Do you ever have long or irregular periods? The menstrual cycles that last 35… 45… or even 60 days or more? You’re not alone. Around 1 in 4 women experience menstrual irregularity, which includes short or long cycles. So, what causes irregular cycle lengths? What can you do about them? When do you need to get help from a healthcare professional? How do you manage the emotional aspects of irregular cycles? We’ll discuss this and more in today’s blog post!
How do you define an irregular cycle? Currently, menstrual cycles that occur every 25-34 days are considered regular. Fluctuations of a couple days from month to month can be expected, as our bodies respond to external influences like stress, illness, changes in diet or exercise, or travel. Even the occasional anovulatory (a cycle when you don’t ovulate) can occur.
However, if your cycles were consistently in the regular cycle range and then suddenly switch to longer than 35-day cycles for 2-3 cycles or more, it’s time to investigate what your body is trying to tell you. Remember, your menstrual cycle is your Fifth Vital Sign… it is one of the ways your body communicates to you about your health, just like your blood pressure, heart rate, breathing rate, and temperature. If you want to know more about how your cycle communicates to you about your health, read The Fifth Vital Sign by Lisa Hendrickson-Jack.
What is happening in my body when I have a long cycle? Your menstrual cycles rely on a symphony of hormones to make the main event happen (aka, ovulation). During your Follicular Phase, just after your bleed, Estrogen is like the conductor of the symphony… it's produced in your ovaries and communicates to your brain to release Follicle-Stimulating Hormone (FSH). FSH helps to grow a follicle (aka egg) to maturity, so it can be ready to release at ovulation. FSH and Estrogen have a beautiful symphony they play, both increasing each other’s levels in the body in a positive feedback loop. It’s like an orchestra all playing in sync, guided by the conductor Estrogen, and beautiful music is played for all to enjoy (a regular, healthy cycle).
Once Estrogen and FSH reach a certain level in your body, your brain releases Luteinizing Hormone (LH) which causes the egg to be released and ovulation occurs. This process takes anywhere from 12-16 days after the start of your last period. Tada! Your magical body is ready to create life if you choose. After ovulation, you switch to your Luteal phase, which is very consistent month to month, about 10-16 days. It ends with your period, starting the next cycle, or pregnancy.
When Cycles Go Awry
In a cycle longer than 35 days (aka Oligomenorrhea), something is amiss in the first half of your cycle. Since the Luteal phase is almost always the same length, you end up spending more time in the first half of your cycle: the Follicular Phase. It’s like some crazy dude came and streaked in the middle of the symphony’s performance, pulled down the conductor’s pants, and ran off down the hall screaming and waving his hands around. Now all the musicians are playing out of sync, the conductor is out of their zone, and it takes a while to get back on track.
Similarly, something comes and interrupts the natural rhythm of your hormones, and it can take some time to get back to the right levels so ovulation can occur. Your body will do its best to ovulate, and if the levels of Estrogen, FSH, and LH aren’t right, it will ditch the follicle it’s been growing and start growing a new one. This grow-misfire-reset process takes about 4-6 days. Your body will continue the process of growing a follicle and trying to trigger ovulation with LH until finally, the levels are right, and ovulation happens.
For example, let's examine this cycle chart from the Groove app for a woman with polycystic ovarian syndrome (PCOS). If you take a look at her patterns of cervical mucus (the blue bars), you'll see she has multiple rounds of her body attempting to ovulate. In this chart, she has 4 misfires and then ovulates on Day 42, as confirmed with a temperature shift. Then, she enters her Luteal Phase for 12 days and begins a new cycle. This Menstrual cycle took 54 days to complete.
What causes long cycles? Lot’s of external and internal factors can influence the length of your cycle. Sometimes, the interruptions are short lived, and the body returns to its baseline rhythm, and other times, complex chronic conditions can cause the cycle to be irregular more often.
Here are some contributing external factors that can delay a cycle:
A stressful event, like a wedding or moving, in the first half of your cycle, between menstruation and ovulation
Travel
Illness
A sudden change in weight
A sharp increase in exercise
Here are some contributing internal factors that can delay a cycle:
Intense emotions, like grief, anger, sadness
Lack of self-care boundaries around menstruation
Difficulty with managing stress
Physical conditions that can cause a delayed cycle:
Polycystic Ovarian Syndrome (PCOS)
Thyroid conditions (Hypothyroidism or Hyperthyroidism)
Perimenopause
Pregnancy
Hypothalamic Amenorrhea (HA) – a condition that can result from extremely low BMI associated with eating disorders, extreme athletics, or other medical conditions
*Note: If you suddenly have a missing period and you are sexually active with a man, it may be a good idea to take a pregnancy test. Even if you are on birth control. Even if you consistently use condoms. Even if you only had sex that one time this month. There are several reasons why your cycle is long or late, and pregnancy is one of them. Unless you know FOR A FACT that you cannot be pregnant (for example, your partner has a confirmed vasectomy, did not have sex with a male partner, or you have a female partner), then it’s a good idea to take a test, just in case.
What can you do if you are experiencing irregular cycles? One of the best things you can do to support your body if you are having changes to your cycle is to LISTEN. Contrary to what we all have been told, our bodies do not “hate us” or are “out to get us” if they bleed irregularly. Changing how we view our bodies and the ways they communicate with us is one of the best things you can do for your health and well-being. If you are having irregular cycles, then your body wants to let you know that something is off, and it needs to be addressed by you before it progresses into full-blown hormonal dysfunction and chronic disease.
Here are 3 ways that you can address irregular cycles:
#1: Build Awareness Around Your Cycle. Every Body is unique, and some are more sensitive to stress factors than others. This is why it’s so important to get to know your unique cycle through Cycle Mindfulness and Tracking. This goes beyond just marking down when you have your period. Not only does Cycle Mindfulness help you get to know yourself and your body, it gives you real time insights into your current state of health and provides feedback when you make changes in your environment or lifestyle.
This information allows you to find patterns so you can address the issue with love and support for your whole body. I love using Cycles Journal to get to know my cycle throughout the month, and Natural Cycles to track my basal body temperature and ovulation patterns. If you need 1:1 help getting to know your cycles and patterns, book a free consultation with me and we’ll come up with a plan to help you get to know your health better.
#2: Double down on your healthy self-care routines. Your body loves support, attention, and nourishment. Just like a garden or house plants, your body thrives in environments where she gets the nutrition and support she needs to grow. These are general recommendations, but they have a huge impact on our hormones and flow of our cycles. Try these out if you’re experiencing irregular cycles.
Nutrition: Focus on whole nutrient-dense foods like whole grains, lean proteins, fruits and vegetables, and healthy fats. Avoid inflammatory foods like processed sugar, fast food, and any food sensitivities you may have, like gluten, dairy, or eggs. Drink plenty of water (at least half your lbs in ounces of water). Fill any gaps in your nutrients with quality supplements specific to your body and health needs. *Always speak to a healthcare provider before taking supplements, as they can interact with other medications. Consult a trained functional practitioner to help with proper supplementation for your unique health.
Movement: Ensure you are getting the Goldilocks Level of movement: not too much, not too little, but jussssttt right. Bring joy to your workouts by doing ones you love and incorporate a balance of resistance training and aerobic movement. Increase your movement as you gain more energy close to ovulation, then scale it back as you approach menstruation. *Speak to a healthcare provider before beginning a new workout regime.
Stress management: Make sure you have daily self-care practices that help you relieve stress and center yourself. Meditation, mindfulness practices, yoga, deep breathing, journaling, regular movement, nature walking, painting, gardening… all of these are fantastic ways to help you relieve stress.
Sleep: Please, for the love of all that is wonderful in this world, get enough sleep. Your body needs 7-9 hours of quality sleep every night to recover and repair. If you only make ONE change from this list, do this one.
Self-Talk Revamp: If you are making a habit of speaking harshly or critically to yourself, now is the time to work on your inner self-talk. Get into some personal development to help you shift your mindset and create a peaceful Zen Garden inside your head.
Menstrual Phase Boundaries: Lastly, start putting boundaries around your self-care practices in your menstrual phase. Just like quality sleep is important to manage your mood and keep your hormones happy, so is resting and restoring your energy during your menstrual phase. That means, stripping down your calendar to the bare minimum, reducing your housework to the essentials, making crock pot meals, and REST. How you take care of yourself in this phase sets the tone for the rest of the cycle, so it’s important to start each cycle off on the right foot.
#3: Know When to Seek Outside Support. If you’ve made the above changes in your health and you are still experiencing irregular cycles, then it might be time to have a conversation with your healthcare provider.
I’m going to shoot it to you straight here, Sister… allopathic practitioners (aka most traditional Western medicine doctors and some nurse practitioners) may do one of two things: They might suggest you go on birth control to regulate your cycle OR they dismiss your concerns outright and tell you it’s no big deal/normal/whatever. Of course, there are exceptions to every generality, but these responses to concerns about menstrual cycles are based on my personal experience and those of the many women I’ve worked with throughout the years. Neither of these are solutions to your irregular cycle problem.
The Birth Control Issue
Taking hormonal birth control (HBC) for irregular cycles is like putting a band-aid on a bullet hole… it does very little to address the ACTUAL root of what is causing your cycle irregularity. While it will make you bleed regularly, HBC is not regulating your period at all. Your menstrual and ovulatory cycles only happens when ovulation occurs. Since the synthetic hormones in HBCs shut down your body’s production of hormones that make ovulation happen, you are not having a period (indeed, this is how HBCs work). The week you take the placebo pills, you experience a Withdrawal Bleed, which occurs when you suddenly take away the synthetic progestin from your body.
The hormones in HBCs are doing nothing to address what is causing the irregularities in the first place. Going back to our symphony analogy, instead of catching the streaker that interrupted your beautiful symphony performance, HBCs tell the whole orchestra to go home and throw the Conductor in jail. Meanwhile, that pesky Streaker still runs loose, creating havoc everywhere he goes. Oh, and HBCs are also stealing all your chairs in the auditorium (stripping your body of much needed nutrients), inviting other hooligans (like depression, low libido, anxiety, and weight gain) to sit in your theater, all while distracting you from the real problem: The Streaker (aka the root cause of your irregular cycle). Not cool, HBCs, not cool.
To learn more about the effects of HBCs on your body, read Beyond the PIll: A 30-Day Program to Balance Your Hormones, Reclaim Your Body, and Reverse the Dangerous Side Effects of the Birth Control Pill by Dr. Jolene Brighten or This Is Your Brain on Birth Control: How the Pill Changes Everything by Sarah E. Hill, Ph.D.
The Dismissal Issue: The other response we often hear from healthcare providers, “it’s not a big deal”, or “wait and see in a year,” is also not going to help you fix the issue. This advice perpetuates the idea that we cannot trust our bodies and that the healthcare system is not here to help us when we need it. I don’t know about you, but I’m over that shit. If you’ve taken the time to schedule an appointment, show up, and open your mouth to talk about your cycle, means there is a voice inside of you telling you something is amiss. LISTEN TO HER. Don’t let some whitecoat tell you it’s NBD. You know your body better than anyone.
What do I do if my provider is unsupportive? Find a provider that is going to support you in finding the cause for your irregular cycles. Speak up and ask for the cause to be investigated further. Maybe you need some lab work, hormone testing, or an ultrasound. If a doctor dismisses your requests for tests or tries to push HBCs despite your feelings about it, run for the hills Sister. Get a new provider that WILL listen to you.
You might need to investigate practitioners such as Certified Nurse Midwives (CNMs) who also take care of women’s health, Nurse Practitioners who specialize in women’s hormonal health, or functional medicine practitioners such as Doctors of Osteopathy (DOs) or Naturopathic Doctors (NDs). Some OB/GYNs take a more holistic approach to health, but they can be hard to find.
Bottom line: YOU are the most important person on your healthcare team. If you feel like you are not being seen or heard in your concerns, or not getting the kind of care you feel you deserve, then find another provider.
I have a diagnosis. Now what? If you've been diagnosed with PCOS, Hashimoto's Thyroiditis, or other hormonal imbalances, now is the time to start educating yourself on your condition and get to know how to care for the specific needs of your body. While conditions like PCOS are incurable, they can be improved and managed with lifestyle and supplementation.
Again, allopathic doctors do not usually investigate the root causes of these conditions, and will likely prescribe HBC or thyroid medications without addressing the lifestyle factors contributing to your condition. Please reach out to me if you need some help navigating a new diagnosis or would like to know resources to help you improve your health with these conditions.
Last Note on the Emotional Challenge of Irregular Cycles
Hey Sis, if you’ve been struggling with irregular cycles for some time, I feel you. I see you. After coming off birth control and finding out I have PCOS in my late 20s, I went through a roller coaster of feelings towards my womb, my body, and my Self. Experiencing infertility related to PCOS complications, lacking support from the military and VA healthcare systems, and then not knowing how to care for my body and condition until well into my 30s, meant that I spent a long time hating my body for “not being normal.” I felt betrayed by my body because I couldn’t trust her to menstruate regularly or without pain. It wasn’t until I started to repair the relationship with my cycle and my body that my feelings changed, as did the rest of my life.
Yes, I still occasionally experience irregular cycles, although much less often than I did in my 20s and 30s. I feel more gentleness and compassion for myself now, which has made all the difference. I now see an irregular cycle as information, like a love note from my womb asking for help and support. She needs me, she cares for me, and she just wants to be heard by her mate in this glorious thing called life: Me.
If you’ve felt so many feelings towards your body, know that your feelings are valid and important to express. If you need an ear, I’m here Sister. If you’re ready to start changing those feelings and repair that relationship with your womb and cycle, then come join the Cycle Tribe, my digital newsletter and online community. You’ll get weekly support to help you improve and grow your Womb Relationship, because let’s face it Sister… our bodies and us, we are together for Life.
Muah!
💋Kori Rae
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