Anovulation

The absence of ovulation, leading to irregular or absent menstrual cycles.

Anovulation: What You Need to Know

‍

Anovulation is a condition where the ovaries do not release an egg during the menstrual cycle. This means that ovulation, the process of the egg being released from the ovary and travelling to the fallopian tube, does not occur. Anovulation can affect a person's fertility, menstrual cycle, and hormone levels.

‍

Causes of Anovulation

‍

Anovulation can be caused by various factors that disrupt the hormonal balance in the body. Some of the common causes of anovulation are:

‍

  • Polycystic ovary syndrome (PCOS): This is a hormonal disorder that affects up to 10% of people with ovaries of reproductive age. PCOS causes multiple cysts to form on the ovaries, which interfere with the normal ovulation process. PCOS can also cause high levels of androgens (male hormones), insulin resistance, weight gain, acne, and excess hair growth.

‍

  • Hypothalamic amenorrhea: This is a condition where the hypothalamus, a part of the brain that regulates many bodily functions, stops producing gonadotropin-releasing hormone (GnRH). GnRH is responsible for stimulating the pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are essential for ovulation. Hypothalamic amenorrhea can be triggered by stress, weight loss, excessive exercise, or eating disorders.

‍

  • Premature ovarian failure (POF): This is a condition where the ovaries stop functioning before the age of 40. POF can be caused by genetic factors, autoimmune diseases, chemotherapy, radiation, or surgery. POF results in low levels of oestrogen and progesterone, which are needed for ovulation and menstruation.

‍

  • Thyroid disorders: The thyroid gland produces hormones that regulate metabolism, growth, and development. Thyroid disorders can affect the production and balance of other hormones in the body, including those involved in ovulation. Hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can both cause anovulation.

‍

  • Prolactinoma: This is a benign tumour of the pituitary gland that produces excess prolactin, a hormone that stimulates milk production in lactating people. High levels of prolactin can inhibit GnRH secretion and suppress ovulation.

‍

Symptoms of Anovulation

‍

The main symptom of anovulation is irregular or absent menstrual periods. However, some people may still experience bleeding without ovulating. This is called anovulatory bleeding and it is caused by the buildup and shedding of the uterine lining without the influence of progesterone. Anovulatory bleeding can be unpredictable, heavy, or prolonged.

‍

Other symptoms of anovulation may include:

‍

  • Infertility or difficulty conceiving
  • Lack of premenstrual symptoms or breast tenderness
  • Low libido or sexual desire
  • Mood swings or depression
  • Hot flashes or night sweats
  • Vaginal dryness or irritation
  • Osteoporosis or bone loss

‍

Diagnosis and Treatment of Anovulation

‍

To diagnose anovulation, a healthcare provider may perform a physical examination, review medical history, and order blood tests to measure hormone levels. They may also use ultrasound imaging to check the ovaries and uterus for any abnormalities.

‍

The treatment of anovulation depends on the underlying cause and the person's reproductive goals. Some of the possible treatments are:

‍

  • Lifestyle changes: These include maintaining a healthy weight, reducing stress, exercising moderately, eating a balanced diet, and avoiding smoking and alcohol.
  • Medications: These include oral contraceptives or progestin pills to regulate menstrual cycles and prevent endometrial hyperplasia (thickening of the uterine lining), or ovulation-inducing drugs such as clomiphene citrate or letrozole to stimulate egg production and release.
  • Surgery: This may be an option for people with PCOS who have enlarged ovaries with multiple cysts that do not respond to medication. Surgery involves removing part of the ovarian tissue or drilling holes in the cysts to restore normal hormone levels and ovulation.
  • Assisted reproductive technology (ART): This includes procedures such as in vitro fertilisation (IVF) or intrauterine insemination (IUI) that help people conceive using their own or donor eggs and sperm.

‍

Sources

‍

_ Debbo Africa: https://debbo.africa

- Cleveland Clinic. (n.d.). Anovulation: Signs, Symptoms, Causes & Treatment. Retrieved from https://my.clevelandclinic.org/health/diseases/21698-anovulation

- Wikipedia. (2021). Anovulation. Retrieved from https://en.wikipedia.org/wiki/Anovulation

- Merriam-Webster Medical Dictionary. (n.d.). Anovulation. Retrieved from https://www.merriam-webster.com/medical/anovulation