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Aumatma Simmons: Do You Have PCOS If Your Menstrual Cycle Is Irregular?
Aumatma Simmons/LinkedIn
Mar 5, 2026, 06:54

Aumatma Simmons: Do You Have PCOS If Your Menstrual Cycle Is Irregular?

Aumatma Simmons, Co-Founder, Chief Fertility Officer at Madre Fertility, shared a post on LinkedIn:

“In reproductive endocrinology, irregular cycles are often reflexively attributed to PCOS without comprehensive evaluation. This diagnostic shortcut overlooks critical underlying pathophysiology.

Redefining ‘Normal’ Parameters:
While standard references cite 21-35 days as normal, optimal reproductive function typically requires 24-35 day cycles. Cycles under 24 days frequently indicate luteal insufficiency or accelerated follicular phases.

Comprehensive Differential Diagnosis:

  • Neuroendocrine Factors:
  • HPA axis dysfunction from chronic stress
  • Subclinical thyroid disorders affecting ovulatory mechanisms
  • Inflammatory Pathways:
  • Systemic inflammation from autoimmune conditions
  • Chronic infections disrupting reproductive hormones
  • Metabolic Disruption:
  • Relative energy deficiency in sport (REDs)
  • Hypothalamic amenorrhea from caloric restriction
  • Structural Abnormalities:
  • Uterine fibroids or polyps
  • Anatomical variants affecting menstrual flow

Clinical Red Flags:

  • Cycles <22 or >34 days
  • Anovulatory patterns
  • Amenorrhea >3 months

The Treatment Gap:
Current standard care often employs hormonal suppression (oral contraceptives) rather than investigating etiology. This approach masks symptoms while the underlying pathology persists.

Evidence-Based Approach:
Comprehensive evaluation, including thyroid function, inflammatory markers, nutritional assessment, and stress hormone analysis, enables targeted therapeutic intervention.

Clinical Outcome: Root cause treatment yields superior long-term results compared to symptomatic management.

How are you approaching irregular cycles in your practice? Are we asking the right diagnostic questions?”

Proceed to the pages attached to the post.

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