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Why does PCOS cause irregular periods and intermenstrual bleeding?

Endocrinology Gynaecology

Hi doctor, why does PCOS cause irregular periods and intermenstrual bleeding?

DOCTOR’S ANSWER (1)

Regular menstrual periods are associated with regular ovulatory cycles. You have a period 14 days after you ovulate. For example, if your period comes every 28 days, you ovulate on day 14. If your period comes every 30 days, you ovulate on day 16. Many women with PCOS don't ovulate regularly, hence they have irregular periods. 

Ovarian hyperandrogenism (excess male hormone coming from the ovary) is often seen in PCOS and leads to irregular periods. This is driven by obesity and insulin resistance. Hence, weight loss and medications to improve insulin sensitivity (Metformin) can help improve cycling of the periods.
 
Women with PCOS are oestrogen replete. When exposed to oestrogen, the womb lining builds up and if you don't have a period for a long while, it can build up excessively, increasing the risk of womb cancer. Hence, it is recommended to have at least 6 periods a year so you ensure regular "shedding" of the womb lining.
 
Abnormal bleeding, especially in women with PCOS who have fewer periods, may signify abnormal lining of the womb and an ultrasound scan would be warranted. Other causes of intermenstrual bleeding include the use of the oral contraceptive pill, fibroids, polyps etc. 
 
If you have abnormal or intermenstrual bleeding, I would suggest that you see your gynecologist for a review. If you're having symptoms of PCOS or concerns about it, I would suggest seeing an endocrinologist or a gynecologist for a review. 
414 views 14 Aug 2018
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