Hello, I have gone through your query and understood the concern. The possibilities for the irregular bleeding in the current scenario are- weight changes, co-existing infections, use of medications that may interfere with the hormone milieu, stress and the last, polycystic ovaries. You will need a complete hormone profile to detect any deficiency. A complete blood picture, coagulation profile since you are using hormone contraceptives over years, urinalysis are also needed to exclude any pelvic and systemic infection. A clinical evaluation should be done and a sonogram of the pelvis, preferably through the trans-vaginal route, should also be done if not done already. This clarifies the picture and further management can be planned accordingly. Hope this helps.