Bicornuate uterus and irregular periods

Irregular cycles therefore deserve their own assessment rather than being attributed automatically to uterine anatomy. The uterine shape and a separate cause of cycle changes can exist at the same time.

Periods are coordinated mainly by signals among the brain, ovaries and uterus. Cycle timing can change with pregnancy, the years around the first or final periods, thyroid problems, polycystic ovary syndrome, substantial weight change, intense exercise, stress, some medicines and hormonal contraception.

A bicornuate uterus has two upper cavities because of development before birth. It can affect pregnancy and sometimes the way blood leaves the uterus if another structural difference is present, but the shape alone does not explain every delayed, missed or unpredictable period.

Record when bleeding begins and ends, how heavy it is, pain, bleeding between periods, medicines, contraception and related symptoms such as acne, excess facial hair, hot flushes or nipple discharge. If pregnancy is possible, take a pregnancy test rather than waiting for the next cycle.

A clinician may review your cycle history, check for anaemia or hormonal causes, and decide whether examination or imaging is useful. Previous scan reports can help separate a confirmed bicornuate uterus from a septum or another structural finding. Treatment depends on the cause of irregularity and whether you are seeking pregnancy.

Seek urgent medical care for very heavy bleeding accompanied by faintness, breathlessness, weakness or severe pain. If you may be pregnant, bleeding with one-sided pelvic pain, shoulder pain, dizziness or collapse needs immediate assessment. These warnings are based on the symptoms and possible pregnancy complications, not on how commonly irregular cycles occur.

Ask whether the bleeding pattern suggests an ovulation or hormonal issue, whether pregnancy and anaemia have been excluded, and whether your prior imaging clearly distinguishes a bicornuate uterus from other shapes. Mention fertility plans because they affect which tests and treatments are appropriate.