Ovulatory dysfunction: what is it and how to deal with it?

Ovulatory dysfunction can be caused by many reasons. Some of them are perfectly controllable, such as being overweight or excessive physical activity. In other cases, treatment is required to overcome this condition.

Last update: June 15, 2022

Ovulatory dysfunction is an abnormality in the natural ovulation process of a woman. In some cases, ovulation does not occur at all, and in others, ovulation is irregular, intermittent, or abnormal.

It is very common that when there is ovulatory dysfunction, there are also abnormalities in menstruation. The usual thing is that there is no period or that this is very irregular. This is due to hormonal disturbances.

ovulatory dysfunction, in particular the absence of ovulation, is one of the main causes of female infertility. However, sometimes this condition is normal, such as during pregnancy and lactation. Other times, it is due to problems in the body.

What is ovulatory dysfunction

Ovulatory dysfunction is a condition that indicates a malfunction of ovulation or the complete absence of it.

Ovulatory dysfunction is a condition in which there is no ovulation or it occurs irregularly.. If there is no ovulation, it is called “anovulation”. If ovulation is irregular, but not completely absent, it is called “oligoovulation”.

During a woman’s normal cycle, a mature egg is released. This can be fertilized by a sperm, thus giving rise to conception. As is obvious, if there is no egg, or it is not in good condition, there can be no fertilization.

It is estimated that up to 40% of cases of female infertility due to ovulatory dysfunction. This condition can be circumstantial or chronic. In some cases, this abnormality can lead to other long-term health problems, such as type 2 diabetes mellitus.

Causes of ovulatory dysfunction

Ovulatory dysfunction has very varied triggers, ranging from stress to Polycystic Ovary Syndrome. Nevertheless, The World Health Organization (WHO) has classified the causes into three large groupsas we will see below.

Hypothalamic-pituitary failure

In this case, ovulatory dysfunction is due to failures in hormone secretion from the hypothalamus and the pituitary. Specifically, the hypothalamus does not produce enough GnRH and the pituitary gland does not release enough gonadotropins. These hormones are what regulate the menstrual cycle. It corresponds to 10% of cases.

The reasons why failures occur in the hypothalamus or pituitary are the following:

  • Kallmann’s syndrome.
  • Hypogonadotropic hypogonadism.
  • Excessive physical exercise.
  • Weight gain and loss, especially due to anorexia or bulimia.
  • Chronic renal insufficiency.
  • Chronic liver diseases.
  • Other systemic diseases.

hormonal alterations

In this group, the Polycystic Ovary Syndrome is located, considered the most common cause of ovulatory dysfunction. This is an endocrine disorder that causes the absence of menstruation in women or very irregular cycles.

Women with this disorder have an increase in size in the ovaries and they fail to produce mature eggs. It is usual that there are also signs of hyperandrogenism, or masculine traits in these women.

Within this group, there are also other diseases such as hyperprolactinemia, or very high levels of the hormone prolactin. Also thyroid disorders. Both factors are the cause of ovulatory dysfunction.

ovarian failure

Premature ovarian failure or early ovarian insufficiency is another cause of ovulatory dysfunction. It is estimated that between 4 and 5% of cases are due to this reason. This condition is characterized by the fact that a woman’s ovaries stop working before the age of 40; that is, without having reached the average age of menopause.

Thus, hormone levels are relatively adequate, but the ovaries fail to produce mature eggs. Also, in some cases there is an estrogen deficiency.

Symptoms and diagnosis

The main symptom of ovulatory dysfunction is the absence or intermittence of menstruation. Likewise, in these cases there are no symptoms of premenstrual syndrome and abundant and elastic cervical mucus does not appear, which is characteristic of the fertile days in women.

In some cases, women with ovulatory dysfunction do have periodsbut this one has some peculiarities:

  • Cycles are less than 21 days or more than 36 days.
  • Cycle lengths vary greatly from month to month.
  • The bleeding is abnormal.

Also, it is the case that some women with this disorder do not have any symptoms. They only realize that they have this condition when they try to get pregnant and they don’t get it.

The diagnosis is usually made from one or more of the following actions:

  • Basal Body Temperature Tracking.
  • Progesterone blood test.
  • ultrasound.
  • Ultrasound.

Treatment of ovulatory dysfunction

A woman can suffer from ovulatory dysfunction regardless of her age.

The treatment of ovulatory dysfunction depends on the cause that is producing it. Sometimes a change in lifestyle is enough, which includes reducing stress, regular eating, losing weight or moderate physical activity.

If there is any hormonal imbalance, fertility drugs are most often prescribed. Clomid is usually used. It is estimated that this drug triggers ovulation in up to 80% of women who do not have it.

In case of polycystic ovary syndrome, metformin may be prescribed. Sometimes, myo-inositol, an over-the-counter supplement, is also used. If these substances do not work, it is possible to combine them with fertility drugs. This increases the chance of success.

If the cause of ovulatory dysfunction is premature ovarian failure, the drugs most likely will not work. In this and in other cases in which the treatment is unsuccessful, the alternative is to try fertilization. in vitro (IVF).

Detecting an anomaly implies knowing one’s own body

It is important to emphasize that women with ovulatory dysfunction do not necessarily stop menstruatingneither in part nor in its entirety. For this reason, it is important to be attentive to the duration of the cycles and bleeding to detect a possible anomaly.

Lifestyle plays a very important role on this ground. In particular, you have to take good care of your diet and maintain a serene state of mind. Stress can cause ovulatory dysfunction to occur.

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