Although periods are supposed to be as regular as clockwork, for some they can be totally unpredictable. Generally most menstruators ovulate every 21 to 35 days and continue to do so till menopause. However, if you are having irregular periods or no periods, then this may be a sign of anovulation. Anovulation and irregular cycles aren’t uncommon in young girls or those women who are approaching menopause (perimenopause).
In fact, women having regular periods can experience this from time to time. Anovulation is defined as when ovaries fail to release an egg. Chronic cases of anovulation are one of the most common causes of infertility. OnlyMyHealth editorial team spoke to Kush Kumar Singh, Lab Head – Delhi Reference Laboratory, Metropolis Healthcare Ltd, to know about anovulation.
Causes of Anovulation
Anovulation occurs normally when a woman is pregnant, breastfeeding, during adolescence, and in perimenopausal women. However, there are many other factors causing ovulation disorder and impacting the fertility of women:
- Polycystic Ovary Syndrome (PCOS) – It is not unusual for women to hear this word in routine whenever they are visiting their gynecologist for fertility review. Its prevalence varies from 4 to 20 % as per various studies. Its clinical features include:
a) Irregular menstrual cycles - Infrequent menstruation, absence of menstruation, heavy or prolonged periods.
b) Hormonal Imbalance - Features suggestive of hormonal imbalance such as acne, hair fall, and increased male pattern of hair distribution (Hirsutism).
c) Skin tags with thickening of the skin.
d) Obesity and recent weight gain in patients.
e) Features suggestive of diabetes like high blood sugar.
f) Anxiety and depression in certain patients are also visible.
- Thyroid and Pituitary disorders – As we all know that TSH and Prolactin are two important hormones, secreted by the brain, and they regulate cycles. Thus, that imbalance can often lead to anovulatory cycles.
- Heavy Workouts - Over exercise at times can also lead to disorders of menstruation
- Certain Medications - Antidepressant, anti-psychotics, birth control pills, and steroids can also lead to anovulation.
Diagnosis of Ovulation Disorders
Diagnosis of anovulation and clinical assessment should always be done by an experienced gynecologist and endocrinologist. It involves various tests for evaluation:
- Ultrasound assessment of Ovaries is done which might at times show small cysts.
- Evaluation of various hormones in the body namely Follicle-stimulating Hormone (FSH), Luteinizing hormone (LH), DHEAS, TSH, Prolactin, Anti Mullerian Hormone (AMH), and others if specified by the doctor.
- Certain cases require Endometrial Biopsy and other procedures under the strict guidance of an experienced gynecologist.
Treatment and Healthy Pregnancy
It is always advised to get treatment under the guidance of an experienced doctor. Certain treatments involve hormonal treatment as well as weight loss methods to regain the full potential of fertility. Sometimes fertility drugs are also given along with lifestyle changes & diets.
Once treatment starts for PCOS and hypothyroidism, there tends to be an increase in the chances of getting a healthy pregnancy. However, in certain cases, assisted techniques of fertility might be required depending on clinician judgment.