Ideally, your annual exam and Pap smear should be conducted when you are not on your period. While heavy menses may possibly interfere with Pap smear interpretation, we generally can see someone when they are on their period, including a pelvic exam and successfully collect their Pap. Understandably, many patients are more comfortable to be examined when they are not on their period, and we are happy to reschedule if they request.
Annual Checkup While on Period
Even if you’ve taken care to schedule your annual exam for when you aren’t menstruating, we understand that if you have irregular periods, it may be difficult to accurately determine when they will start. If you prefer, we can usually reschedule your appointment for when you are no longer on your period. If more convenient, you may also keep your original appointment as your period will typically not interfere with your examination.
”Irregular periods are very common. We always put the comfort of our patients first,” said Dr. Sonya Williams.
While the Pap smear and pelvic exam are an important part of your yearly exam, we also believe this is an ideal time to discuss your general wellness and sexual health. We care for the whole patient, and that’s why we want to know if you have any other health issues such as high blood pressure or high cholesterol. It is also a chance to review and discuss your lab work and conduct a clinical breast exam.
If your period came unexpectedly, we’d like to talk to you about that too. Painful, heavy or irregular menses can be indicative of another health problem. If you have an irregular period, you should keep a record of when it occurs, for how long and how heavy the flow is. This will be a useful tool that will help us determine the root of the problem.
What constitutes an irregular period?
It’s very frustrating not knowing when you are going to have your period. It can cause problems planning vacations or other activities and can cause stress, worrying about what outfit to wear or if you could be pregnant. Your period should occur every 21 to 35 days and last up to seven days. An irregular period comprises anything that is outside of this norm.
The following are also signs that you have an abnormal period:
- Periods that cause you to feel nauseated to the point of vomiting
- Flow that is heavier than usual
- Bleeding between periods
- Passing blood clots during your period
- Extremely painful periods with severe cramping — this is known as dysmenorrhea.
If your period has stopped completely, or you are a young woman who hasn’t had your first period by the age of 16, then you may be diagnosed with amenorrhea. This means you have gone 90 days or more without a period and you are not using contraception known to stop periods, pregnant, breastfeeding, or menopausal. If you have infrequent periods (those consistently greater than 35 days apart), then you may have oligomenorrhea. (Cleveland Clinic)
You should speak with us if:
- You have skipped two periods and you are not pregnant
- You have recently had a heavier menstrual flow than what is normal for you
- Your periods last longer than seven days
What causes irregular periods?
Irregular menstrual cycles are most common around the time your first period starts and just before you begin menopause. However, there are many causes of irregular periods such as:
- Ovarian cysts
- Certain medications for anxiety or depression
- Certain birth control methods like IUDs
- Ovulation disorders
- Eating disorders
- Hormonal irregularities
- Thyroid problems
How are irregular periods treated?
First, we’ll review your medical history and perform a pelvic exam. Then, we’ll order blood tests to rule out other medical disorders such as thyroid problems or hormonal deficiencies.
Because fibroids, polyps and ovarian cysts can cause irregular periods, we may need to perform a pelvic ultrasound to check for them. If needed, we’ll perform an endometrial biopsy, removing sample tissue from your uterine lining. This helps us diagnose precancerous changes or even certain types of cancer.
Depending upon the diagnosis, treatment may include:
- Prescribing hormones such as progestin or estrogen. These can control heavy bleeding and also induce a period if you have not had one for several months.
- Taking low-dose birth control pills
- Using gonadotropin drugs, which can reduce the size of fibroids and also control heavy bleeding
We’ll work with you to create a treatment plan that addresses your concerns.
If you have your checkup scheduled and you’ve started your period, please contact us. Usually, we can easily reschedule you for another appointment within a week. If that isn’t possible, we urge you to keep your appointment so we can discuss why you’re having an irregular menstrual cycle. Together, we’ll tailor a treatment plan that will enable us to treat the problem.
For more than 40 years, Chapel Hill OBGYN has served women in the Triangle area, sharing the joy of little miracles and supporting them during challenges. Our board-certified physicians and certified nurse midwives bring together the personal experience and convenience of a private practice with the state-of-the-art resources found at larger organizations. To schedule an appointment, please contact us for more information.
Cleveland Clinic. “Abnormal Menstruation (Periods)” Online.