes appear during the teenage years in particular include polycystic ovary syndrome (PCOS) and endometriosis. Treating these conditions as early as possible is important.

"Talk to a healthcare provider if the majority of your cycles fall outside of the range of 21 to 45 days, or 24 to 35 days if you've been menstruating for over two years. If your periods become very irregular after having regular cycles for at least six months, it's also worth speaking to a GP."