Why Women with PCOS Have Irregular Periods

Polycystic Ovary Syndrome (PCOS) is the main cause of ovulatory infertility. One of the classic and key features of PCOS is irregular or absent menstrual cycles. The primary reason many with PCOS have irregular periods is due to a hormonal imbalance.

Here's how PCOS affects your menstrual cycle: every month a follicle matures and gets released by your ovaries to be fertilized. But because of the hormonal imbalance seen in PCOS (typically higher levels of androgens like testosterone and high levels of luteinizing hormone), the follicle doesn't mature or get released. Instead of being released, the follicle (often miscalled a cyst) stays in the ovaries where it can be seen on an ultrasound. High levels of circulating androgens such as testosterone interfere with your menstrual cycle and can prevent ovulation. Without ovulation and the hormonal events that lead up to it, your uterus does not have the stimulation it needs to shed its lining.

Keep in mind that this symptom can be experienced in different ways. Some with PCOS can have regular periods every 28 days, others have periods every 30 to 40 days, and still, others don't have periods at all. While this is a "normal" symptom of PCOS, it is one that needs to be addressed, especially if you are getting fewer than eight or nine periods each year.

When you don't have a regular period, not only can it affect your fertility but it can increase your risk of developing endometrial cancer.

Woman laying in bed with period cramps
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Best Ways to Regulate Your Cycle

There are some very simple ways that you can control your period and ensure that your uterus sheds its lining regularly.

  • Losing Weight: Even losing 5% to 10% of your total body weight can improve the reproductive aspects of PCOS.
  • Taking the Birth Control Pill: Birth control medications can regulate your hormone levels and lower testosterone to give you a more consistent period.
  • Taking Medications Such as Glucophage or Provera: Both of these medications can cause women with PCOS to have a period. Provera is used more in the short run, whereas Glucophage (Metformin) can help on a regular basis.
  • Taking a Combination of Myo and d-Chiro Inositol: Inositol has been shown to reduce testosterone and aid in regulating menstrual cycles as well as promoting ovulation in women with PCOS. 

Of course, you should speak with your healthcare provider before starting to take any medication or supplement. You may not be a good candidate to take a particular medication or your healthcare provider may have a preference for a certain regimen. Don't hesitate to ask your healthcare provider about other alternatives, or why he or she recommends the suggested treatment. And above all, if you feel uncomfortable with the suggested plan, mention it. The regimen needs to be acceptable for both you and the healthcare provider, and with clear communication between both of you, you should be able to find something that works.

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