Menopause and irregular periods

As the ovaries become less consistent in releasing an egg, a period may come earlier, later, or be missed. Flow can vary too. Irregular periods can also occur with stress, weight change, thyroid disease, [Polycystic Ovary Syndrome](/conditions/polycystic-ovary-syndrome/), [Anovulation](/conditions/anovulation/), some medicines, or [Premature Ovarian Insufficiency](/conditions/premature-ovarian-insufficiency/).

[Perimenopause](/conditions/perimenopause/) is a possible explanation, not a diagnosis based on cycle timing alone. Pregnancy remains possible while periods continue, even when cycles are unpredictable.

Keep a calendar of bleeding dates, flow, pain, and symptoms such as hot flushes. Take a pregnancy test when relevant and arrange a review for a new or persistent pattern, troublesome bleeding, or symptoms of anaemia. Bring your medication list and note contraception use.

A clinician can decide whether examination or tests are needed. Treatment depends on the cause and goals; options may include the [Combined Pill](/treatments/contraception-and-family-planning/combined-pill/) or [Metformin for PCOS](/treatments/medical-gynaecology/metformin-for-pcos/) when clinically suitable.

Seek urgent help for very heavy bleeding, severe pelvic pain, fainting, or possible pregnancy with pain or bleeding. Arrange prompt review for bleeding after periods have stopped, bleeding between periods, or cycles that remain markedly different. Seek earlier advice if dizziness, breathlessness, or unusual tiredness develops.

Ask whether your pattern fits perimenopause, whether pregnancy or another condition should be excluded, and which tests are useful. Ask about contraception, symptom relief, and what bleeding changes require urgent contact.