Menstrual cycle in PCOS

PCOS can interfere with the regular release of an egg. When ovulation is delayed or absent, the womb lining may continue building before it sheds, which can lead to irregular or heavy bleeding. Some people have long gaps between periods, while others have frequent unpredictable bleeding.

Cycle changes are a presentation of PCOS, but they do not by themselves confirm the diagnosis. Clinicians consider your history, examination and other signs. Irregular ovulation can also make it harder to predict fertile days and may contribute to trouble getting pregnant, although pregnancy can still occur.

Track bleeding dates, flow, pain and medicines, and tell your clinician about periods that have stopped or become very infrequent. Care may focus on protecting the womb lining, regulating bleeding, managing other PCOS features or supporting pregnancy plans. A combined pill may be discussed when suitable, but the choice depends on your medical history and goals.

Book an assessment for persistent irregular periods, repeated missed periods, new heavy bleeding or bleeding between periods. Seek urgent help for severe pain, faintness, marked weakness or bleeding that is rapidly soaking products. If pregnancy is possible, take a test and seek prompt advice for pain or bleeding.

Ask how often you should have a bleed, how the womb lining will be protected, and whether tests are needed for anaemia or other causes. Discuss contraception, pregnancy planning, signs of ovulation and whether a combined pill is appropriate for you.