Certain patterns of bleeding could indicate underlying issues that need medical attention, especially if you're on hormone replacement therapy (HRT). You should seek advice if you experience:

✔️ Heavy bleeding—soaking through pads/tampons in under two hours, passing large clots, or feeling lightheaded.

✔️ Bleeding between periods—especially if it happens consistently.

✔️ Bleeding after sex—this could be due to cervical changes or other concerns.

✔️ Bleeding that lasts more than 7 days—especially if it’s happening frequently.

✔️ A sudden change in your usual pattern—such as much heavier or more frequent bleeding.

✔️ Any bleeding after menopause—if you haven’t had a period for 12 months and then experience bleeding, this should always be checked.

✔️ Cycles shorter than 21 days—if your periods are coming more frequently, this could suggest an underlying issue.

✅ Irregular periods—cycles may become shorter or longer, and skipping periods is common.

✅ Changes in flow—periods may be heavier, lighter, or have spotting between cycles.

✅ Occasional skipped cycles—you might miss a month or more, then have a heavier period.

It’s completely normal for periods to be irregular in the first few years after they start. The body is still figuring things out, and ovulation (which helps regulate cycles) doesn’t always happen consistently at first. Because of this, longer cycles (up to 45 days) are acceptable in teenagers for the first 4–6 years after their first period. This happens because the communication between the brain and ovaries is still maturing, and ovulation doesn’t always happen every cycle.

However, there are some signs that a teenager should see a doctor:

🔹 Very heavy periods (soaking through pads/tampons in under 2 hours or passing large clots)

🔹 Periods that last longer than 7 days

🔹 Cycles shorter than 21 days or longer than 45 days after the first few years

🔹 Severe pain that affects daily life

🔹 Missing periods for more than 3 months (unless pregnant)

🔹 Signs of hormonal imbalance (such as excess hair growth, acne, or unexplained weight changes)

If you’re unsure whether your teen’s periods are normal, a chat with a doctor can help figure out if anything needs further investigation.

Seeing polycystic ovaries (PCO) on an ultrasound does not automatically mean your teenager has polycystic ovary syndrome (PCOS). In teenagers, it’s actually quite common to have ovaries that look “polycystic” on a scan because their ovaries are still developing, and they naturally have more follicles (which can look like small cysts).

PCOS is a clinical diagnosis, not just an ultrasound finding. To diagnose PCOS, there need to be at least two of the following:

✔ Irregular or absent periods (not just in the first few years of puberty)

✔ Signs of excess androgens (such as acne, excess hair growth, or scalp hair thinning)

✔ Polycystic ovaries on ultrasound

If your teen has regular periods and no signs of excess androgens, then they likely do not have PCOS, and the ultrasound finding alone doesn’t mean there’s a problem. In many cases, no treatment is needed. However, if you have concerns about their cycles, symptoms, or long-term health, it’s always a good idea to check in with a doctor for reassurance and advice.

Yes! If your teenager is struggling with heavy periods, there are several options beyond the pill that can help. Heavy periods shouldn’t just be something they have to put up with—there are safe and effective treatments that can make a big difference in their quality of life.

Here are some options:

✔ NSAIDs (like ibuprofen or mefenamic acid) – These can help reduce blood loss and ease period pain. They work best when taken regularly during the first few days of the period rather than just as needed.

✔ Tranexamic acid (TXA) – This is a non-hormonal medication that helps to reduce bleeding by improving blood clotting in the uterus. It’s taken only during the period and can significantly cut down blood loss.

✔ Cyclical progesterone – If heavy periods are due to hormonal imbalance, progesterone can be taken in the second half of the cycle to help regulate and lighten bleeding.

While these options can work well, sometimes the pill is the best tool in the toolkit—especially if periods are affecting school, sports, or daily life. It can help regulate cycles, lighten bleeding, and reduce pain.

If your teen’s periods are making life miserable, it’s worth having a chat with a doctor about the best approach. Heavy periods shouldn’t be something they just have to “push through.” There are safe and effective options to help them feel better. 💙

Not necessarily! Just because you had heavy periods as a teenager doesn’t mean they’ll stay that way forever. In the first few years after periods start, cycles can be irregular and heavier because the body is still learning to regulate hormones. Over time, as ovulation becomes more consistent, periods often become lighter and more predictable.

However, it’s good to be aware that heavy periods can return later in life, particularly in perimenopause. As hormone levels fluctuate again, periods can become heavier, longer, or more unpredictable—sometimes in a way that feels familiar to those early years! If that happens, there are plenty of options to manage it, so you don’t have to just put up with it.

If heavy periods are affecting your life at any stage, it’s always worth talking to a doctor about what can help. 💙

No — having PCOS doesn’t mean you can’t get pregnant.

PCOS can affect ovulation, which may make it harder for some people to conceive, but many do — some naturally, others with support. It’s more accurate to think of PCOS as a spectrum — some people meet the full diagnostic criteria, while others experience only some signs, like irregular cycles, acne, hirsutism (excess hair), or insulin resistance. Even without a formal diagnosis, these can still affect your fertility.

I remember a patient who came in early in her fertility journey and said, “I don’t think I’m ovulating — my cervical mucus hasn’t changed this month.” At the time, I was (wrongly) a little sceptical — but she was absolutely right to trust her body. She showed signs of insulin resistance, mild hirsutism, and abdominal weight gain — all pointing toward the PCOS spectrum.

We checked her day 21 progesterone — a hormone that normally rises after ovulation — and it didn’t. That small test gave us clarity and meant I could refer her for early fertility support.

🧭 This is why tuning into your body — even subtle changes — can give powerful clues about your hormonal health and help you get the right support sooner.

Want to explore this further?

If you suspect PCOS or have questions about ovulation and fertility, feel free to get in touch. I often have a bit of a wait for full appointments, but there’s an option for a brief review — I can organise lab forms in advance to check your hormones. That way, when we meet, we’re fully informed and can hit the ground running.

Polycystic Ovary Syndrome (PCOS) is a common hormonal condition that affects how the ovaries work. Despite the name, you don’t actually need to have “cysts” on your ovaries to be diagnosed. PCOS is really about how your body regulates hormones — particularly ovulation, insulin, and androgens (so-called “male” hormones like testosterone, which we all have in varying amounts).

✨ PCOS is usually diagnosed based on a combination of:

• Irregular or absent periods (a sign you're not ovulating regularly)
• Signs of high androgens — like acne, hair growth on the face/body, or scalp hair thinning
• “Polycystic-looking” ovaries on ultrasound (which reflect lots of small, undeveloped follicles)

I believe that there are more people on the PCOS spectrum with symptoms than fulfil the criteria for diagnosi ie might have some features but not meet the full diagnostic criteria — and it can still affect your wellbeing and fertility.

🧭 PCOS across the life cycle

One of the things I feel passionate about is helping people recognise PCOS in all its forms — because it can look different at each life stage.

Here’s how I often see it show up:

• Teenagers – Irregular cycles, acne, excess hair growth, heavy or painful periods
• Pre-conception – Ovulation challenges and difficulty getting pregnant
• Postnatal – Issues with milk supply or delayed period return
• Perimenopause – Weight gain, blood sugar changes, cycle irregularity again

💡 Why body awareness matters

One patient told me, “I don’t think I’m ovulating — my cervical mucus hasn’t changed this month.” She was right. Subtle changes in cervical fluid, energy, skin, and weight can all offer early signs something's shifting hormonally. We confirmed she wasn’t ovulating with a day 21 progesterone blood test — and she was able to get early fertility support.

👩‍⚕️ How I can help

I see people with PCOS at every stage of life. My approach combines:

✔️ Evidence-based medicine

✔️ Supportive supplements and nutrition

✔️ Individualised hormone testing

✔️ Real talk about how you're feeling

If you're curious about your cycle, unsure whether PCOS is part of your story, or want help preparing for pregnancy, get in touch. I offer brief pre-consult reviews and can send lab forms ahead of your appointment — so we’re ready to hit the ground running.