Irregular bleeding / periods / menstrual irregularity

Irregular Periods and Menstrual Bleeding: Understanding the Causes and Finding Answers

Your menstrual cycle is often called a “vital sign” — a key indicator of your body’s overall health. So when your periods become unpredictable, unusually light, heavy, or prolonged, it’s important to listen.

Irregular periods are common and can happen for many reasons, especially at different life stages. But if your cycle is becoming a source of stress, pain, or confusion, you don’t have to navigate it alone.

At Happiher, we take menstrual health seriously. As a private gynaecologist in London, I help women find the causes of irregular bleeding — and create personalised treatment plans that respect your health, goals, and peace of mind.

What Is Considered Irregular Bleeding?

Menstrual irregularity covers a wide range of changes to your cycle, including:

• Cycles that are consistently shorter than 21 days or longer than 35 days

• Missed periods (amenorrhoea)

• Bleeding between periods (intermenstrual bleeding)

• Spotting after sex

• Very heavy or prolonged periods

• Unpredictable cycle length each month

Age can also play a significant role, with younger girls and women approaching menopause often experiencing more pronounced irregularities.

Occasional cycle changes can be normal, especially with stress, travel, or minor illness. But persistent irregularities deserve investigation.

Vaginal Bleeding Patterns

Vaginal bleeding is a normal part of the menstrual cycle, with most women experiencing some form of bleeding during their period. The amount and duration of bleeding can vary significantly from woman to woman. Some may experience heavy or prolonged bleeding, while others may have lighter or shorter periods.

Irregular periods, including changes in bleeding patterns, can be caused by various factors such as hormonal imbalances, certain health conditions, or stress. It’s important for women to be aware of their usual bleeding patterns and seek medical attention if they notice any significant changes, such as heavier or lighter bleeding, or bleeding between periods.

Vaginal bleeding can also be a sign of underlying health conditions, such as infections, polyps, or cancers, and should be evaluated by a healthcare provider if persistent or severe. Keeping a diary or tracking the menstrual cycle can help women identify patterns and changes in their bleeding, making it easier to discuss with their doctor. This proactive approach ensures that any potential issues are addressed promptly and effectively.

What Causes Irregular Periods?

There are many potential causes of irregular bleeding, some minor and some requiring more attention. Common causes include:

• Polycystic Ovary Syndrome (PCOS)

• Perimenopause (natural hormonal changes leading to menopause)

• Thyroid disorders (overactive or underactive thyroid)

• Stress (physical, emotional, or mental)

• Significant weight changes (loss or gain)

• Excessive exercise (especially in athletes)

• Hormonal contraception changes (starting, stopping, or adjusting)

• Uterine fibroids or polyps

• Endometriosis or adenomyosis

• Bleeding disorders

• Pregnancy-related issues (early pregnancy bleeding, miscarriage)

• Pelvic infections (such as pelvic inflammatory disease, PID)

• Changes in birth control methods

• Infections (Infections, such as pelvic inflammatory disease (PID), can cause symptoms like abnormal bleeding, pain, or discharge, and should be treated promptly to prevent long-term damage.)

• Missed periods (Missed periods can be due to various factors including stress, lifestyle changes, or pregnancy, and should be discussed with a healthcare provider if they occur frequently.)

A full assessment helps distinguish between temporary disruptions and conditions needing active management.

Health Conditions That Affect Reproductive Health

Various health conditions can affect reproductive health, including endometriosis, fibroids, and polyps, which can cause irregular periods, heavy bleeding, or pelvic pain. Certain health conditions, such as thyroid disorders or polycystic ovary syndrome (PCOS), can also impact hormonal balances and menstrual cycles.

Infections, such as pelvic inflammatory disease (PID), can cause symptoms like abnormal bleeding, pain, or discharge, and should be treated promptly to prevent long-term damage. Women with a history of cancer, such as cervical or uterine cancer, may experience changes in their menstrual cycle or bleeding patterns and should be monitored closely by their healthcare provider.

Breastfeeding can also affect menstrual cycles, with some women experiencing a delay in their period or changes in bleeding patterns while nursing. Regular check-ups with a healthcare provider, including physical examinations and medical history discussions, can help identify and manage health conditions that affect reproductive health. This ensures that women receive proper treatment and care, maintaining their overall well-being.

When Should You See a Gynaecologist?

You should seek specialist advice if you experience:

• Periods that have become suddenly irregular

• Bleeding between periods

• Bleeding after sex

• Very heavy bleeding

• Very light or missed periods not related to pregnancy

• Symptoms like pelvic pain, unusual discharge, or fatigue

If you are experiencing any of these symptoms, it is important to speak with a healthcare provider to determine the underlying cause and appropriate treatment.

Early investigation often means simpler treatment — and peace of mind.

How Are Irregular Periods Diagnosed?

At Happiher, we approach menstrual irregularity with careful, detailed evaluation.

Your assessment may include:

• Medical history and cycle tracking (how long, how heavy, pattern changes)

• Physical examination. This may include a check of the cervix to identify any abnormalities that could be causing irregular bleeding.

• Pelvic ultrasound to check the uterus and ovaries

• Blood tests for hormones (thyroid function, ovarian reserve markers, PCOS screening)

• Pregnancy test if needed

• Endometrial biopsy (sampling womb lining if bleeding is persistent or heavy)

Our goal is not just to find a label, but to understand the full picture — from hormone levels to uterine structure to lifestyle factors.

Treatment Options for Irregular Bleeding

Treatment depends on the underlying cause — and also your personal priorities (e.g., symptom relief, fertility preservation, avoiding hormones if preferred).

Options include: For example, hormonal therapy can be effective for regulating cycles, while surgical options may be necessary for structural problems. Medical treatments, such as cryotherapy for genital warts, can also be considered based on the specific problem.

It is important to address any underlying problems to ensure effective treatment and relief from symptoms.

Lifestyle Adjustments

• Nutritional support

• Stress management techniques

• Exercise moderation

Understanding how these lifestyle changes affect your body can help in managing irregular periods more effectively.

Hormonal Therapy

• Combined oral contraceptive pill to regulate cycles. These methods of birth control can help in maintaining a regular menstrual cycle and managing symptoms of irregular bleeding.

• Progestogen-only therapies

• Hormonal IUS (e.g., Mirena coil) to manage heavy bleeding

Targeted Medical Treatment

• Thyroid medication if thyroid imbalance is the cause

• PCOS-specific management, including weight support and insulin-sensitising agents

These treatments are tailored to address the specific underlying causes of irregular periods.

Surgical Options

• Polyp or fibroid removal if structural problems are present

• Minimally invasive or robotic-assisted techniques for precision and faster recovery

For example, polyp or fibroid removal can be performed using these advanced surgical methods.

At Happiher, Dr Kaur’s expertise in minimally invasive and robotic-assisted surgery ensures the best outcomes with the least disruption whenever surgery is needed.

Living with Irregular Periods

Menstrual irregularity can cause more than just physical symptoms. It can trigger anxiety, affect intimacy, complicate planning, and impact confidence. If you are worried about your irregular periods, it is important to seek help and not let worry affect your quality of life.

You deserve clear answers — and a supportive plan that fits your lifestyle and goals.

At Happiher, menstrual health is treated with the same respect and seriousness as any other aspect of your wellbeing. Your experiences are valid, and help is available.

Why Choose Happiher for Irregular Bleeding Management?

If you’re looking for a specialist for irregular periods in London, Happiher offers:

• Private, compassionate consultations

• Specialist imaging and diagnostic services

• Personalised treatment plans, never one-size-fits-all

• Our team provides helpful practices and guidance to ensure you receive the best care possible.

• Minimally invasive and robotic surgical options

• Locations at Chelsea & Westminster, The Lister, and The Wellington Hospital

We blend advanced expertise with a genuine commitment to your comfort, confidence, and health.

Final Thoughts

Irregular bleeding doesn’t have to be a mystery you live with in silence. With the right care, your cycle — and your life — can feel predictable, manageable, and free again.

At Happiher, we’re here to listen, to diagnose carefully, and to help you find lasting solutions.