Irregular periods - possible cause?

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I'm experiencing some symptoms I think I should maybe get checked out, but I wondered if anyone had similar experiences.

I'm 38, childfree, never been pregnant to my knowledge. I'm not on any contraception, I do have a partner, we use condoms.

My period is currently 6 days late. This is the second time this year this has happened. Two years ago it was 8 days late, no idea why. Last year I had a sudden and unexpected bleed between periods, it lasted a few days but I don't remember if I got my period as usual a couple of weeks later. My cycle is usually a bit shorter than average, around 25 days. I don't have any pain beyond ordinary period pains, and my last smear was negative for HPV. I'm due my next smear in December, I think.

I'm wondering if it might be something hormonal that's causing these issues, does anyone have any thoughts?

It's likely just random, your body is sometimes just out of whack, could be your going into peri. If it's not painful and there aren't other symptoms it's likely fine.

Is the spotting heavy? I'd leave it for now, but you could see an advanced nurse practitioner or your GP for a quick check. It other symptoms pop up, or it's heavy etc, a pelvic ultrasound could double check there's nothing there but I'd wait for a while to see if its persistent before that.

It can be caused by illness, it was notable how many had their cycle affected by Covid.

I did have Covid twice, the last time being three years ago, but I don't remember it affecting my cycle. Worth looking at though, thanks.

I only had one episode of bleeding between periods, and it was a sudden flood with no warning at all. I was in the pub at the time and had to leave because it had gone through my jeans!

Oh that is very different then, sorry for yohr first post it sounded like light bleeding/spotting. That shouldn't happen, I'd ask for a temporary prescription of tranexamic acid now, at a relatively high dose, then I'd also ask for a pelvic and transvaginal ultrasound.

Whilst you wait for further investigation and results the tranexamic acid will reduce your bleeding a lot, make sure you take it consistently for it to work the best.

It may be some fibroids etc, but the ultrasound will show that. Book an appointment with your GP.

Definitely push for a referral it could be a polyp or all sorts. It will take ages to be seen no doubt.

I've got an appointment next Friday to get bloods taken to check hormones, thyroid etc. I'm to take a pregnancy test as well, just to rule it out. Doctor doesn't think it's early onset menopause as I've no symptoms of it, same for PCOS. So we'll see.

It doesn't sound like PCOS or peri, I only mentioned peri before you clarified the amount of bleeding.

It doesn't fit PCOS diagnostic criteria which would be persistent irregular, short, and missed periods, way more than 2 times, and would have to be quite a long-term thing, across many periods and pretty consistent for years. Then for PCOS you also need on a transvaginal ultrasound to see lots of small follicles near the ovaries and/or certain hormones at a higher level than normal. You need 2/3 for a PCOS diagnosis but you don't sound like you meet the criteria for any one, but even if you did, you'd need 2 for diagnosis.

It's more likely a polyp, or a fibroid espeically with the gushing. Definitely ask for tranexamic acid, you can ask for that on an online form, it's just a temporary prescription for a few weeks but it massively reduces heavy bleeding so definitely ask for it tomorrow online or on the phone. Then depending on the bloods which you'll review when you see the GP, ask about getting a transvaginal ultrasound as that's the only way to check for a fibroids etc and either rule it out or rule it in. Give us an update when you have your appointment and get tests done etc, but you definitely need a transvaginal ultrasound.

It was a phone appointment with the GP today, the bloods are being taken at a separate treatment centre. The GP said they likely won't contact me if everything is normal, ie no news is good news. In the meantime I've had a little bit of cramping today, so I think I'll probably start bleeding tomorrow. If the bloods don't show anything then it might just be a case of keeping track of things as usual and going back if it keeps being considerably late.

I wouldn't rely on the bloods too much. You have only recently had the bleeding so iron shouldn't be too low. The rest are good to look at but wouldn't reveal a cyst, fibroid, polyp etc, and so folate, B12 etc all important for general health but it doesn't mean there is not something else going on.

The gushing you describe is really common with fibroids, which is why regardless of what the bloods show you need to ask for a transvaginal ultrasound. They aren't painful, and you'll have a chaperone etc, but you really need one to check the endometrium, for fibroids, any other issues as well. I'd definitely ask for one, have you considered asking for tranexamic acid yet or not? The bloods will likely take a few days but should be on the app by end of week or early next week. I'd still track anything as well.

@TheLivelyViper the bleeding was last year, so not that recent. The doctor didn't seem overly concerned but agreed it was worth getting the bloods done just to check all is OK there, coupled with my period being so late three times in the last couple of years. I'm in Scotland so we don't have the app you mentioned, but I've seen it talked about on other threads so I know what you mean. Unless something is way off it doesn't sound like I'll hear back. The soonest appointment I could get for bloods is next Friday, 31st, so I'll have to wait for that anyway.

Oh right yes it won't take long from the 32st though, but I'm sure you can still check in with them to see them. If you have any other recent bloods compare these new ones to them - as they may be in range but lower than your normal range.

Sorry when was the bleeding exactly? How long did it last? Has it been persistent or not since them?

If it's only been one incident of bleeding then no I wouldn't be concerned. The lateness is just the body sometimes and wouldn't qualify for PCOS yet nor the criteria for Irregular periods. I'd check in with it, as across the next few years it may be peri. Something like low dose topical vaginal oestrogen can help a lot and HRT in different forms as well. Something like a mirena could be worth looking into and there's good pain relief available for the insertion.

@TheLivelyViper it was about a year ago, came on very suddenly and if I remember right it lasted a few days. It's only happened once. I've had three periods in the last two years that have arrived a week late. I don't think it's PCOS as I don't have any symptoms of that, the doctor didn't think it was that either.

It’s entirely within normal range for menstrual cycles to fluctuate a week or so, sometime women miss a period for no apparent reason. Lots of things determine menstrual bleeding.

What is it about three late periods in two years that worries you?
Sounds like GP has done right thing to check thyroid.

Bleeding between periods is more of a concern and if that happens again you should book a GP appointment.

@FullBl00m I wouldn't say I'm worried per se, more that you hear a lot of advice saying that if there's anything unusual you should get checked out. So it seemed sensible to do that.

Bloods showed slightly elevated FSH, but everything else was normal. The doctor doesn't seem concerned, so I guess my body is just weird! I'll keep an eye on things anyway though, just thought I'd update.