hi, thank you for your query. Heavy menstrual bleeding or mennorhagia is an unusual but a serious component of PCOS. This is more common in patients who are obese with PCOS. Sometimes the small and primitive follicles produce enough oestrogen to thicken the lining of the uterus but the compacting and balancing hormone, progesterone, is absent. This can lead to the lining of the uterus becoming thicker and thicker .This may be associated with quite heavy bleeding or irregular, frequent and even constant bleeding. this form of bleeding needs investigation of the lining of the uterus by hysteroscopy and biopsy to make sure that they are not developing cancerous or pre-cancerous changes. treatment includes lifestyle changes including excercise,diet control and medications. medications include- 1.hormone therapy to help control your ovary hormones. To correct menstrual cycle problems, birth control hormones keep your endometrial lining in check.Hormone therapy can also help with male-type hair growth and acne. 2.Birth control pills, patches, or vaginal rings are prescribed for hormone therapy.these help in menstrual flow regulation and also help with the pain. 3.Androgen-lowering spironolactone is often used with estrogen-progestin birth control pills. This helps with hair loss, acne, and male-pattern hair growth on the face and body you can discuss these options with your OB/GYN and start the appropriate treatment. thank you, you can contact me for further queries.