12/17/2025
If you have PCOS and skip periods, read this.
Going months without bleeding can mean the lining is getting ongoing estrogen exposure without regular progesterone.
Why it matters:
➡️ Without regular progesterone, the uterine lining can keep building instead of shedding.
➡️ This can lead to heavy bleeding, prolonged bleeding, or unpredictable spotting.
➡️ Over time, unopposed estrogen can lead to endometrial overgrowth (hyperplasia). Hyperplasia is important because it is treatable and preventable.
You might still bleed sometimes, but it can be irregular spotting or heavy bleeding, and it does not always mean the lining is “reset” in a healthy, predictable way.
What you can do (ways to bring on safe, regular bleeding or protect the lining):
➡️ If no bleed for 45 to 60 days, talk to your doctor.
➡️ Ask about: cyclic progesterone (withdrawal bleed), hormone IUD, or the birth control pill (if not TTC)
➡️ If TTC: ask about letrozole ovulation induction + monitoring
➡️ Ask if metformin is right for you (especially with insulin resistance)
➡️ Heavy bleeding? Check iron and ferritin
Bottom line: Skipped periods are common in PCOS, but they need a plan. Remember, this is for education only and is not medical advice.