An occasional change in the menstrual cycle is common. Persistent early, late or missed periods, or a marked change in flow, deserves assessment. Stress, rapid weight change, intense exercise, thyroid disorders, polycystic ovary syndrome, perimenopause and pregnancy are among the possible causes.
A three- to six-month record of cycle dates, flow, clots, pain, sleep, stress and medicines can help the clinician. Pregnancy testing, blood tests or pelvic ultrasound may be recommended.
TCM assessment considers not only cycle length but also bleeding pattern, pain, temperature preference, energy, sleep and emotional wellbeing. The aim is individualised supportive care rather than forcing a period before the cause is understood. Possible pregnancy, very heavy bleeding, severe pain, dizziness or weakness should be medically assessed first.
Record whether changes began with new medicines, weight change, shift work, travel or stress. Prolonged absence of periods may require assessment of endometrial, bone, metabolic and fertility implications.
