Are your periods not coming on time? Some months they are a few days late? Or do they not come at all? Or do you bleed heavily during your periods, or do they just stop for a little while? Many women have these kinds of problems. Most of the time we think this is normal. But did you know that even if you have your period, sometimes one of the most important processes that should happen inside your body, which is ovulation, may not happen. This is what we medically call anovulation. Today, we will talk about this in a simple way that you can understand.
Simply put, what is anovulation?
Simply put, anovulation is when your ovaries do not release an egg, which is supposed to be released once a month. This process, called ovulation, only happens once during your menstrual cycle. It is the egg that is released in this way that can unite with a sperm to create a pregnancy.
So, if ovulation does not occur, there is no possibility of pregnancy. This condition, called anovulation, is the main cause of infertility.
Imagine that the hormones in our body are like an orchestra. Beautiful music is created only when all the instruments are playing properly and in the same rhythm. If one violin or a serpent is played in the wrong place, the whole song will be disrupted, right? That's how it is. This complex process called ovulation requires a number of hormones to work together, in perfect harmony. Even a slight deficiency or excess of one hormone can disrupt the entire system and prevent ovulation.
How does the process of ovulation occur?
Ovulation usually occurs around day 14 of a 28-day menstrual cycle. This can vary by a few days depending on the length of the cycle.
1. The beginning: This begins with the release of a hormone called Gonadotropin-releasing hormone (GnRH) from the hypothalamus in your brain.
2. Message: This GnRH hormone goes to the pituitary gland in the brain and tells it to release two hormones called Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH) .
3. Ovulation: From the 6th to the 14th day of the menstrual cycle, follicles in the ovaries, which are small sacs containing eggs, begin to mature under the influence of the FSH hormone.
4. Release of the egg: Between 10-14 days, only one of these follicles matures completely and becomes large. As the 14th day approaches, the LH hormone level suddenly increases rapidly. It is because of that LH surge that the fully mature egg breaks out of the follicle and comes out. This is what we call ovulation .
Now you understand how complex this process is, and how important the balance of hormones is.
What are the symptoms of anovulation?
If you pay a little attention to your body and your menstrual cycle, it's not difficult to recognize these signs. Remember, getting your period doesn't always mean you ovulated.
| Symptom | What does this mean? |
|---|---|
| Irregular periods | If the number of days in your menstrual cycle varies frequently, such as 25 days one month and 40 days the next, it's irregular. The average cycle is 28 days, but it's normal for it to vary between 21 and 35 days. But if it varies a lot, it can be a problem. |
| Excessive or scanty bleeding | Usually, if a pad is completely soaked hour after hour for several hours, that is heavy bleeding. If it is just a little bit and stops after a few days, that is also abnormal. |
| Complete cessation of menstruation (Amenorrhea) | Even if you are not pregnant, if you do not have a period for several months, it is a strong sign of anovulation. |
| Lack of 'egg white' vaginal discharge | As you approach ovulation, your vaginal discharge will become clear and stretchy, like raw egg whites. This helps sperm move through more easily. If you don't see this type of discharge, you may not be ovulating. |
| Irregularity in basal body temperature | This is the body temperature that is measured in the morning before getting out of bed. After ovulation, the body temperature rises slightly. If you measure this every day and record it, you can recognize this change. If there is no such clear pattern, that is also a symptom. |
The important thing is that, while it may look like menstruation, it could actually be bleeding caused by a hormonal imbalance without ovulation. This is called anovulatory bleeding .
Why is ovulation not happening? What are the reasons?
The main reason is the hormonal imbalance we discussed earlier. There can be a number of factors that contribute to this.
1. Polycystic Ovary Syndrome (PCOS)
This is the most common and main cause of anovulation. About 70% of people with anovulation have PCOS . In this condition, the level of androgens, which are considered male hormones, increases in the body. Due to this, the follicles in the ovaries do not grow like a normal egg, but rather accumulate into small cysts. So, an egg is not released.
2. Body weight
- Obesity: When fat cells in the body increase, they also start producing hormones. This causes increased androgen levels in particular. This is similar to what happens in PCOS.
- Very low body weight: If the body weight is very low (Body Mass Index - BMI), that is, if it is at a malnutrition level, the pituitary gland in the brain does not receive the necessary signals to produce the FSH and LH hormones required for ovulation.
3. Excessive exercise and stress
- Excessive exercise: This condition can also occur in people like athletes who exercise excessively for hours on end, day after day. The excessive fatigue felt by the body disrupts the functioning of the hormonal system.
- Excessive stress: Excessive stress caused by things like exams, work problems, and family problems directly affects the production of the GnRH hormone in the brain. This can disrupt the entire hormonal chain.
4. Thyroid problems
The thyroid gland, which is shaped like a butterfly in your neck, produces hormones that affect almost every process in your body. When thyroid hormone levels are low (hypothyroidism) , it causes an increase in a hormone called prolactin . Prolactin is a hormone that normally helps nursing mothers produce milk. When this hormone is high, it suppresses the hormones FSH and LH, which are needed for ovulation.
5. Age
- Newly menstruating period: Anovulatory cycles are common in the first year or two after a young girl begins menstruating, as her hormonal system has not yet stabilized.
- Perimenopause: As you approach menopause in your 40s, your ovaries naturally stop functioning. You may still not ovulate and your menstrual cycles may become irregular.
What complications can occur due to anovulation?
This is not just a menstrual cycle disorder. If left untreated for a long time, it can lead to other health problems.
- Infertility: This is the main reason and one that many people seek medical advice for. If an egg is not released, pregnancy cannot occur.
- Endometrial hyperplasia: The hormone progesterone is produced after ovulation. When this hormone is lost, the lining of the uterus (endometrium) thickens. This can increase the risk of uterine cancer in the long term.
- Osteoporosis: The hormone estrogen is essential for strong bones. If estrogen levels decrease due to hormonal imbalance, bones can become thinner and more easily broken.
- Cardiovascular disease: Some hormonal imbalances, especially conditions like PCOS, are also linked to things like diabetes, high cholesterol, and high blood pressure, which increase the risk of heart disease.
How is this condition diagnosed and treated?
If you have an irregular menstrual cycle, the first thing you should do is see your doctor . He or she will ask you about your menstrual cycle and your lifestyle. Then, they will order a few tests to find out the exact cause.
- Blood tests for hormones: These test hormone levels such as progesterone, thyroid hormones, prolactin, FSH, and LH.
- Ultrasound Scan: This helps to check the condition of the ovaries (to see if there are any symptoms like PCOS) and the condition of the uterus.
Treatment methods depend on the cause of your anovulation.
1. Lifestyle changes
These are often the first things to try.
- Maintaining a healthy weight: If you are overweight, losing a little weight can make a big difference. If you are underweight, you need to gain weight in a healthy way. It is best to seek the advice of a dietitian for this.
- Stress management: Things like yoga, meditation, and breathing exercises can help reduce stress.
- Balancing exercise: If you are exercising excessively, your doctor may advise reducing the intensity and frequency of your exercise.
2. Medical treatment
If lifestyle changes alone don't help, your doctor will prescribe medication.
- Treating the underlying condition: If you have something like a thyroid problem, taking medication for it may help your ovulation return to normal.
- Ovulation Stimulation Medications: There are medications that can be given to a woman trying to conceive to help induce ovulation. Clomiphene citrate (Clomid) and Letrozole (Femara) are two of the most commonly used medications.
- Hormone injections: In some cases, hormones such as (HCG) and (FSH) may need to be administered through injections.
Very important: All of these medications should only be used under the supervision of a doctor. Never start or stop taking any of these medications without first consulting your doctor.
Those who are not successful with these treatments and are hoping to have children can also resort to techniques such as (IVF) or (IUI) .
When should you see a doctor?
If you have any of the following symptoms, see your doctor without delay.
| Do you also have these characteristics? | What to do |
|---|---|
| The menstrual cycle is incredibly irregular. It happens every few days, every month. | See your doctor immediately. |
| Menstruation can be heavy, very light, or last longer than a week. | See your doctor immediately. |
| There is pain in the lower abdomen or pelvic area. | See your doctor immediately. |
| If you are under 35, one year, or over 35, six months, if you have tried without any birth control and have not conceived. | Both you and your partner should see a doctor and seek advice. |
Anovulation can be a very distressing and distressing condition, especially for someone who is expecting a baby. But remember, you are not alone. This is a very common condition. And it can often be successfully treated. Even if you are not expecting a baby, getting this condition treated is very important to avoid future health complications. So, pay attention to your body. If you feel that there is a problem, do not be afraid to talk to a doctor. He or she will provide you with the best solution.
Take-Home Message
- Anovulation is the failure of an ovary to release an egg. This is a major cause of infertility.
- The main symptoms are irregular menstrual cycles, heavy or light bleeding, and months without menstruation.
- This is mainly caused by hormonal imbalances such as PCOS, body weight, high stress, and thyroid problems.
- It is essential to seek medical advice to diagnose and treat this condition. Avoid self-treatment.
- This condition can often be successfully controlled with lifestyle changes and proper medical treatment.
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