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What causes anovulatory bleeding?

What causes anovulatory bleeding?

Catherine Poslusny | July 24, 2020 | Women's Health
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Whether you’re trying to conceive or avoid, it’s natural to start paying closer attention to how your body changes during each menstrual cycle. After all, knowledge is power. And when you know how to chart the signals surrounding your ovulation, it’s easier to make sure you’re having sex (or not) while you’re at your most fertile. However, reading the signs can get a little tricky if you’re not ovulating. This is called anovulation, and most women experience it at least once during their reproductive years (1). Here, we’ll clear up some of the confusion about charting anovulatory cycles and dig into what you really want to know: what anovulation means for your fertility.

What is anovulation?

Usually, each menstrual cycle begins with a series of hormonal and physical changes that lead to ovulation. Your estrogen rises steadily (along with the water content of your cervical mucus, which we’ll get to in the next section) until a surge in luteinizing hormone (LH) triggers the release of a mature egg from a follicle in the ovary. Sometimes, for one reason or another, the egg is never released. This is called anovulation. Since you need an egg for conception, you cannot get pregnant while you’re anovulatory (2, 5).

Anovulatory bleeding and your fertility chart 

Anovulation is estimated to cause almost 30% of infertility cases, though it’s difficult to know how common anovulatory cycles really are because women may not always realize when they aren’t ovulating (3). Charting your menstrual cycles can help you tune in to the complex processes going on in your body around the time you ovulate. It can also help you recognize signs that you aren’t ovulating. Anovulation isn’t always easy to spot, but there are a few things to look out for when charting your ovulation:

Anovulatory bleeding and cycle length

Anovulation doesn’t always cause noticeable changes in your cycle length, but skipped periods and irregular bleeding may be a sign that you’re not ovulating. Cycles that are consistently less than 21 days or more than 35 days can also suggest anovulation (4).

If you’re still having seemingly regular periods while you’re anovulatory, it’s probably because you’re still experiencing the buildup of estrogen that causes your uterine lining to thicken as your body prepares for ovulation. Eventually, your estrogen levels will either drop or your uterine lining will build up to a point where it can’t sustain itself anymore, and you’ll shed it in a process that can look very similar to typical period bleeding (5, 6).

Anovulatory bleeding can occur before, after, or around the same time as your normal period, so vaginal bleeding, even if it seems like your period, isn’t always a sign that you’ve ovulated (6).

Cervical mucus

Estrogen does more than grow your uterine lining. It also makes your cervical mucus (CM) more watery and slippery in the days leading up to your ovulation, which helps give sperm a better chance of reaching and fertilizing the egg. Just like the initial thickening of your uterine lining, CM changes happen before ovulation and can’t be used to confirm that ovulation has happened (5).

Basal body temperature

The main way to tell the difference between a regular cycle and an anovulatory cycle is by looking at your basal body temperature (BBT). A sustained spike in your BBT is a good indicator that you’ve ovulated because the temperature increase is caused by a rise in progesterone that only happens after an egg has actually been released from a follicle (6).

If you feel like tracking your BBT isn’t working for you, read how your continuous core body temperature can predict ovulation before it happens and check out our new product, Priya:

Learn About The Priya Fertility Monitor

Luteinizing hormone tests

Luteinizing hormone (LH) tests can be a great tool for predicting ovulation because LH levels typically surge right before your body releases an egg. However, LH tests can’t be used to confirm that ovulation actually happened. Some conditions, like polycystic ovary syndrome (PCOS) and luteinized unruptured follicle syndrome (LUFS), may cause measured LH spikes that aren’t followed by ovulation (7) sometimes called false peaks. Here is an example of what a chart with false peaks might look like.

What does anovulation mean for your fertility?

Sometimes, anovulation can be caused by problems with the ovaries or the regulation of reproductive hormones can cause anovulation. This can include conditions such as PCOS, hypothalamic dysfunction, premature ovarian failure, and hyperprolactinemia (when the pituitary gland creates too much of the hormone prolactin). Physical health issues, such as being overweight or underweight, thyroid issues, stress, and dietary choices, can also affect how often you ovulate (3, 8, 9).

Because there are so many different reasons you may not be ovulating, there’s no one-size-fits-all answer to how long it’ll be before you start ovulating again. The American Society for Reproductive Medicine recommends talking to your physician if you’re trying to conceive and you think you’ve gone two or more cycles without ovulating (10). Fortunately, there are many treatment options available, ranging from lifestyle changes to fertility medications, for women with chronic or intermittent anovulation (4).

Charting an anovulatory cycle can feel like you’re trying to decipher mixed messages, but it’s worth the effort to better understand what’s going on in your body, especially when you’re trying to conceive. Your CM may be waving pom-poms and screaming that you’re fertile, but it’s up to your BBT to confirm whether ovulation actually happened. Keeping track of when you ovulate (and when you don’t), can help you stay informed about your reproductive health while you’re on your journey to conceive.


Photo by Ba Tik from Pexels

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