Beyond the Flow: Understanding PCOS Bleeding

Amoha Jha
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Dr. Kaushal

Review medical content on WOW Rx Pharmacy, so that accurate drug use information is easily accessible to everybody.
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pcos bleeding

Bleeding is a normal thing that happens to a woman during her menstrual cycle.

But several conditions, like Polycystic Ovary Syndrome (PCOS), can hinder the smooth menstrual flow.

Some women may have elongated and heavy periods, while others may have little to no bleeding during menstruation.

There are also many other types of PCOS bleeding.

Understanding these distinct bleeding patterns can help women navigate the challenges and seek appropriate management strategies.

This article will discuss the different types of bleeding during your menstrual cycle due to PCOS.

Approximately 75-85% of women with PCOS will have clinically evident menstrual dysfunction.


FatigueSource: marchenko_family

Menorrhagia refers to excessive or prolonged menstrual bleeding. 

Women with PCOS often experience heavy flow and extended periods, significantly impacting their quality of life. 

Hormonal imbalances primarily cause Menorrhagia, which can be seen in Polycystic Ovary Syndrome.

It can lead to side effects such as:

  • Fatigue
  • Anemia
  • Discomfort
  • Severe menstrual cramps

How do you know if you have heavy bleeding?

According to the Centers for Disease Control and Prevention, if you need to change your tampon or pad after less than 2 hours or you pass clots the size of a quarter or larger, that is heavy bleeding.

Recommended Article:
Read PCOS Discharge: Symptoms, Causes, and Management to learn about different types of discharges in PCOS.


Oligomenorrhea refers to irregular or inconsistent menstrual bleeding. 

In this, the time interval between periods ranges from 35 days to six months or longer. 

Polycystic Ovarian Syndrome often causes Oligomenorrhea.

Thus women suffering from this hormonal disorder may face this type of extended menstrual bleeding.

This bleeding irregularity stems from the hormonal imbalances associated with PCOS. 

Oligomenorrhea can affect fertility and complicate family planning efforts. 

How do you know if you have Oligomenorrhea?

If you don’t get your period for 35 days or more and, as a result, have only four to nine periods each year, it indicates that you might have Oligomenorrhea.


Amenorrhea is the absence of menstrual bleeding. 

Most women with Polycystic Ovary Syndrome may experience Amenorrhea.

It is of two types:

  • Primary: It is when you haven’t gotten your first period by age 15 or within five years of the first signs of puberty 
  • Secondary: It is when you’ve been getting regular periods, but you stop getting your period for at least three months, or your period stops for six months when they were previously irregular

Amenorrhea can be due to the hormonal imbalances in PCOS. 

It can have implications for fertility and overall reproductive health.

How do you know if you have Amenorrhea?

Amenorrhea can be diagnosed if you miss at least three periods in a row without being pregnant.

Breakthrough bleeding in PCOS

Breakthrough bleeding refers to unexpected vaginal bleeding that occurs outside of the regular menstrual cycle. 

Women with PCOS may experience breakthrough bleeding while using hormonal contraceptives or at random intervals. 

It can be attributed to hormonal imbalances and irregular ovulation in PCOS. 

How do you know if you have breakthrough bleeding?

According to the American College of Obstetricians and Gynecologists, you will usually have a small amount of spotting when you’re not expecting your period. 

However, some women may also have heavier bleeding.


Menstrual Calendar(marked with heart shape)Source: shironagasukujira_from_Getty_Images
Menstrual Calendar

Polymenorrhea refers to frequent menstrual bleeding cycles occurring more than once within a 21-day timeframe. 

This condition can disrupt daily life and indicate underlying hormonal imbalances. 

Polymenorrhea is often related to Polycystic Ovary Syndrome.

How do you know if you have Polymenorrhea?

If you notice that your menstrual cycle is getting shorter, it is an indication that you might have Polymenorrhea.


Spotting refers to light, irregular vaginal bleeding that occurs between periods. 

Women with PCOS may experience spotting. It may be due to hormonal fluctuations and irregular ovulation. 

While spotting is considered benign, it can cause inconvenience and emotional distress.

How do you know if you have spotting?

Spotting may be red or brown in color and very light. You will not bleed enough to use a pad, cloth, or tampon.

Immediately consult a gynecologist if you notice any irregularity in your menstrual bleeding, as delaying may increase the complications.


Understanding the various bleeding patterns associated with Polycystic Ovary Syndrome is crucial for women facing menstrual challenges. 

PCOS can lead to different forms of bleeding, including Menorrhagia, Oligomenorrhea, Amenorrhea, breakthrough bleeding, Polymenorrhea, and spotting. 

These distinct bleeding patterns usually stem from hormonal imbalances and irregular ovulation associated with PCOS. 

Each type of bleeding can have significant implications for a woman’s quality of life, fertility, and reproductive health. 

It is essential for women experiencing irregularities in their menstrual bleeding to consult a healthcare professional promptly to seek appropriate management strategies and prevent potential complications.

Frequently Asked Questions

What is PCOS bleeding like?

PCOS bleeding can be in various ways. Women with PCOS may experience heavy and prolonged periods (Menorrhagia), irregular or inconsistent bleeding (Oligomenorrhea), absence of menstrual bleeding (Amenorrhea), breakthrough bleeding outside of the regular cycle, frequent bleeding cycles (Polymenorrhea), or light and irregular spotting between periods.

Does PCOS cause random bleeding?

Yes, PCOS can cause random or unexpected bleeding, known as breakthrough bleeding. This type of bleeding occurs outside the regular menstrual cycle and can be attributed to hormonal imbalances and irregular ovulation associated with PCOS. 

How often do you bleed with PCOS?

It is not uncommon for women with PCOS to have menstrual irregularities. The frequency and pattern of bleeding with PCOS can vary among individuals. Some women with PCOS may experience heavy and prolonged periods, while others may have irregular or infrequent bleeding. 

Can PCOS cause spotting instead of period?

Yes, Polycystic Ovary Syndrome can cause spotting instead of a regular period. Spotting refers to light and irregular vaginal bleeding that occurs between periods. Hormonal fluctuations and irregular ovulation associated with PCOS can lead to spotting instead of a full menstrual flow.

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