Unpredictable or heavy periods may be a sign of something more than a hormonal fluctuation

Irregular cycles and unpredictable periods are often dismissed as a delayed menstrual cycle or a temporary hormonal fluctuation.

However, in some cases there may be more happening beneath the surface. A widespread assumption is that monthly bleeding automatically confirms ovulation — but medically, this is not always the case.

It is possible to experience bleeding that resembles a menstrual period even without releasing an egg. If your cycles are difficult to track, your bleeding feels inconsistent, or you are unsure whether ovulation is occurring at all, it may be worth investigating further rather than assuming everything is functioning normally.

What is anovulatory bleeding?

Dr Kunal Sood, an anaesthesiologist and interventional pain medicine physician, has broken down what may be happening in the body when periods become irregular or unpredictable.

In an Instagram video shared on Friday, he explained the concept of anovulatory bleeding — what it means, why it happens, and how it can affect hormonal balance and menstrual health.

Dr Sood explains that many people assume bleeding every month — particularly when it looks and feels like a typical period — means the body is functioning normally.

However, he cautions that this is not always the case, particularly when cycles are erratic. It is possible to bleed monthly without ovulating, meaning no egg has been released despite what appears to be routine menstrual bleeding.

In a typical cycle, ovulation triggers the production of progesterone, which helps the uterine lining build up and shed in an organised, timely, and predictable way.

"A lot of people think that if you bleed every month, you must be ovulating. But medically, that's not always true. You can still have monthly bleeding even when no egg was released.

"In a normal cycle, ovulation triggers progesterone production. Progesterone helps stabilise the uterine lining so it sheds in a more organised and predictable way," he said.

What happens in the body when ovulation does not occur?

When no egg is released, progesterone is not produced, whilst oestrogen continues to stimulate and thicken the uterine lining.

Over time, that lining can become unstable and begin shedding irregularly, producing bleeding that resembles a period but follows an entirely different hormonal pathway.

"When ovulation doesn't happen, progesterone is missing. Oestrogen keeps stimulating the lining on its own, causing it to keep thickening without proper regulation.

"Eventually, that lining becomes unstable and starts breaking down irregularly which can still cause bleeding that looks like a period even though ovulation never actually occurs.

"This is called anovulatory bleeding and it's common in conditions like PCOS, thyroid disorder, significant stress, major weight changes or sometimes during puberty and perimenopause," Dr Sood explained.

Why it is worth seeing a doctor

Dr Sood stresses that ovulation is about far more than fertility. It plays a critical role in regulating hormones and supporting long-term endometrial health — which is why persistent irregularities should not simply be attributed to a normal cycle.

"The reason it matters is because ovulation is not just about fertility. Ovulation is also part of hormonal balance and long-term endometrial health.

"That's why persistent irregular cycles, very unpredictable bleeding or difficulty tracking ovulation are worth discussing with the doctor rather than just assuming everything is functioning normally because bleeding is still happening," he said.

Note to readers: This article is for informational purposes only and is not a substitute for professional medical advice. It is based on user-generated content from social media. The claims have not been independently verified.