Overview

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 women 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:

  • body weight that’s too high or too low
  • extreme exercise habits
  • eating habits
  • high levels of stress

If you’re having a period every 24 to 35 days, it’s likely that you’re ovulating normally.

In the United States, 10 to 18 percent of couples have trouble getting or staying pregnant. Chronic anovulation is a common reason for infertility.

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.

Treatment for anovulation

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.

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.

Katie Mena, MD

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Was this helpful?