Irregular bleeding is one of the most common reasons patients contact their OB-GYN. While occasional changes in your cycle can be normal, persistent or unexpected bleeding may signal that something needs further evaluation.

Knowing when irregular bleeding is part of normal hormonal variation and when it is time to check in with your provider can help you feel more confident about next steps.

What Is Considered Irregular Bleeding?

Menstrual cycles vary from person to person, but irregular bleeding generally refers to changes that fall outside your usual pattern. This can include:

Periods that come much sooner or later than expected
Bleeding between periods
Periods that are unusually heavy or last longer than seven days
Bleeding after sex
Any vaginal bleeding after menopause

A single irregular cycle is often not a cause for concern. Patterns that repeat or become more noticeable over time are more important to evaluate.

When Irregular Bleeding Can Be Normal

In many cases, irregular bleeding is related to temporary hormonal shifts rather than an underlying condition. This is commonly seen during adolescence, perimenopause, or after starting or stopping hormonal birth control. Stress, illness, postpartum changes, and significant weight fluctuations can also affect cycle regularity.

When bleeding changes are mild and resolve on their own, reassurance and monitoring may be all that is needed.

Signs It Is Time to See Your OB-GYN

You should consider scheduling an appointment if irregular bleeding:

Becomes heavy enough to interfere with daily activities
Occurs consistently over several cycles
Happens after sex
Is accompanied by pelvic pain, fatigue, dizziness, or lightheadedness
Starts suddenly after years of regular cycles

These symptoms do not necessarily mean something serious is wrong, but they do warrant further evaluation.

Common Causes of Irregular Bleeding

Irregular bleeding can have many causes, most of which are treatable. Your provider may evaluate for:

Fibroids or uterine polyps
Ovarian cysts
Hormonal imbalances
Thyroid disorders
Changes in the uterine lining
Infection or inflammation

Identifying the cause allows for more targeted treatment and appropriate reassurance.

How Irregular Bleeding Is Evaluated

Evaluation is individualized based on your age, symptoms, and medical history. Your visit will typically begin with a detailed discussion of your cycle patterns and overall health, followed by a pelvic exam when appropriate. Depending on your symptoms, your provider may recommend:

Pelvic ultrasound
Bloodwork to assess hormone or thyroid levels
Endometrial biopsy in certain cases

Not every patient needs extensive testing. The goal is to rule out concerning causes while avoiding unnecessary procedures.

Bleeding After Menopause Should Always Be Checked

Any vaginal bleeding after menopause is considered abnormal and should be evaluated promptly. While many causes are benign, postmenopausal bleeding should never be ignored.

Trusting Your Instincts

If something about your bleeding pattern feels off, it is always appropriate to reach out. You do not need to be certain that something is wrong to ask questions or schedule a visit.

When You Are Ready to Talk

If you are experiencing irregular bleeding or have concerns about changes in your cycle, our team at MAIA Gynecology is here to help. Scheduling a visit can provide clarity, reassurance, and a plan tailored to your individual needs.

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