If skipped periods or late menses, and the patient is sexually
active, we would suspect pregnancy and proceed to do a Urine
Pregnancy Test (which is highly specific after 5 days of conception
with regards to the human chorionic gonadotrophin
hormones)...
If the irregular menses is chronic, an abdominal ultrasound will be
done to reveal any presence of fibroids, ovarian cysts or
endometriosis... If it cannot be viewed properly, a transvaginal (a
probe inserted into the vagina) ultrasound will be done and a
sample of the cervix will be taken (if there is intermenstrual
bleed - bleeding in between menses) to rule out the possiblity of a
malignant change of the cervical tissues...
