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Why Women With PCOS Have Irregular Periods

Irregular cycle can mean a lot of things - and one of the cause is PCOS. But why do women with PCOS have irregular cycle and what can you do about it? Read more in this article.

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Posted on March 14, 2022 ·

Having regular periods is a sign of good overall health. Although missing your periods is not a life-threatening condition per se, irregular periods can reflect an imbalance in your body’s functions. This is because your periods are an outcome of 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 regularize your period cycle, which will help you track your ovulation better.

What does irregular periods mean?

Although some women with PCOS have regular periods – high levels of androgens (male hormones) and too much insulin can disrupt the monthly cycle of ovulation and menstruation of many women with PCOS.

If you have PCOS, your periods might be irregular, or stop altogether. As menstrual cycles lengthen, ovulation can stop entirely (called anovulation) or occur only occasionally. Some women with PCOS also experience heavier or lighter bleeding during their menstrual cycle.

An ‘irregular’ period cycle is defined as either:

  • eight or fewer menstrual cycles per year
  • menstrual cycles shorter than 21 days
  • menstrual cycles longer than 35 days; or,
  • for young women within three years of starting periods, longer than 45 days.

Regular periods help to prevent excess thickening of the uterine lining (womb). Not having regular periods can lead to a build up of abnormal cells inside the womb which can increase the risk of cancer.

Is your irregular cycle due to PCOS?

A number of other conditions that could cause similar symptoms of irregular periods or no periods need to be checked by your doctor and ruled out before a correct diagnosis of PCOS can be confirmed.

Also certain factors such as stress, too much exercise, unhealthy diet, poor sleep can also affect your cycle. Although these factors can be managed by making lifestyle changes – certain conditions such as PCOS can cause irregular cycles too.

To be diagnosed with PCOS, two of these three things must be present:

  1. Irregular periods – infrequent or no menstrual periods
  2. Symptoms – acne, scalp hair loss, or increased facial and/or body hair growth, or a blood test showing higher levels of androgen hormones.
  3. Ultrasound – image of ovaries showing 20 or more follicles on one or both ovaries.

How can you regularise periods?

Weight loss

Women with PCOS who are overweight can experience significant improvement in their PCOS symptoms when they lose even 5-10% of body weight. This can improve menstrual regularity. Although just losing weight won’t help reverse PCOS – your body warrants a lifestyle reset.

 

Lifestyle changes

This includes eating a balanced and nutritious diet, maintaining a healthy weight, being physically active, getting quality sleep, managing stress and minimising harmful habits such as smoking and drinking.

 

Consider taking combined oral contraceptive pill (COCPs)

The pill contains both oestrogen and progesterone and helps improve cycles and decrease androgen levels.

 

Consider taking metformin

Metformin helps reduce insulin resistance and the production of androgens. This can improve the function of the ovary and regularise periods.

Not all women require OCPs or birth control pills to regularise their periods. Many women are able to restore normal menstrual cycle naturally by making lifestyle changes.

And although some women might be prescribed OCPs to regularise periods, they are never a replacement for making lifestyle changes. You need to continue following a healthy lifestyle to see lasting results.

So if you are not sure what is the root cause of your irregular cycle or if you’re wondering what the right treatment is, speak to a gynaecologist, who can assess your condition and recommend tests if required.

Disclaimer: Content on Veera is provided for informational purposes only and is not intended as medical advice, or as a substitute for medical advice given by a physician

Verified by Dr. Iris Lee

Fellow in Reproductive Endocrinology and Infertility, University of Pennsylvania

Dr. Lee is a fellow in reproductive endocrinology and infertility at the University of Pennsylvania. She completed medical school and residency training at the University of Pennsylvania as well. Her work focuses primarily on PCOS, particularly the metabolic and mental health implications. Outside of work, she enjoys baking, reading, and spending time with her husband and two puppies.

BY Team Veera

Medically Reviewed

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