What does an irregular menstrual cycle in a suspected PCOS patient indicate?

An irregular menstrual cycle in a patient suspected of having polycystic ovary syndrome (PCOS) is indicative of ovarian dysfunction. PCOS is characterized by a hormonal imbalance that affects the way the ovaries function, leading to irregular ovulation or anovulation, which directly contributes to the irregularity of menstrual cycles.

When the ovaries are not releasing eggs regularly, the hormonal signals necessary for regulating the menstrual cycle become disrupted. This results in variations in menstrual cycle length, often leading to cycles that are either significantly longer or shorter than what would be expected in a typical menstrual pattern. Additionally, the hormonal profile in PCOS often includes elevated levels of androgens, which can further impact the regularity of menstruation.

While endometrial hyperplasia, normal physiological variations, and thyroid dysfunction can also affect menstrual cycles, in the context of PCOS, the primary issue is the dysfunction of the ovaries themselves. This makes ovarian dysfunction the most accurate explanation for irregular menstrual cycles in suspected PCOS patients.