The menstrual Period in most women lasts every 28 days or so, but cycles that are slightly shorter or longer than this in the range of 21 to 40 days is also normal. It is also normal that women do not always have a regular menstrual cycle. Menstrual periods may be early or late, and how long it lasts and how heavy it is may vary every cycle. Missed Periods can be a sign of many changes in a woman’s body. Women may experience missed periods, or periods might stop altogether due to many reasons. Finding the underlying cause can sometimes take time and usually requires more than one kind of testing. If a woman has 3 missed periods in a row, the gynaecologist for irregular periods treatment in Chennai will suggest diagnostic tests to arrive at the diagnosis.

Pregnancy test for missed periods

Missed periods are one of the first signs of pregnancy and the doctor will probably suggest a pregnancy test as the first test to rule out or confirm a possible pregnancy. A pregnancy test checks for a particular hormone called Human Chorionic Gonadotropin (HCG) in urine or blood. HCG is made in a woman’s body only during pregnancy. While the urine pregnancy test is done in a health center or home can find the HCG hormone about a week after a missed period, a pregnancy blood test can be done only in a health center that can find smaller amounts of HCG to confirm or rule out a pregnancy earlier than a urine test or even before missing a period.

Consultation with a gynaecologist for missed periods

If a pregnancy test is negative, there are a variety of other reasons for missed periods to occur. If the doctor feels that a medical condition might have caused missed periods, the woman is usually referred to the gynaecologist, who is a specialist in treating conditions that affect the female reproductive system. The most common reasons include:

• Stress
• Rapid weight loss
• Being overweight
• Too much exercise
• Taking contraceptive pills
• Menopause or perimenopause
• Polycystic Ovarian Syndrome (PCOS)
• Hormonal problems
• Genetic disorders
• Medical conditions of the heart, uncontrolled diabetes, thyroid disorders or early menopause.

The initial consultation for missed periods with the gynaecologist always involves discussions on personal and family medical history, sexual history, emotional issues if any, recent changes in body weight or physical activity.

Pelvic exam for missed periods

The gynaecologist may perform a pelvic exam to check for any problems with the reproductive organs. Through a pelvic exam, the position and size of the uterus, ovaries, and cervix can be assessed. After visual inspection of the vulva, vagina, and cervix, the doctor may physically examine the vagina by inserting her fingers to find and feel the pelvic organs to identify any unusual growths or painful spots. This may also include examination of the breast and genitals to check for normal changes of puberty.

Blood tests for missed periods

Blood tests recommended at the best gynaecology hospital in Chennai can check out a number of possible causes that include hormone levels or if needed, tests to detect gene abnormalities.  

• Thyroid function test measures the amount of thyroid-stimulating hormone (TSH) in the blood to determine if thyroid functions are normal. The thyroid is a gland that produces hormones to control the body’s metabolism. An underactive thyroid causes a condition hypothyroidism in which the thyroid does not produce enough of thyroid hormones. An overactive thyroid results in high levels of thyroid hormones in the body, causing hyperthyroidism. Both these conditions can affect the frequency of menstrual cycles, causing missed periods.
• Ovary function test is done to measure the amount of follicle-stimulating hormone (FSH) in the blood to indicate if there is any abnormalities of the ovaries. Levels of the ovarian hormone progesterone plays a vital role in pregnancy. A blood test one week before the menstrual cycle begins can provide the simplest and accurate method of detecting ovulation. 
• Prolactin test measures the level of lactating hormone called prolactin. Low levels of the hormone prolactin or high level condition called hyperprolactinaemia could mean a non-cancerous (benign) growth of the pituitary gland in the   brain, called prolactinoma.
• Male hormone test may be required to test the level of male hormones in the blood if there is increased facial hair and a lowered voice along with missed periods which may be the case in PCOS.

Hormone challenge test for missed periods

This is a special test also called the progesterone challenge test where hormonal medication for seven to 10 days to trigger menstrual bleeding is given and results can tell if periods have been missed due to a lack of oestrogen.

Imaging tests for missed periods

Based on the opinion derived from the signs and symptoms along with the result of  other tests, gynaecologists might recommend one or a few of the imaging tests that include:

• Pelvic ultrasound uses sound waves to visualise images of internal organs of the lower pelvis, including the uterus, cervix, fallopian tubes, ovaries, and bladder. The procedure uses sound waves that are emitted from a transducer or through a intravaginal probe. Pelvic ultrasound helps in the diagnosis of irregular menstrual bleeding, to view the lining of the uterus or to check for any abnormalities in the reproductive organs.
• Magnetic resonance imaging (MRI) uses radio waves with a strong magnetic field to produce highly detailed images of soft tissues within the body such as to check for a pituitary tumour. MRI can also be used to help find many of the structural causes of missed periods such as fibroids, polyps, endometriosis and adenomyosis.

Scope test for missed periods

If needed, the gynaecologist in OMR recommends hysteroscopy that is usually done in an operating room setting of the hospital, using a thin, lighted camera called the hysteroscope passed through the vagina and cervix to get a detailed view of the inside of the uterus. The image is transmitted to a screen and allows for a biopsy in diagnosing the cause for missed periods.

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