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Reasons for Having Two Periods in a Month?

Written by Elizabeth Buescher, Gynecologist

Having two periods in one month can either constitute peculiarities of a regular menstrual cycle or an evidence of a number of functional disorders and diseases of the female reproductive system.

When do two periods a month represent a specific feature of a regular menstrual cycle?

The term menstrual cycle refers to the time interval starting from the first day of one menstruation until the first day of the next menses (and not the interval between periods). A menstrual cycle averages out at 28 days. Even in this case, a woman can observe two menses in one calendar month (for example, if the first menstruation started on the 1st day of the month and the next one – on the 28th day). However, a regular menstrual cycle may comprise from 21 to 35 days. Thus, as long as the patient has periods every 3 weeks on a regular basis, bleeding continues for no longer than 7 days, it is of moderate intensity and does not lead to anemia, then having two periods in a month can be considered an individual feature of the woman’s organism. Understandably, this condition does not require medical intervention.

When does having two periods in one month testify to a certain pathology?

Too close periods require medical examination in the following cases :

-The menstrual cycle (starting from the first day of one menstruation until the first day of the next menses) comprises less than 21 days;

Periods are irregular, profuse and persist for a long period;

Periods are accompanied by changes in the structure of the discharged blood (appearance of acrid smell, blood clots, mucous lumps, tissue fragments);

Periods are accompanied by changes of general state of health: acute abdominal pain, dizziness, fainting.

All the above mentioned conditions constitute pathological symptoms and may be indicative to the development of a serious disease.

All the conditions that may cause two periods in one month can be conditionally classified into two groups: functional and organic. The first group of causes is characterized by reproductive system dysfunctions without the development of organic changes in female genitalia. Such a disorder can be eliminated either by changing the regimen (for example, reconsidering one’s diet, having good rest), or opting for medicamental therapy. The second group of causes involves rough modification of a certain organ’s structure (for example, in case of excessive growth of the inner layer of the uterus, which is responsible for periods; formation of a myomatous nodule in the uterine walls; development of a hormonally active oothecoma). Organic disorders are more severe; they can present serious threat to the woman’s life and often require urgent treatment (curettage of the uterine lining, hysteroresectoscopy, excision of a cystic ovary, etc.).

Functional disorders of the reproductive system

These are disorders that are associated with hormonal regulation of the menstrual cycle. Among them are:

1. Failure to form a regular menstrual cycle in girls during the first 1-2 years following the first period. This pathology requires thorough observation by a gynecologist until the cycle comes to a regular periodicity.

It is desirable to have sonography of pelvic organs. In case too close periods in young girls do not involve heavy bleeding, last for no longer than 7 days, do not affect the girl’s general state of health, and the menstrual cycle eventually normalizes, then no treatment is required. The young patient will rather be advised to maintain a balanced regimen with good rest, healthy diet, and possibly take a cyclic vitamin therapy (usage of folic acid in the first half of the menstrual cycle and vitamin E in the second). In some cases, the doctor may recommend homeopathic drugs.

2. Hormonal imbalance in women a few years prior to climax (the so-called menopause). This condition also requires medical examination and sonography. Too close periods during menopause can be accompanied by profuse bleeding. In case of such disorders the patient should by all means seek medical help.

3. During the first 2-3 months after starting to take hormonal birth control pills (contraceptives) women may observe midcycle bloody discharge. It is a variant of norm and does not require any treatment. However, in case this type of discharge persists longer than 3 months, it is required to consult a doctor and consider using another contraceptive. When speaking about hormonal birth control means, it should be mentioned that in case of using injectable hormonal contraceptives (contraceptive injections) of long-lasting effect, it is possible to develop profuse bleeding from the genital tubes. This condition requires immediate medical intervention.

4. Disruptions of the endocrine profile in chronic and persistent stressful situations, intoxication, rapid fluctuations of weight.

5. Intake of certain drugs can significantly affect the liver function, and consequently, metabolic processes and excretion of sex steroids.

6. Thyroid dysfunction often accompanies disturbance of synthesis and exchange of sex hormones.

7. Chronic inflammatory processes in the pelvic area may lead to the disturbance of production of sex hormones by ovaries, as well as reduction of contractive ability of the uterine muscular layer and increased fragility of endometrial vessels. All the above mentioned disorders contribute to the appearance of midcycle bleeding.

8. The intrauterine contraceptive device («Lippes loop») may also cause too close and long-lasting periods. In this case, it is required to opt for another contraceptive means.

9. One-time preterm period may be observed at changing the time or climatic zone, and understandably, does not require any treatment.

10. Disorder of the menstrual cycle after abortion, its restoration after child delivery or delectation.

Organic causes of too close periods include:

  1. Endometrial polyps (local proliferation) or overall thickening of the above mentioned lining (hyperplasia). Polyps can also emerge from the part of the uterus, which is located in the vagina (uterine cervix). The treatment involves surgical removal of the uterine inner lining (curettage or hysteroresectoscopy) with subsequent hormonal therapy.
  2. Uterine fibroid (previously known as fibromyoma), requires customized treatment of each individual patient.
  3. Hormonally active ovarian cysts require surgical treatment.
  4. Bloody discharge, which the patient may confuse with an unscheduled period, can also be observed in case or cervical erosion, vaginal and vulval traumas, oncological pathologies. In any of these cases, immediate medical consultation is required.
  5. Implantation bleeding (accompanies the ovum’s invasion into the uterine lining in the 7-14 day after conception) in sexually active women can also be confused with an unscheduled period, unprompted miscarriage in early pregnancy, bleeding in case of ectopic pregnancy or hidatidiform mole (placental disorder, leading to excessive growth of placental villi and thus, destruction of the uterine walls). All the above mentioned conditions require taking a pregnancy test and consulting a doctor.

Some of the mentioned conditions (ectopic pregnancy, bleeding caused by unprompted miscarriage, etc.) can be threatening not only to the health of the patient, but also to her life. The woman should immediately call emergency in case the unscheduled period is accompanied by acute abdominal pain, heavy bleeding (2 or more pads in an hour), dizziness, vision deterioration, sudden weakness, cold sweat.

Do not put off the visit to a clinic and take care of your health!

Read also:

What Does a One or Two Day Period Mean?
Brown Discharge Instead Of Period 7 Common Causes And Preventive Measures
Brown Discharge Before Period Top 7 Things To Do
Difference Between Spotting and a Period. Basic Distinctive Features