The anovulation definition is definitely an infertility cause. It be treated successfully, sometimes with certain lifestyle modifications, medications, or surgery.
Anovulation definition is the absence of ovulation; that is, the condition that occurs when the ovaries do not produce eggs. Usually this is due to hormonal imbalances and its most obvious effect is the inability to achieve pregnancy.
The most common is that in each menstrual cycle an egg is released and it travels to the fallopian tube, where it can be fertilized. However, it is also normal that in some of these cycles the egg does not mature enough and is not released.
For obvious reasons, if there is no ovulation, there can be no fertilization either. It is estimated that up to 25% of infertility cases are related to anovulation. However, one must not lose sight of the fact that some of the menstrual cycles are anovulatory and that this is normal.
Anovulation usually occurs hand in hand with the absence of bleeding.
The main symptom of anovulation is the absence of menstruation, or amenorrhea. However, in these anovulatory cycles there may also be bleeding that is mistaken for normal menstrual flow.
Therefore, it is necessary to take into account other symptoms such as the following:
- Decrease in premenstrual syndrome.
- Irregular menstrual periods.
- Shorter than normal menstrual periods.
- Absence of cervical mucus.
- Excessive or very light bleeding.
- Irregular basal body temperature.
- Impossibility of getting pregnant.
Ovulation prediction kits can be found in pharmacies. These are available over the counter and measure hormone levels in the urine. In this way, it is possible to know when a woman is ovulating. This helps to detect anovulation indirectly.
Why does a cycle occur without ovulation?
The causes of anovulation can be of very different nature. The usual thing is that it has to do with hormonal imbalances or that it occurs as a result of an inappropriate lifestyle.
According to the World Health Organization (WHO), the causes of anovulation can be classified into three large groups, as we will see shortly.
Group I: hypothalamic-pituitary failure
Anovulation can be the effect of the lack of secretion of a hormone called GnRH, which originates in the hypothalamus; or others, called gonadotropins, which are produced in the pituitary. These are the hormones which are responsible for the entire menstrual cycle.
It is estimated that 10% of ovulatory dysfunctions, including anovulation, have their origin in the malfunction of the hypothalamus or pituitary. The following are some of the reasons for this deficiency in the secretion of these hormones:
- Excessive physical exercise.
- Abrupt weight changes, especially in cases of anorexia or bulimia.
- Chronic renal failure.
- Chronic liver diseases.
- Hypogonadotropic hypogonadism.
- Kallman syndrome.
Group II: Hormonal alterations
In this group is located the disorder that causes 80% of cases of anovulation that leads to infertility, or anovulatory infertility. This disorder is polycystic ovary syndrome (PCOS).
This pathology influences so that the ovules do not reach maturity and, therefore, are not released. Women with this pathology also tend to have signs of hyperandrogenism, such as acne or the appearance of hair on the face.
This group also includes hyperprolatinemia, or an abnormal increase in a hormone called prolactin. Also, thyroid disorders, such as hypothyroidism or hyperthyroidism. All of them can lead to anovulation.
Group III: Ovarian failure
Anovulation is also due to by an abnormality known as premature ovarian failure (PFO). It occurs when the ovaries stop working before the age of 40, before woman reaches the average age of menopause.
In these cases, there is a drop in estrogens. The levels of the hormones produced by the pituitary are normal, but the ovaries fail to respond. Therefore, they stop producing mature eggs and lead to anovulation.
Some medications and treatments also cause anovulation. Among the medications that can prevent ovulation are the following:
- Contraceptives or birth control pills.
- NSAIDs or non-steroidal anti-inflammatory drugs.
- Hormone creams and topical products.
- Drugs for epilepsy or seizures.
- Herbs and natural remedies.
- Some supplements.
Anticancer drugs, as well as chemotherapy and radiation, can cause permanent damage to the ovaries. Your doctor may prescribe an alternative medicine to stimulate ovulation.
When to consult a professional?
Consult the doctor, in particular, when you’ve made an attempt to conceive and has not been successful. The reason this occurs may be anovulation and may require assisted fertility treatment.
It is also advisable to check if there is amenorrhea with some frequency, the periods are very irregular or short, menstrual bleeding is too heavy or too little, or if you have any of the health conditions that cause anovulation.
The doctor will order different tests to confirm the absence of ovulation.
The usual thing is that the doctor begins by conducting an interview to find out the medical history. He will also perform a pelvic exam. Once done, you will most likely order a few procedures like the following:
Blood test. You need to do it between days 21 and 23 of the menstrual cycle to measure the level of progesterone. If it is very low, it is most likely that the patient is not ovulating.
Gynecological vaginal ultrasound. It allows to establish if there are cysts in the ovary or an increase in size in these organs. These are common symptoms of PCOS.
Serial ultrasounds. It allows you to monitor the process and establish if there’s completion or not.
It is possible that, depending on the case, other tests such as thyroid blood levels, examination of the lining of the uterus, etc.
How can you treat it?
The treatment of anovulation will depend on the cause that originates it. The usual thing is that it begins with the adoption of modifications in the lifestyle. These include changes in diet, physical activity, and stress management. Many times this is enough to overcome the problem.
On some occasions, especially if you are trying to get pregnant, you may use medications such as the following:
- Clomiphene citrate.
- Human chorionic gonadotropin (hCG).
- Follicle Stimulating Hormone (FSH).
- GnRH agonists and antagonists.
The use of these drugs induces ovulation and is usually very successful. However, if they don’t work, you may want to have surgery called an ovarian drilling. It is minimally invasive and causes the level of testosterone to drop. When this happens, it helps ovulation
Anovulation definition – it prevents pregnancy
It is advisable to monitor ovulation, especially if the intention is to get pregnant. This helps to become more aware of the so-called “fertile window” or stage in which ovulation occurs and fertilization is more feasible.
This works by detecting your basal body temperature and confirming that ovulation has occurred. It also makes it possible for doctors to detect anovulation. All this contributes both to planning and avoiding pregnancy and to better control of gynecological health.
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