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Periods might be delayed but phantom PMS is real

When you have PCOS, irregular periods are common, but is five months too long?

Pushing past prying eyes as I made no attempt to hide the tears flowing down my face, I knew I was being melodramatic; nothing had actually happened to me, I was just feeling quite randomly but overwhelmingly sad. This was in April, a month after I had my previous period. And I knew – or thought I knew – that the burst of emotion meant a period was coming. 

Sensitivity is a part of premenstrual syndrome (PMS), and according to the NHS, one of the most common symptoms. While mood swings, feeling upset, anxious or irritable can occur during a bleed, it can also precede a period. When I cried in public, it usually meant I was feeling especially sensitive, meaning a period was due.

But that was five months ago and I have yet to start (no, I’m not pregnant). It’s not just hypersensitivity I’ve felt in waves, but other PMS signs. These include cramps and even breast tenderness. It’s like my body is trying to remind itself that it needs to menstruate, and yet, nada. As someone who has polycystic ovary syndrome (PCOS) – a condition that affects how the ovaries work – I’m used to irregular periods as one of its major symptoms. But five months is a long time, even for me. 

And to add to the stress of it all, when I think about it for too long, I feel myself having cramps.  They could be genuine signs of PMS or just my body manifesting symptoms as I’ve been stressing about it for so long. So why am I experiencing these phantom symptoms? Am I just due for a really big period soon, one that’s had a five-month build-up?

Of course, a missed period can be a sign of pregnancy (and you should take a test asap to rule this out), but delayed periods can be a result of myriad other things. According to period-tracking website Flo, delayed menstruation can be due to stress, low weight, excessive training, medications, a thyroid condition and, of course, PCOS.

Dr Nick Panay, consultant gynaecologist and spokesperson for the Royal College of Obstetricians and Gynaecologists, tells Stylist: “There are many reasons why a woman may experience PMS without having a period.

“Common reasons why someone may miss their period or why their periods may have stopped are: pregnancy, stress, sudden weight loss, over-exercising, having a high BMI or reaching menopause. Periods may also be irregular or stop due to PCOS, or long-term medical conditions such as an overactive thyroid. It is possible to still have symptoms of PMS due to hormonal changes caused by these lifestyle factors or medical conditions.”

And PMS doesn’t necessarily look the same for any two people and can overlap with other conditions, which can be confusing for people experiencing symptoms.

Dr Panay says: “There are over 150 symptoms linked to PMS, which cover psychological and behavioural symptoms such as anxiety and depression as well as physical symptoms, including headaches and breast tenderness. Sometimes symptoms such as headaches can be mistaken as PMS rather than recognising that they may be caused by stress or menopause.”

But, of course, symptoms such as breast tenderness aren’t the same as a headache and, due to hormones, you could be experiencing symptoms without later getting a period.

Meg Wilson, consultant gynaecologist at London Gynaecology, says: “Even if you are not experiencing a period, your ovaries may still be producing hormones in a cyclical pattern. This may give you hormone-related symptoms and PMS.

“There are treatments for PMS offered by your doctor, such as hormone treatments, and some women benefit from taking antidepressants for certain weeks in their cycle. Exercise and diet can also help with symptoms and some women benefit from supplements of vitamin B6.”  

When you have irregular periods, it can often be a waiting game for the next one. But is there a point when you should see a GP?  Dr Panay adds: “We would advise anyone who has missed more than three periods in a row and is not pregnant to speak to a healthcare professional. A doctor may recommend waiting for a woman’s periods to return on their own or in some cases may refer them to a gynaecologist.”

I was diagnosed with PCOS in my early 20s and despite having an on-again 0ff-again relationship with my period in the last decade, I haven’t been able to see a gynaecologist about my condition. In the last month I have tried to reach out to my GP but we all know how hard it is to get an appointment when the NHS is so desperately underfunded. And I know I’m not alone in my situation – PCOS affects about one in every 10 women in the UK, people who may also experience similar symptoms to me. 

The NHS says you don’t need to get medical advice if you have always had slightly irregular periods or if you’re still going through puberty.

But see a GP if:

  • your periods suddenly become irregular and you’re under 45
  • you have periods more often than every 21 days or less often than every 35 days
  • your periods last longer than 7 days
  • there’s a big difference (at least 20 days) between your shortest and longest menstrual cycle
  • you have irregular periods and you’re struggling to get pregnant

There might not be anything wrong, but it’s a good idea to get checked out to see what the cause might be. You might be referred to a specialist or gynaecologist if you need any tests or treatment.

If you’re experiencing PCSO, the charity Verity offers support and additional resources.

Images: Getty

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