When to Test for Pregnancy If You Have Irregular Periods

By Dr. Kenosha Gleaton, OBGYN

It’s a tale as old as time- a missed or late period is one of the first indications that someone might be pregnant. But for someone with irregular periods, this may not be a very helpful tip. How do you know when to test or when to suspect a pregnancy if you never have predictable periods? Let’s talk about it. 

Causes of Irregular Periods

For most people, a normal menstrual cycle lasts anywhere from 21 to 35 days, with about four to seven days of menstruation. [1] While we expect there to be some inconsistencies during certain times in someone’s life, such as puberty, menopause, or postpartum, up to 25% of menstruating people report having frequent irregular periods. [1-2] Menstrual irregularities may include shorter or longer cycles, heavier or lighter bleeding, absent menstrual periods, painful periods, and more. So what causes these irregularities? There are a few factors that can contribute to cycle regularity, including [1]:

• Significant weight change
• Extreme exercising
• Stress
• Endometriosis: A condition in which uterine tissue grows outside of the uterus. This can lead to abnormal bleeding, cramping, and severe pain.
• Polycystic Ovary Syndrome (PCOS): A condition often characterized by high levels of androgens, irregular ovulation, and cystic ovaries. PCOS can lead to irregular periods or amenorrhea (absent menstruation) 
• Bleeding disorders, such as a clotting disorder
• Hormonal disorders: Sometimes caused by a problem with the thyroid or pituitary gland. 

Many other factors can influence cycle regularity. It’s best to speak with a provider directly to get to the root of the cause. 

Signs of Pregnancy If You Have Irregular Periods

If you already have missed or irregular periods frequently, the “missed period” telltale sign of pregnancy may not be a very important symptom to you. Other early signs of pregnancy include [3]:

• Sore or swollen breasts: Tender breasts may be a sign of pregnancy and are caused by hormonal changes. 
• Darken or enlarged areolas
• Morning sickness: While the name suggests otherwise, nausea and vomiting associated with pregnancy can appear at any time during the day or night. Morning sickness can range from mild nausea to vomiting one or more times a day. 
• Fatigue: Feeling extremely tired is common during early pregnancy. This is thought to occur as a result of high progesterone levels. 
• Frequent urination: Another early sign of pregnancy is the need to urinate more often. This is a result of the body’s increased blood supply, filtration, and expulsion of waste (urine). 
• Spotting: This can be confusing, but some spotting may actually appear after an embryo implants in the uterus. If you notice light bleeding, such as a few small drops of blood or brown discharge, don’t immediately assume it is a light period, especially if you’ve had unprotected heterosexual sex recently. 
• Metallic taste: This is a less common symptom, but is reported in some people during early pregnancy. This may happen when eating certain foods or randomly throughout the day. 

Other less common but possible signs of early pregnancy include mood swings, congestion, cramping, headaches, food cravings, food aversions, and acne or skin changes. 

Not everyone will experience noticeable symptoms during early pregnancy. The best way to know for sure is to take a pregnancy test at home and have a provider perform a blood test or vaginal ultrasound. 

When Should I Test for Pregnancy If My Period Is Irregular?

If you do have irregular periods, it can be difficult to determine when you need to take a pregnancy test. If there is any chance you may be pregnant, you may want to consider stocking up on bulk pregnancy tests, which can come in the form of midstream tests or pregnancy test strips, which often come in larger packs. Having these on hand can be helpful if you are someone that needs to test frequently. The Office on Women’s Health suggests counting 36 days from the start of your last menstrual cycle, or four weeks from the time you had sex when testing for pregnancy. [4] If you are getting a negative result but believe you are pregnant, you should contact a healthcare provider. Learn how early you can test for pregnancy →

When to See a Doctor for Pregnancy with Irregular Periods

It’s always a good idea to visit a healthcare provider if you have questions about your health. If you think you might be pregnant but aren’t sure when to test, you can try using an at-home pregnancy test before you see your provider. Healthcare providers can always confirm a pregnancy test result by doing a blood test, which can detect lower amounts of hCG than a urine pregnancy test will. This can give you the confirmation you need. 

Planning for Pregnancy With Irregular Periods

If you are hoping to conceive soon and have irregular periods, don’t be too discouraged. Many people with irregular periods still go on to have healthy pregnancies. The hardest part about TTC with irregular cycles is knowing how to identify your fertile window and when to test for pregnancy. Fortunately, we’ve already discussed how to track ovulation with irregular periods, so check out that article if you have questions. 

Some things are simply out of our control when it comes to fertility and pregnancy. What you can do to set yourself up for success is to schedule a visit with your provider, start taking prenatal vitamins for women, and stock up on ovulation tests and pregnancy tests. While your irregular periods may not be tied to any serious underlying conditions, it is important to see a provider when planning to conceive so that you can address any potential problems. 

How Natalist Can Help

Everyone’s cycle is unique, which can make it difficult to navigate reproductive health all on your own. You should speak to a provider to get personalized advice, but in the meantime, equip yourself with knowledge using the Natalist blog. Natalist also offers products to support your journey from TTC to postpartum life. Shop menstrual cycle supplements to support regularity, postnatal vitamins for breastfeeding support, and more on the Natalist site. 

References:

1. What are menstrual irregularities? NIH Office of Communications. January 2017. https://www.nichd.nih.gov/health/topics/menstruation/conditioninfo/irregularities
2. Irregular Periods. Cleveland Clinic. January 2023. https://my.clevelandclinic.org/health/diseases/14633-abnormal-menstruation-periods
3. Am I Pregnant? Cleveland Clinic. July 2022. https://my.clevelandclinic.org/health/articles/9709-pregnancy-am-i-pregnant
4. Pregnancy tests. Office on Women’s Health in the U.S. Department of Health and Human Services. February 2021. https://www.womenshealth.gov/a-z-topics/pregnancy-tests

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, health equity, and mentoring. She is the CEO of The EpiCentre, an OBGYN spa-like practice, and is a Clinical faculty member of Charleston Southern University. She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women