What should you know about irregular and long periods?

A cycle may become irregular when ovulation does not happen consistently, during the transition towards menopause, or with hormonal conditions such as polycystic ovary syndrome. Premature ovarian insufficiency can also alter bleeding patterns. Some people have long or unpredictable bleeding after starting, stopping, or changing contraception. Pregnancy and conditions affecting the uterus must be considered when bleeding is unusual for you.

The clinician may ask about cycle dates, bleeding volume, clots, pain, discharge, pregnancy possibility, medicines, weight changes, stress, and symptoms such as acne or increased facial hair. Examination, pregnancy testing, blood tests, or ultrasound may be suggested according to your history.

Record the first and last day of each bleed, spotting between periods, pain, clots, and any missed cycles. Note whether bleeding affects sleep, work, exercise, or sexual activity. Arrange a medical review if the pattern persists, returns after being settled, or is accompanied by pelvic pain, unusual discharge, or symptoms of anaemia. Do not start hormonal treatment or metformin without an assessment of the cause.

You can read about [Irregular Periods](/symptoms/irregular-periods/), [Anovulation](/conditions/anovulation/), and [Polycystic Ovary Syndrome](/conditions/polycystic-ovary-syndrome/).

Seek urgent care if bleeding is soaking through protection repeatedly, you feel faint or unusually weak, have severe or one-sided pelvic pain, or could be pregnant. Emergency assessment is also needed for chest pain, severe breathlessness, or collapse. Arrange prompt review for bleeding after menopause, bleeding after sex, or a new persistent change in your usual cycle.

What causes should we consider from my bleeding pattern and other symptoms? Do I need a pregnancy test, blood tests, or an ultrasound? Which treatments might help, such as the combined pill or metformin for PCOS, and how would they affect fertility or future pregnancy plans?