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Two periods in a month: When should you worry?
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Two periods in a month: When should you worry?

An average menstrual cycle lasts 21–35 days. Having a cycle spanning less than 21 days is a cause of concern and needs medical attention
Two periods a month can make be indicative of a possible health condition
Photo by Anantha Subramanyam K/Happiest Health

Menstruation typically occurs once a month. So when a woman gets it twice, it is natural to be worried. Among women with short period cycles, menstruating at the beginning and end of a month might be common. 

 An average menstrual cycle lasts 21–35 days with 3–7 days of bleeding or menses. Unless the cycle is shorter than 21 days, there is no cause for concern, say experts. Talking of short menstrual cycles, Shobha M, a 52-year-old from Bangalore recalls her having severe bleeding with a short cycle of 16–18 days. “I was 41 when I first experienced an 18-day cycle and I assumed it was because I had overstrained my body. Back then, I had just returned from Delhi after a long journey. My next menstrual cycle was delayed by more than 45 days and this time around, the frequency became even shorter — just 12 days — which made me worry.”

After examination, Shobha was informed that she was going through early menopause. Moreover, her shortened periods were a sign of perimenopause, a transitional stage to menopause.

Two periods in one month: What does it indicate?

“The natural menstrual cycle lasts three to five weeks. However, when this changes to less than 21 days, or a woman experiences more than seven days of bleeding in a month, it might indicate an underlying condition or hormonal imbalance,” shares Dr Dhivyambigai Rajendran, obstetrician and gynecologist, Apollo Cradle & Children’s Hospital, Chennai.

Dr Jayasree Sundar, senior consultant, obstetrics and gynecology, Madhukar Rainbow Children’s Hospital and BirthRight By Rainbow Hospitals, Malviya Nagar, Delhi, stresses, “You must watch out for a change in the pattern of the menstrual cycle. In such a situation, it’s crucial to consult a doctor.” Signs like bleeding in between the cycles, heavy bleeding and foul smell discharge could indicate an underlying condition and must not be ignored, Dr Sundar affs.

Common causes behind two periods in a month

1. Thyroid disorders

Conditions such as hypothyroidism or hyperthyroidism can disrupt the menstrual cycle. They affect hormone production from thyroid glands, leading to changes in the frequency and intensity of periods. Dr Rajendran cautions, “Some women may not be aware of the disorder — it is then detected through changes in the pattern of menstrual cycle.” Further, he shares, “In those aware of the condition, changes to the duration of the menstrual cycle may indicate that the medicines or dosage they are on are insufficient, as a result of which, the condition is not in control.” 

2. Hormonal imbalance

An imbalance in hormones like estrogen and progesterone can lead to irregular periods. “Stress, lack of sleep, diet and lifestyle play a big role in hormonal imbalances and can affect one’s menstrual cycle,” shares Dr Sundar. She added that early pregnancy can also cause irregular bleeding.

According to Dr Rajendran, women with PCOD (Polycystic ovarian disease) and PCOS (Polycystic ovarian syndrome) have irregular cycles. “Generally, they have longer cycles, menstruating once in three or four months. They may have their periods for five days and start to bleed again after 10–15 days. This is not a short cycle but a continuation of the same period cycle. As they have long cycles, they could bleed for over seven days, which may be mistaken as a short cycle,” she explained.

3. Perimenopause 

Perimenopause typically occurs when women are in their 40s. Dr Rajendran shares that perimenopausal women present with both short and long cycles. “They have irregular menstrual cycles and having two periods in a month is common. They don’t need to worry as they bleed less during that time — it’s purely because of aging,” she adds.

Any bleeding or spotting post-menopause must not be ignored as it can indicate cervical, vaginal or endometrial cancer.

4. Uterine fibroids or polyps

Uterine fibroids are noncancerous abnormal and unwanted tissue growths that can develop in or on a woman’s uterus. “Fibroids can lead to heavy or irregular bleeding, as a result of which affected women have a cycle of less than 21 days and have two periods in a month,” explains Dr Sundar.

Uterine or endometrial polyps, which are abnormal growths inside the inner lining of the uterus, may also affect the menstrual cycle. They can result in frequent periods too, Dr Rajendran shares.

Why shouldn’t you ignore it?

Women who have heavy bleeding for over seven days every month can develop anemia over time, reminds Dr Rajendran. “Having shorter cycles with scanty flow may not be an immediate problem. However, those who bleed for 10 days a month due to shorter cycles will eventually lose a lot of blood and become iron-deficient. If left untreated, it could worsen their condition and they will eventually require blood transfusions,” he adds.

However, anemia alone does not cause shorter cycles, clarifies Dr Sundar. “Shorter cycles in older women could also indicate an underlying malignancy. They need to be thoroughly examined to rule out uterine cancer which can cause frequent periods,” she says.

Takeaways

  • An average menstrual cycle lasts 21–35 days with three to seven days of bleeding.
  • Having two periods or over seven days of bleeding in one month typically occurs in those with a menstrual cycle of less than 21 days, which must not be ignored. 
  • A short menstrual cycle can be caused by hormonal changes, thyroid disorders, perimenopause or uterine fibroids.
  • A sudden change in the pattern of the menstrual cycle, bleeding in between the cycles, heavy bleeding and foul-smelling discharge are warning signs, which need immediate medical attention.

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