It’s normal for adult women to have a menstrual cycle that ranges from 24 to 38 days, and for teenage girls to have a cycle that lasts 38 days or longer. But every woman is different, and each person’s cycle can vary from month to month.
During some months, your cycle may last for more or fewer days than the previous month, or it may start earlier or later than it has before. Sometimes, you may even have two periods in a single month.
If your cycles are on the shorter end of the spectrum, you could have your period at the beginning and end of the month with no reason for concern.
But if you experience bleeding outside of your normal menstrual cycle and suspect you’re having a second period, the first thing you should do is figure out if it’s spotting or menstrual bleeding:
- If you’re having menstrual bleeding, also known as your period, you should expect to soak through a pad or tampon every few hours. The blood may be dark red, red, brown, or pink.
- If you’re having spotting, you won’t bleed enough to fill a pad or tampon. Blood from spotting is usually dark red or brown.
After you’ve determined if you’re having spotting or menstrual bleeding, you can start to explore what may be causing your increased bleeding.
Your increased bleeding may be caused by a shorter menstrual cycle or by a health problem that causes vaginal bleeding.
Causes of a shorter cycle
If your cycle suddenly becomes shorter, it could be due to any of the following:
- anovulation (lack of ovulation)
- onset of menopause
- uterine fibroids or cysts
- extreme weight loss or gain
- birth control
Conditions that cause extra bleeding
If you usually have a regular cycle, a change in your cycle — such as suddenly having two periods in a month — could indicate a medical condition. Some health conditions cause bleeding that can be mistaken for a period:
- Pregnancy can cause spotting. Spotting during pregnancy can be normal, but you should tell your doctor about any bleeding during pregnancy.
- Sexually transmitted infections can cause discharge and bleeding.
- Miscarriage can cause heavy bleeding. If you suspect you’re pregnant and begin to have bleeding similar to a period, call your doctor.
If you have a family history of fibroids, cysts, or early onset menopause, you’re at an increased risk for having two periods in a month.
You should make an appointment with your doctor if you:
- experience pain in your lower abdomen that doesn’t go away after a couple of days
- have heavy periods
- spot or bleed in between periods, which is often mistaken for two periods in a month
- experience pain during sexual intercourse
- have more menstrual cramping than normal
- notice dark clots during your period
One health effect of more frequent bleeding is anemia, which occurs due to a lack of iron in your blood. Your doctor can check your iron levels while they do other tests to determine the cause of your abnormal bleeding.
The symptoms of anemia can include:
- shortness of breath
- irregular heartbeat
Your treatment will depend on the underlying cause of your frequent bleeding. If you naturally have shorter cycles or if you’ve recently started menstruating, you won’t need treatment. If anemia is a concern, your doctor may recommend iron supplements.
One possible treatment for periods that occur too frequently is hormonal birth control. This type of birth control can help regulate your periods and help resolve anemia issues caused by heavy bleeding.
Here are treatments for other possible causes of frequent bleeding.
If you have hypothyroidism, it means you have an underactive thyroid gland. Your body can’t make enough of the thyroid hormone. Your doctor will prescribe a thyroid hormone replacement therapy that you can take by mouth.
If you have hyperthyroidism, it means you have an overactive thyroid gland. Your body makes too much thyroid hormone. Several treatments are available for this condition. Your doctor will suggest the one they think is best for you.
If you’re beginning menopause, your doctor may prescribe hormone therapy and estrogen replacement therapy. These treatments can help regulate your periods until they slowly disappear as menopause progresses.
Fibroids and cysts
Your doctor may recommend a few different treatment options if you have uterine fibroids or cysts. These can include:
- Intrauterine device (IUD). An IUD is a form of birth control and can help relieve heavy periods. However, it won’t shrink fibroids.
- MRI-guided ultrasound surgery. This procedure is performed while you’re inside an MRI scanner. It’s considered noninvasive, and doctors can use it to remove the fibroid or cyst. This procedure is only done in specialized clinics.
- Uterine artery embolization. This is a minimally invasive procedure that blocks the blood supply to the uterus. That causes the fibroids to decay and shrink.
- Myomectomy. There are different types of myomectomy, which is a surgical procedure to remove fibroids. In a hysteroscopic myomectomy, the fibroid is removed through the cervix. No incisions are needed. In a laparoscopic myomectomy, small incisions are made in your abdomen to remove fibroids. An abdominal myomectomy is an open abdominal surgical procedure.
- Hysterectomy. A hysterectomy is a surgical procedure to remove the uterus.
- Gonadotropin-releasing hormone agonists. These are medications that can help treat fibroids. They block estrogen and progesterone and put you into a temporary postmenopausal state. This stops the fibroids from growing and can make them shrink. Your doctor may use this treatment to help prepare you for surgery.
Lifestyle changes can greatly impact your stress level, which can in turn affect your menstrual cycle. To help relieve stress, try exercising frequently, practicing meditation, or engaging in talk therapy.
If you’re feeling stressed because you’re overcommitted, ask for help. Finding the time to relax is important to your health, so don’t feel bad about saying no to additional projects or responsibilities.
Extreme weight loss or gain
Talk to your doctor about the possible reasons why you have had such a dramatic change in weight. They’ll work with you to help you manage your weight.
Reaction to birth control
Hormonal birth control introduces hormones into your body. This can affect your menstrual cycle. You may need to try a few different types of birth control to find one that works for you. It also takes a few months for your body to adjust to a new method of birth control.
Talk to your doctor about what you should expect when starting a new birth control method.
Changes to your menstrual cycle can indicate a health problem, so it’s always important to discuss abnormal bleeding with your doctor. Your doctor will likely ask you a lot of questions about your symptoms.
By being prepared for your appointment, you can help your doctor find the correct treatment as quickly as possible. Here are some questions your doctor may ask:
- How long are your cycles? Is this normal for you?
- If your shorter cycle isn’t normal for you, when did the changes to your bleeding start?
- How long does the bleeding last?
- What color is the blood?
- How heavy is the bleeding? How quickly does it fill a pad?
- Are there clots? If so, how big are they?
- Do you have any other symptoms?
To calculate the length of your cycle, start counting on the first day you bleed. This will be day one. Your cycle will end on the first day that you start bleeding again. Many smartphone apps are available to help you track your cycle.
If you have a history of irregular bleeding, tracking your cycles on an app can help you identify a problem more quickly. It can also make it easier to share your cycle information with your doctor.