Irregular bleeding / periods / menstrual irregularity

Irregular Periods and Menstrual Bleeding: What’s Going On?

Your period is often called a “vital sign” — a key indicator of your overall health. So when your periods become irregular, light, heavy or long, listen up.

Irregular periods are common and can happen at any stage of life. But if your cycle is causing you stress, pain or confusion, you don’t have to go it alone.

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

What Is Irregular Bleeding?

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

• Cycles under 21 days or over 35 days

• Missed periods (amenorrhoea)

• Bleeding between periods (intermenstrual bleeding)

• Spotting after sex

• Very heavy or long periods

• Unpredictable cycle length each month

Age also plays a part, with younger girls and women approaching menopause often experiencing more pronounced irregularities.

Occasional cycle changes are normal, especially with stress, travel or minor illness. But persistent irregularities need investigating.

Vaginal Bleeding Patterns

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

Irregular periods, including changes in bleeding patterns, can be caused by hormonal imbalances, certain health conditions or stress. Women should 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 your cycle can help you identify patterns and changes in your bleeding, making it easier to discuss with your doctor. This proactive approach means any issues are addressed quickly and effectively.

What causes irregular periods?There are many causes of irregular bleeding, some minor and some more serious. Common causes include:

• PCOS

• Perimenopause

• 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 to distinguish between temporary disruptions and conditions that need 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, some women may experience 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 means women receive proper treatment and care and maintain their overall well being.

When should you see a gynaecologist?* 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 you should speak with a healthcare provider to determine the underlying cause and treatment.

Early investigation 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)

We don’t just want to find a label, we want 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.

You need 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 you manage irregular periods better.

Hormonal therapy

• Combined oral contraceptive pill to regulate cycles. These methods of birth control can help maintain a regular menstrual cycle and manage 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 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 done with these advanced surgical methods.

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

Living with irregular periods

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

You deserve clear answers — and a 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, confidential consultations

• Specialist imaging and diagnostic services

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

• Our team provide helpful practices and guidance so you get the best care.

• Minimally invasive and robotic surgical options

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

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

Conclusion

Irregular bleeding doesn’t have to be a secret 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.