Anovulation: Causes, Symptoms and Treatments

If you’re trying to conceive, you’re probably going to be spending a fair bit of time thinking a lot about your menstrual cycle. Even if you haven’t given a whole lot of thought to your periods before, learning about your cycle and when you’re due to ovulate can often be the first step on the road to pregnancy. However, some women hit a roadblock here: anovulation. What causes these eggless cycles, and what can you do about them? Let’s break down what anovulation is and what it means for your fertility goals.

Anovulation: What is it?

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An anovulatory cycle refers to a menstrual cycle where your period arrives as normal, but your ovaries haven’t actually released an egg. If the ovaries fail to release an egg for three months or more, it’s considered to be anovulation. Anovulation is thought to be responsible for about 30% of all infertility cases.

Symptoms of an anovulatory cycle

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Some of the classic signs of anovulation include:

  • Irregular menstrual cycle which comes twice in a month
  • Decreased amount of menstrual blood
  • Absence of menstrual pain

These signs aren’t exclusive to anovulation, and can be tied to other problems. For example, hormone changes due to stress could throw your cycle off like this, but it returns to normal soon afterwards.

At the same time, it’s also possible to appear to be having regular periods while still having anovulatory cycles. In fact, many women don’t realize they haven’t been ovulating until they start trying to conceive.

How do you know if you have an anovulatory cycle?

BBT chart

An effective way to see if you’re ovulating or not is to chart your Basal Body Temperature (BBT) over the course of your menstrual cycle. In a regular cycle, there should be a spike in temperature just after ovulation as levels of the hormone progesterone begin to rise. Progesterone isn’t released in an anovulatory cycle, so the temperature graph should stay low throughout the month.

If the period of low temperatures continues for more than a couple of cycles in a row, take your charts with you to a gynecologist – they should be able to help you work out what’s going on. Your healthcare provider will likely conduct a blood test to confirm whether or not you’re anovulatory and identify the cause of anovulation by measuring the hormone levels in the blood.

What causes anovulation?

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There are a number of possible causes for anovulation, but a big one would be the endocrine system. In order for ovulation to happen as normal, there needs to be good communication between three parts of the body: the hypothalamus, the pituitary gland and the ovaries. Doctors call this the HPO axis.

Once per cycle, the hypothalamus in the brain tips off the pituitary gland that it’s time to get ready for ovulation. The pituitary responds by sending another chemical signal to the ovaries, telling them to start developing a batch of dormant ovarian follicles. Once one of them is fully matured ready to go, ovaries get another signal from the brain, and the follicle releases its egg. Voila! We have ovulation.

However, there can sometimes be breakdowns on this HPO chain of command. Excessive physical or mental stress can disrupt the hypothalamus’ reproductive functions, leading to hormone imbalances. This kind of stress can be caused by a number of factors, but may include some of the following.

  • Excessive dieting
  • Sudden weight loss
  • Extreme exercise
  • Psychological stress
  • Irregular lifestyle

Other possible factors in anovulation may include smoking, drug side effects, and underlying hormonal conditions such as polycystic ovary syndrome (PCOS).

If I’m anovulatory, can I still get pregnant?

If you aren’t ovulating at all, then there’s no egg present to combine with a sperm cell, making the whole “getting pregnant” business rather difficult. Fortunately, if you’re trying to conceive, fertility treatments are available to spur the ovaries into releasing an egg. These therapies have helped thousands of women conceive, so if you’ve been diagnosed with anovulation, speak to your doctor or fertility specialist about your treatment options.

Anovulation treatments and remedies

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Treatments for anovulation are based on the idea of inducing the ovaries into releasing an egg, but the precise therapy will depend on the underlying cause of your ovarian trouble.

For instance, fertility drugs such as Clomid® pills or hCG injections may be used to anovulation caused by sex hormone imbalances. On the other hand, if the anovulation is caused by high prolactin levels, doctors will tend to address it with dopamine agonists. Anovulatory women who are either obese or underweight may also benefit from a medically-approved diet and exercise program to support healthy hormone balance.

Early treatment for anovulation makes a difference

Anovulatory cycles may have a number of possible causes, but early diagnosis and treatment will allow your healthcare provider to determine the most appropriate treatment for you. Don’t hesitate to make an appointment with your doctor or OB-GYN if you notice anything unusual in your BBT chart or menstrual cycle.