Could irregular periods and intense pain signal menstrual health issues?

Dear Doctor I hope this message finds you well. I am writing to seek your expertise regarding some troubling changes I have been experiencing with my menstrual cycle. Historically, I have maintained regular periods, typically occurring on a predictable monthly schedule. However, over the past few months, I have observed a pattern of increasing irregularity. Specifically, my cycles have been increasingly delayed, with periods arriving two, four, and even five days later than expected. Most recently, I experienced a delay of eight days. Moreover, following the onset of my most recent period, I noticed an abnormal occurrence of spotting that lasted for approximately three days. This extended spotting has added to my concerns about my menstrual health. Additionally, I would like to highlight that the level of pain associated with my menstruation has become significantly more intense, to the point of being almost unbearable during some cycles. Given these developments, I am eager to understand the potential underlying causes and whether there are recommended steps I should take to address these issues. Your guidance and insights would be greatly appreciated. Thank you for your attention to this matter. I look forward to your response. Sincerely, Naomi