"Going back to the causes, most important are cerebral cortex, which hold hypothalamus and pituitary gland. Menstruation starts by a hormone secretion in the hypothalamus and pituitary called as GnRH hormone. Whenever there is a variation of these hormones there is a variation of estrogen and progesterone leading to irregular cycles. Stress doesn’t mean sleepless nights, emotional imbalance, psychological shock. Stress could be in the form of drug abuse, antipsychotic drugs or eating disorders like binge eating, stress eating, where you put on a lot of fat in the body or malnutrition where you are avoiding to eat. Stress can be due to excessive exercise. People have a lot of craving to zero size. Doing exercise that your body is not used to, excessive vigorous exercise, where you are losing a lot of body fat or putting on a lot of weight, where you have sedentary lifestyle, excessive weight gain. All these are related to a hypothalamus abnormality, where the GnRH hormone is reduced and because of this there is either stimulation or depression of these hormones which leads to irregular cycles"

"The tests we do for irregular periods depends on the cause of irregular periods. The causes can be from the brain that is the hypothalamopituitary axis, or in the ovaries or the uterus. Our investigations depends on where can be the pathology. So a simple history taking will help us diagnose. So a good menstrual history is very important. Second we may just do an examination, just to look if the area is very normal, with a hymen or if there is an infection. Third is we do the blood test, that is we do hormonal tests to see if the menstrual flow is good. So we do a few array of hormonal test. To name them they are the follicular stimulating hormone luteinizing hormone, estrogen, progesterone and most important is the thyroid and the prolactin. So if there is any variation in that, if it is a thyroid we can address the issue. If it is a pituitary gland, then we do a little bit of investigation. If the hormone levels are normal, we do the next level of abdominal scans. There are two types of abdominal scans that is transabdominal or transvaginal. Most of the times the radiologist will ask for a transvaginal scan because most of the organs could be probably seen in a better view doing a transvaginal scan. If you are not comfortable and if you feel there are tumors in the ovary, we would what a transabdominal scan as well. This will tell us the ovarian and uterine cause. Tuberculosis of the uterus is some condition were we would want to do a diagnostic D&C and test for TB of the uterus also if it becomes beyond this stage where it shows normal in the uterus , ovaries or the hormonal assay we may have to go upto the brain tissues where we have to do MRI of the brain called as prolactinomas and a CT scan. Even some of the investigation like knowing the karyotyping of a woman may be required"

"To have regular cycles we have something called hypothalamus which is in the brain, ovaries which is responding to your uterine axis. There are hormones secreted in the hypothalamus which is called as GnRH hormone which goes into the pituitary gland to produce a hormone called as FSH and LH. This will act on the ovaries to produce the main two hormones called as estrogen and progesterone. These are responsible for regular ovulation and this causes regular bleeding. Whenever there is pathology in the hypothalamus or pituitary or ovarian cause. This causes irregular cycles. So the irregular cycles causes hypothalmo pituitary axis, that is as simple as stress related or going through anxiety period or nutritional imbalance, like excessive eating or vigorous exercise. Can be as simple as antihypertensive or antipsychotics or tumors in the brain. Second coming into thyroid gland. Thryoid abnormalities can cause a lot of irregular cycles. Coming to the ovaries, ovarian tumors, commonest cause being endometriotic cyst. Uterine abnormality like fibroid uterus, endometriosis or adenomyosis uterus or any tumors or common in Indian scenario called as tuberculosis uterus or vaginal infections, vaginal septum, absence of the uterus in vagina, all these conditions can cause these conditions"

"Irregular periods does cause difficulty in conception. There are various causes for irregular periods. To have regular periods, there is a HPO axis, which is a Hypothalamo pituitary ovarian axis. This is related form the brain to the ovaries then to the uterus, then the bleeding occurs. Any causes which will lead to irregular periods, which can be a Hypothalamic cause or an ovarian cause or a uterine cause which can lead to irregular periods. It becomes very important for us to know whether the irregular periods is just due to a physiological condition or a pathological condition. As long as we know it is a physiological condition, you need not worry that it can lead to pregnancy difficulty. There are various causes for physiological condition. It can be a stress or drug induced or nutritional defect or vigorous exercise. In these conditions you need not worry that there is any issue with the pregnancy but there are certain pathological conditions like a tumor in the brain or an abnormality in the uterus, where there is a fibroid or uterine tuberculosis or an ovarian cause which is the commonest being polycystic ovarian disease or endometriotic cyst. It can also have a defect in the vagina where here can be absence of vaginal septas. In these conditions there can be irregular periods. In that condition there is a difficulty in conceiving and you need to require to take guidance from your obstetrician"