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Gynecology

I am spotting which is irregular?

03/25/2009

Question:

I am 21 years old, and have always had regular periods, 28 day cycles with the period lasting 3 to 4 days. In the past year however my periods have been come and go. I won`t have a period for a month or two and then when I have one its regular in 3-4 days in length. My husband and I have been trying to conceive, and haven`t had any luck. I wondered if this spotting could be a symptom. My last period was in November 2008. I didn`t have one in December 2008, but did on January 20, 2009, it lasted four days and was over. (It was slightly heavier than usual). I have been spotting everyday since the 24th of January and don`t know why. It isn`t a heavy spotting, however it is enough I have to wear protection, and it is causing bad cramps. What could this be?

Thanks,

Answer:

The most common cause of irregular cycles in a women not on hormonal contraception is the failure to ovulate regularly. Regular ovulatory cycles are predictable (28 days plus or minus 7 days) and preceded by symptoms typical of declining hormone levels 14 days after ovulation (bloating, mood changes, breast tenderness, etc). When you skip cycles, it is because you failed to ovulate and the hormonal decline doesn't happen. There are many causes for this and most are easily treated. You should seek a gynecologic evaluation and look for treatable causes because without regular ovulation, achieving pregnancy will be more difficult.

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Response by:

Thomas  A deHoop, MD Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated