Irregular Periods

Q. Do irregular periods always mean a fertility problem?

A. First of all, the answer depends on your definition of “irregular.” If a woman has a cycle that’s sometimes 26 days, sometimes 30...that’s normal. It may seem somewhat irregular to the woman, but it’s not a problem. Normal cycles can be from 21 to 35 days long, and it’s also normal for women to have cycles that are slightly different lengths from month to month. A variation of a few days doesn’t mean anything. As long as periods occur approximately once a month, that’s okay.

But cycles that vary more than this can indicate either less frequent ovulation than normal, or even anovulation (no ovulation). Women who have irregular periods may not be ovulating even though they do get their periods. They may just be having what’s referred to as breakthrough bleeding, which isn’t the normal menstrual bleeding that occurs two weeks after ovulation. In those cases obviously there’s an impact on fertility, and a doctor can help determine what the problem is and what needs to be done to conceive.

Finally, there are also women who have very irregular periods who do ovulate, but ovulate infrequently or less frequently than the usual 21- to 35-day cycle. These women can conceive naturally, but it may take them a bit longer. It may also be more difficult for these women to predict when ovulation will occur, making it tough to time intercourse to create a pregnancy. For these reasons, women who ovulate less frequently often need fertility treatment.