Irregular Menstruation: Insights on PCOS and Treatment Options

Menstrual irregularities

Hello, doctor.
My period was about three to four days late last month.
I went to see a traditional Chinese medicine doctor and took some medication, after which my period started, but it lasted a long time.
In the following days, there was only a little bit of bleeding, which made me a bit worried, so I visited a gynecology clinic near my school.
The doctor said I have polycystic ovary syndrome (PCOS) but did not explain my symptoms in detail.
He prescribed a medication called Shiton S.C.
tablet, instructing me to take it twice a day.
Because I was very concerned, I went to a larger hospital for further examination last week.
The doctor there said that it was too early to diagnose PCOS and advised me to return after my period this month.
He also told me that I did not need to continue taking the medication prescribed by the previous doctor.
After the visit, my period started two to three days later, but only the first day had a heavier flow, and the next day it became very light.
I looked up the medication prescribed by the previous doctor online, and the information said that menstruation would typically start two to three days after stopping the medication.
However, the flow is so light that it doesn't seem like a normal period.
Should I go back for a follow-up appointment now, or should I wait to see if my period comes next week? I'm concerned that the medication might have an impact.
Thank you, doctor.

Zhuang Xiaojie, 20~29 year old female. Ask Date: 2016/03/15

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if your period is delayed by up to one week, there is usually no need to rush to see a doctor.
However, if you continue to experience menstrual irregularities, it is advisable to visit a hospital and consult with a gynecologist for a blood test.
Wishing you good health.

Reply Date: 2016/03/15

More Info

Irregular menstruation can be a source of concern for many women, and it is often associated with conditions like Polycystic Ovary Syndrome (PCOS). Based on your description, it seems you have experienced a delay in your menstrual cycle, followed by light bleeding after taking medication. Let's break down your situation and provide some insights into PCOS, its symptoms, and potential treatment options.

Understanding PCOS
Polycystic Ovary Syndrome is a hormonal disorder common among women of reproductive age. It is characterized by a combination of symptoms, including irregular menstrual cycles, excess androgen (male hormones), and polycystic ovaries. The exact cause of PCOS is not fully understood, but it is believed to involve a combination of genetic and environmental factors.

Symptoms of PCOS:
1. Irregular Menstrual Cycles: Women with PCOS may experience infrequent or prolonged menstrual periods.

2. Excess Androgen: This can manifest as hirsutism (excess hair growth), acne, and scalp hair thinning.

3. Polycystic Ovaries: An ultrasound may reveal enlarged ovaries with multiple small cysts.

Your Current Situation
You mentioned that your menstrual cycle was delayed by several days, and after taking medication prescribed by a Traditional Chinese Medicine (TCM) practitioner, you experienced some bleeding. However, the bleeding was light and not typical of a regular menstrual flow. The subsequent visit to a gynecologist indicated that a diagnosis of PCOS should not be made hastily, and you were advised to wait until after your next cycle for further evaluation.

Treatment Options
1. Lifestyle Modifications: Weight management through diet and exercise can significantly improve symptoms of PCOS. Even a modest weight loss can help regulate menstrual cycles and improve insulin sensitivity.

2. Medications:
- Hormonal Birth Control: Birth control pills can help regulate menstrual cycles and reduce symptoms like acne and hirsutism.

- Metformin: This medication, commonly used for type 2 diabetes, can improve insulin sensitivity and help restore normal menstrual cycles in women with PCOS.

- Anti-androgens: Medications like spironolactone can help reduce excess hair growth and acne.

3. Monitoring and Follow-Up: Since your gynecologist suggested waiting until after your next menstrual cycle for further evaluation, it is essential to monitor your symptoms. If your menstrual cycle does not normalize or if you continue to experience irregular bleeding, it would be wise to follow up with your healthcare provider.

When to Seek Further Help
If you experience any of the following, it is crucial to seek medical attention:
- Prolonged irregular bleeding or spotting.

- Severe pain or discomfort.

- Symptoms of hormonal imbalance (such as excessive hair growth or severe acne).

- Concerns about fertility or other health issues.

Conclusion
In summary, while your symptoms may suggest a possibility of PCOS, a definitive diagnosis should be made based on a comprehensive evaluation, including your menstrual history, physical examination, and possibly imaging studies. It is advisable to follow your gynecologist's recommendations and monitor your menstrual cycle closely. If you have concerns about the medication you were prescribed or its effects, do not hesitate to discuss these with your healthcare provider. They can provide you with the best advice tailored to your specific situation. Remember, managing PCOS often requires a multifaceted approach, and you are not alone in this journey.

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