Experiencing irregular periods is a common concern for many women and deserves a workup, particularly in women 40 and over. The definition of regular periods is 3-7 days of bleeding every 21-35 days.

In the perimenopause years (the time frame before periods stop), about 90 percent of women will notice a change in their menstrual cycle. During perimenopause, the ovaries do not regularly ovulate (release an egg), which can lead to a thickened lining of the uterus. When the lining becomes thickened, it can shed at irregular intervals. If this occurs, a workup with your clinician is recommended to determine the cause and best care management. An evaluation can include tests such as a pregnancy test, thyroid test, pelvic ultrasound, pelvic exam, and/or endometrial biopsy.

Causes of irregular bleeding include thyroid abnormalities, polycystic ovarian syndrome, high prolactin hormone, vaginal dryness, pregnancy, infection, medication side effects, uterine polyps or fibroids, pre-cancer, and uterine cancer.