PCOS & Menstrual Health: How PCOS Impacts Your Cycle

Have you ever felt like your period has a mind of its own? One month it’s missing in action, then the next it shows up unannounced and way heavier than usual. If that sounds familiar, you’re not alone. Polycystic ovary syndrome (PCOS) could be the reason your menstrual cycle doesn’t run like clockwork.

For example: A 16-year-old could go three months without a period, only to have two in one month. When her doctor mentioned PCOS, her erratic cycle suddenly made sense. The best part? It’s not “just in your head.” PCOS is actually pretty common, affecting an estimated 6–13% of people with ovaries (and up to 70% don’t even know they have it!).

Let’s decode how PCOS impacts your period, and how you can work with your body to feel more in control.

What Is PCOS (and Why Does It Mess with Periods) 🤔?

PCOS is a hormonal imbalance that often starts in the teen years. In simple terms, it means the body produces higher-than-normal levels of androgens and this throws off the reproductive hormone rhythm. Doctors call this hyperandrogenism, which just means excess hormones like testosterone.

What does that do? Well, high androgen levels can prevent ovulation (the release of an egg), leading to very irregular menstrual cycles. Without ovulation, the usual hormone signals that trigger a period are disrupted. Good to know: anovulation is the medical term for missed ovulation, i.e. when your body skips releasing an egg. In fact, PCOS is the most common cause of chronic anovulation and a leading cause of infertility worldwide! 😱😱

When ovulation doesn’t occur regularly, your uterus doesn’t get the memo to shed its lining on a normal schedule. Periods may become few and far between, or show up after long gaps. According to the Mayo Clinic, if you have PCOS “you may not have periods very often – or you may have periods that last many days”. Some cycles might be ultra light; others can be prolonged and heavy once the body finally decides to shed that built-up lining. It’s no wonder people with PCOS often say their menstruation is unpredictable!

Menstrual Irregularities with PCOS: The New “Normal”

Every person’s experience is a bit different, but PCOS commonly causes menstrual irregularities like these:

💡Infrequent periods:
You might have far fewer periods in a year than average. Many with PCOS have fewer than 9 periods per year, or cycles longer than 35 days.

💡Unpredictable timing:
Your cycle might not follow any set pattern – skipping months, then coming twice in a row. Missed ovulation often means you can’t predict when (or if) your next period will happen.

💡Long or prolonged periods:
When your period does come, it can last longer than usual or be unusually heavy. Going months without a period can cause the uterine lining to build up, so the next period can be heavier or more intense.

💡Absent periods:
Some people with PCOS stop getting periods for a while (amenorrhea). Others might just spot on and off. PCOS can cause “intermittent, unpredictable or absent periods,” as noted by the WHO. In a future blog, we will go more in depth about this topic and why this is crucial for women’s health.

It’s not just the timing. PCOS-related hormone imbalances can bring other symptoms too: acne breakouts, scalp hair thinning, or extra hair in places you don’t want (hello, chin hairs) due to those androgen levels. You might also experience weight fluctuations or trouble managing weight, which in turn can affect your cycle. All of this can be frustrating and emotionally draining, and that’s completely valid.

Working With Your PCOS Cycle (Instead of Fighting It) 🥊💥

Here’s the empowering part: understanding what’s happening in your body means you can start to working with it. PCOS may not give you a tidy 28-day cycle, but there are ways to find a healthier rhythm:

🌟 Track your unique pattern

Even if your periods are irregular, tracking symptoms can reveal insights. Note when (if) you bleed, but also track moods, energy, cervical mucus, or cramps. You might discover small patterns (for example, feeling extra bloated or moody during times when you would be ovulating). This kind of body awareness is the first step in regaining a sense of control. Hot tip: Keeping a simple journal could help you see that your body still had some rhythm, just on “PCOS time”.

🌟 Lifestyle tweaks for hormone balance

There’s truth to the saying “food is medicine.” Balancing blood sugar and insulin can improve hormone balance in PCOS. Focus on nutrient-dense foods and a good mix of protein, healthy fats, and fiber to support steady energy and hormones. By the way, if you need ideas check out our guide on building a PCOS-friendly plate for hormone balance and steady insulin levels. Regular physical activity (even daily walks) can also help regulate insulin and may promote more regular ovulation over time. And don’t forget stress management – chronic stress can worsen hormone imbalance, so self-care routines like yoga, meditation, or simply getting enough sleep can make a difference. 💕

🌟 Medical support when needed

Every body is different, and it’s absolutely OK to seek medical help. Doctors might prescribe hormonal birth control to help regulate your cycle (the pill can ensure a regular monthly period and lower androgen levels). They may also recommend medications like metformin to address insulin resistance, or fertility medications if you’re trying to conceive. There’s no one-size-fits-all – it’s about finding what works for you. Don’t hesitate to talk to a healthcare provider about bothersome symptoms or if you’re trying to regulate your periods.

🌟 Lean on period-friendly products

Since PCOS periods can be unpredictable, it helps to have period gear that’s ready for anything. Many with PCOS carry a tampon or pad at all times, just in case. Another game-changer is period underwear – no more panic about surprise leaks. And don’t underestimate the power of comfort! For example, try our Relief Cotton Shortie Period Underwear for cloudlike softness and leak-proof protection on those days you’re not sure if your period will hit. Or on heavy flow days, a high-absorbency style like the Relief Feel Nothing Bikini offers breathable, worry-free coverage (so you can go about your day without fear of leaks). It’s all about finding tools that make you feel secure and supported.

Embrace Your Rhythm 🥁

PCOS can make your menstrual cycle feel like a rollercoaster, but knowledge is power. The more you understand why your body is doing what it’s doing, the more you can respond with patience and healthy habits. Remember, your body isn’t “broken” – it’s responding to a specific hormonal pattern. With tracking, self-care, and the right support, you can find stability even within an irregular cycle. Jess, our example friend, eventually learned to anticipate her own version of a cycle: she noticed subtle signs when a period was likely on its way, started nourishing herself accordingly, and kept comfy period undies on hand for surprises.

You’ve got this. PCOS might change the cadence of your cycle, but it doesn’t change who you are. By working with your body’s unique rhythm – feeding it well, moving it kindly, and getting help when needed – you’re in a partnership with your hormones, not at war with them. Every small step, from a balanced breakfast to a ten-minute walk or swapping in hormone-friendly products, is a step toward a more empowered you. Your cycle, PCOS and all, is yours – and you can still own it. 💪❤️

Also read: Relief Wear - Top 8 Natural Tips to Manage Your Menstrual Cycle (for cycle care tricks that anyone can try!)