Women are blessed to give birth to children and at the same time experience their share of mood swings, cramps and uneasy times during menstrual cycle every month. What if I told you some women get to experience these twice a month?
The Normal Cycle
Any girl child is ready for menstruation from the age of 10 but the average age of onset is around 12 years. The duration of the menstrual cycle varies from woman to woman, but the average is to have periods every 28 days. It is also common for any woman to experience cycles that last anywhere from 20 to 40 days. The menstrual cycle dances to the tune of the hormones. When hormone production is normal and adequate, menstrual cycles cause no problem and occur regularly. Any imbalance in these hormones is the root cause of most menstrual cycle-related problems such as missed periods, two periods in a month, heavy bleeding and so on.
During each menstrual cycle, rising estrogen levels cause the ovary to release an egg. The womb lining also starts to thicken. During the second half of the cycle, progesterone hormone helps the womb prepare for implantation of a developing embryo. The released egg travels down the fallopian tubes (2 tubes that connect the ovaries to the womb) and when there is no chance of pregnancy, the egg gets pulled back into the body. Estrogen and progesterone levels fall, the womb lining comes away and is expelled out of the body as a period. Any period can last between 2 and 7 days during which women lose around 3-5 tablespoon of blood. The length of the cycle varies depending on many other factors such as stress, emotional imbalance, fluctuating weights, extreme physical activity and travelling.
Menstrual cycles last anywhere between 3 and 7 days. Women who get a shorter cycle can get their period at the beginning or end of month and this is normal. But, if the same woman bleeds outside her normal menstrual cycle or suspects the occurrence of a second period, it is wise to first figure out if it is spotting or menstrual bleeding. Once sure about this, it is better to meet your doctor and figure out what is causing this kind of bleeding/spotting between periods.
Several underlying reasons exist for periods that occur twice in a month:
Out of the blue: Rarely, the person might experience short menstrual cycles that occur twice a month. But once done, the periods might return to normalcy and cycles become regular. Due to reasons such as these, the physician investigates the bleeding pattern frequency before suggesting any treatment or making a diagnosis.
Age: Menstrual cycles mostly take time to become regular. Some girls get their first menstrual cycle after which they don’t menstruate for a couple of months. Sometime later, the bleeding again starts to occur. Puberty too can cause shorter or longer menstrual cycles which can lead to two cycles in a month. Research even suggests that it can almost take 6 years from the onset of the first period for the menstrual cycles to become regular.
Perimenopause: This stage starts several years before menopause when ovaries begin to make less and less of estrogen and lasts up to menopause. It usually lasts for some 10 years during which individuals experience skipped cycles, irregular menstrual cycles, shorter or longer cycles or experience light or heavy bleeding. Any person who misses her periods for twelve consecutive months is said to have entered menopause.
Endometriosis: This is a condition where a tissue similar to the uterine tissue grows in any other part of the body. Symptoms include irregular bleeding, abdominal pain and abnormal cramping. The bleeding is so heavy that some people mistake it for another period cycle. Although a pelvic exam or ultrasound can help in diagnosis, a laparoscopy is the definite way to diagnose the condition.
Thyroid problems: Irregular menstrual cycles are one of the most common symptoms of a thyroid problem, underactive or overactive.
Uterine fibroids: These are mostly non-cancerous growths in the uterus that can cause bleeding, especially heavy bleeding. Other common symptoms include pain during sex, low back pain, urge to urinate frequently and pressure or a felling of fullness in the pelvis. This is hereditary, but the cause is unknown. A pelvic exam or ultrasound can help in diagnosis.
Stress, birth control pills, extreme weight loss/gain and illnesses are other common reasons for repeated menstrual cycles. Genetic history of cysts, fibroids or early menopause onset can also increase your risk of having two periods in a month.
Time to Visit Your Doc!
Any person who experiences two periods a month continuously for 2-3 months should meet a doctor. Other common factors that suggests that you visit your doctor include:
Treatment depends on the cause of the disease. Individuals who have just started menstruating or those who experience shorter cycles need not seek treatment. If you are worried about anemia, your physician might recommend iron supplements.
Hormonal birth control is a suggested treatment option for individuals who experience heavy bleeding. This helps to regulate periods as well as resolve anemia issues caused by heavy bleeding.
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Dietitian & Nutritionist Dr. Nafeesa Imteyaz.