Initially the doctor will enquire regarding some more details about when the period of the woman starts, how many days it lasts and when it reappears.
In women with irregular cycles, hormonal disorders that may involve higher centers of the brain, pituitary gland, and ovaries will be explored (increased stress, weight disorders, strenuous exercise, hyperprolactinemia, etc.). Correction or adjustment of these disorders will often contribute to resolution of symptoms. Some symptoms that sometimes occur along with period disorders will often give the key to the diagnosis of the primary cause. Heavy and painful periods, e.g., accompanied by pain during intercourse will increase the suspicision for adenomyosis. Menorrhagia which is associated with increased vaginal secretions, and abdominal pain can lead a diagnosis of pelvic inflammation.
The woman’s age is also a key factor that determines the need for more investigations. Patients who are under 40 years old have a low risk of developing endometrial cancer. Pharmaceutical treatment can be the first line of therapy, and further investigation may be required only when symptoms persist. On the other hand, women with menorrhagia and close to menopause, it could be then worthwhile performing further investigations, however the risk for endometrial cancer still remains low. From the medical history it could also lead to the discovery of some blood clotting disorders or undiagnosed thyroid disease.