Understanding Abnormal Periods: Top 5 Tests Doctors Recommend

Top 5 Tests for Abnormal Periods

These tests help determine whether abnormal periods are due to hormone imbalance or any other health-related issues.

1. Hormone Tests: FSH, LH, Estrogen, and Progesterone

Hormones are responsible for ovulation, uterine lining, as well as the menstrual flow. Some of these hormone tests are:

• FSH (Follicle-Stimulating Hormone): Encourages the development of the ovarian follicles, and test is done on the 2nd or 3rd day of the cycle. Very high levels show you have low reserve eggs, while the low levels of it suggest a pituitary gland malfunction. 

• LH (Luteinizing Hormone): LH causes ovulation, and it is most likely you will find either an unbalanced or high level of LH in comparison with FSH in PCOS. A surge of LH provokes the ovulation to stop. 

• Estrogen: This hormone makes the uterus lining thicker. Having very low estrogen might lead to no menstruation; while high levels lead to heavy flow and mood changes. 

• Progesterone: This hormone maintains the uterine lining after ovulation, and the test is typically performed around day 21. The low level of progesterone reveals woman doesn’t ovulate, while high levels of it confirm ovulation. 

2. Prolactin Test

Prolactin primarily regulates milk production, which can lead to menstrual cycle disruption if it becomes elevated. A high amount of prolactin not only makes the menstruation light but also lead to a condition where menstruation stops totally. A few women can also experience the secretion of milk from their nipples even though they are not pregnant.

When to Test: Early morning, the best time would be 2–5 days of cycle after a good rest.

Interpretation: High levels of prolactin give the indications of pituitary problems or a hormonal imbalance, while low levels are usually not a cause for concern.

3. Androgen Profile: Testosterone and DHEA-S 

Androgens are the group of hormones, generally referred to as male hormones, however, they are also present in women. A rise in these hormones may cause your periods to become irregular, you may get acne, grow excess facial/body hair, and your scalp hair might become thin.

When to Test: Usually done early in the cycle (Days 2–5) or follow the instructions of your doctor.

Interpretation: Elevated androgens signify the presence of PCOS or other hormonal disorders; if levels are low, they hardly influence menstruation but may affect vigor and libido.

4. AMH (Anti-Müllerian Hormone)

AMH is an indicator of your egg supply; hence it shows the potential number of eggs that are still left in your ovaries.

Testing time: The test can be performed at any time of the menstrual cycle.

Explanation: Elevated AMH is typically associated with PCOS; reduced AMH might signal a decrease in the number of eggs as a result of aging or some ovarian abnormalities. The test is very valuable for women who want to become pregnant or are in doubt about their fertility capacity.

5. Thyroid and Metabolic Tests

The thyroid is the main organ that affects the metabolism,  energy, and reproductive health. The abnormal functions of the thyroid gland can cause changes in menstrual cycles.

Tests: TSH, Free T3, Free T4; fasting blood sugar and insulin levels.

When to Test: Any day of the cycle, preferably in the morning for thyroid; fasting is required for insulin/blood sugar test.

Interpretation: 

If TSH is high and T3 and T4 are low (hypothyroidism) → excessive, prolonged, or missed periods

If TSH is low and T3 and T4 are high (hyperthyroidism) → scanty, shortened, or frequent periods

If insulin is high → insulin resistance, which is typically associated with PCOS.