Reasons for irregular periods

Clinicians look at whether periods are early, late, unusually light or heavy, or absent, and whether the change is new. Anovulation can produce uneven bleeding because the uterine lining is not being regulated by a regular ovulatory cycle. Polycystic ovary syndrome may cause infrequent periods alongside acne or increased hair growth. Perimenopause can create changing intervals as ovarian activity fluctuates. Premature ovarian insufficiency may be considered when periods become infrequent at a younger age. A symptom alone cannot distinguish these possibilities.

Use a calendar or app to note bleeding, spotting, cramps, flow, and any missed cycles. Include recent illness, stress, major exercise or weight changes, medicines, and contraception in your notes. If pregnancy is possible, take a test and tell the clinician the result. Depending on your history, assessment may involve blood tests or an ultrasound. Management is individual: the Combined Pill may be discussed for predictable withdrawal bleeding, while Metformin for PCOS may be considered for selected people. Treatment should follow a personalised review.

Book an appointment when the pattern continues, keeps returning, or comes with pelvic pain, bleeding after sex, unusual discharge, new hair growth, acne, or troublesome tiredness. Get urgent care for bleeding that is rapidly soaking through protection with weakness or faintness, severe pelvic pain, or any bleeding with a possible pregnancy. A period that is late with one-sided pain should be assessed promptly.

What pattern do my symptoms suggest? Which tests are useful now? Could pregnancy, contraception, thyroid problems, or PCOS be involved? How can we manage bleeding while protecting my fertility plans?