What Causes Two Periods in One Month?

Health Line

2 days ago

If you have a shorter menstrual cycle, you may get your period twice in the same month. But bleeding between periods can also occur with certain medical conditions.
A typical adult menstrual cycle ranges from 21 to 35 days, and the typical menstrual cycle for preteens and teens can last 38 days or longer.
However, every woman is different, and each person's cycle can vary from month to month.
During some months, your cycle may last for more or fewer days than the previous month, or it may start earlier or later than it has before.
If your cycles are on the shorter end of the spectrum, you could have your period at the beginning and end of the same month with no reason for concern.
But if you experience bleeding outside of your usual menstrual cycle and suspect you're having a second period, the first thing you should do is figure out if it's spotting or menstrual bleeding:
If you're having menstrual bleeding, also known as your period, you should expect to soak through a pad or tampon every few hours. The blood may be dark red, red, brown, or pink.
If you're having spotting, you won't bleed enough to fill a pad or tampon. Blood from spotting is usually dark red or brown.
After you've determined if you're having spotting or menstrual bleeding, you can start to explore what may be causing your increased bleeding. This article reviews potential causes and treatment options.
What causes two periods in one month?
Increased bleeding may be caused by a shorter menstrual cycle, or by a health condition that causes vaginal bleeding.
Causes of a shorter cycle
If your cycle suddenly becomes shorter, it could be due to any of the following:
anovulation (lack of ovulation)
hyperthyroidism
hypothyroidism
onset of menopause (also known as perimenopause)
uterine fibroids or cysts
uterine polyps
cervical polyps
stress
extreme weight loss or gain
birth control
illness
Conditions that cause extra bleeding
If you usually have a regular cycle, a change in your cycle, such as suddenly having two periods in a month, could indicate a medical condition. Some health conditions cause bleeding that can be mistaken for a period, including:
Pregnancy can cause spotting. Spotting during pregnancy can occur, but you should tell your doctor about any bleeding during pregnancy.
Sexually transmitted infections can cause discharge and bleeding.
Polycystic ovary syndrome (PCOS) is a hormonal condition that can cause irregular periods.
Perimenopause can cause heavier and more frequent bleeding, it can also cause lighter or less frequent bleeding. While our hormones may become more unbalanced during this time, they should regulate once you've reached menopause.
Miscarriage can cause heavy bleeding. If you suspect you're pregnant and begin to have bleeding similar to a period, call your doctor.
Cervicitis. Cervical infections that are not sexually transmitted can also cause bleeding.
What are the risk factors for unusual menstrual bleeding?
If you have just started getting your period due to puberty, it's possible that you will be irregular for a year or two, which means you may possibly experience two periods in one month.
If you are an adult and have a family history of fibroids, cysts, or early-onset menopause, you're at an increased risk of having two periods in a month.
However, an increased risk does not mean you will definitely experience it.
When should you see a doctor about irregular menstrual cycles?
While two periods in one month is not always a cause for concern, it's a good idea to consult a doctor anytime your body's rhythms seem out of whack.
For example, you should see a doctor if you:
experience pain in your lower abdomen that doesn't go away after a couple of days
have very heavy periods
spot or bleed in between periods (which is often mistaken for two periods in one month)
experience pain during sexual intercourse
have more menstrual cramping than usual
notice dark clots during your period
What are the complications of more frequent menstrual cycles?
There are a few complications that may arise from irregular periods.
Anemia
One health issue of more frequent bleeding is anemia, which occurs due to a lack of iron in your blood. Your doctor can check your iron levels to determine the cause of your abnormal bleeding.
The symptoms of anemia can include:
fatigue
headache
weakness
dizziness
shortness of breath
rapid or irregular heartbeat
A singular experience of two periods in one month will not necessarily cause anemia. The condition is usually triggered by prolonged heavy bleeding, such as several months of heavy periods.
Difficulty tracking ovulation
Having two periods in one month may make it difficult to track your ovulation, especially if this experience is unusual for you. If you are not planning on becoming pregnant, practicing safe sex is essential.
Difficulty becoming pregnant
If you are trying to become pregnant, abnormal bleeding can add complexity to the process.
Consult with a doctor if you are actively trying to become pregnant and are experiencing heavy or irregular periods.
How are frequent menstrual cycles treated?
Your treatment will depend on the underlying cause of your frequent bleeding. If you naturally have shorter cycles or if you've recently started menstruating, you won't need treatment.
If anemia is a concern, your doctor may recommend iron supplements.
One possible treatment for periods that occur too frequently is hormonal birth control. This type of birth control can help regulate your periods and help resolve anemia issues caused by heavy bleeding.
Here are treatments for other possible causes of frequent bleeding.
Hypothyroidism
If you have hypothyroidism, it means you have an underactive thyroid gland. Your body can't make enough of the thyroid hormone. Your doctor will prescribe a thyroid hormone replacement therapy that you can take by mouth.
Hyperthyroidism
If you have hyperthyroidism, it means you have an overactive thyroid gland. Your body makes too much thyroid hormone. Several treatments are available for this condition. Your doctor will suggest what they think is best for you.
Menopause
During perimenopause or the menopausal transition, your doctor may prescribe hormone therapy and estrogen replacement therapy. These treatments can help regulate your periods until they slowly disappear as menopause progresses.
Fibroids and cysts
Your doctor may recommend a few different treatment options if you have uterine fibroids or cysts. These can include:
Intrauterine device (IUD). An IUD is a form of birth control that can help relieve heavy periods. However, it won't shrink fibroids.
MRI-guided ultrasound surgery. This procedure is performed while you're inside an MRI scanner. It's considered noninvasive, and doctors can use it to remove the fibroid or cyst. This procedure is only done in specialized clinics.
Uterine artery embolization. This is a minimally invasive procedure that blocks the blood supply to the uterus, which causes the fibroids to decay and shrink.
Myomectomy. There are different types of myomectomy, which is a surgical procedure to remove fibroids. In a hysteroscopic myomectomy, the fibroid is removed through the cervix. No incisions are needed. In a laparoscopic myomectomy, small incisions are made in your abdomen to remove fibroids. An abdominal myomectomy is an open abdominal surgical procedure.
Hysteroscopy. During this procedure, a thin tube with a light on the end is inserted through the vagina. This allows a doctor to look inside the uterus and diagnose the cause of abnormal bleeding. A doctor may also be able to treat some causes of bleeding during a hysteroscopy.
Dilation and curettage (D and C). This procedure involves the dilation of the cervix, which allows a doctor to scrape the uterine lining to remove any abnormal tissue.
Endometrial ablation. This surgery involves the removal of the endometrial lining of the uterus. It is not usually recommended if you wish to have children later in life, as it can cause complications.
Hysterectomy. A hysterectomy is a surgical procedure to remove the uterus.
Gonadotropin-releasing hormone agonists. These are medications that can help treat fibroids. They block estrogen and progesterone and put you into a temporary postmenopausal state. This stops the fibroids from growing and can make them shrink. Your doctor may use this treatment to help prepare you for surgery.
Stress
Lifestyle changes can greatly affect stress levels, which in turn can affect menstrual cycles. To help relieve stress, try exercising frequently, practicing meditation, or engaging in talk therapy.
If you're feeling stressed because you're overcommitted, ask for help. Finding the time to relax is important to your health, so don't feel bad about saying no to additional projects or responsibilities.
Extreme weight loss or gain
Talk with your doctor about possible reasons for a dramatic change in weight. They'll work with you to help you manage your weight.
Reaction to birth control
Hormonal birth control introduces hormones into your body. This can affect your menstrual cycle and cause spotting in between periods.
You may need to try a few different types of birth control to find one that works for you. It also takes a few months for your body to adjust to a new method of birth control.
Have a discussion with your doctor about what you should expect when starting a new birth control method.
Preparing for your doctor's appointment
Changes to your menstrual cycle can indicate a health problem, so it's important to discuss abnormal bleeding with your doctor. They will likely ask a lot of questions about your symptoms.
By being prepared for your appointment, you can help your doctor find the correct treatment as quickly as possible. Here are some questions your doctor may ask:
How long are your cycles? Is this typical for you?
If your shorter cycle isn't normal for you, when did the changes to your bleeding start?
How long does the bleeding last?
What color is the blood?
How heavy is the bleeding? How quickly does it fill a pad?
Are there clots? If so, how big are they?
Do you have any other symptoms?
To calculate the length of your cycle, start counting on the first day you bleed. This will be day one. Your cycle will end on the first day that you start bleeding again. Many smartphone apps are available to help you track your cycle.
If you have a history of irregular bleeding, tracking your cycles on an app can help you identify a problem more quickly. It can also make it easier to share your cycle information with your doctor.
The takeaway
In certain situations, such as puberty and perimenopause, having two periods in one month may not be cause for alarm.
However, if you're familiar with your cycle and have noted recent changes, or if you just feel like you're bleeding more than you should be, talk with a doctor.
They can help get to the bottom of your issue, and if warranted, can help you balance your hormone levels and regulate your bleeding.