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Gynecology Services


Irregular Menses & Polycystic Ovarian Syndrome


Irregular Menses and Polycystic Ovarian Syndrome*

Abnormal uterine bleeding is one of the most common reasons women see their health care provider. It can occur at any age and has many causes. Some are easiily treated while others are more serious. Finding the cause is the first step in treamtent.

The normal menstrual cycle contains two hormones, progesterone and estrogen, which are made by the ovaries. Each month these hormones cause the endometrium to grow in preparation for a possible pregnancy. About 12-14 days before the start of a period, an egg is released from the ovary. This is called ovulation. The egg travels down the fallopian tubes where it can be fertilized by sperm. If it is not and pregnancy does not occur, the levels of hormones decrease and signal the uterus to shed its lining. This shedding is the menstrual period. In most women, this cycle lasts about 28 days but cycles that are 7 days shorter or longer are considered normal. 

Bleeding in any of the following situations is abnormal:

  • Bleeding between periods
  • Bleeding after sex
  • Spotting anytime in the menstrual cycle
  • Bleeding heavier or for more days than normal
  • Bleeding after menopause

Causes of abnormal bleeding:

  • Hormone imbalance
  • Pregnancy
  • Miscarriage
  • Ectopic pregnancy
  • Polycystic Ovarian Syndrome
  • IUD or birth control
  • Fibroids
  • Polyps
  • Cancers

 Depending on your history and physical exam findings, treatment options will be discussed. If you are having abnormal bleeding see your health care provider. There can be a number of things causing abnormal bleeding and there is no way to tell until you have an examination. Once the cause is found it can often be treated with success.

Polycystic Ovarian Syndrome (PCOS)

PCOS is a disorder that results from abnormal levels of certain hormones. Many women are born with the condition, but symptoms may not occur until later in life. In a typical menstrual cycle, only enough hormones are made for one ovary to make a follicle which will then release an egg to be fertilized by sperm each month. In a polycystic ovary, there are many follicles but they do not mature and an egg is not released. Because eggs are not released, progesterone levels are too low and androgen and estrogen levels are too high. This may cause irregular periods and other symptoms of PCOS. Also, many women with PCOS produce too much insulin or the insulin they do produce doesn't work correctly. This is one reason why women with PCOS tend to gain weight or have a hard time losing weight.

Signs and Symptoms:

  • Excess hair on the face and body
  • Acne
  • Darkened color and change in texture of the skin along the neck and armpits
  • Obesity
  • Irregular menstrual periods or no periods
  • Trouble getting pregnant
  • Hair loss
  • Vaginal Yeast Infections

To diagnose PCOS an ultrasound can be done to look at the ovaries and to check the lining of the uterus to see if it is thickened.

Treatment is a lifelong process with the main goal of lifestyle changes. Weight loss will help lower the insulin level enough to allow ovulation to begin and may help relieve the other symptoms of PCOS such as hair loss. Your health care provider can also use birth control pills to help regulate menstrual periods.

With proper treatment, PCOS can be managed and symptoms can be relieved. You should have long-term health care to look for other disorders that may arise.

*All information was provided by ACOG

Click here for more information (American College of Obstetricians and Gynecologists)