Periods or no periods? Although not having periods might sound like a dream to some, women with polycystic ovary syndrome (PCOS) understand the real challenges that can come with that. Abnormal menstrual bleeding is often the result of anovulatory (no ovulation) cycles and is cause for concern if persistent. Eating a balanced and nutritious diet, keeping yourself active, managing your stress, and sleeping well can help regularise periods and ovulation, help with weight loss, and improve insulin resistance. All of this can ultimately improve your quality of life and reduce the risk of future health complications.
Start PCOS Treatment Free Nutrition GuideMost women get their monthly periods in a 21- to 35-day cycle. Although what’s normal for one woman may not be normal for another, it is important to get regular periods. Sometimes certain factors or health conditions can affect your menstrual cycle and make your cycle irregular.
An irregular period cycle is defined as:
Although some women do have regular periods, irregular periods are one of the most common symptoms of PCOS. In PCOS, higher-than-normal levels of insulin and androgens (male hormones) cause an imbalance in hormone levels. The presence of high levels of androgen interferes with the normal cycle of ovulation (egg release) and menstruation, causing irregular periods. As a result, many fluid-filled sacs called follicles do not mature and hence do not release an egg. This affects fertility as well.
Although PCOS is one of the causes of irregular periods, it is not the only cause. Many other factors and health conditions can also cause irregular periods. Chronic stress, too much exercise, an unhealthy diet, a sedentary lifestyle, poor sleep, and the effect of certain medications can also affect your cycle.
Having regular periods is a sign of good overall health. Although missing your periods is not a life-threatening condition, irregular periods can reflect an imbalance in your body’s functions. This is because your menstrual cycle depends on a balance of several hormones that all work together. Irregular cycles over time increase the risk of developing complications such as infertility and endometrial cancer. So if you are planning to conceive, it is important to first regularise your period cycle, which will help you track your ovulation better.
No, it is not normal to miss a period. It is important to have regular shedding of the uterine lining to keep your uterus healthy. When you miss a period, it can be a sign of hormonal imbalance and should be checked by a doctor. It is important to identify the root cause of missing periods so that you can address it early on. It is recommended that women should have at least eight menstrual cycles a year to prevent future complications. If you are experiencing missed or irregular periods, then it is best to consult a doctor.
Having irregular periods does not always mean PCOS. A number of other conditions could cause similar symptoms of irregular periods or no periods. Your doctor will need to rule out any other conditions before a diagnosis of PCOS can be confirmed.
To make a diagnosis of PCOS, your doctor will look for at least two of these three factors:
PCOS can be difficult to diagnose in young women in the first few years after their periods begin. This is because periods are often irregular at first and might not settle into a regular pattern for some years.
Treating irregular periods is usually a combination of lifestyle modifications and medications. However, not all women need medications. Lifestyle changes are often effective in regulating periods and improving other symptoms. Weight loss of even 5% to 10% of body weight can greatly improve PCOS symptoms. Eating a balanced diet — along with regular exercise, stress management, and good sleep — can help you make an overall holistic lifestyle change
Apart from lifestyle changes, some women may also benefit from medications such as these:
When your body’s hormonal balance is disturbed and your ovaries aren’t functioning properly (such as producing an excess of male hormones), the best way to restore this balance is by getting hormones from another source. That’s what oral contraceptive pills (OCPs) do. Although OCPs cannot reverse PCOS, they are a temporary treatment. A short course of OCPs (3 to 6 months) can help restore hormonal balance and reduce male hormone production. This will give you time to improve your insulin resistance, lose weight, and/or make lifestyle changes so that when you stop using OCPs, your periods should still come regularly.
Metformin is a commonly prescribed drug to treat insulin resistance and diabetes. In PCOS especially, metformin helps improve insulin resistance and reduce androgen levels, which can in turn improve the function of ovaries and regularise periods. Metformin’s primary effect is on insulin levels, so it might not be as effective as OCPs in regulating periods and ovulation.
There are a number of treatment options for PCOS hair loss, including topical treatments, oral medications, laser therapy, or, in some cases, hair transplantation. These cannot completely cure hair loss, but they can certainly make living with symptoms easier overall.
Lifestyle factors such as diet, exercise, and stress can cause irregular periods. Certain other health conditions can cause similar symptoms to PCOS, and thus it is important to get the correct diagnosis for your symptoms.
Hypothyroidism can cause symptoms similar to that of PCOS, especially irregular menses. In order to rule out hypothyroidism as a cause of your symptoms, the doctor will prescribe you a thyroid stimulating hormone (TSH) test. TSH controls the levels of T3 and T4 thyroid hormones, and when the levels of these hormones are low, you can have PCOS-like symptoms.
Hypothalamic amenorrhea is a condition in which a woman experiences irregular periods due to stress, low calorie intake, or intense exercise. This condition can be prevented early on, and future complications can be prevented.
Prolactin is a hormone released by the pituitary gland, a pea-shaped organ present at the base of your brain. Prolactin promotes lactation in women, and when its levels are elevated, it can lead to irregular menses. A prolactin test is done to rule out hyperprolactinemia as the root cause of your irregular or absent periods.
Irregular periods could mean many different things, so if you are experiencing irregular periods, don’t ignore them. Instead, speak to a professional who can evaluate the root cause and advise you of the correct treatment regimen. To prevent future complications, the earlier you correct the underlying condition, the better the health outcomes.
Veera’s free online assessment helps you understand your risk scores based on your symptoms. Since PCOS is a multifactorial disease, many symptoms can show up at varying degrees and in clusters. Our screening tool can serve as a preliminary screening assessment, and based on your score, you can speak to one of our PCOS experts to get the right care.
