When Your Period Isn't Regular
A "normal" menstrual cycle ranges from 21 to 35 days, with periods lasting 3-7 days. If your cycles are consistently shorter, longer, unpredictable, or absent, something may need attention.
Irregular periods are one of the most common reasons women visit a gynaecologist, and in many cases, the underlying cause is treatable.
What Counts as Irregular?
| Pattern | What It Might Mean |
|---|---|
| Cycles shorter than 21 days | Hormonal imbalance, thyroid issues, perimenopause |
| Cycles longer than 35 days | PCOS, thyroid dysfunction, stress |
| Missed periods (not pregnant) | PCOS, excessive exercise, low body weight, stress |
| Very heavy periods | Fibroids, endometriosis, clotting disorders |
| Bleeding between periods | Polyps, hormonal changes, infection |
| Painful periods (severe) | Endometriosis, adenomyosis, fibroids |
Understanding PCOS
Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder in women of reproductive age, affecting an estimated 8-13% of women globally. In the Middle East, rates may be even higher due to genetic and lifestyle factors.
The three hallmarks of PCOS:
- Irregular or absent periods, Ovulation doesn't occur regularly
- Excess androgens, Higher-than-normal levels of "male" hormones, causing acne, excess hair growth, or hair thinning
- Polycystic ovaries, Multiple small follicles visible on ultrasound (though not all women with PCOS have this)
You need two of these three criteria for a diagnosis.
PCOS Symptoms
- Irregular, infrequent, or absent periods
- Acne, especially along the jawline and chin
- Excess facial or body hair (hirsutism)
- Hair thinning on the scalp
- Weight gain, especially around the abdomen
- Difficulty losing weight
- Darkened skin patches (neck, armpits, groin)
- Difficulty getting pregnant
- Mood changes, anxiety, or depression