Anovulatory cycle: symptoms, diagnosis, treatment

Every woman has anovulatory menstrual cycles. What it is, how to determine whether they are considered the norm and when treatment is required? You will find the details in our article.

What is an anovulatory cycle?

An anovulatory cycle is a menstrual cycle during which ovulation does not occur and therefore the woman will not be able to become pregnant.

The number of cycles per year depends on their duration, which usually ranges from 21 to 35 days. During a calendar year, with a regular cycle, a woman experiences an average of about 13 menstruations. Some of these cycles are anovulatory and this is completely normal.

An anovulatory cycle may be the reason why a woman fails to conceive on the first attempt.

As menopause approaches, anovulatory cycles occur more frequently. This is due to hormonal changes.

Ovulatory vs anovulatory cycles: what's the difference?

If you have regular periods and feel the usual changes in your body during the cycle (pain in the lower abdomen in the middle of the cycle, breast swelling at the end of the cycle, or symptoms of PMS), you probably have ovulated.

You can check this yourself by tracking changes in basal body temperature or by doing an ovulation test.

Lack of ovulation can be suspected if periods are irregular, and the cycle may be too short (less than 21 days) or very long (more than 35 days).

If you often experience delays of more than 2 weeks and cannot determine ovulation using tests or basal body temperature charts, see your doctor.

How to identify an anovulatory cycle?

In order to determine ovulation, the doctor usually prescribes several ultrasounds. With their help, it is possible to confirm the maturation of the follicle, the release of the egg from it and the formation of the corpus luteum, as well as to evaluate the characteristics of the endometrium.

Usually 3-4 studies with an interval of 2-3 days are sufficient.

The doctor may also order a blood test for hormones according to the phase of the cycle. During the follicular phase (day 3-5), the levels of follicle-stimulating (FSH) and luteinizing (LH) hormones, prolactin, thyroid hormones and estradiol are measured. With a regular cycle in the middle of the luteal phase (20–23 days), the level of progesterone is also determined.

If the ultrasound shows the formation of a corpus luteum, and the level of progesterone during the luteal phase reaches the peak, ovulation has occurred.

With an anovulatory cycle, the follicle does not mature and the egg does not come out of it.

If tests reveal lack of ovulation or a luteal phase deficiency (when the corpus luteum does not produce the required amount of progesterone), the doctor may prescribe treatment.

Lack of ovulation can be suspected if:
• the menstrual cycle is disturbed: the length of the cycle varies greatly (7 days or more); your cycles are less than 21 or more than 35 days (in very rare cases, regular cycles can also be anovulatory);
• the woman is diagnosed with polycystic ovary syndrome (PCOS), thyroid dysfunction, or elevated prolactin levels.
• lack of ovulation can also be the result of stress, unbalanced diet, low weight or being overweight.

Non-drug ways to restore ovulation

There are several simple ways to stimulate ovulation.

Change your diet. Choose healthy foods, especially those rich in folate (green leafy vegetables, lentils, broccoli); avoid fried and sweet foods.

If you have bad habits, get rid of them. Smoking and alcohol can affect ovulation negatively.

Be physically active. Very often, the anovulatory cycle is associated with low weight or being overweight. Daily exercise will help you maintain healthy weight and relieve stress.

Increase the duration of sleep and try to improve its quality. Organize the daily routine (time of sleep and wakefulness), use a sleep mask or purchase dark curtains, create a favorable microclimate in the bedroom.