Why Your Periods Are Irregular & What to Do About It | Episode 13

In this episode of The Hormone Café, Dr. Sarah Pederson, holistic OB-GYN and founder of Vera Health and Fertility in Westminster, Colorado, discusses irregular bleeding. She explains what counts as an irregular period, the possible causes—from hormonal imbalances to structural issues—and how to properly evaluate and treat irregular cycles. In This Episode, You’ll Learn: 💡 Definition & Differential Diagnosis Normal cycles: 24–35 days, varying by no more than 3 days per cycle. Signs of irregular bleeding: Too few or too many periods per year Spotting or brown bleeding before a period Very heavy (multiple pads/hour) or very light flow Mid-cycle bleeding or bleeding after intercourse Causes can be grouped into: Hormonal: Estrogen too high or low, progesterone imbalance, thyroid issues, high prolactin, adrenal dysfunction Structural: Ovarian cysts, fibroids, uterine or cervical polyps, cervical ectropion Blood-related: Genetic or acquired clotting disorders (e.g., Factor V Leiden) 🩺 Workup of Irregular Bleeding Hormone testing: Estrogen, progesterone, LH, FSH, thyroid hormones, prolactin, testosterone Cycle mapping with urine tracking (e.g., Mira, NEDO) and blood work at multiple points in the cycle Ultrasound: Assess ovaries, uterine lining, fibroids, cysts, or polyps Pelvic exam and cervical check, including vaginal swabs for infections Endometrial biopsy for uterine health or infection 🌿 Treatment & Management Nutrition & Lifestyle: Foods and supplements to support hormone balance; tailored to whether estrogen, progesterone, or other hormones are high or low Medical Interventions: Bioidentical hormones to correct estrogen or progesterone imbalances Medication or surgery for ovarian cysts, fibroids, or polyps Cervical treatments (e.g., silver nitrate) for ectropion Antibiotics or probiotics for infections Monitoring & Tracking: Chart cycles to ensure interventions are effective; cycle mapping helps identify hormone shifts and empowers long-term management Key Takeaways: Irregular periods are not “normal” and often signal underlying hormonal, structural, or blood-related issues. Comprehensive evaluation—including hormone testing, imaging, and pelvic exams—is essential to identify causes. Treatment can include lifestyle changes, supplements, medical interventions, and monitoring. Balancing hormones and achieving regular cycles may take 3–6 months, but long-term consistency leads to improved health and well-being. Resources & Next Steps: Dr. Sarah and her team at Vera Health and Fertility can help evaluate and treat irregular cycles with a personalized, holistic plan. 📍 Westminster, Colorado 🌐 Schedule a consultation: verafertility.com 📧 Follow along: @verafertility on Instagram & TikTok