Irregular periods don’t always mean PCOS: Other common causes you should know

Stress, thyroid issues, weight changes, or post-contraceptive shifts could be behind irregular cycles—not just PCOS. (Image: Pexels)

With an overwhelming amount of information available at our fingertips today, it is easier than ever to make symptom-based connections to a condition. One of the associations most women make is that irregularly timed menstrual cycles lead to the diagnosis of polycystic ovary syndrome (PCOS).

Though this sort of connection is often considered rational, the reality is more complex. There are many other factors that can influence menstrual cycles, and understanding these helps women reclaim control over their reproductive health.

According to Dr. Apurva Satish Amarnath, Fertility Specialist, Nova IVF Fertility, Yelahanka, most of the conditions affecting irregular periods can be treated in many cases, and menstruation will return to regularity after the cause is treated and resolved, says Dr. Apurva Satish Amarnath, Fertility Specialist, Nova IVF Fertility, Yelahanka.

Interwoven hormonal influences govern the menstrual cycle. Temporary disturbances to this hormonal regulation, such as chronic stress, abrupt lifestyle changes, and weight disruption, will hinder cycle regularity, which doesn't mean you have PCOS.

• Stress: This is probably the most common, reversible cause affecting ovulatory hormones, and periods become regular when stress levels drop.
• Weight changes: Weight gain and (less frequently) loss will disturb the hormonal balance governing reproduction. If/when a healthy BMI is achieved and maintained, the complications typically resolve.

Thyroid dysfunction may occur in 1-10 percent of adults according to NCBI (National Center for Biotechnology Information) and women are more prone to thyroid dysfunction.

• Hyperthyroid and hypothyroid: Both these conditions can change menstrual cycles temporarily. Hormone levels come back to normal within a couple of months and the cycles resume normalcy with certain medical treatment.
• Additional symptoms: If the irregular cycles were due to thyroid disease, then other symptoms such as fatigue, temperature insensitivity, and unintentional weight gain or loss would have come as a package.

Changes in your menstrual patterns when you stop hormonal contraceptives might be viewed as irregular (unless you confuse this with PCOS).

• Transition Period: When your natural menstrual cycles are returning back to their normal rhythm, the process can take from three to 12 months, and during that time, these cycles may be irregular or have no definite set pattern. This change is perfectly normal (temporary) and women should not worry or consider it as an illness.

A lot of people can confuse premature ovarian insufficiency with PCOS, but it’s a whole different thing. Premature ovarian insufficiency occurs when ovarian function stops prior to age 40. This will usually cause some missed periods or irregular periods, lower estrogen, and, unlike PCOS, reduced supply of eggs. Timely diagnosis allows for plans for fertility and supporting hormone health.

PCOS diagnosis must include a variety of elements, including:

• Irregular patterns of ovulation
• Hormonal imbalances noted in blood work
• Polycystic-appearing ovaries noted on ultrasound Also Read: Sports injuries in children: How overtraining affects growing bones and joints At least two of the three viewpoints need to be met to confirm a PCOS diagnosis, so that we don't overlook other treatable conditions. Having irregular periods isn't synonymous with PCOS. In most cases, they are either temporary or reversible factors, such as stress, thyroid dysfunction, weight changes, or the aftereffects of stopping contraception.

Knowing what is going on and appropriately assessing it can lead to a regular cycle again and bettering reproductive health.