If you have an irregular cycle or no periods at all, you may wonder if you can get pregnant. The good news is that it’s possible to conceive. However, it might take a bit longer or be more difficult for you than for someone with regular cycles, which are usually defined as an average of 28 days in length. While research shows that people with irregular periods are less likely to get pregnant, with time and treatment, it’s possible.
Will It Be Easy To Conceive?
How easily you’ll be able to conceive depends on:
- The cause of your irregular periods
- How irregular your periods are
- Whether or not you can accurately time sex for pregnancy
Parents / Illustration by Brianna Gilmartin
Are Your Cycles Truly Irregular?
An irregular period is defined as a menstrual cycle that’s either shorter than 21 days or longer than 36 days. Your cycle may also be considered irregular if it varies significantly from month to month. For example, if one month your cycle is 23 days, and another it’s 35, your cycles would be considered irregular.
Research has found that variations in cycle length are associated more strongly with infertility than just having a shorter or longer regular cycle. In other words, if your cycles tend to be slightly longer than the normal range, but they are consistently that length, you may be less likely to experience fertility problems than someone whose cycles vary significantly but the length falls within the norm.
If your cycles are off by a day or two from month to month, you don’t need to worry. It’s when the variations are longer—five or more days—that you may face fertility difficulties.
An occasional irregular cycle is also normal. Stress or illness can delay ovulation or menstruation, causing your cycle to be longer, and sometimes shorter, than usual. If you have just one or two of these “off” periods a year, you don’t need to worry.
How To Detect Ovulation When Cycles Are Irregular
If you’re ovulating irregularly, you’ll need to make a special effort to determine your most fertile time. There are many ways to predict ovulation, and you might need to use more than one to pinpoint when is the best time to have sex for conception.
Ovulation predictor tests work a lot like pregnancy tests, in that you pee on test strips to determine when you’re most fertile. However, in some people, the tests give multiple “false positives.” This is especially common in people with polycystic ovary syndrome (PCOS).
You may also want to consider charting your basal body temperature (BBT). BBT charting can show you when you already ovulated. You can also share your BBT charts with your health care provider; they may be able to use this information to make a diagnosis.
Of course, the most accurate way to detect ovulation, or lack thereof, is through a transvaginal ultrasound and bloodwork taken at your physician’s office. Talk to your health care provider about these options to determine if they suit you.
How To Get Pregnant With Irregular Cycles or No Period
Eating healthy, getting plenty of exercise, and developing good sleep hygiene may help you regulate your cycles. As long as you’re ovulating, you have a good chance of getting pregnant.
One effective way to get pregnant with irregular cycles is to forgo trying to detect ovulation and just have sex frequently throughout your cycle. Some couples find timing sex for pregnancy stressful. This approach avoids that stress. You won’t be trying to have sex when you get a positive ovulation test result. Instead, you’ll just have sex, frequently, all month long (ideally, every other day).
With this method, you don’t have to worry about missing ovulation. If you’re having sex three to four times a week, you’re very likely to have sex on a fertile day.
Causes of No Period or Irregular Cycles
Irregular cycles may point to a subtle hormonal imbalance. You may still be ovulating every month, but your ovulation day may vary. If you’re ovulating, you may be able to get pregnant without the help of fertility drugs. Here are some possible causes of irregular cycles that are also infertility risk factors.
Polycystic ovarian syndrome (PCOS)
Irregular periods may be a sign of polycystic ovarian syndrome (PCOS). PCOS is a common endocrine disorder affecting 1 in 8 people with ovaries. Not everyone with PCOS will experience infertility, but many will take longer to get pregnant. People with ovaries who have PCOS also have a higher risk of early miscarriage.
Thyroid imbalance
An underactive or overactive thyroid can cause irregular periods, as well as infertility. Other possible symptoms of a thyroid imbalance include weight changes, difficulty falling asleep or feeling tired all the time, unexplained anxiety or depression, or problems with constipation or diarrhea.
Hyperprolactinemia
Prolactin is a hormone primarily responsible for stimulating the breasts to produce breast milk. Hyperprolactinemia is when the hormone is elevated even if a person is not pregnant or currently breastfeeding.
Abnormally high levels of prolactin can cause irregular periods or make your periods cease completely. Other possible symptoms may include swollen or tender breasts, leaking breast milk from the nipples, or painful sexual intercourse (from vaginal dryness).
Primary ovarian insufficiency (POI)
Also known as premature ovarian failure (POF), primary ovarian insufficiency can cause irregular or completely absent periods. Low estrogen levels sometimes occur along with POI/POF, and this can lead to symptoms like vaginal dryness, painful sexual intercourse, hot flashes or night sweats, difficulty sleeping, or unexplained depression or anxiety.
Obesity
Obesity is the most common preventable cause of irregular periods and decreased fertility. Sometimes, fluctuations in weight are caused by an underlying and undiagnosed hormonal imbalance. For example, both PCOS and hypothyroidism can cause sudden weight gain and difficulty losing weight.
If you experience a sudden increase in weight despite not changing your lifestyle significantly or have great difficulty losing weight, talk to your health care provider. If a hormonal imbalance is contributing to your fluctuating weight, they might be able to help.
Being underweight
Just as having more body fat can cause irregular cycles, having too little body fat can also lead to irregular periods and fertility problems. Eating disorders are a risk factor for infertility and absent periods as well.
Extreme exercise and extreme dieting are also potential causes of irregular cycles. Athletes are more likely to experience infertility for this reason.
Anovulation
Sometimes irregular periods are a sign of anovulation. Anovulatory cycles are menstrual cycles where ovulation doesn’t take place. If you’re not ovulating, you can’t get pregnant without the help of fertility treatments.
Medications For Conceiving Without a Period or With Irregular Cycles
If it turns out that you’re not ovulating, you may need fertility drugs to help boost your ovulation. Fertility treatments can also help those with irregular ovulation.
Clomid is the most commonly prescribed drug for ovulatory dysfunction, and it has a good success rate, but you should discuss all possible options with your health care provider. They may also suggest injectable fertility drugs (gonadotropins), IUI treatment, or IVF.
Lifestyle Changes and Supplements To Regulate Ovulation
Fertility drugs aren’t your only option. You may be able to make lifestyle changes, depending on the cause of your irregular cycles.
For example, obesity is known to impact fertility, often by disrupting ovulation. If have more body fat, losing some weight may be enough to jumpstart ovulation and help you conceive. Research shows that people with obesity who lose just 2% to 5% or more of their body weight can restart ovulation or begin ovulating more regularly again.
Remember, though, that an underlying health issue, such as a thyroid problem or hormonal imbalance, can also be to blame. See a health care provider, and then make a weight loss plan.
If you have too-little body fat, changing your diet and gaining some weight can help regulate your cycles. If your issue is over-exercise, cutting back may regulate your cycles. You may also want to consider trying a fertility supplement (only after consulting with a medical provider).
Talking to a Medical Provider About Irregular Cycles or No Period
If you have irregular or no periods, the best thing to do is see an OB-GYN right away. Even if you weren’t trying to get pregnant, it’s a good idea to get checked out if you don’t have a regular period.
Your health care provider can run some simple blood tests to see if you’re ovulating. If your blood work indicates that you are ovulating, and you’re not over 35, you might want to keep trying to get pregnant on your own for a bit longer.