When a patient experiences irregular periods, indicating irregular ovulation, the underlying cause is identified through a systematic evaluation. Initially, pregnancy is ruled out, as it is a common reason for secondary amenorrhea. Subsequently, tests are conducted for thyroid function and prolactin levels, and any issues found are addressed. If these are normal, Polycystic Ovarian Syndrome (PCOS) is considered. PCOS often presents with androgenic symptoms like excessive hair growth or acne, elevated testosterone, and a characteristic ovarian ultrasound appearance. Another potential cause is hypothalamic amenorrhea, frequently seen in individuals with compulsive exercise habits, eating disorders, high stress, or significant weight fluctuations. The diagnostic process involves a comprehensive assessment to pinpoint the specific cause of the ovulation problem, enabling appropriate treatment.