Irregular Periods/Secondary Amenorrhoea

What are irregular periods?

An average menstrual cycle lasts approximately 28 days, although most women have menstrual cycles that vary and can range from slightly longer to slightly shorter than the stipulated average.

Menstrual cycles are temperamental at times. While some women may notice the gap between the end of their last periods and the start of their next period constantly changing, others may have missing or infrequent menses. 

There are two types of irregular periods, these are:


Amenorrhoea, also known as the absence of menses and can be further categorised into:

Oligomenorrhoea, also known as infrequent irregular menses and is defined by fewer than 6-8 periods per year.

 irregular periods
Irregular or absent periods can be a sign of underlying medical conditions.

What are the symptoms of irregular periods?

Women with irregular periods may experience the following symptoms:

If you are experiencing any of the above symptoms, you are advised to consult your doctor to evaluate your symptoms further.

What causes irregular periods?

Irregular periods can be normal in some women. However, for others, there may be underlying medical conditions that require intervention/attention to re-establish a normal period cycle.

Below are some common medical causes of irregular or ceasing of periods: 

Be honest and open when sharing your medical history with your doctor. This will help him/her come to the most accurate diagnosis with regards to your irregular periods.

absent periods
Irregular periods can be regular again for some women if the underlying cause is treated.

When should I see a doctor for irregular periods? Should I be worried if I have irregular periods?

You are advised to seek medical attention if your period:

How are irregular periods diagnosed?

Irregular periods and the underlying cause(s) can be diagnosed with clinical history and physical examination which involves a full body examination including abdominal and pelvic examinations. 

Depending on your condition, you may be required to undergo the following:

For sexually active patients, a pregnancy test will be offered. Depending on individual cases, further investigations such as blood tests, hormonal tests, ultrasound of the pelvis, MRI of the brain, and genetic testing may also be advised or conducted. 

pap smear
Pap smears can be used to identify underlying medical reasons for irregular periods.

What are the treatment options for irregular periods?

The goal of treatment is to treat the underlying condition and restore fertility in women who are in the reproductive phase of their life. How can we make irregular periods regular? This depends on the cause of the irregular periods. 

Let’s take a look at some general treatment options for irregular periods:

Do speak to your doctor for further understanding on individual treatment and management of your irregular periods.

What is a healthy diet and lifestyle for irregular periods?

You are advised to consider moderate exercise; some women can restore a regular menstrual cycle with healthy moderate exercise. Exercises such as yoga, have also been clinically proven to alleviate premenstrual syndrome (PMS) symptoms as there is an increase in the production of endorphin and serotonin, commonly known as the ‘happy’ hormones.

In terms of diet, a healthy balanced diet, high in fibre, omega-3 fatty acids, calcium, and vitamin D is also important. Fatty meals high in saturated fats, salt, carbohydrates, and caffeine should be reduced or avoided.

You are encouraged to discuss your daily lifestyle when sharing your concerns regarding irregular periods with your doctor. 

healthy lifestyle
Healthy lifestyle choices can improve your life in more ways than one, from regulating your menstrual cycle to improving your overall wellbeing.

Can I get pregnant if I have irregular periods?

Some women with irregular periods may have difficulty in getting pregnant as they may not ovulate regularly. Hence, it is good practice to speak to your doctor if your menstrual cycle is abnormal.

Depending on individual medical circumstances, your doctor may advise hormonal medication or fertility treatment to facilitate the process of conceiving naturally.

Are irregular periods normal?

Some women may notice their period irregularity since young/puberty— this can be normal. Occasionally, period cycles may also become irregular due to stress, lifestyle changes, medical conditions, illnesses, vaccinations, etc.

You are encouraged to discuss your symptoms with your doctor so that he/she can come up with a concerted plan to screen for any underlying medical issues that may be the cause of your irregular periods and manage accordingly.

Polycystic Ovarian Syndrome (PCOS)

What is Polycystic Ovarian Syndrome?

In a healthy menstrual cycle, the reproductive hormones induce the ovaries to make the egg and release it every month. In PCOS, due to the imbalance of the hormones, the egg may not be developed, and even if it is developed, it may not be released during ovulation each month.

PCOS is a common condition that affects 10% of women of childbearing age. PCOS causes missed or irregular menstrual periods. Irregular periods in women can lead to:

What causes PCOS?

Hormonal imbalance of the reproductive system

High levels of androgen. Androgen is a male hormone that is responsible for the development of male traits, such as being more masculine, having more hair, acne, male-pattern baldness. In the reproductive organs, when the level of androgen is high in females, this can prevent the ovaries from releasing the egg during the menstrual cycle.

PCOS is associated with diabetes and insulin resistance. Insulin is a hormone that controls the carbohydrate and sugar in your body and turns them into energy. In insulin resistance circumstances, the body is not able to respond to insulin, leading to a high level of sugar in the body, which is termed diabetes mellitus.

Symptoms of PCOS include:

Irregular or absence of menstrual cycle

What are other health conditions associated with PCOS?

What do I expect during my consultation with my doctor?

Your doctor will take a relevant, thorough medical history, and a physical examination of your face, hair, chest back, abdomen, and pelvis. Other physical examinations include measuring your blood pressure, body mass index (BMI), and waist size. You will be offered hormonal blood tests and ultrasound of the pelvis to evaluate further your reproductive organs.

How is PCOS treated?

Although there is no cure, there are treatment options to manage PCOS. The goal of management is to manage your symptoms, restore and increase the chance of fertility in childbearing ladies, and manage risks of long term health issues such as diabetes and heart disease.

Leading a healthy lifestyle and eating a normal healthy balanced diet is crucial in PCOS ladies. A reduction of 5% of body weight has been shown to increase fertility chance and to restore spontaneous ovulation in some women.

In ladies who are not planning pregnancy, hormonal birth controls in the form of pills, patches, shot, vaginal rings, or intrauterine hormonal devices are used to regulate the menstrual cycle, reduce the risk of endometrial cancer, improves acne and reduce excessive hair in the face and body.

A medication known as metformin may be recommended in those with insulin resistance and diabetes. Interestingly metformin also lowers the androgen levels in ladies with PCOS, and aid in restoring ovulation.

Speak to your doctor for further advice, as every lady has different needs and concerns, and your treatment is likely individualized to yourself.

Can I still become pregnant if I have PCOS?

Yes. Although PCOS is a common cause of infertility in women, thankfully often, it is treatable. Your doctor can discuss ways to help you to ovulate and increase your chance of becoming pregnant.