Menstruation is a normal, healthy process. In most cases, your menstrual cycle should not affect your day-to-day activities.  However, a few symptoms are signs of menstrual irregularity. If your menstrual periods stop (called amenorrhea), if you bleed between your periods, skip a period, or have very heavy menstrual periods this could mean that something is wrong. It is important to tell your doctor about these symptoms.

When not caused by pregnancy, menstrual irregularities are usually a sign of a larger condition or problem.  There are many conditions that can cause menstrual irregularities. Causes of abnormal menstruation can include pregnancy, breastfeeding, and extreme weight loss caused by serious illness, eating disorders, excessive exercising, or stress. Hormonal problems or more serious problems with the reproductive organs, may also be involved.

Reasons you might miss your period include:

• Eating disorders
• Endometriosis
• Extreme exercise (such as running long distances each day)
• Hormone problems
• Illness
• Medication side effects
• Premature ovarian failure
• Stress
• Sudden change in weight
• Uterine fibroids

Chart your cycle
The first step to diagnosing period problems is track your menstrual period.  This way, you can know the difference between a normal cycle and an abnormal cycle.  Use a calendar to keep track of your periods. Mark the first day your period starts on your calendar with an "X." Count the first "X" as day 1. Keep counting the days until you have your next period. If you do this every month, you will be able to tell how many days there are between your periods. This calendar tracking method will also help you learn when your next period should start.

The second step to getting a diagnosis is to note when and what symptoms occur during your menstrual cycle.  Mark on a calendar when symptoms occur and when they are most severe.  After you've carefully charted your symptoms for two to three cycles, discuss your findings with your doctor. Symptom charting will also help your doctor diagnose possible causes for the irregularities.

Diagnostic tests
Your doctor may also request a physical exam or other tests including:

• Blood tests (hormone, insulin, glucose, cholesterol, or triglyceride levels)
• CT scan
• Dilation and curettage
• Endometrial biopsy
• Hysteroscopy
• Laparoscopy
• MRI (magnetic resonance imaging)
• PAP test
• Pelvic exam
• Sonohysterogram
• Vaginal ultrasound
• X-rays

If you have any concerns about your menstrual cycle, discuss them with your doctor.  Proper diagnosis is critical to learning about correct treatment options. Together, you'll be able to see just how closely your symptoms relate to your menstrual cycle.  Continue reading to learn more about the causes of abnormal menstruation and how to treat menstrual problems.