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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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Anovulatory patterns Aumatma Simmons caloric restriction Fertility Fertility News follicular phases Hypothalamic amenorrhea inflammatory markers Inflammatory Pathways luteal insufficiency menstrual flow Neuroendocrine Factors nutritional assessment oral contraceptives PCOS polyps Reproductive Endocrinology reproductive health Reproductive Medicine symptomatic management Thyroid Function Uterine Fibroids
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