Anovulation, or the failure to release an egg during a woman’s monthly cycle, can be caused by factors such as weight, exercise, polycystic ovary syndrome, thyroid disease, and stress. Hormones produced by the hypothalamus, pituitary gland, and ovaries regulate ovulation, and disruptions at any level can cause problems. Treatment options include lifestyle changes, medication, and ovulation induction.
No ovulation, or anovulation, is a condition in which an egg is not released during a woman’s monthly cycle. Normally, one egg is produced each month by reproductive organs known as the ovaries. The egg is usually released about two weeks before the start of the woman’s next menstrual period. If ovulation doesn’t occur, there are many possible causes. Some common examples include being overweight or underweight, exercising excessively, a condition known as polycystic ovary syndrome, thyroid disease, and stress.
Normal ovulation relies on a complex system of hormones produced by the hypothalamus and pituitary gland in the brain and by the ovaries in the pelvis. If the system is disrupted at any level, ovulation problems can occur. Ovulation begins with the hypothalamus producing hormones that stimulate another part of the brain known as the pituitary. Pituitary hormones are then released which cause the ovaries to produce estrogen. The feedback between the different hormones serves to regulate the entire system.
The function of the hypothalamus can be affected by factors such as stress, not eating enough or exercising excessively. In the absence of ovulation, in about a fifth of cases the cause is a problem with the hypothalamus. Disorders of the pituitary gland, such as tumors that produce a hormone called prolactin, can also prevent ovulation.
In the condition known as polycystic ovary syndrome, or PCOS, eggs fail to mature normally and little or no ovulation occurs. PCOS is found in up to three-quarters of women with ovulation disorders. Symptoms of the condition include irregular menstrual periods, excessive body hair, acne, and being overweight.
An underactive thyroid is probably the most common hormonal cause of failure to ovulate. The disease, known as hypothyroidism, affects levels of reproductive hormones, including estrogen. Symptoms of increased menstrual bleeding and irregular periods may occur. Sometimes hyperthyroidism, or an overactive thyroid, can also result in abnormal menstrual cycles with no ovulation patterns.
In women who have premature ovarian failure, a condition in which ovulation does not occur, menopause begins earlier than usual, usually before age 40. While this condition cannot be reversed, many other disorders that prevent ovulation can be treated. Women can be helped to achieve a normal weight through diet and exercise changes, and medications can be used to regulate abnormal hormone levels.
For hypothalamus problems, a synthetic version of a natural hormone called hCG can be administered using a syringe pump. The pump delivers pulses of hCG, and ovulation rates usually improve enough for couples to have a normal chance of conceiving a child. Ovulation induction is a treatment sometimes used for women with PCOS. A drug is given that stimulates the pituitary gland to produce more hormones, increasing the chances of ovulation occurring.
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