Irregular Cycles & Ovulation
Are you trying to get pregnant but are constantly dealing with irregular menstrual cycles? If so, you may need lab testing and a pelvic ultrasound to better understand your source of the issue. Having problems with your cycle either under or over-performing can lead to fertility issues.
What is a normal menstrual cycle?
A normal cycle occurs every 24 to 35 days lasting for 7 days or less and is where your body releases an egg (ovulation). If your cycles occur less frequently than every 35 days (oligomenorrhea), specific lab studies can be performed to attempt to determine the cause. The following are typical of tests that may be done:
- Pregnancy test
- Thyroid studies (TSH and T4)
- Prolactin (PRL)
- Total testosterone (T)
To help you check your ovulation, we have provided an Ovulation Calculator.
What are my risks?
Overactive and underactive thyroid
Women who have an overactive (hyperthyroidism, low TSH), or an underactive thyroid (hyperthyroidism, high TSH) can experience infrequent menstrual cycles or heavy menstruation and are at risk for:
Elevated prolactin levels
High prolactin levels may cause you to not release an egg each month and experience headaches or narrowed vision. Over the short term this can lead to greater risk for infertility. If this condition continues, you could find your lower estrogen causes you to have vaginal dryness and higher risk of fracture due to thinning bones (osteopenia or osteoporosis).
High total testosterone
Women with elevated levels of total testosterone may experience infrequent menstrual cycles and abnormal hair growth (hirsutism) on the body.
In cases where your cycles occur too frequently, usually more than every 24 days, or lasting longer than 7 days, you may be prone to anemia. Anemia is when you are experiencing a low red blood cell count and is due to the excess loss of blood. A simple test called a Complete Blood Count (CBC) can be performed to determine if you are anemic.
Ovulation Medication to treat irregular menstrual cycles
If your infertility is related to abnormal thyroid function, elevated prolactin or high testosterone levels, the good news is that there are ovulation medications to correct these. Once treated for a course of 1-2 months, your symptoms typically are reversed and normal ovulation occurs.
At times, your ovulation issues could be more significant and due to diminished ovarian reserve (DOR), poor ovarian response (POR) or premature ovarian failure (POF). During your fertility evaluation, blood and urine tests as well as pelvic ultrasound to determine your ovarian reserve as it relates to high FSH and low AMH.