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Q. What are the ways to manage irregular periods in a PCOS patient?

Answered by
Dr. Zulfiqar Ahmed
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on May 10, 2020 and last reviewed on: May 19, 2020

Hi doctor,

I have been diagnosed with PCOS for more than 3 years. Recently I have been doing yoga and doing intermittent fasting for the past 2 months. Now I got my period twice in April and for may month it is spotting for the last 2 days. Please help me.

Dr. Zulfiqar Ahmed

Diabetology Endocrinology


Welcome to

Treatment of women with PCOS should begin with lifestyle measures. For those who are obese, a combination of weight loss and exercise may stimulate ovulation. Intermittent fasting is wonderful lifestyle. What is your mode of intermittent fasting. Are you doing 16/8 or fast and feast? Have you tried 36 hours fasting? Please let me know.

Also, low carbohydrates diet with no sugary juices and no added sugar is very beneficial. If the woman is not overweight or weight loss is ineffective then: taking into account potential adverse effects, ease and mode of use, the woman's BMI, and monitoring needed, Clomifene citrate or Metformin or a combination of the above.

For women who are taking Clomifene citrate, I offer ultrasound monitoring during at least the first cycle of treatment to ensure that they are taking a dose that minimises the risk of multiple pregnancy. Women prescribed Metformin may know side effects such as nausea, vomiting and other gastrointestinal disturbances. If woman known to be resistant to Clomifene citrate, we can go for laparoscopic ovarian drilling or combined treatment with Clomifene citrate and Metformin if not already offered as first-line treatment or Gonadotrophins. So, there are plenty of options available and you are not alone we can together make a plan for management. Please give me more details if you have done investigations ultrasound and Harmone tests.

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