Reasons for irregular menstruation

A cycle may be irregular when bleeding comes earlier or later than expected, lasts a different length, or is missed. Anovulation means an egg is not released during a cycle and can make bleeding unpredictable. Polycystic ovary syndrome may affect ovulation and can also occur with acne or increased facial hair. Perimenopause can alter bleeding patterns as ovarian hormone production changes. Premature ovarian insufficiency is another condition clinicians may consider when periods become infrequent or stop earlier than expected. These symptoms do not identify one cause on their own.

Record the first day of each bleed, how long it lasts, how heavy it feels, pain, medicines, contraception, and related symptoms. A clinician may ask about pregnancy possibility, recent stress, weight or exercise changes, thyroid symptoms, and breastfeeding. Assessment can include a pregnancy test, examination, blood tests, or imaging when indicated. Treatment depends on the cause and your goals; options may include the Combined Pill for cycle control or Metformin for PCOS when clinically suitable. Do not start or stop hormonal treatment without advice.

Arrange a medical review if irregular bleeding persists, repeatedly disrupts daily life, follows previously predictable cycles, or occurs with new acne, excess hair growth, pelvic pain, or symptoms of low iron such as marked tiredness. Seek urgent help for very heavy bleeding with dizziness or faintness, severe or one-sided pelvic pain, or bleeding during a possible pregnancy. A missed period with pain needs prompt assessment because pregnancy-related problems require timely care.

What causes fit my cycle pattern and other symptoms? Do I need a pregnancy test, blood tests, or an ultrasound? Could my contraception be affecting the bleeding? What treatment matches my plans for pregnancy and symptom relief?