Does menstrual bleeding pattern change in women with PCOS/PMOS?

Question

Hello doctor,

I would like to share some symptoms I have been experiencing over the past two menstrual cycles and ask for your guidance. I have been diagnosed with polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome, and recently I have noticed a change in my menstrual bleeding pattern. I am bleeding very little on sanitary pads, but I see more blood and mucus discharge when I am sitting on the toilet, especially during bowel movements or when I strain.

This pattern has happened in the last two cycles. The bleeding is sometimes mixed with blood clots and mucus, but there is no bad smell or severe pain. The bleeding depends on my posture. It often does not occur when I am lying down or sitting for long periods.

This is different from how my periods used to be. I am wondering if it could be related to changes in the endometrium caused by polycystic ovary syndrome, narrowing of the cervix, or another condition like pelvic floor dysfunction.

I would appreciate your advice on whether I should get any tests, such as a pelvic ultrasound or hormone test. I am also wondering if this could be due to blood pooling, a blockage in the flow, or a hormonal imbalance.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your symptoms suggest that the menstrual blood might be collecting slightly before being released, especially when your posture changes or when you strain. Although polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome can lead to irregular bleeding, the presence of mucus and the fact that the bleeding depends on your position make it important to check for other possible causes.

I recommend having a pelvic examination to check your cervix and the function of your pelvic floor muscles. A transvaginal ultrasound will also help examine the thickness of your endometrial lining and assessing the overall structure of your pelvic organs.

We can also discuss whether it is necessary to repeat your hormone tests, since you have polycystic ovary syndrome. These symptoms should be investigated further to rule out conditions like narrowing of the cervix, polyps, or any other issues that may be affecting the normal flow of menstrual blood. Please schedule an appointment so we can look into this more closely.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.