If a woman has late menstruation, the most common cause is ovarian endocrine dysfunction, resulting in long-term failure to ovulate, causing anovulatory gonorrhea, such as in patients with polycystic ovary syndrome. Other women are caused by organic diseases of the uterus, such as adenomyosis or multiple fibroids of the uterus, and may experience delayed menstruation. Other women may not actually have a period but may have abnormal vaginal bleeding, such as a pre-eclampsia or ectopic pregnancy, and may have repeated irregular vaginal bleeding that the woman mistakes for a menstrual flow. After a delayed menstrual flow, it is important to go to the gynecologist for an ultrasound and may require a blood test for HCG and hormone 6 to determine the exact cause.