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What Does It Mean When a Period Comes Early

Most women's cycles last anywhere from 21 to 35 days—but about one in 10 have irregular periods or super heavy bleeding, according to the National Institutes of Health. That can mean lots of things, from a period that goes MIA, to periods that are completely unpredictable, to bleeding that drags on for eight days or more, to random spotting.

"Most women are pretty attuned to their period, though changes can occur through decades and after kids," says Alyssa Dweck, M.D., an ob-gyn in in New York. "But if you still think something's wrong with your period after a month or two, get it checked out."

Jessica Shepherd, M.D. (@JShepherd_MD), an ob-gyn in Chicago, notes that sometimes, changes can be a sign of something more serious. "We may look for an STD or do a biopsy to make sure it's not something that needs to be treated," she says.

Here are a few reasons why your period might go wonky—and what you can do about it.

PCOS

Alyssa Zolna

Polycystic ovarian syndrome—a.k.a. PCOS—is a common hormonal imbalance that messes with ovulation. "Women either miss their period, or it can be very irregular, or they won't get their period at all," says Dweck. Other PCOS symptoms are more obvious, especially since an excess of testosterone is involved, she explains: hair growth in typically male places, like above the lip or on the chin, difficulty losing weight, and acne. Your doctor may start you on birth control and/or the diabetes drug metformin, both of which can help make your cycle more regular. If you're overweight, she'll also help you come up with a plan to shed excess pounds, since even a 10 percent reduction in weight can help regulate periods and relieve other PCOS symptoms.

Related: Are Your Periods Irregular? You Could Have This Syndrome and Not Even Know It

Pregnancy

Alyssa Zolna

Skipped a period—or got a weird flow? Pregnancy might seem obvious, but it's not always. "We like to rule pregnancy-related issues out very early when a patient comes in with erratic bleeding," says Dweck. "There are people who get what seems to be a 'regular' period even though they're pregnant and everything is fine." Other times, bleeding can be linked to more serious issues, like miscarriage or ectopic pregnancy. So if you're think there might be a chance egg and sperm met, see your doctor.

Perimenopause

Alyssa Zolna

The months to years that lead up to menopause (typically defined as 12 months with no bleeding after the age of 40) are marked with erratic, heavy, or light bleeding and spotting, combined with hot flashes, night sweats, and moodiness. "Some women might go six months without their period, then start bleeding again. That's part of perimenopause," says Dweck. If you're having any of these symptoms, check in with your doctor, who might suggest medications, surgery, or lifestyle changes to help with symptoms.

Thyroid problems

Alyssa Zolna

An imbalance of hormones produced by your thyroid is a very common cause of spotting, says Shepherd, since one woman in eight develops a thyroid problem in her lifetime. Your thyroid modulates a number of hormones, including those that regulate your metabolism. When it either produces too much hormone or not enough, you also get persistent, irregular periods. "The hormones that regulate the thyroid are in the in hypothalamus and pituitary, which is also where the hormones that instruct the brain to menstruate are. So when one goes awry, others may as well," says Dweck.

If you're experiencing any other signs of thyroid issues—including feeling super tired, depressed, and forgetful (hypothyroidism) or irritable, nervous, and weak (hyperthyroidism), and have unexplained weight gain or loss—talk to your doctor. Most thyroid issues are completely treatable with the right medication, which will also put your period right back on track, says Dweck.

Related: Vagina Dos and Don'ts: A Guide to Keeping Her Happy and Healthy

Prolactinoma

Alyssa Zolna

Known as prolactinoma, this small, benign growth in the brain's pituitary gland is fairly common, especially in women, and most won't experience symptoms. But if the tumor starts to secrete the hormone prolactin, it can affect other hormones that cause your period to skip or stop. It also results in a milky discharge from your breasts, since prolactin is the same hormone that causes you to lactate post-baby, explains Dweck, as well as vision changes. If you aren't nursing, check in with your doctor, who may order a blood test and brain imaging. In many cases, medications can shrink the tumor and regulate your period.

Not Eating Enough Or Exercising Too Much

Alyssa Zolna

If your BMI dips below 19 or if you're working out like a maniac, your period might go MIA. "Preventing ovulation is your body's way of reacting to 'terrible stress'—i.e., starvation," explains Dweck. "I explain it as nature's way of preventing you from getting pregnant if you're under distress." Your doctor will work with you to reach a healthy weight as well as check for any other issues that could be affecting your cycle.

Significant stress

Alyssa Zolna

"We're not talking a stressful day at work," says Dweck. "This is more going off to college, or losing a family member." Check in with your doctor, and take steps to manage your stress— yoga, meditation, talking to a therapist.

Related: Your Private Parts: A Lesson In Female Anatomy

Abnormal growths

Alyssa Zolna

Sometimes, abnormal growths in your uterus can cause your period to go wacko. These include:

Polyps: These little growths on the cervix or inside the uterus are caused by an overgrowth of uterine lining. Uterine polpys tend to cause bleeding between periods, and cervical polyps lead to bleeding after sex, says Dweck. You likely won't notice any other symptoms; you're more at risk if you're obese, diabetic, or have high blood pressure, says Shepherd. Often, your doctor will recommend just keeping an eye on them. But if bleeding is particularly problematic, your doctor may surgically remove ovarian polyps; cervical polyps can be easily removed in office.

Ovarian cysts: These fluid-filled sacs form in or on the ovaries, typically as a byproduct of ovulation. In addition to irregular periods, they cause bloating and pain. Many cysts aren't problematic and go away on their own. Depending on the size, location, and symptoms, your doctor may watch and wait or put you on birth control to help shrink the cyst and get your period back in line, says Dweck. About one in 10 women end up needing minimally-invasive surgery.

Uterine fibroids: These benign tumors are super common, usually during your thirties and forties. Many women don't even know they have them, but if yours is larger you'll likely have very heavy bleeding, painful cramps, and you'll feel like you gotta go all the time. Often, doctors recommend watchful waiting. But if fibroids are rapidly growing, causing severe pain or heavy bleeding, or interfering with fertility or bathroom habits, your doctor may suggest surgery or embolization (a radiological treatment that shrinks fibroids), says Dweck.

Endometriosis: When the uterine lining grows outside of the uterus, women experience super-heavy bleeding with painful cramps, intestinal pain, and sensitivity, and spotting between periods. If your doctor determines you have endometriosis, she may put you on birth control; in more severe cases, surgery may be necessary, Dweck says.

Precancerous or cancerous tumor: Cancer or precancer causes all types of symptoms. "Because it's usually diagnosed in women in menopause, it typically causes postmenopausal bleeding—so it's usually fairly easy to diagnose," says Dweck. Your provider might offer ultrasounds, blood testing, biopsies, or other tests to figure out next steps.

Related: What Your Period Says About How Long You'll Live

Obesity

Alyssa Zolna

Obesity can up your risk of irregular bleeding, says Shepherd. "Fat tissue produces a form of estrogen, which may increase the endometrial lining," she explains, which then sheds at times other than your period. Your doctor might check your thyroid, and she may suggest an IUD to get your period back in line. If you're obese, she can also help you come up with a weight-loss strategy, including changes to your diet, exercise, and possibly weight-loss surgery. (Speed up your progress towards your weight-loss goals with Women's Health's Look Better Naked DVD.)

Recently Starting Birth Control

Alyssa Zolna

All forms of birth control, including the Pill, implant, and Depo shot, can cause what's known as breakthrough bleeding between periods at first. "These outside hormones are trying to regulate or minimize your cycle, and they're fighting against the normal hormones given off by your ovaries. It's your body trying to balance the two," says Shepherd. She suggests waiting 12 weeks to see if things work themselves out. If not, your doctor may recommend a different higher-dose birth control or recommend another method altogether, like the patch or IUD. She may also test for STDs or check for improper IUD placement, if you have one, since both can cause irregular bleeding.

If you have an IUD, keep in mind that many women have little—if any—bleeding for the long haul, says Shepherd, and it when it does show up it may be irregular. That's a perfectly fine (um, welcome!) effect.

Watch men answer questions about birth control (spoiler alert—they're clueless):

STDs

Alyssa Zolna

STDs including gonorrhea and chlamydia can cause inflammation and irritation of the uterus and cervix, resulting in spotting, says Shepherd. Look for unusual discharge that's foul-smelling and thick and/or discolored (i.e., green-insh or bright yellow) along with itching or irritation. Even without these symptoms, if you've had sex with a new partner lately, particularly if it was unprotected, talk to your doctor—often women with chlamydia don't experience other symptoms, says Shepherd. If testing reveals you do, indeed, have an STD, your doctor will put you (and possibly your partner) on antibiotics right away.

Colleen de Bellefonds is an American freelance journalist living in Paris, France, with her husband and dog, Mochi.

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What Does It Mean When a Period Comes Early

Source: https://www.womenshealthmag.com/health/a19947375/reasons-for-irregular-period/