What is Ovulation & Anovulation? Why is your menstrual cycle so important and what areas of your life can it effect?
What is ovulation?
Ovulation occurs when a woman’s ovary ejects a ripe egg in readiness for fertilization. Ovulation generally commences within a couple of years after the onset of puberty and occurs monthly until menopause. In a normal 28-day menstrual cycle ovulation occurs about 14 days from the first day of your last menstrual period.
At the point of ovulation the follicle (sac surrounding the egg) only breaks open and releases the egg. The egg moves into the fallopian tube (horn of the uterus) and can be fertilized by male sperm within 12-48 hours. If it is not fertilized, it disintegrates. Ovulation disorders cause 25% of infertility in females.
What is Anovulation?
Anovulation is when ovulation fails to take place. It is not uncommon
for this to happen occasionally during a woman’s reproductive lifecycle, however around 10% of women experience anovulation on a regular basis.
The failure of the ovary to release a mature egg has a dramatic impact on the production of the hormone progesterone which is only produced if ovulation is successful. As a consequence, this has a disruptive effect on the woman’s hormonal balance. Multiple anovulatory cycles generally result in a variety of symptoms which can adversely affect a woman’s quality of life, overall general health, fertility and, with time, lead to more severe medical conditions.
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How can I detect ovulation?
If you have variable periods, counting days is ineffective for determining when you ovulate. Look for these signs of ovulation:
- Your cervical mucous looks like egg white (clear, slippery, and stringy)
- Your basal body temperature (BBT) before you arise from bed is elevated 0.2°C (0.4°F-0.6°F) above its usual level (around 37°C)
- Slight to mild pelvic pain
- Possible spotting or slight bleeding for 1-2 days mid-cycle (not equivalent to a menstrual flow)
You can also use an ovulation test kit, available from your pharmacist. Prices vary from about $20-$65.
If you do not have these signs and symptoms of ovulation mid-cycle, then the following menstrual period will possibly be heavy and/or painful due to anovulation.
How do I calculate blood loss?
A regular menstrual pad or tampon holds around 5 milliliters (ml) of blood. To calculate the approximate amount of blood you have lost if you wear regular pads or tampons, multiply the number you used by the number of days you have been bleeding. For example:
10 regular pads X 5 days = 50 ml of blood lost (a heavy period)
An overnight pad or super tampon holds around 10 ml of blood. To calculate the approximate amount of blood you have lost if you wear extra-absorbent pads or tampons, multiply the number you used by the number of days you have been bleeding. For example:
20 extra-absorbent pads X 10 days = 200 ml (menorrhagia)
In the first example, you do not require treatment. In the second example, you require treatment to prevent iron deficiency anemia.
If you are really concerned about being absolutely accurate, you can:
- Weigh a dry pad and record the result
- Weigh each and every pad you use during the entire period and record the results
However, this type of exact measurement is time-consuming and usually unnecessary. If you think you have menorrhagia, your doctor will verify your estimate with a Complete Blood Count (CBC) and iron studies. The doctor will pay particular attention to the hemoglobin and hematocrit results included in the CBC, and the ferritin level in the iron studies.
Low levels of hemoglobin, hematocrit and ferritin confirm that you have anemia.
What causes Anovulation?
Anovulation can occur for a variety of reasons. Traumatic events such
as high or prolonged stress, grief and extreme physical exertion can be disruptive to the normal ovulatory cycle. More commonly anovulation
is the result of exposure to estrogens either natural, supplemented or environmental. Anovulatory cycles is one of the potential consequences
of what is commonly termed estrogen dominance and is characterized by high surges of estrogen and low levels of progesterone.
Taking an oral contraceptive is a chemically induced form of anovulation. Birth control pills suppress the release of an egg and thus prevents pregnancy. Many women do not realize that this suppression of ovulation is how the Pill actually works and in doing so results in little or no natural progesterone production.
Anovulation is a normal consequence of frequent breastfeeding. However, it is not always the case and you may still release an egg if you do not breastfeed every two hours, so use contraception if you do not want your children spaced closely together.
Anovulation can also be caused by the following:
- The onset of menopause (perimenopause)
- Depleted egg supply
- Eating disorders (obesity, anorexia, or malnutrition)
- Genetic disorders
- Heavy athletic training
- High and/or sustained stress
- Occupational exposure to radiation or environmental toxins
- Pituitary gland tumor in the brain
- Polycystic ovarian syndrome (PCOS)
- Smoking, alcohol and/or drug abuse
Why is anovulation a problem?
Anovulation is a significant health issue and should not be ignored. Anovulation results in a serious hormonal imbalance between estrogen
and progesterone and is often overlooked as the cause of many seemingly unrelated symptoms.
In women the overall symptoms as a result of a failure to ovulate are often nondescript and include:
- a general malaise
- a feeling that something is just not right
- of not being on top of life
- a general loss of confidence in one’s self and abilities. Physically, mentally and emotionally the most common symptoms include:
- mood changes
- forgetfulness/memory blanks
- tiredness/fatigue
- irritability/anxiety/anger
- sleep disturbances
- decreased concentration
- breast tenderness/soreness
- aches and pains
- fluid retention/bloating
- sugar cravings
- menstrual changes
- increased body fat/weight gain
- lowered sexual desire
Understand more on Ovulation and Anovulation:
What is a normal menstrual cycle?
All about Anovulation and Ovulatory changes with age
More serious medical conditions associated with Anovulation
 The information in this article has been taken with permission from the official Lawley booklet on Understanding Anovulation.