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Getting Pregnant

Anovulatory Cycle: Symptoms, Causes, and Treatment When You Don’t Ovulate

woman wondering about anovulatory cycle

Essential Takeaways

  • An anovulatory cycle is a menstrual cycle where no egg is released
  • While anovulatory cycles are associated with irregular bleeding, you can still have anovulatory cycles with a regular period
  • There are some signs of anovulation you can track on your own, but for a conclusive diagnosis, see your healthcare provider

When you’re trying to conceive, it’s easy to start paying extra close attention to your menstrual cycle and your fertile time. Being so in tune with your body can help you conceive, but sometimes those signals can get crossed, leaving you confused about what’s going on.

Many women assume that if they are getting a regular period then it means that they are also ovulating. However, this isn’t always the case. Some women have what’s known as an anovulatory cycle, where she doesn’t actually ovulate (release an egg). 

What exactly is an anovulatory cycle and could it be affecting your fertility? Well don’t worry, because we’ve got the skinny on this tricky situation. Read on for the answers to some common questions on anovulatory cycles.

What is an anovulatory cycle?

Each menstrual cycle, the body goes through complex hormonal changes that lead up to a process known as ovulation, when a mature egg is released from the ovary. After ovulation occurs, the empty egg follicle, now called a corpus luteum, produces the hormone progesterone. Progesterone helps support a possible early pregnancy. 

If conception doesn’t occur, the corpus luteum breaks down and stops producing progesterone, which is what triggers the start of a period. 

During an anovulatory cycle, a woman does not ovulate and therefore does not release an egg. A woman who is not ovulating is not able to get pregnant.

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What are signs that you’re not ovulating?

Though only a healthcare provider can definitively determine whether you are having anovulatory cycles, there are a few signs that might clue you in:

  • Irregular or skipped periods
  • Periods that are often more than 10 days late
  • Cycles that are fewer than 21 days from one period to the next
  • Having certain hormonal diseases, like polycystic ovary syndrome or hypothalamic amenorrhea

If you suspect that you are having anovulatory cycles, mention it to your healthcare provider! They can run a progesterone blood test or perform an ultrasound to determine whether you are actually ovulating. 

What causes an anovulatory cycle?

There are many reasons why a woman might not ovulate, but some common reasons include:

  • Being overweight or obese
  • High levels of stress
  • Being underweight
  • Exercising too much
  • Hormonal imbalances of thyroid stimulating hormone (TSH) and prolactin
  • Polycystic ovary syndrome (PCOS)

In addition, anovulation is common during periods of hormonal transition. For example, a girl’s first few periods are usually anovulatory. The first few periods after stopping birth control are often anovulatory, as is the time during perimenopause. Many women also have an anovulatory cycle after miscarriage or after childbirth. 

How long do anovulatory cycles last?

The answer is different for everyone and can depend on what is causing the anovulation. This is because bleeding can occur less frequently, about the same, or even more frequently than your regular menstrual cycle length. 

Estrogen levels play an important role in how often a woman with anovulatory cycles will bleed. If she has enough estrogen to cause her uterine lining to build up, she may still get a “period,” which can be regular or irregular. This is known as estrogen breakthrough bleeding; excess estrogen is produced, which causes the uterine lining to build up in an abnormal way. When ovulation does not occur, the hormone progesterone is not produced, which can cause irregular bleeding that can be confused with a period.

However, if estrogen levels are very low than the uterine lining is not able to build up a thick enough lining to have a period. Some women can even go years without having any bleeding at all.

How is an anovulatory cycle treated?

It depends on what is causing the anovulation. For example, if anovulation is caused by being over- or underweight, getting into the healthy weight range may help to re-establish ovulation. Similarly, a woman who is not getting her period due to extreme exercise or stress levels may find that finding ways to deal with stress or cutting back on exercise can help her to start ovulating again.

Anovulation due to hormonal changes may need medication or other lifestyle changes to help correct those imbalances.

The good news is that there are medications available to induce ovulation if lifestyle changes aren’t effective. There are both pills, like clomid and letrozole, and injectable options, depending on your age, treatment goals, medical history, and response.

Are anovulatory cycles common?

Most women will have an anovulatory cycle at some point in their life. However, it can be difficult to know exactly how common this is because women may not even be aware that they aren’t ovulating. 

However, it’s estimated that anovulation is responsible for close to 30% of infertility cases

Does having a period mean that you ovulated?

Unfortunately, the answer to this is no. In most cases, a woman who is having regular cycles and the symptoms that come along with them (like bloating, breast tenderness or moodiness) is ovulating. 

However, this isn’t always the case.

As mentioned earlier, high levels of estrogen can still cause the uterine lining to increase during the first half of a woman’s cycle. If progesterone isn’t produced because ovulation didn’t occur, the lining will eventually break down and cause bleeding, usually after about a month. This regular bleeding can sometimes be mistaken for a period.

When do you ovulate after an anovulatory cycle?

This also varies from woman to woman and even from cycle to cycle. It can happen immediately, or it can take a few days, weeks, or even months before ovulation occurs.

If you are taking ovulation induction medications with a fertility specialist, the hope is that you will ovulate within a couple weeks after starting the medication. The doctor will monitor your response to help you figure out when to have sex or an intrauterine insemination (IUI).

Monitoring your basal body temperature, cervical mucus and ovulation tests can help you determine exactly when ovulation is occurring.

Do you have cervical mucus during an anovulatory cycle?

The short answer is yes, you can have fertile cervical mucus during an anovulatory cycle. Cervical mucus changes in response to increasing estrogen levels in anticipation of ovulation. Fertile cervical mucus is a sign that the body is preparing for ovulation, but it does not confirm that ovulation successfully occurred. 

Women with anovulatory cycles may notice that their cervical mucus is thin, stretchy, and egg-white like for several days. It may go away and come back several days later as their body attempts to ovulate again.

What does an anovulatory cycle chart look like?

Women who ovulate and check their basal body temperature (BBT) chart will probably notice a small, but sustained rise in temperature after ovulation, especially after a few months of experience with close monitoring. 

A woman who is not ovulating will not have that small temperature change.

Tracking BBT in addition to cervical mucus can be helpful. Observing the lack of temperature rise, with or without multiple instances of fertile cervical mucus, is highly indicative of anovulatory cycles.

What should I do if I have anovulatory cycles?

The good news is that there are many treatment options for women with anovulatory cycles. While lifestyle changes can be helpful in some situations, medical help is indicated in others. If you suspect that you are having anovulatory cycles, you should mention it to your healthcare provider. They can run blood tests or ultrasounds, or refer you to a fertility specialist for further evaluation. 

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Cycle characteristics after discontinuation of oral contraceptives

Nicole Galan, RN

Nicole Galan, RN, is the author of "The Everything Fertility Book." She lives in sunny San Diego with her husband, three sons, and their dog, a puggle named Roxy. She graduated from nursing school at Pace University and worked for 10 years as an infertility nurse who specialized in third party reproduction. Nicole recently left full time practice in order to focus on raising her kiddos and attending graduate school for a Master’s degree in Nursing Education.

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