What should you know about the main cause of irregular periods?

A period comes after hormonal signals prepare the womb and ovulation has occurred. If ovulation is delayed or does not happen, bleeding may arrive early, late, become heavier, or be missed. Anovulation is one explanation, while polycystic ovary syndrome can affect ovulation alongside acne or increased facial hair.

Perimenopause can make cycles less predictable as ovarian hormone patterns change. Premature ovarian insufficiency is another condition clinicians may consider when periods become infrequent or stop earlier than expected. Irregular bleeding can also follow starting or stopping contraception, major stress, illness, or a substantial change in exercise or body weight.

Track the first day of each bleed, how long it lasts, how heavy it is, pain, and any bleeding between periods. Note pregnancy possibility, medicines, contraception, new skin or hair changes, hot flushes, and changes in weight or energy. A clinician may use this history with a pregnancy test, examination, blood tests, or an ultrasound.

Treatment depends on the cause and your goals. A Combined Pill may regulate bleeding for some people, while Metformin for PCOS may be discussed when PCOS and insulin-related features are present. These options need individual review.

Arrange an appointment if irregular periods persist, repeatedly stop, become difficult to manage, or occur with pelvic pain, bleeding after sex, or symptoms such as excess hair growth. Seek urgent help for very heavy bleeding with dizziness or weakness, severe pain, or a possible pregnancy with pain or bleeding.

Ask whether your pattern suggests an ovulation problem, which tests are appropriate, and how pregnancy should be excluded. Ask how treatment would affect fertility, bleeding control, contraception, and any other symptoms.