Irregular menstrual cycles may be caused by a vast number of different conditions, from stress to cancer, and so many things in between. Therefore, it is necessary to take a comprehensive history, do a careful physical exam, and usually perform other tests, to arrive at a diagnosis. Other causes of irregular cycles include:

• Polycystic Ovary Syndrome (PCOS)
• Thyroid and other hormonal disorders
• Nutritional challenges, including malnourishment, underweight, and overweight
• Anatomic problems, such as fibroids, polyps, scar tissue
• Congenital (birth) abnormalities
• Pregnancy complications, including tubal or ectopic pregnancy
• Brain disorders and tumors including high prolactin levels
• Perimenopausal status
• Use of hormones or supplements

And the list goes on. It is easy to see why a complete evaluation is often needed to rule out serious disorders and provide proper treatment. Other than a history and exam of the individual, other steps are often needed:

• Pelvic Ultrasound
• Evaluation for ovulation
• Sonohysterogram or hysterosalpingogram
• MRI or CT, pelvic or brain as indicated
• Laboratory testing
• Hysteroscopy or even laparoscopy

Most gynecologists can perform this evaluation very well. We serve as a referral center for those cases where the diagnosis remains unclear or where the treatment is beyond the scope of the general practitioner. We would be privileged to assist you if you are experiencing continued difficulties with irregular menses or abnormal uterine bleeding.