Experiencing irregular periods is a common concern from many women and deserves work up particularly in women 40 and over. The definition of regular periods are 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 are not regularly ovulating (releasing 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 work up with your clinician is recommended to determine the cause and best care management. An evaluation can include such things 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.

Irregular bleeding should never be considered normal. While most causes are benign, a work up with your clinician and appropriate care management is the best option for your overall health.