The untold story of Anovulatory cycles; a leading cause of infertility in women

What is Anovulation?
Anovulation is the lack of ovulation when you don’t release an oocyte.
If you’re trying to conceive, it is normal to start paying closer attention to your cycle. Needless to say that you must ovulate in order to become pregnant.
It is usual to assume that your period is a sign that you’re ovulating but let me shock you, it is not always the case.
In a normal scenario, a woman’s reproductive system will ovulate every month. However, there are some situation that causes anovulation (lack of ovulation) in a menstrual cycle. If that happens, you may still assume that the bleeding you’ve experienced was your normal cycle, but if you’ve had an anovulatory cycle, it isn’t technically a period.
What is an anovulatory cycle?
Just as its name, an anovulatory cycle occurs when a woman skips ovulation. Normally, the ovary releases an egg or oocyte during ovulation.
It is not unusual for a woman in her prime to experience anovulatory cycle. As a matter of fact, you may have experienced one and not be aware. That is because when a woman experiences anovulation, she may still seem to menstruate normally.
Why do women go through an anovulatory cycle?
A menstrual cycle without ovulation occurs often in two distinct age groups:
  • Girls who just started menstruation: in the year following a girl’s first period, known as menarche, she’s more likely to experience anovulatory cycles.
  • Women who are close to menopause: women between the age of 40 and 50 are at a greater risk of changes to her hormones. And this may lead to anovulatory cycles.
Many changes are happening in the bodies of women in these two groups. Sudden changes in hormone levels can trigger anovulatory cycles.
Other causes of Anovulation
  •     Obesity.
  •     Too low body weight.
  •     Extreme exercise.
  •     Hyperprolactinemia.
  •     Premature ovarian failure.
  •     Perimenopause, or low ovarian reserves.
  •     Thyroid dysfunction (hyperthyroidism)
  •     Extremely high levels of stress.
What are the signs that you’re not ovulating?
If you are not experiencing these signs below, you are probably not ovulating:
1. Cervical mucus change
2. Increase sense of smell
3. Tenderness or soreness in the breast
4. Mild pelvic or lower abdominal pain
5. Discharge or light spotting
6. Change in libido
7. Change in cervix
If you will like to know how these signs may be an indication that you’re not ovulating, click here to read more.
 
If you are having a period every 24 to 35 days, it’s likely that you’re ovulating normally. However, chronic anovulation is a common reason for infertility. Unfortunately, in Nigeria, about 10% of women have trouble getting or staying pregnant.
Other reasons why your ovulation may not be happening
Ovulation doesn’t take place or it can be irregular in some women. Generally, if you are pregnant, menopausal or you take birth control pills regularly and on time, you won’t ovulate.
  • Certain diseases or disorders (such as polycystic ovarian syndrome (PCOS) or premature ovarian failure, among other conditions) and certain medications (including some antidepressants, anti-nausea medication and chemotherapy) may cause a woman to stop ovulating for periods of time.
  • Lifestyle factors such as stress or being overweight (measured by body fat) or significantly underweight may affect menstruation and ovulation.
If you’re dealing with irregular menstruation or the ones that are short (fewer than 21 days) or long (more than 35 days), get a medical evaluation to rule out any underlying medical conditions that might be causing those irregular cycles.
Yes, it is difficult to track ovulation with irregular cycles but do know that ovulation occurs 14 days before the onset of menstruation, so even with irregular periods, you could still conceive at some point in your cycle.
Ovulation won’t occur during the period you’re breastfeeding. So, if you’re breastfeeding your baby exclusively, do note that you likely won’t ovulate during that time. However, there are exceptions, so don’t use breastfeeding as a means of birth control.
Plan your birth control accordingly, unless you want to give your baby a possible surprise.
Frequently Asked Questions (F.A.Q.)
Can a woman just stop ovulating?
About one percent of women go through the menopause earlier than usual and stop ovulating before they reach the age of 40. This is usually preceded by an irregular period and as you approach menopause your periods may become fewer and this makes ovulation increasingly irregular too.
Can you not ovulate and have a period?
Technically, if a woman is not ovulating or releasing an egg, she shouldn’t have any bleeding at all. This bleeding is called anovulatory bleeding and even though it is like a regular menstrual period, it is not the same thing and should not be confused for a normal period.
Can you have a period without ovulating?
In a normal cycle, the production of progesterone is stimulated by the release of an egg. It is this hormone that helps a woman’s body maintain regular periods. But during an anovulatory cycle, an insufficient level of progesterone can lead to heavy bleeding. It is easy for a woman to mistake this bleeding for a real period. This kind of bleeding may be also caused by a buildup in the lining of the uterus, known as the endometrium, which can no longer sustain itself. It can be caused by a drop in estrogen as well.
How is anovulation diagnosed?
It is easy to diagnose anovulation if a woman has no period or periods that come very erratically. But that doesn’t happen with every woman.
Fortunately, there are few things your doctor can check, which includes;
  • your progesterone levels
  • the lining of your uterus
  • your blood for the presence of certain antibodies
Your doctor may also perform an ultrasound to take a closer look at your uterus and ovaries.
Treatment of anovulation
If the findings from the test show that the cycles are related to an outside influence like nutrition or lifestyle, we do have effective treatments and recommendations
Surgery is an option in the case of a serious complication, such as when a tumour is discovered.
Confirming the diagnosis of anovulation means you can find a solution, so don’t give up, there is hope.

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