Getting your period twice a month can sometimes be a sign of underlying conditions like thyroid issues.
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Real talk: Menstruation can be exceptionally unpleasant (period farts, bloating and cramps, we're looking at you). So, if your flow visits more frequently — say, a period twice a month — you might be freaking out a bit. After all, no one wants to deal with double the trouble.
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Still, you might also be worried about whether bleeding bimonthly is a cause for concern. So, is it normal to have your period twice a month?
Well, it depends. Sometimes, shedding your uterine lining twice in one month is NBD, while other times, it can indicate a more serious health issue.
"Anytime your period changes significantly, especially if it is heavier, lasts much longer or results in large blood clots or pain," you should talk to your doctor, says Angela Marshall, MD, a board-certified internist and the CEO of Comprehensive Women's Health. These can all be signs of an underlying medical condition.
Likewise, "whenever anyone is experiencing symptoms associated with menstruation that are impacting their lives in a serious way, whether it is frequency of periods, length of periods, pain, irritability or mood," don't just grin and bear it, says Nisha Verma, MD, a complex family planning specialist and the Darney-Landy Fellow at the American College of Obstetricians and Gynecologists. Period-related problems shouldn't diminish your quality of life.
We spoke with experts to understand why you get your period twice a month and when you should see a doctor.
If you have to change your tampon or pad after less than two hours or you pass blood clots that are quarter-sized or bigger, visit your doctor to avoid complications like anemia, according to the Centers for Disease Control and Prevention.
1. You Have a Short Menstrual Cycle
Indeed, you can get your period twice in a month. And for some people, a bimonthly flow is totally typical.
Here's why: "A normal menstrual period may last between 21 and 35 days, so many [people] with normal menses may still have more than one period per month," Dr. Verma says.
In other words, if you have a shorter cycle, you can bleed twice in the span of 30 days.
Your bimonthly menses may be a byproduct of perimenopause, the time of transition to menopause that marks the end of your reproductive years.
During perimenopause, "as the ovaries start to decline in estrogen production, they stop the ovulation process, which results in what we call anovulatory cycles," Dr. Marshall says, meaning you don't ovulate (or release an egg from your ovaries).
But as ovulation becomes more erratic, your periods can become irregular. "When the hormone levels fall, it disrupts this entire process," and this can confuse your uterus about when it should shed its lining, Dr. Marshall says. Sometimes, the result is a more frequent flow.
Per the Mayo Clinic, other signs of perimenopause include:
- Hot flashes and sleep problems
- Mood changes
- Vaginal and bladder problems
- Decreasing fertility
- Changes in sexual function
- Loss of bone
- Changing cholesterol levels
3. Uterine Fibroids
Uterine fibroids — benign tumors that grow in and on your uterus — can sometimes cause bleeding.
Fibroid statistics show these growths can vary in size from 1 millimeter to 20 centimeters (that's as large as a watermelon) and are very common — between 40 and 80 percent of people assigned female at birth (AFAB) have fibroids, according to the Cleveland Clinic.
While most fibroids don't cause symptoms, larger growths can bring things like bleeding. "At times, this bleeding can be very heavy, and it can occur both with the cycle and at periods (no pun intended) that are outside of the normal menstrual cycle," Dr. Marshall says. In other words, this excess bleeding can make it appear that you're getting your period twice a month.
According to the Cleveland Clinic, other symptoms may include:
- A feeling of fullness in your lower abdomen/bloating
- Frequent urination or inability to urinate/completely empty yourbladder
- Pain during sex
- Low back pain
- Chronic vaginal discharge
- Increased abdominal distention (enlargement)
Talk to your doctor about the best way to treat your fibroids, which may include taking over-the-counter pain medicine, birth control or other hormonal therapies, per the Cleveland Clinic.
4. Thyroid Issues
Your thyroid could be to blame for your bimonthly bleeding.
That's because your thyroid plays a pivotal role in your menstrual cycle, so if it produces too much or too little thyroid hormone, your periods may become abnormally light, heavy or irregular, according to the Office on Women's Health.
Put another way, "thyroid problems can cause issues with the hormonal synchrony that triggers ovulation and uterine lining shedding," Dr. Marshall says.
And if your hormones become unbalanced, a bimonthly menses may occur.
Getting your period twice a month can be a side effect of endometriosis, a condition where the uterine lining tissue grows in other parts of the body (besides the inside of the uterus), Dr. Marshall says.
"This tissue can occasionally cause period disruption, pain and heavy bleeding," she explains.
Endometriosis affects as many as 10 percent of people AFAB between the ages of 25 and 40, according to Johns Hopkins Medicine.
In addition to an abnormal menstrual flow, this condition can also cause the following symptoms:
- Pain during intercourse or tampon insertion
- Excessive menstrual cramps in the abdomen orlower back
- Painful urination during periods
- Painful bowel movements during periods
- Other gastrointestinal problems, such as diarrhea, constipationand/or nausea
Talk to your doctor to determine the best way to manage excessive menstruation from endometriosis, including treatments like over-the-counter pain medicine, birth control, hormonal therapy or surgery, per Johns Hopkins Medicine.
6. Skipping Birth Control
Forget to take your birth control pill? This can mess with your monthly menses.
"Imperfect use of birth control can cause more-frequent periods or bleeding between periods," Dr. Verma says.
That's because it can "disrupt the hormonal synchrony that controls ovulation and the menstrual cycle," Dr. Marshall says.
7. Weight Gain
Putting on a few pounds can perturb your period, too.
"Weight gain, and, in particular, changes in body fat, can cause a disruption in the reproductive hormones, which are mostly fat soluble," Dr. Marshall says. So, an increase in body fat can upset your hormonal balance, bringing about an irregular period.
Stress can also be the source of your twice-monthly menses.
Indeed, "stress-related hormones can disrupt reproductive hormones, resulting in period changes," Dr. Marshall says. "Cortisol is one of the main hormones that can alter the hormonal balance necessary for normal menstrual cycle and blood flow."
9. Polycystic Ovary Syndrome
Period problems may also be produced by polycystic ovary syndrome (PCOS), a condition characterized by the imbalance of reproductive hormones.
Some people with PCOS may have multiple periods in a month due to hormonal imbalances that interfere with ovulation, Dr. Marshall says.
Per the Office on Women's Health, other signs of PCOS may involve:
- Facial hair growth
- Acneon the face, chest and upper back
- Thinninghair or hair loss on the scalp
- Weightgain or difficulty losing weight
- Darkeningof skin, particularly along neck creases, in the groin and underneath breasts
PCOS statistics show the condition is fairly common, affecting one in 10 people AFAB in their reproductive years, according to the Office on Women's Health.
10. Bleeding Disorders
Your bimonthly menstrual cycle can also be a sign of a more serious bleeding disorder such as hemophilia.
Bleeding disorders — a set of conditions defined by problems with the body's blood clotting process — can cause abnormal or heavy menstrual bleeding, Dr. Verma says. People with bleeding disorders may also experience easy bruising and frequent nosebleeds, she adds.
According to the National Library of Medicine, other symptoms associated with bleeding disorders may be:
- Bleedinginto joints or muscles
- Excessivebleeding with surgical procedures
- Umbilicalcord bleeding after birth
Bleeding twice in a month can occur during pregnancy. Spotting — which is light bleeding that's not enough to fill a panty liner — is normal, particularly during the first trimester, according to the Cleveland Clinic.
Heavier bleeding, however, can sometimes be a sign of pregnancy complications or underlying health issues like a molar or ectopic pregnancy, hematoma, cervical polyps or a miscarriage, per the Cleveland Clinic.
If you experience heavy bleeding during pregnancy, call your doctor to determine if there is a problem, per the Cleveland Clinic.
12. Endometrial Cancer
Abnormal vaginal bleeding can sometimes be a symptom of cancer. For instance, 90 percent of people with endometrial cancer experience atypical bleeding, like changes in your period, bleeding between periods or bleeding after menopause, according to the American Cancer Society (ACS).
Similarly, unusual bleeding — like bleeding after sex or after menopause — can be a sign of vaginal cancer, per the Mayo Clinic. However, this is a rare cancer, so it's always best to visit your doctor and rule out more common causes of vaginal bleeding first.
Per the ACS and Mayo Clinic, other symptoms to look out for include:
- Unprompted weight loss
- Pelvic pain
- Feeling a lump or mass
Is Blood Loss a Concern?
In some instances, a bimonthly period may produce potential complications related to excessive blood loss. The thing is, losing too much blood can cause a damaging domino effect in your body.
For example, "if a person experiences too much bleeding, it can result in a low blood count (otherwise known as anemia), which can be serious if not treated," Dr. Marshall says. So, when your period comes twice a month, keep an eye out for other signs of anemia such as pale skin, weakness and fatigue.
If you suspect you have period-related anemia, speak with your doctor, who can perform bloodwork to properly assess and diagnose the condition.
In severe cases, "sometimes a blood transfusion is needed," Dr. Marshall says. "More often, though, iron and vitamin supplementation are necessary for several months to restore the red blood cell level." But always check with your doctor before and while taking iron supplements, as too much iron can cause other problems.
Also, keep in mind "there's a difference between chronic abnormal bleeding and a sudden, severe case of uterine bleeding," Dr. Verma says. The latter can be acutely dangerous.
If your menstrual cycle leads to abrupt, heavy bleeding (for example, needing to change tampons or pads every two hours or less) along with chest pain, dizziness or shortness of breath, something serious might be up, and you should seek emergency care immediately to treat any possible complications from blood loss or change in blood pressure, Dr. Verma says.
Once you're in stable condition, your health care team will work to identify the cause of the bleeding, including any underlying health problems.
Talk to your doctor before trying any supplement, as the FDA doesn't require these products to be proven safe or effective before they're sold, so there’s no guarantee that any supplement you take is safe, contains the ingredients it says it does or produces the effects it claims.
Getting your period twice in one month usually isn't anything to worry about if it happens just once or you know you have a shorter cycle. But if this is happening repeatedly each month and is different from your normal cycle, you'll want to see your healthcare provider to find out what's going on.
This is because your hormone levels drop. It is also called breakthrough bleeding, and usually happens about 2 weeks after your last period. Breakthrough bleeding should stop after 1 or 2 months.
Bleeding between menstrual cycles can be due to structural issues within the uterus or womb, including endometrial polyps or fibroids. Polyps are small abnormal tissue growths that can occur in a number of places, including the cervix and uterus. Most polyps are benign, or noncancerous.
Perimenopause can begin in some women in their 30s, but most often it starts in women ages 40 to 44. It is marked by changes in menstrual flow and in the length of the cycle. There may be sudden surges in estrogen. Late Stage.
The reason behind after-period spotting is usually that your uterus didn't finish flushing out its unused inner lining. Unless your period starts again soon after it ends, you don't have anything to worry about.
An early period may be due to lifestyle changes like periods of stress, strenuous exercise, or drastic weight changes that alter your hormone production. But early periods can also be caused by underlying conditions like Polycystic Ovary Syndrome (PCOS) and endometriosis.
Stress can lead to spotting between periods, but the hormonal changes that stress causes in your body don't stop there. In fact, stress is also a common cause of late or skipped menstrual periods. Finding healthy ways to manage stress can make a big difference for your overall well-being, menstrual regularity included.
- Irregular periods. ...
- Hot flashes and sleep problems. ...
- Mood changes. ...
- Vaginal and bladder problems. ...
- Decreasing fertility. ...
- Changes in sexual function. ...
- Loss of bone. ...
- Changing cholesterol levels.
- Irregular periods.
- Vaginal dryness.
- Hot flashes.
- Night sweats.
- Sleep problems.
- Mood changes.
- Weight gain and slowed metabolism.
Most women experience menopause between ages 40 and 58. The average age is 51. Physical changes begin years before the final menstrual period. This transition phase is called perimenopause and may last for 4 to 8 years.
Bleeding outside your period can be really alarming, but most of the time it's nothing to worry about. There are several reasons why a woman might experience spotting. Spotting can be an early symptom of pregnancy, a side effect of birth control, or a symptom of an underlying medical condition.
Most women have menstrual periods that last four to seven days. A woman's period usually occurs every 28 days, but normal menstrual cycles can range from 21 days to 35 days. Examples of menstrual problems include: Periods that occur less than 21 days or more than 35 days apart.