Cycles ranging from 21-35 days are considered normal – unless accompanied by other undesirable or abnormal symptoms. If your bleeding varies from cycle to cycle in amount, color, length or your cycle falls outside the 21-35 day range, it’s best to chart what you are experiencing and speak with your doctor about your symptoms and cycle length. Having intercourse two times at the right time of your cycle for conception is better than having sex all month long when you don’t know when ovulation is occurring and when the timing of conception is ideal.

Bleeding can occur without ovulation in what is known as anovulatory menstrual cycles. These cycles occur because estrogen production continues to plump the uterine lining but without reaching the threshold necessary for ovulation. The uterine lining (endometrium) builds up until it can no longer function, and with the lack of progesterone to help maintain its health, it releases in a process known as ‘estrogen breakthrough bleeding.’ 

Stopping the birth pills

Many women are prescribed birth control pills to help “regulate their cycles”. However, since a birth control pill cannot fix the underlying hormonal imbalance causing these symptoms, once the pill is stopped, the hormonal imbalances causing the menstrual problems usually resume.  

Birth control pills shut down a woman’s natural hormonal production and replace it with the synthetic hormones contained in the birth control pill. While on birth control pills, ovulation does not occur despite monthly bleeding and pregnancy is prevented. Bleeding on the pill occurs not because the body is seeing the rise and fall of normal estrogen and progesterone with ovulation as nature intended, but because the precise timing of synthetic hormones is provided to mimic a natural cycle. 

Many women find that when they come off the pill, they are in the same position as when they started, with heavy, irregular cycles. Further, they discover that the same issues that contribute to menstrual irregularity may contribute to difficulty conceiving. Because there is no way to predict when cycles and ovulation will return to a normal pattern after discontinuation of the pill, it is best to use temperature and cervical fluid analysis to determine when fertility has returned.

Woman having menstrual pain

Pregnancy & Breastfeeding

When the baby suckles, it triggers the release of prolactin, a hormone that blocks follicle-stimulating hormone (FSH) and luteinizing hormone (LH), hormones essential for ovulation. Breastfeeding women may not experience ovulation for over a year. Moreover, prolactin also causes low estrogen levels which suppress the production of fertile cervical fluid. 

Illness

Getting sick during a cycle may or may not affect ovulation. This will often depend on what part of your cycle you’re in when you fall ill, and how serious the illness is.

Traveling

Travel is infamous for disrupting menstrual cycles. Your body can interpret that beach vacation you’ve been planning for weeks as stress because of shifts in time zone, weather, places, etc, Many women experience very long cycles when traveling while others stop getting periods altogether.

Exercise

Physical activity is an important part of maintaining health and wellbeing for all women. Interestingly, excessive exercise can interfere with pregnancy.  Think professional athletes with intense training schedules, strict diets, low body fat percentages – they often have irregular cycles because this amount of exercise puts the body under physical and emotional stress, which the body interprets as not an ideal time to get pregnant. When the body sees exercise as stress vs health promoting it typically deals with it by delaying or preventing ovulation and/or shortening the luteal phase of a woman’s cycle. If you have been a long term exerciser, check with your physician regarding the amount and frequency of your exercise regimen. Continuing a long term healthy exercise regimen while trying to get pregnant and during pregnancy is normally fine. If you are just starting an exercise program while trying to get pregnant, go slow with gentle walking or yoga until your fitness level improves.

Weight

The average woman’s body feels comfortable with about 22% body fat in order to maintain regular ovulatory cycles. Too thin? Your body may not produce the hormones necessary to ovulate or menstruate all together. Too heavy? Your body may be estrogen dominant which interferes with the body’s natural hormonal feedback system and ability to conceive. When asked, “What is the ideal weight for me to get pregnant?” My answer is that it’s best to follow the Goldilocks principle. You can’t be too hot, or too cold, you need to be just right. In general,  a woman should have a body fat percentage that ranges anywhere from the low to mid 20’s for her to be at her ideal weight for conception. And while this is an ideal, women below or above these body fat percentages may get pregnant and deliver healthy babies. 

Stress

Have we mentioned stress yet? Stress can delay ovulation, prevent ovulation or decrease the quality of fertility quality cervical fluid all affecting fertility. However, stress is an inevitable part of life. Fortunately- our bodies are designed to deal with stress and still allow us to be healthy and fertile. If this was not the case, no woman would get pregnant and the human race would cease to exist.  Stress tends to have little effect on women if it is counterbalanced with calm or relaxation. Stress reduction programs will look different for each woman and can include practices like yoga and meditation or common everyday things which bring us back into balance like walking the dog, reading a book or enjoying nature.