An ovulation may be caused by several endocrinologic disorders. Screening for abnormal thyroid function or elevations in the hormone prolactin is typically required. In these cases, specific treatment of those disorders is necessary. Many women who are an ovulatory have polycystic ovarian syndrome (PCOS) which is diagnosed when there is evidence for elevations in androgen levels (like testosterone) and ultrasound findings of many small immature follicles in the ovaries. These women may be benefit from clamed treatment or in some cases with insulin sensitizing medications like glucophage. Women who don’t menstruate at all (amenorrhea) require investigation to assess the cause of the problem that may relate to abnormalities of the brain (hypothalamus and pituitary gland) or the ovaries. These women may require more involved treatments, like injectable fertility medications.