Anovulatory Cycles and Breakthrough Bleeding

Unless you’re totally new to this (in which case, welcome!), you probably already know that the Fertility Awareness Method teaches you how to know when you’re ovulating so that you can either maximize your chances of getting pregnant, or know when to avoid intercourse (or use a barrier method) so that you WON’T get pregnant. Awesome, right?

But what if you’re using FAM, but you’re not ovulating? What if you’ve been diligently charting your signs, but the temperature shift and eggwhite/watery cervical fluid just aren’t there?

Most women will experience anovulatory cycles (cycles in which ovulation does not occur) at some point in their lives. Anovulatory periods are really common in the 2-3 years after a woman’s first period, in the years leading up to menopause, and for women who are breastfeeding. Women who have recently come off the Pill will also probably experience several anovulatory cycles after coming off the Pill– however, it IS possible to ovulate in your first cycle after coming off the Pill, so if you’re trying to avoid pregnancy, don’t assume you won’t ovulate!

Anovulation due to the above causes is totally normal. But sometimes, women who are nowhere near their first period or menopause, aren’t breastfeeding, and who have never been on the Pill (or haven’t been on it for a while) will experience anovulatory cycles.

One of the most common causes of anovulation is Polycystic Ovarian Syndrome. But, there are LOTS of other factors that may cause you to have anovulatory cycles – such as being overweight, underweight, exercising too much, thyroid disfunction, stress, illness, extended travel, and other hormonal imbalances – to name a few!

Because it’s impossible to get pregnant without ovulation, anovulation can be frustrating and stressful for women who are trying to conceive. But even if you’re trying to avoid pregnancy, experiencing anovulatory cycles can be discouraging, since it can make using FAM as birth control more confusing. The good news is, there are a lot of ways to naturally treat most of these issues. So, if you’re experiencing anovulatory cycles, don’t panic! You can chart your fertility signs and work with your practitioner to figure out exactly why you’re not ovulating, and then from there you can take steps to regulate your cycles and induce ovulation.

The first step is to find out for sure whether you are ovulating or not. Charting your basal body temperature will clue you in to this. If you don’t experience a clear, sustained temperature shift during your cycle, it’s highly unlikely that you ovulated. If you do experience a temperature shift that is sustained for at least three days, then you can confirm ovulation. Tracking your cervical fluid can also help you determine when you are approaching ovulation. However, keep in mind that it is possible for women with hormonal imbalances to experience ‘false peaks’ in which their cervical fluid builds up from infertile to seemingly fertile and then back to infertile again, but ovulation does not occur. That’s why it’s important to keep track of BOTH your BBT and your cervical fluid – so you can know for sure if and when ovulation occurs!

Some women who are anovulatory have really long cycles and light, infrequent periods, while others have short cycles with heavy periods. If your cycles are shorter than 21 days, or longer than 36 days, that may be a sign that you are anovulatory. Also, if your cycles fall within the normal 21-36 day range, but the length of each cycle varies widely from one cycle to the next (meaning you might have a 22-day cycle one month, but a 35-day cycle the next), this could also be a sign of anovulation. On the other hand, although it’s not very common, some women who are anovulatory bleed each month like clockwork. So really, the length of your cycles is not always an indicator of whether you are ovulating.

Regardless of how long (or short, or regular) the cycle is, anovulatory bleeding is not a menstrual period in the true sense of the term. Here’s why:

During the first half of your cycle, your estrogen levels steadily increase, causing your body to build up a uterine lining (called the endometrium) in which a fertilized egg can implant. In a normal ovulatory cycle, after an egg is released from the ovary, what’s left of the follicle that was housing the egg before it was released is called the corpus luteum. Then, for the rest of your cycle until you get your period, the corpus luteum produces progesterone, and estrogen levels drop. The reduced estrogen levels slow the development of the endometrium, but progesterone provides structural support to the endometrium until conception or the next cycle. If conception does not occur, the corpus luteum stops producing progesterone about 12-16 days after ovulation (this time period in between ovulation and the end of your cycle is also known as the luteal phase). This signals to the body that conception did not occur, and the endometrium is shed – meaning you get your period. This is also known as progesterone withdrawal bleeding.

But if an egg isn’t released from the ovary, there is no corpus luteum, meaning your body doesn’t produce any extra progesterone. Without progesterone, estrogen is unable to support the growing endometrium on its own. So, eventually the uterine lining is shed, and you get what seems to be your period. But because ovulation did not occur, this type of anovulatory bleeding is not a true period, but rather is known as estrogen breakthrough bleeding.

So, if you’ve tracked your BBT and have determined that you are not ovulating, the next step is to figure out what’s up. Take a look at your day-to-day lifestyle and see if there’s anything that might be throwing your body off balance. For instance, do you get enough exercise? Do you get too much? Do you get enough sleep, and are your stress levels under control? Do you drink lots of water every day, and are you eating a balanced diet? Too often we forget about the toll that our modern, busy lifestyles can take on our body.

Here’s an article by Kindara co-founder Kati Bicknell that goes into more detail about some of the ways you can naturally regulate your cycles.

If you think the cause of your anovulation is hormonal, you can take a hormone test to check the levels of your reproductive hormones. You can order home hormone tests online or visit your doctor to get a test done. Keep in mind that saliva tests are often more accurate than blood tests for testing hormone levels - so if your bloodwork indicates that everything is fine, but you really feel that something is off, you may want to get another test done. 

Often, hormonal imbalances can also be resolved through dietary and lifestyle changes. However, in some instances, such as if you’ve tried altering your lifestyle without results, if you want to get pregnant and don’t have a lot of time to spend trying to conceive, or if the hormonal imbalance is severe, you may want to seek medical treatment. In this case, make sure to go over your medical options with your doctor and understand exactly what you’re getting into. 

For women who experience anovulatory cycles and want to avoid pregnancy, using FAM as birth control can be a little tricky, and some different rules apply. Click here for an article on how to use FAM as birth control for women with anovulatory cycles.

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