Let's say you're wanting to become pregnant — you need to get your uterine health all checked out, with a pap smear and everything from your gynecologist. When your periods are irregular, it's a sign that you may not be ovulating correctly.

A menstrual cycle is a direct sign that you ovulated — but it needs to be regular. If you haven't had a period in three months and you then bleed in the fourth month does not mean you've ovulated. Having a regular period of four months in a row does. Irregular periods are often directly tied to infertility.

To treat infertility, you first need to be diagnosed. if you think you're infertile, see a doctor first.

After you're diagnosed, you can start to treat it by improving your ovaries' cycle and lowering your testosterone production. Typically, your gynecologist will put you on birth control pills to give you extra estrogen to help your ovaries rest (this will help you ovulate properly and lower your body's testosterone). After a year of that, you will probably be able to stop, since you've kickstarted your period. But you can't only be on birth control for that year — you need to use that time to make sure you are wholly healthy. Lose weight (and thus insulin resistance) if that is a need, so it'll be easier for your body to keep up with your regular periods without the help of your hormone therapy (birth control pill).

I've also treated patients with Metformin. It's very well studied, cost-effective, and reliable. It helps facilitate weight loss, improves insulin resistance, and improves ovulation for women with PCOS.

Once you do these things, you should ovulate regularly. If these things do not work, there are more complicated treatments that your doctor has access to. You'll go from simple to complicated treatments, one step at a time. The timeframe will also make a difference in your treatment. If you're young and not in a rush to get pregnant, you'll probably be treated with simple methods. If you're older and "really need to get pregnant right now," your doctor may choose more complicated treatments first (to give you the best chance of success).

Villanova University

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