Contrary to what many believe, irregular periods are not "normal" and something that is "just part of life." As an experienced physician, I'll teach you how to recognize irregular periods, their effects on NFP methods, and how NFP can help you manage these irregularities. Being able to track and identify if you are having irregular periods is extremely important because it can be a sign of underlying health issues or hormonal changes. NFP helps women to understand their menstrual cycles, be able to observe any irregularities, and therefore be able to know when to seek out medical advice from a health professional for possible treatment of medical conditions that may have otherwise gone unnoticed and undiagnosed.
Recognizing Regular vs. Irregular Menstrual Cycles
Regular Cycles: These are typically 21 to 35 days long, averaging around 28 days. Additionally, cycle length consistency is key. If your cycle length varies little from month to month (by less than 7-9 days in length from cycle to cycle), it's considered regular.
Irregular Periods: Look out for notable changes in cycle length, frequency, duration, and amount of menstrual flow.
Identifying Irregular Periods
Cycle Length Variability:
Use a calendar or period-tracking app to record the start and end dates of each period. Also note your cycle length in total, which is measured by the first day of your period up until the start of your next period.
Monitor your cycle for a few months. Note any variation greater than 7-9 days in cycle length from cycle to cycle. For example, if your cycle length is 34 days one cycle, 23 days the next cycle, and then 31 days for the last cycle, this would be considered increased cycle length variability (even though cycle lengths of 23, 31, and 34 days are all normal lengths on their own), and thus irregular periods.
Too Long or Too Short of Cycles:
Take note if your periods occur more frequently than every 21 days or less often than every 35 days.
Document the frequency of your periods over several months to spot any patterns. If your cycle length consistently tends to be less than 21 days in total (from the first day of your period up until the start of your next period), or if your cycle length is consistently longer than 35 days, then this would be considered irregular periods.
Change in Flow Duration and Quantity:
Observe if your period lasts significantly shorter or longer than the usual 3-7 days.
While having shorter periods (less than 3 days in duration) may seem like a blessing, it can actually be a sign that you have an underlying medical condition that should be monitored and treated by your physician.
Additionally, note if your periods last longer than 7 days or are marked by heavy flow requiring changing a pad/tampon every hour or more. Having long periods and/or heavy menstrual flow is called menorrhagia and can be a sign of underlying conditions such as endometriosis, polyps, or fibroids.
Unraveling the Causes of Irregular Periods
Hormonal Imbalances: Be aware of symptoms like unexpected weight changes, fatigue, hair loss, constipation, or diarrhea, which could indicate thyroid issues. Also, symptoms such as difficulty losing weight, increased acne, and hair growth on face, chin, or chest can be a sign of underlying polycystic ovarian syndrome (PCOS).
Lifestyle Factors: Reflect on your stress levels, dietary habits, weight changes, and exercise routines, as these can impact your menstrual cycle. If you are able to pinpoint any stressors or recent changes in diet or exercise that occurred around the same time as cycle changes, you may be able to make lifestyle changes or find ways to better manage stress in order to make menstrual cycles return to normal.
Medical Conditions: Different medical conditions such as endometriosis, fibroids, and PCOS can cause irregular periods. Furthermore, different medications, including contraceptives can affect your cycle as well. Make sure to consult with your physician when starting any new medications or supplements, and let them know a detailed list of your medical history, and all supplements and vitamins that you are taking. This way, your medical provider can note any medication interactions and can get a better sense of possible causes to your irregular periods.
Managing Irregular Cycles in NFP: Proactive Steps
Detailed Tracking: Keep a detailed log of your cycle, noting physical symptoms, mood changes, and signs of fertility. This detailed chart can be very useful for your physician of NFP practitioner to interpret. As a NFP-only physician, myself, I always appreciate when a patient has their chart on hand. The more information provided to me, the better I can help care for my patient.
For more information about how to chart your cycle, check out my blog posts about the basics of the basal body temperature, sympto-hormonal, and cervical mucus methods.
Some apps that can help you with tracking your cycle are:
BBT Method: Natural Cycles and Tempdrop.
Cervical Mucus Method: NFPCharting.
Consult Health Professionals: Schedule a consultation with your healthcare provider to discuss NFP and its alignment with your menstrual health. Make sure to bring your detailed menstrual cycle log with you when meeting with an NFP provider to give extra information for them to better understand your specific menstrual cycle pattern.
Lifestyle Adjustments: Implement changes in your diet, exercise, and stress management techniques to potentially regulate your periods. As discussed previously, being able to self-reflect and identify any possible stressors or lifestyle changes that occurred around the same time as cycle changes can be very useful.
Challenges and Tips for Navigating NFP with Irregular Cycles
Consistency: Maintain a daily routine of monitoring and documenting your cycle. This not only should include cycle length and period duration, but also include physical symptoms, mood changes, and fertility signs (observations of cervical mucus, basal body temperature, or measured hormone levels).
Understanding Your Body: Invest time in learning about fertility signs, through workshops, online resources, and meeting with an NFP instructor. Be patient with yourself as well, and remember that learning about your body's fertility signs will not be mastered overnight.
Seek Expert Guidance: Do not hesitate to reach out to NFP specialists or healthcare providers for personalized advice and training. This will give you more tools to better understanding your body, and will also help your healthcare provider to better know you as a patient.
When to Seek Medical Help
Persistent Irregularity: If irregular patterns persist for several months (3 or more months), it's time to seek medical advice.
Accompanying Symptoms: Should you experience symptoms like pain or excessive bleeding, get them evaluated.
Trying to Conceive: Consult with your physician or an NFP practitioner if you're facing challenges in conceiving in the presence of irregular cycles. This could be due to low progesterone, anovulation (not ovulating), PCOS, or endometriosis. If a medical condition can be diagnosed early, it can be treated early and not only improve fertility, but possibly prevent any fertility issues in the first place.
Conclusion:
Irregular cycles can make it hard to predict ovulation. While this may have impacted the effectiveness of the rhythm/calendar method, which solely relied on regular periods to predict when ovulation would occur based off of previous cycle lengths, NFP methods do not rely on making predictions. Those with irregular periods may need to monitor fertility indicators (like measured hormone levels, basal body temperature and cervical mucus) more closely, but can still use NFP just like anyone else. In fact, using NFP should be encouraged for women with irregular periods since natural family planning can be used to diagnose and treat causes of these irregular cycles. Being able to recognize that you are experiencing irregular periods can help you know when to talk with a doctor and thus be aware of medical conditions that would have possibly gone unnoticed. Earlier detection of hormonal and menstrual irregularities can lead to earlier treatment for medical conditions and infertility.
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