Bleeding and irregular periods

Cycles can vary when ovulation is inconsistent, during perimenopause, with polycystic ovary syndrome, after changes in hormonal contraception, or because of conditions affecting the cervix or uterus. Pregnancy-related bleeding must also be considered when pregnancy is possible.

Irregularity may involve periods arriving unpredictably, bleeding between periods, a changing flow, or bleeding after sex. Anovulation can present with widely spaced or unpredictable bleeding because the womb lining is not exposed to the usual sequence of cycle hormones. Polycystic ovary syndrome can present with irregular periods alongside signs such as increased facial or body hair or acne.

Perimenopause can present with cycle changes as ovarian hormone production becomes less predictable. Premature ovarian insufficiency can present with periods becoming irregular or stopping before the expected age of menopause, sometimes with hot flushes or vaginal dryness. None of these patterns can confirm a condition without assessment.

Keep a calendar of bleeding days, flow, clots, pain, bleeding after sex, and medicines or contraception. If pregnancy is possible, take a home pregnancy test and seek advice about any positive result with bleeding. Mention pelvic pain, unusual discharge, weight change, acne, hair growth, hot flushes, and whether you are trying to conceive.

A clinician may discuss your cycle history, check for anaemia or hormonal contributors with blood tests, examine the pelvis, or arrange imaging. Treatment depends on the cause and your priorities. Options may include managing an underlying condition or using hormonal contraception to regulate bleeding when medically suitable.

Obtain emergency care for bleeding that is soaking through pads rapidly, severe or one-sided pelvic pain, fainting, marked dizziness, breathlessness, weakness, or bleeding during pregnancy with significant pain. Urgency comes from these warning signs, not from guessing which diagnosis is most likely.

Arrange a prompt appointment if bleeding repeatedly occurs between periods or after sex, periods have stopped and bleeding returns, the pattern continues to disrupt daily life, or you develop tiredness and reduced exercise tolerance that could reflect anaemia.

Ask what causes fit your bleeding pattern, whether pregnancy testing, blood tests, cervical assessment, or ultrasound is appropriate, and how treatment might affect contraception or fertility plans. Clarify what change in flow, pain, or general wellbeing should trigger urgent care.