Have you ever had two periods in one month or cycle?
While spotting between periods is not necessarily anything to worry about, it could indicate an underlying health concern… or even pregnancy!
In this article, we’ll cover everything you need to know about abnormal vaginal bleeding – including why it happens, common symptoms, and when you should seek advice from a doctor.
What Is Considered a Normal Menstrual Cycle?
A normal menstrual cycle lasts between 21 to 35 days.
Approximately midway through the menstrual cycle, the ovaries release an egg into the uterine tube. This is called ovulation, and it’s when the body is at peak fertility. If you conceive, the fertilized egg will implant itself in the uterine lining that is prepared for pregnancy. If you do not conceive, the uterine lining will shed (this is your period) and the whole cycle starts again!
Hormones are the driving force behind this entire process, and they are often to blame when a cycle is irregular or ‘abnormal’. For example, an imbalance in hormone levels may prevent some individuals from ovulating. Others will have cycles that are longer or shorter than what’s considered normal. And in some cases, period flow may feel too light or too heavy.
For the purpose of this article, we’re covering what happens when there appear to be two periods within one menstrual cycle.
Two Periods in One Menstrual Cycle: Common Causes
Hormone Imbalance
An imbalance in hormones can lead to cycle irregularities, which may cause spotting and the appearance of period-like bleeding.
There are a number of different lifestyle factors that can cause your hormones to become out of balance. Some of the most common include:
- Stress
- Illness
- Lack of sleep
- Being over or underweight
- Poor diet and nutrition
- Exposure to certain toxins and chemicals
If you have been experiencing period-like bleeding or spotting throughout your cycle, it’s worth getting your reproductive hormones checked. You can do this with a blood test at your doctor’s office – or, you can test your hormones at home with Mira. Together with the Mira App, the Mira Monitor enables you to test and track four key fertility hormones (LH, E3G, PdG, and FSH) with lab-grade accuracy – helping you take the guesswork out of your irregular cycle.
Uterine Abnormalities
Irregular bleeding may also indicate an underlying condition in the uterus. For example, uterine fibroids, polyps, ovarian cysts, endometriosis, and in rare cases, cancer can all cause irregular bleeding and the appearance of multiple periods.
In addition to irregular bleeding, uterine abnormalities are also often accompanied by other symptoms such as lower back or pelvic pain, pain during intercourse, and infertility.
If you are experiencing any of the above symptoms, it’s a good idea to book an appointment with your doctor – especially if your symptoms worsen or begin to interrupt your day-to-day life. Your doctor will be able to provide you with the very best advice for your situation.
Changes in Birth Control or Medication
Certain birth controls and medications can also cause irregular bleeding and spotting.
For example, any hormonal birth control method (such as the pill, vaginal ring, patch, and injections) can cause spotting. This is especially true for those who have recently started or switched their birth control. Emergency contraception (sometimes referred to as the ‘morning after pill’) can also disrupt your hormones and cycle.
Other medications known to disrupt the menstrual cycle in some cases include non-steroidal anti-inflammatory drugs (NSAIDs), chemotherapy drugs, and thyroid medications.
Natural Causes
Irregular bleeding and spotting are more common during certain phases of life – particularly puberty and perimenopause. Both are natural phases of transition during an individual’s life where hormone levels can fluctuate, leading to irregular bleeding and the appearance of multiple periods in one menstrual cycle.
What About Implantation Bleeding?
Implantation bleeding is light spotting that can occur when a fertilized egg implants itself into the uterine lining. It’s often brown or pink in color, and it happens around 6 to 12 days after ovulation. Not everyone bleeds during the implantation process, with researchers estimating approximately 25% of pregnant individuals experience it.
Implantation bleeding is much different from a normal period in that it is typically lighter in color and shorter in duration. However, depending on what’s ‘normal’ for you – it’s possible for implantation bleeding to be mistaken for a period.
The most common signs and symptoms of implantation bleeding include:
- Pink or brown spotting
- Lasts a few hours up to a few days
- Light cramping
It’s important to remember that implantation bleeding does not necessarily confirm pregnancy. You’ll have to wait a few more days and take a pregnancy test when the time is right.
When to Take a Pregnancy Test
So when exactly is the right time to take a pregnancy test?
The standard advice is to wait until the first day of your next expected period. It’s also recommended to wait until at least 12 days past ovulation (DPO) to ensure the most accurate results.
When it comes to purchasing a pregnancy test, there are several options to choose from. The most common at-home tests that measure hCG (human chorionic gonadotropin) levels in urine include:
- Traditional pregnancy tests: These tests can be purchased as paper strips or wands. If you are pregnant, two lines will appear on the test. Traditional tests are up to 99% accurate – however, the lines can sometimes be faint, making them difficult to interpret.
- Digital pregnancy tests: These tests are also up to 99% accurate, but instead of displaying the results as two lines, a positive result will be displayed with the words ‘pregnant’. This helps to take some of the guesswork out of interpreting your results.
- Early pregnancy tests: These tests are often marketed as being able to detect hCG levels up to five or six days before the start of your next period. However, this is only true for approximately 75% of individuals, making them a less accurate option when compared to traditional and digital tests.
You can also have your hCG levels tested at your doctor’s office with a blood test. This is the most accurate way to confirm the results of your at-home test.
To learn more about when to take a pregnancy test, check out our article When to Take a Pregnancy Test Based on Science and Ovulation
Early Signs of Pregnancy
In addition to implantation bleeding/spotting, other common early signs of pregnancy include:
- Frequent urination
- Breast swelling or tenderness
- Fatigue
- Headaches
- Sensitivity to smell
- Nausea and vomiting (particularly in the morning)
- Food cravings
- Bloating
- Constipation
- Heartburn and/or indigestion
- Thick and creamy discharge
- Leukorrhea
- Metallic taste in the mouth
If you have recently become pregnant, you may already be experiencing some of these symptoms. To help, check out Mira’s Pregnancy Tea. This tea was carefully crafted by our in-house experts to help soothe some of the most unpleasant symptoms of early pregnancy – such as morning sickness, heartburn, and headaches.
Other Potential Causes of Abnormal Bleeding, Spotting, and Multiple Periods
Polycystic Ovary Syndrome (PCOS)
Another potential cause of abnormal bleeding is PCOS – a hormonal disorder that affects approximately 7-10% of women worldwide.
Individuals with PCOS often have chronically high testosterone levels. This hormonal imbalance creates problems in the ovaries – which can lead to irregular cycles, irregular/missed ovulation, and abnormal bleeding and spotting. Even though PCOS is considered one of the most common causes of infertility, it’s important to remember that it can be treated with both lifestyle and medical interventions.
You can learn more by exploring our dedicated library of articles on PCOS. If you are actively TTC with PCOS, check out our PCOS Supplements. Crafted by fertility experts and doctors, these supplements can help to balance your hormones, regulate ovarian functioning, and restore cycle regularity.
Thyroid Issues
Thyroid disorders are another big disrupter for your hormones and menstrual cycle.
For example, hyperthyroidism is a condition where thyroid-stimulating hormone (TSH) levels are too low – causing symptoms such as weight loss, irritability, fatigue, difficulty sleeping, and irregular periods. Hypothyroidism, on the other hand, occurs when TSH levels are too high, leading to weight gain, depression, fatigue, muscle aches, and irregular periods.
If you have ever experienced any of the above symptoms alongside an irregular period, it’s a good idea to ask your doctor about having your thyroid hormones checked at your next appointment.
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You can also check your thyroid hormones from the comfort of your home with Mira’s Panorama Fertility Lab Test. In addition to TSH, you can also test for AMH (anti-mullerian hormone), fT4 (free thyroxine), prolactin, and free testosterone. Once your test kit is analyzed, you’ll receive a personalized report with insights into your menstrual cycle rhythm, ovarian reserve, hormone balance, thyroid functioning, and general fertility health.
Other Medical Issues
Other medical issues that may cause abnormal vaginal bleeding or spotting include:
- Certain sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and trichomoniasis.
- Pelvic Inflammatory Disease (PID)
- Primary Ovarian Insufficiency (POI)
- Trauma to the vagina or cervix
- Gynecologic cancer
In addition to attending your regularly scheduled checkups with your doctor, it’s also a good idea to stay in tune with your body and symptoms so that you can spot potential problems early on.
If you frequently experience abnormal vaginal bleeding, we recommend making an appointment with your doctor immediately. They can assess your individual symptoms and provide the best care and treatment.
If you are actively TTC and looking for some additional support, we would love to see you in our virtual Hormone Health Clinic! Our fertility coaches are here to help you navigate your symptoms, better understand your hormones, and achieve your fertility goals.
Final Thoughts
Having what feels like a period twice a month (or even multiple times a month) can be super frustrating. To prevent any symptoms from developing into long-term issues that affect your fertility, it’s always good to be proactive with your reproductive health. You can do this by listening to your body, keeping track of any abnormal symptoms, attending your regular checkups, and seeking medical advice when you need it.
Frequently Asked Questions
What does a normal period cycle look like?
Among individuals of reproductive age, a normal menstrual cycle lasts between 21 to 35 days. Menstruation (i.e. your period) starts on day one and can last between two to seven days. Ovulation then occurs midway through your cycle, which marks the day at which your body is at peak fertility.
What causes a woman to menstruate twice in a month?
There are a number of underlying causes that may lead to irregular bleeding, spotting, and the appearance of multiple periods in a cycle. The most common underlying causes include hormone imbalance, changes in birth control or medication, PCOS, thyroid disorders, and implantation bleeding due to pregnancy.
How many days after your period can you get pregnant?
Based on a 28-day cycle with ovulation around day 14, pregnancy would be possible as early as 10 days after your period ends. However, everyone’s cycle is unique and timings can vary.
Can you have a period while pregnant?
It is not normal to have a period when you are pregnant. The most common causes of bleeding during pregnancy are implantation, ectopic pregnancy, and miscarriage. If you are pregnant and have experienced what feels like a period during pregnancy, reach out to your doctor immediately for further guidance as you may need immediate medical attention.
Does implantation bleeding mean you’re pregnant?
Not necessarily. The only way to confirm pregnancy is by taking a pregnancy test no sooner than the first day of your next anticipated period.