Irregular Periods: When to See a Doctor

Ladies, has your body seemed a little off since this pandemic started? Or, are you worried about the COVID-19 vaccine impacting your cycle? Melinda Hansen, MD and Diana Kaufman, MD weigh in on which period changes are normal and when it’s time to see the doctor.

What Are Some Causes of Irregular Periods?

“A ‘normal’ interval between your menstrual cycle, or period, is 24 to 35 days from the first day of one period and the first day of the next,” Dr. Hansen says. “Some people have the same interval every month, and for others, it varies. The average cycle is 28 days with the average length of bleeding usually five to seven days.”

Here are five causes of irregular periods:

• Stress. Stress hormones keep the ovaries from ovulating, thereby delaying the period.
• Weight Change. Quick weight loss or gain can delay ovulation, changing the interval between periods.
• Medications. Certain medicine can interfere with the ovulation process and delay the menstrual cycle.
• Illness. Acute illness, including respiratory or gastrointestinal infection, could impact ovulation and cause menstrual irregularities.
• Surgery. Undergoing surgery of any kind can affect ovulation and the menstrual cycle.

What’s Causing Irregular Periods During COVID-19?

“During the pandemic, I believe stress would be the most likely culprit to a change in someone’s menstrual cycle. When we are under emotional stress, our stress hormone (cortisol) levels rise, and this can prevent ovulation, thereby affecting the menstrual cycle,” Dr. Hansen says.

Dr. Hansen says she doesn’t know the percentage of women have experienced irregular periods during the pandemic, but it’s probably pretty common.

“Women who are on any kind of hormonal contraceptive, either to prevent pregnancy or regulate bleeding, would be less likely to experience irregular periods due to stress or any other factor. This is because their periods are regulated by the medication rather than their internal hormone fluctuations,” Dr. Hansen says.

Can the COVID-19 Vaccine Affect Menstrual Cycles?

“I have read and heard anecdotal stories about a limited number of women missing a period, having unexpected periods or even having a heavier-than-normal period after getting the COVID-19 vaccine,” Dr. Kaufman says. “But, at this point in time, there is no data to link changes in a woman’s menstrual cycle to the COVID-19 vaccine.” 

Furthermore, no large-scale adverse events regarding irregular menstrual bleeding have been recorded during ongoing safety surveillance. 

“If you are experiencing any stress associated with getting the vaccine, that could also be a factor for why you may see short-term changes to your cycle,” Dr. Kaufman says.

Additionally, you might be hearing the COVID-19 vaccine can be passed or “shed” from one immunized woman to another, then causing impacts to the non-vaccinated woman’s reproductive cycle. 

“This is a conspiracy theory created to make you doubt the COVID-19 vaccine. The vaccine cannot shed or be passed from person to person. I know this vaccine is new and might feel overwhelming and scary. If you have questions, talk to your doctor instead of googling. Remember, as health care workers, we are devoting our careers and lives to promoting the health of our patients. We would not recommend anything we know to be harmful,” Dr. Kaufman says.

When Should I See a Doctor About Irregular Period Symptoms?

“If your period comes a few days earlier or later than usual, it’s not usually concerning. Even having your period come a week late isn’t too uncommon. Some women might occasionally notice they skip a whole menstrual cycle and then resume regular monthly cycles again. These are rarely signs of something concerning or dangerous,” Dr. Hansen says.

However, she suggests if you’re sexually active and your period is later than usual, you should take a pregnancy test as a precaution. It’s a good idea even if you’re using a form of birth control, or if you or your partner has undergone surgical sterilization.

When is it Best to See the Doctor?

Dr. Hansen and Dr. Kaufman says if your periods are consistently irregular, they’d recommend seeing your doctor or gynecologist. Here is what to watch for:

• Consistently having periods closer than 24 days apart
• Consistently having periods longer than seven days
• Consistently having periods associated with severe pain
• Consistently going two months between periods (for women not on hormonal medication)
• Consistently having bleeding between periods (for women not on hormonal medication)
• Consistently noticing heavy bleeding (requiring a pad or tampon change every hour)

“If women are bleeding too much or too often, they can lose so much blood they develop low blood count (anemia). This can result in unusual fatigue and even fainting,” Dr. Hansen says.

She also often suggests getting your thyroid tested if you’ve noticed changes to your period. Thyroid disorders and polycystic ovarian syndrome are the most common medical conditions that impact the menstrual cycle.

“If needed, there are medications for irregular periods, including oral contraceptives, contraceptive patches, contraceptive vaginal rings, oral progesterone and progesterone containing IUDs (intrauterine device). If you’re looking for a long-term option, there are also surgical interventions such as endometrial ablation or hysterectomy. Come see us and we’ll figure out what’s right for you,” Dr. Kaufman says.