Does it seem like your period just ended the other day? When you look back at the calendar, do you see that it did just end three weeks ago? If so, you’re not alone. From our perspective, it seems there are as many causes of polymenorrhea, or frequent periods and short cycles, as there are women who deal with them. Frequent periods and short cycles are a frustrating menstrual health issue we hear about all the time. Note: through this guide we will refer to this topic as “frequent periods”.
For many women we speak to, menstrual bleeding is so erratic or continuous that they can’t determine when their fertile window is, let alone plan for intercourse during it, or know when to actively try to conceive. Frequent Periods – cycles that occur less than 21 days apart – contribute to fertility problems in many ways. Determining the cause and addressing it is a key to regaining menstrual cycle balance and a return to optimal uterine health and fertility health.
The Causes of Frequent Periods and How To Rebalance
Frequent periods and short cycles have a long list of triggers. They are routinely caused by:
- lack of ovulation
- PCOS
- luteal phase defect
- coming off hormonal birth control
- Perimenopause
Uterine fibroids and problems with the uterine lining are other common causes of excess bleeding, breakthrough bleeding (spotting between cycles) and short cycles. It’s important to note that short cycles may also occur in the first 2-3 years after a woman’s first period in her teen years but tend to become more normal with age.
A checkup with your fertility specialist or Ob/Gyn can help determine what’s causing the issue for you and is an important first step so that you can address it in a way that most benefits your needs. While most cases of frequent periods are not serious, some cases can require medical evaluation and treatment.
Thickened Uterine Lining: A thickened uterine lining is caused by hormone imbalance and can lead to short cycles, heavy menstrual bleeding and breakthrough bleeding (bleeding between cycles). If you suspect you have a uterine lining issue, ask your doctor about an ultrasound to check. Surgical measures like uterine lining ablation may be considered to stop the bleeding, but be aware it causes infertility due to a scarred uterine lining and becoming pregnant would put you at risk for miscarriage so it is used as a last resort before hysterectomy. A D&C may be used if an endometrial biopsy is concerning for hyperplasia or uterine cancer.
Natural approaches are very effective for women with a thickened uterine lining. The supplement DIM can help balance excess estrogen, a routine trigger. Astringent herbs like Shepherd’s Purse (Capsella bursa-pastoris) and Lady’s Mantle (Alchemilla vulgaris) work as short-term measures for relief. Consider a DIY Uterus Strengthening tea.
Herbal iron sources like Nettles (Urtica dioica), Yellow Dock (Rumex crispus) and organic dulse seaweed are a good choice to help protect against anemia if your period is very heavy, lasts longer than 7 days or occurs more than every 21 days. Natural Progesterone Therapy can be a good option if your progesterone levels are also low, confirmed through hormone tests.
Perimenopause: Perimenopause is a major cause of short cycles for women over 40. If you’re over 40, a blood or saliva hormone test can help determine if perimenopause is a factor in your short cycles. Body changes can provide helpful clues, too. In addition to cycle shifts, look for symptoms like hot flashes, night sweats, vaginal dryness or unexplained weight gain.
As the number of eggs in the ovaries naturally decreases with age, the brain releases more FSH (follicle stimulating hormone) to help stimulate the ovaries. This can shorten the follicular phase, lead to early ovulation and shorter cycles. Further, many women in perimenopause have anovulatory months, which can cause breakthrough bleeding and short cycles.
Medical approaches include short-term progestin therapy or hormonal birth control to stop the bleeding, but these techniques don’t work for everyone. I recommend considering biphasic herbal formulas to help bring the cycle back into balance. A Fertility Cleanse can also help the body normalize by supporting healthy liver function and cleansing the uterus. Reducing stress is another key, as stress hormone surges tend to worsen perimenopause symptoms and cycle shifts.
Lack of Ovulation (Anovulation): Anovulation could be the cause of your short cycle. If an egg isn’t released from an ovary, extra progesterone is not produced by the body. Without rising progesterone levels, the endometrium is not supported and eventually begins to shed. This causes what seems like a period, but is actually breakthrough bleeding. If you’re unsure, fertility charting or medical tests can confirm if you’re ovulating or not.
Chronic anovulation is usually caused by PCOS, perimenopause, or nutrient deficiencies. It may also result from breastfeeding, thyroid or prolactin disorders, or excessive stress. Fertility drugs like Clomid help promote ovulation for some women, but often not without side effects.
There are many natural options to encourage normal ovulation and fertility. I recommend focusing on the cause of anovulation and addressing that first. Herbs like Vitex (Vitex agnus-castus) and Tribulus (Tribulus terrestris) are effectively used to promote normal ovulation, too.
PCOS: While many women with PCOS have long cycles or no cycle, others experience short cycles or near constant bleeding. This is caused by PCOS-related hormone imbalance, lack of ovulation or a thickened uterine lining. Medical approaches like Clomid and/or Metformin may be considered over the short-term, but diet and lifestyle changes are critical for a long-term return to health and fertility if you have PCOS.
Short (or long) cycles caused by PCOS regularly improve with a PCOS Fertility Diet, weight management and lifestyle changes like getting regular exercise. Staying consistent is the key! It can take at least 6-12 months of consistent lifestyle and diet changes to regain menstrual cycle balance and fertility when dealing with PCOS. However, the changes are well worth it. Many women are amazed by their health and life transformation! Fertility herbs like Maca (Lepidium meyenii) and Royal Jelly – in addition to a PCOS Fertility Diet, PCOS-specific herbs and lifestyle changes – offer critical hormone and energy support as you go through the process.
Luteal Phase Defect: Luteal phase defect also contributes to short cycles for many women with fertility issues and recurrent miscarriages. If progesterone levels do not elevate enough after ovulation or drop too soon, this can cause a shortened luteal phase. Without adequate progesterone, the body automatically begins to shed the lining of the uterus triggering a period and beginning the entire menstrual cycle again.
Fertility Charting is one of the best ways to determine if you have a luteal phase defect. If your luteal phase lasts 12-16 days, there is generally no reason to be concerned. If your luteal phase lasts 11 days or less, you could have a luteal phase defect.
One of the best herbs that has been used for luteal phase defect is Vitex (Vitex agnus-castus). In studies, Vitex helped 83% of women experiencing luteal phase defect. Vitex encourages the body to produce LH (luteinizing hormone), promoting normal ovulation and progesterone production. While Vitex is not a source of hormones itself, evidence shows it offers profound benefits for women with hormone balance problems and fertility concerns.
Coming Off Of Hormonal Birth Control (the Pill, IUD, patch or shot): It’s important to remember that hormonal birth control works in part by suppressing a natural menstrual cycle. The cycle women experience on hormonal birth control is not technically a period. It’s actually hormone-dependent breakthrough bleeding.
Coming off hormonal birth control can cause the body to become confused. Ovulation may be skipped as the body readjusts to its new normal. Lingering hormones or a thinned-out uterine lining can lead to breakthrough bleeding and short cycles as the body struggles to regain its balance.
If this sounds like your situation, a Fertility Cleanse along with Self-Fertility Massage can help your body normalize. Both of these techniques support reproductive health and help rid the body of excess toxins and hormones. Fem Rebalance is an herbal blend to consider, which is designed to help restore balance when coming off of hormone containing birth control.
Find Your Balance
Frequent periods can be very upsetting, especially when you’re trying to get pregnant. It’s incredibly hard to time intercourse or plan for conception when you are always dealing with breakthrough bleeding, spotting or having another unexpected early cycle.
Finding out the cause of your short cycle is the first step to solving the problem. Be easy on yourself during the process! Consider the following…
- Try some Mind-Body Therapies to help manage stress, which worsens menstrual cycle imbalances.
- Choose low impact exercises during your recovery process. Intense exercise programs often worsen breakthrough bleeding and short cycles for women we work with.
- Eat a Fertility Diet to keep your body nourished as you start rebalancing.
- Consider a Fertility Cleanse which can help, especially if you have been dealing with short cycles for a long time or have been taking injectable or implantable hormonal birth control or fertility drugs.
- Fertility Herbs are another great choice to support reproductive health as you move forward. They come without long lists of warnings, and work to support and encourage endocrine health, menstrual cycle balance, normal ovulation and healthy fertility.
- Hudson, T. (2006, Oct.). Perimenopause: What Is It? Retrieved from: http://drtorihudson.com/articles/perimenopause-what-is-it/
- What Does Your Menstrual Cycle Say About Your Fertility? (2014). Retrieved from: https://www.shadygrovefertility.com/blog/fertility-health/what-does-your-menstrual-cycle-say-about-your-fertility/
- Miller, C. (2013). Anovulatory Cycles and Breakthrough Bleeding. Retrieved from: https://www.kindara.com/blog/anovulatory-cycles-and-breakthrough-bleeding
- Frequent Periods or Polymenorrhea: Definition and Causes. (2017). Retrieved from: http://www.menstruation-info-with-doc.com/frequent-periods.html
- Campbell, L. (n.d.). Anovulation. Retrieved from: https://natural-fertility-info.com/understanding-anovulation.html
- Rodriguez, H. (n.d.). Luteal Phase Defect: Natural Treatment Options. Retrieved from: http://natural-fertility-info.com/luteal-phase-defect.html
- Luteal Phase Defect. (n.d.). Retrieved from: http://www.webmd.com/infertility-and-reproduction/guide/luteal-phase-defect#1
- Rodriguez, H. (n.d.). Vitex: Fertility Super Herb? Retrieved from: http://natural-fertility-info.com/vitex
Sarah has worked in the field of natural foods and herbalism for over 20 years. She’s the Co-Author of “Healthy Healing” with over 1 million copies sold, a Certified Herbalist, and a health and wellness consultant. Sarah Graduated from the Professional Herbal Studies program at East West School of Herbology, and holds a Bachelor’s Degree in English from St. Mary’s College. Working with women on their journey to wellness is her passion and she loves to share what she has been blessed to learn from naturopaths and other herbalists over the years.
Hi, I’m a naturopathic physician and I have a clinical question about this. I understand that anovulation can cause frequent menses. I also understand that ovulation does not always begin at the same time as menarche. My question is how long after menarche should you wait before you start investigating for these other conditions if a patient continues to have frequent menses (<21 day cycles), particularly if there are conditions such as PCOS and luteal phase defects in the family? Also, are there issues with inaccurate hormone lab results in a patient with recent menarche? Thank you for your time and for all you do in making this information available to both patients and practitioners.
Hello Ashley!
Thank you for asking!
The author of this article and I discussed your questions and while we aren’t experts on your patient(s), we have read and learned that it may be important to allow 1-2 years for a young women’s cycle to settle in on her “normal” after the onset of menarche (menstruation). Her hormones are working hard to “wake up” and sort out their jobs so to speak. Polymenorrhea could just be part of their natural process.
We’re also not certain that familial history of PCOS or luteal phase defect, especially in the absence of other signs/symptoms, are indicative of further testing for girls just beginning to menstruate. There are so many other factors involved… namely diet and lifestyle. We know the standard American diet and lifestyle aren’t all that supportive of hormone balance!
In terms of “inaccurate hormone lab results in a patient with recent menarche”, I am not certain as we are not a lab or interpreters of test results. It may be for each age cohort, there is a specific scale for each hormone level (something to discuss with the lab used).
I hope this is helpful!