Irregular Periods: Causes, Tests and When to See a Gynaecologist in Gurgaon — By Dr. Chetna Jain

Few things worry women more than a period that does not arrive when expected, or one that arrives too early, too late, or not at all. Irregular periods are among the most common reasons women visit my clinic in Gurgaon. The good news is that most causes are identifiable and treatable. The important thing is not to ignore a pattern that has changed.

I am Dr. Chetna Jain, a senior gynaecologist and obstetrician in Gurgaon. In this guide I explain what counts as irregular, what commonly causes it, which tests help find the reason, and when you should see a doctor.

What Is a Normal Menstrual Cycle?

Cycle length is counted from the first day of one period to the first day of the next. In adult women a typical cycle is 21 to 35 days, and bleeding usually lasts two to seven days. In the first few years after periods begin, cycles can be longer and more variable, and that is often normal.

Your periods are considered irregular if:

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

• The gap between cycles varies widely from month to month

• You miss three or more periods in a row without being pregnant

• Bleeding is unusually heavy, unusually light, or lasts more than seven days

• You bleed between periods or after intercourse

Common Causes of Irregular Periods

PCOS / PMOS

Polycystic ovary syndrome, now also called PMOS, is one of the most common causes in women of reproductive age. Ovulation becomes infrequent or absent, so periods become unpredictable or stop. It is often accompanied by acne, excess facial or body hair, scalp hair thinning and weight gain, and it is linked to insulin resistance.

Thyroid disorders

Both an underactive and an overactive thyroid can disturb the cycle. Thyroid problems are common and easily checked with a simple blood test.

High prolactin

Prolactin is a hormone that, when raised, can suppress ovulation and stop periods. It can be caused by medication, stress or, less often, a small benign pituitary growth, and it is treatable.

Stress, weight change and over-exercise

Significant weight loss or gain, very intense training, restrictive dieting and prolonged stress can all switch off ovulation. Periods often return once the underlying factor is addressed.

Perimenopause and early ovarian decline

From the late thirties or forties, cycles often become irregular as ovulation becomes less predictable. If periods become irregular or stop before 40, this needs evaluation for premature ovarian insufficiency.

Contraceptives and other medicines

Hormonal contraceptives, emergency contraception and some other medicines can change your pattern, both while using them and after stopping.

Pregnancy and structural causes

A missed period should always prompt a pregnancy test first. Uterine polyps, fibroids and other structural problems can cause irregular or heavy bleeding, and are found on ultrasound.

How Irregular Periods Are Investigated

Finding the cause starts with a careful history of your cycle pattern, weight changes, stress, medicines and symptoms, followed by an examination. Depending on what I find, tests may include:

• Urine or blood pregnancy test

• Thyroid function (TSH) and prolactin

• Hormone profile such as FSH, LH, testosterone and AMH, when indicated

• Fasting glucose or HbA1c and a lipid profile, if PCOS/PMOS is suspected

• Haemoglobin and iron levels, particularly with heavy bleeding

• Pelvic ultrasound to assess the uterus, lining and ovaries

An ultrasound alone does not diagnose PCOS/PMOS. The diagnosis depends on your symptoms, hormones and cycle pattern together.

Treatment Depends on the Cause

There is no single treatment for irregular periods because there is no single cause. Thyroid problems are corrected with thyroid medication. High prolactin is treated with medicines that lower it. For PCOS/PMOS, the foundation is lifestyle change, with medication to regulate cycles or improve insulin sensitivity where appropriate, and ovulation induction if you are trying to conceive. Stress-, weight- and exercise-related irregularity usually improves when those factors are addressed. Polyps and fibroids may need minimally invasive treatment if they are causing problems.

Please avoid starting hormonal pills on your own just to bring on a period. That can hide the real cause and delay the right treatment.

When Should You See a Gynaecologist?

Book a consultation if:

• You have missed three periods in a row and are not pregnant

• Your cycles are consistently shorter than 21 or longer than 35 days

• Your periods suddenly changed after being regular

• You soak a pad or tampon every hour, or bleeding lasts more than seven days

• You bleed between periods, after sex, or after menopause

• You have severe pain, or you are trying to conceive and your cycles are unpredictable

Seek urgent care if heavy bleeding comes with dizziness or fainting, or if you have severe one-sided pelvic pain, particularly if you could be pregnant.

Frequently Asked Questions

Is it normal to have an irregular period occasionally?

An occasional late or early period, for example after illness, travel, stress or a change in routine, is common and usually not a concern. A pattern that persists for three months or more deserves evaluation.

Can irregular periods affect fertility?

They can, because irregular cycles often mean irregular ovulation. Many causes are treatable, and a lot of women conceive once the underlying issue is managed. If you are trying to conceive, do not wait a year before getting checked.

Can irregular periods be cured?

Many causes can be corrected or well controlled. Conditions such as PCOS/PMOS are long-term but manageable, and cycles often become much more regular with the right plan.

Book Your Consultation in Gurgaon

If your periods have become unpredictable, you do not have to wait and wonder. I see women from Palam Vihar, DLF, South City, Sector 22, Sector 23 and across NCR. Please book an appointment through this website so we can find the cause and build a plan that fits you.

Your cycle is a vital sign. When it changes, it is worth listening.

Dr. Chetna Jain | Senior Gynaecologist & Obstetrician | Gurgaon, Haryana