Is it normal to miss periods for over 40 days with PCOS?

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Let me explain the Federation of Gynecology and Obstetrics (FIGO) classification of the menstrual cycle:

Frequency:

1. A cycle is considered normal when it occurs between 24 to 38 days.

2. A cycle is classified as frequent if it is less than 24 days.

3. A cycle longer than 38 days is considered infrequent.

The absence of menses is referred to as amenorrhea.

Duration:

1. A normal menstrual duration is up to eight days.

2. A duration of more than eight days is considered prolonged.

Regularity:

1. A cycle is considered regular when the difference between the longest and shortest cycle is less than nine days.

2. A cycle is classified as irregular when this difference is more than eight days.

Flow:

Menstrual flow can be classified as normal, heavy, or light.

In your case, a cycle longer than 38 days would be considered an infrequent or irregular menstrual cycle. I recommend certain investigations and a three-month course of medication for better regulation.

Investigations:

1. Serum Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH) on the second day of your period.

2. Serum Prolactin.

3. Serum FT4 and thyroid stimulating hormone.

Medications:

1. Tablet Dydrogesterone 10 mg, twice daily for 21 days. After completing the 21 days, take a seven-day pill-free interval and then repeat this cycle for three months.

2. Tablet Cholecalciferol 2000 IU, one tablet every ten days for three months.

Lifestyle Advice:

1. Follow a balanced diet.

2. Incorporate regular exercise into your routine.

3. Focus on weight loss if needed.

I hope this response addresses your concerns. If you have further queries, please do not hesitate to reach out.

Thank you.