What is PCOS-Irregular periods?
Every month, a follicle matures and gets released by the ovaries to be fertilized. This is not the case in PCOS. When ovulation doesn’t occur, it can cause ovulatory infertility. PCOS is the most common cause of ovulatory infertility.
Among its effects, PCOS causes females to have higher levels of androgens like testosterone, and high levels of luteinizing hormone.
Here’s how PCOS affects your menstrual cycle:
- High levels of circulating androgens, such as testosterone , interfere with the menstrual cycle and can prevent ovulation.
- Because of the hormonal imbalance of PCOS, the follicle doesn't mature or get released.
- Instead of being released, the follicle (often miscalled a cyst) stays in the ovaries, where it can be seen on an ultrasound.
- Without ovulation and the hormonal events that lead up to it, the uterus does not have the stimulation it needs to shed its lining leas to irregular periods.
This effect can produce different symptoms. Some people who have PCOS can have, regular periods every 28 days, others have periods every 30 to 40 days, and still, others don’t have periods at all
Normal Menstrual Cycle:
Menstrual Phase
This is the time of your cycle when you have a period, also known as menses. This phase typically lasts 4 to 7 days. When you have a period, your body is shedding the nutrient-rich lining created during the previous cycle from inside your uterus. This occurs when estrogen and progesterone hormone levels decrease and there is no pregnancy.
Follicular Phase (also known as the Pre-ovulatory Phase)
This phase accounts for the first half of the menstrual cycle; beginning on the first day of your period and continuing for 10 to 17 days. At birth, your ovaries contain all the immature eggs you will use during your entire lifespan. Under the control of various hormones following puberty, your brain will send a hormonal signal to the Follicle Stimulating Hormone (FSH) to your ovaries to recruit several follicles to mature each month. We can think of this as a race amongst the follicles as to which follicle will result in a mature egg to be released at the time of ovulation. Each follicle recruited during a cycle contains a single egg. The fastest, healthiest follicle and egg (also known as the dominate follicle) will win the race and release an egg (ovum) at the time of ovulation. The other follicles and eggs that were in the race are then reabsorbed, having lost their chance to fully mature or ever be released. As follicles within the ovary race to mature, changes are also occurring within the lining of your uterus. Increasing amounts of estrogen stimulate a thickening of the lining of the uterus, known as the endometrium. This can be thought of as growing a thick, lush lawn, but instead of a lawn, you’re growing a nutrient-rich uterine lining in preparation to receive a fertilized egg. Estrogen is the fertilizer. The thickened endometrium or “bed of grass” is essential for a fertilized egg (egg + sperm = embryo) to attach or implant into the uterine lining. This is an essential process that occurs in preparation for an embryo (a fertilized egg that will become a fetus) to attach or implant itself in the uterus and continue its development.
Ovulatory Phase
Everything that took place during the Follicular phase has prepared your body for a spectacular series of hormonal events that lead to ovulation. Ovulation occurs mid-cycle in response to a series of hormonal changes that are set off by a peak in estrogen, occurring any day from day 10 to 17 of the Follicular phase. This peak in estrogen triggers a brief surge in Luteinizing Hormone (LH), which triggers ovulation within usually 24 hours and occasionally up to 48 hours. Ovulation is the time when an egg is released from the dominant follicle (winner of the race) within an ovary, into the fallopian tube where it can become fertilized by sperm. This is the only time during the menstrual cycle that a woman can become pregnant. Women planning a pregnancy or using the “rhythm method” to prevent pregnancy often track their cycles using various methods such as body temperature, changes in vaginal secretions, and ovulation kits, also known as LH kits, to achieve pregnancy. If sperm are available, now is their chance! Once an egg is released, the egg is viable for up to 1 day, while sperm can be viable for up to 3 days. This means that the few days leading up to ovulation are the most fertile days of your cycle. With this in mind; conception is most likely to occur when sperm are available a few days prior to or just the following ovulation.
Luteal Phase
This part of the Ovulation Cycle lasts approximately 14 days. In this phase, the dominant hormone of the Follicular Phase estrogen declines, and progesterone levels increase. Estrogen’s job was to fertilize and promote the growth of the uterine lining and now progesterone’s job is to maintain that lining, or continue to “water the grass” so that a fertilized egg can implant or attach itself to the uterus. Progesterone levels are at their peak around 1 week after the LH surge, which coincides with the timing of embryo implantation, only if fertilization of the egg has occurred. The corpus luteum, which is what remains of the follicle in the ovary that released an egg at ovulation, is responsible for the increasing progesterone levels. Human Chorionic Gonadotropin (HCG) is secreted by the embryo and becomes detectable in urine and blood samples approximately 2 weeks following implantation, or 4 to 5 weeks following the first day of your last period. Increased levels of progesterone also signal the ovaries to not produce any more eggs at this time. If a fertilized egg has not attached itself to the uterine lining during the Luteal Phase, then progesterone levels will fall and the corpus luteum is reabsorbed a few days before your period starts. At the same time, the brain begins hormonal signaling all over again to prepare the next batch of follicles for their race to ovulation! An Ovulatory Cycle, better known as your Menstrual Cycle, begins again! Menstrual cycles are normally anywhere from 24 to 35 days, with an average cycle of 28-30 days This bleeding typically lasts about five days. Then, the monthly cycle repeats itself.
But some women have what is called abnormal uterine bleeding — another term for irregular periods — which can happen for a variety of reasons, from stress and lifestyle factors
Symptoms of a PCOS-Irregular periods
Hormonal imbalance can have the worst effect on the body as it can increase the number of health issues and diseases. The symptoms are:
You haven’t had a period for 90 days
Your period suddenly becomes irregular
You have a period more often than every 21 days
You have a period less often than every 35 days
Your period lasts for more than a week
Your period becomes unusually heavy
You bleed between periods
Your periods are extremely painful
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