If you have no periods or very irregular cycles, particularly if your cycle is shorter than 24 days or longer than 45 days, you likely have an ovulation disorder.  

Main Causes of Ovulation Disorders  

1. Polycystic Ovary Syndrome (PCOS)  

   - The most common ovarian disorder affecting ovulation.  

2. Hypogonadotropic Hypogonadism (brain-related ovulation dysfunction)  

   - Caused by impaired brain signaling that regulates follicle selection in the ovaries.  

   - Potential causes:  

     - Brain tumors  

     - Radiotherapy to the brain  

     - Certain medications  

     - Genetic factors  

   - Severe weight loss, restrictive eating, or intense physical activity can also disrupt the hypothalamic-pituitary axis, leading to low FSH and LH levels, which can stop ovulation.  

3. Hypergonadotropic Hypogonadism or Premature Ovarian Insufficiency (POI)  

   - Previously called "early menopause", this condition is due to excessive depletion of ovarian follicles.  

4. Medication-Induced Amenorrhea (Absence of Periods)  

   - Some medications can suppress ovulation and menstruation, including:  

     - Neuroleptics (antipsychotics)  

     - Progestin-based treatments  

If you suspect an ovulation disorder, a medical evaluation is recommended to identify the cause and explore treatment options.

A pelvic ultrasound helps:  

- Measure uterine size and assess its structure (cervix and uterine body).  

- Identify fibroids (benign growths in the uterine muscle).