The anovulatory cycle is a menstrual cycle characterized by varying degrees of menstrual intervals and the absence of ovulation and a luteal phase. In the absence of ovulation, there will be infertility.
When you’re trying to conceive, it’s normal to begin paying closer attention to your cycle. After all, in order to become pregnant, you first must ovulate. It’s common to assume that your period is a sign that you’re ovulating normally. But surprisingly, that’s not always the case.
In an optimal scenario, a woman’s reproductive system will ovulate every month. But there can be situations that cause anovulation, or the lack of ovulation in a menstrual cycle. When that happens, you may still assume that the bleeding you’ve experienced was your monthly menstrual cycle. But if you’ve had an anovulatory cycle, it isn’t technically a period. If you’re trying to get pregnant, it’s important to understand the causes of an anovulatory cycle and options for diagnosis and treatment.
What’s an anovulatory cycle?
As its name suggests, an anovulatory cycle occurs when a woman skips ovulation. During ovulation, the ovary releases an egg or oocyte.
It’s not uncommon for a woman in her prime conception years to experience an anovulatory cycle occasionally. In fact, you may have experienced one and not even noticed. That’s because when a woman experiences anovulation, she may still seem to menstruate normally.
In a normal cycle, the production of progesterone is stimulated by the release of an egg. It’s 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. A woman may mistake this bleeding for a real period.
This kind of bleeding may also be 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.
Why do women experience an anovulatory cycle?
A menstrual cycle without ovulation is most common in two distinct age groups:
- Girls who’ve recently begun menstruating: 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: A woman between the ages of 40 and 50 is at a greater risk of changes to her hormones. This may lead to anovulatory cycles.
For women in both age groups, many changes are happening to their bodies. Sudden changes to hormone levels can trigger anovulatory cycles. Other causes include:
- bodyweight that’s too high or too low
- extreme exercise habits
- eating habits
- high levels of stress
How is anovulation diagnosed?
Diagnosing an anovulatory cycle can be simple when a woman has no period or periods that come very erratically. But that’s not the case for every woman.
To diagnose an anovulatory cycle, your doctor may check:
- 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.
The findings from these tests will help your doctor recommend the best treatment for you.
If these cycles are related to an outside influence like nutrition or lifestyle, effective treatments will include regulating eating habits and moderating physical activities. Making changes to your weight (gaining or losing weight as directed by your doctor) may also be enough to restart stalled ovulation.
Sometimes internal imbalances are the reason a woman is experiencing anovulatory cycles. In that case, your doctor may prescribe medications for fertility.
These medications are designed to combat the cause of a woman’s infertility. There are drugs designed to ripen the follicles, increase estrogen, and help the ovaries release an egg.
Women who do not ovulate and who want to get pregnant need a medical workup to d out why they do not ovulate. Drugs are often given to induce ovulation, including oral medication such as clomiphene or injectable medications. In patients who do not want to get pregnant anovulation can be managed with the use of cyclic progesterone or progestin supplementation or use of hormonal contraception.
Surgery is an option in the event that a serious complication, such as a tumor, is discovered.
Next steps
If you’re experiencing consistent anovulation — identified by very irregular and erratic cycles that vary wildly in length from one to the next — your doctor may recommend making small lifestyle changes.
Better nutrition, exercise, and stress relief can be very powerful. Try sticking to these changes for at least a few months, and then start paying close attention to whether your monthly cycle is becoming more consistent.
If these changes don’t seem to make a difference, or you just aren’t sure, speak to your doctor. Confirming the diagnosis of anovulation means you can find a solution.
Q:
Should you contact your doctor if you’re trying to get pregnant and are experiencing irregular periods?
Anonymous patient
A:
If you have a history of irregular periods and are thinking of becoming pregnant, it may be a good idea to let your doctor know in case you experience difficulties conceiving. Sometimes irregular periods can be a sign that you may be at increased risk for infertility. Otherwise, if you’re over the age of 35 and have tried to conceive for six months, or under 35 and have been trying to conceive for 12 months, you should contact your doctor if you still haven’t become pregnant. If you have any questions or concerns, you can also feel free to contact your doctor.
6 Questions Everyone Should Ask Themselves About Their Fertility, Right Now
Our in-depth State of Fertility study discovered that today, 1 in 2 millennial women (and men) are delaying starting a family. Find out more about the trends and what you need to know.
Let’s face it: Family planning is a huge and life-changing decision, and it can sometimes be uncomfortable to think or talk about. But like all scary medical things, it’s important to face your discomfort head-on. Your fertility is no different.
According to the Centers for Disease Control and Prevention (CDC), 12.1 percent of trusted sources of women will have difficulty getting or staying pregnant. So, grab your favorite hot beverage, sit down in your comfy chair, and give these questions some thought.
1. Do I want kids, and how many?
You don’t have to have a definite plan in mind, but try to have an idea of what your family planning goals are.
Do you want to have kids or think it might not be for you? Planning on becoming a mom within the next year? Do you want one kid or five?
Having a general idea can help you start to plan for the future. For example, if you want to have a big family, you should think about starting younger and spacing your kids closer together.
2. Should I freeze my eggs?
Egg freezing technology has had some significant advancements over the last several years, but it’s still not the right solution for all women and all situations.
Generally speaking, women in their 20s or early 30s will have greater success with egg freezing. Reproductive specialists have varying degrees of success with pregnancy after egg freezing. There’s no guarantee that freezing your eggs now will guarantee a baby later on.
If you’re thinking about freezing your eggs, call a fertility specialist to get more information.
What can I do to protect my fertility right now?
There’s so much you can do today to protect your fertility later on:
- Use protection: If you’re not in a monogamous relationship, make sure you use barrier contraception (like condoms) every single time you’re sexually active. Some sexually transmitted infections (STIs) can damage your reproductive organs and make it difficult — or impossible — to get pregnant later on.
- Maintain a healthy weight: Being overweight or underweight can make it more difficult to get pregnant.
- Quit smoking: If you’re smoking cigarettes, now is the time to quit. Seriously. It’s no secret that cigarettes are bad for you and can hurt a baby if you become pregnant.
Do I need medical testing?
The short answer: It depends.
- If you’re over the age of 35 and have been actively trying to get pregnant for over six months, most doctors will recommend you get evaluated.
- If you’re under the age of 35, testing is recommended if you’ve tried to conceive for over one year.
- If you’re not trying to get pregnant, it’s important to get tested for STIs regularly, especially if you’re not in a monogamous relationship.
As always, make sure to keep going to your yearly well-woman visits with your gynecologist.
5. Should I take prenatal vitamins?
Is babymaking in the near future? It may be beneficial to start taking your prenatal vitamin now. Docs recommend that a woman start taking a good quality prenatal vitamin before they actually start trying to conceive.
Look for a prenatal vitamin with at least 400 micrograms of folic acid, or ask your doctor for a recommendation.
Don’t forget your partner! It’s actually healthy for men to take a multivitamin around three months before they start trying for a baby, too.
6. What about my birth control?
Some forms of birth control have a longer impact than others. For example, some hormonal birth controls can delay your period for several months. (But check in with your doc to confirm everything is OK.)
If you’re thinking about getting pregnant in the near future, it may help you conceive faster if you stop using hormonal birth control a few months beforehand. On the other hand, if babymaking isn’t in your near future, you may want to consider something that’s more long-term, like an intrauterine device (IUD) or implant.
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