What is anovulation?

As we discussed earlier, anovulation is when the ovaries fail to release a mature egg during the menstrual cycle. Many women experience at least one anovulatory period during their lifetime, but if you chronically have no ovulation symptoms, it could be a sign of reduced fertility or reproductive issues. 

You can get a period without ovulating or at least experience bleeding as the uterus sheds its lining. The difference between anovulatory bleeding vs period: it may be heavier than usual, or there may not be any difference at all.

Can you have a period without ovulating?

Is it possible to have a period without ovulation symptoms? The short answer is yes: anovulation, or having a period in a cycle without ovulation, is fairly common, affecting around 30% of women. 

During a regular menstrual cycle, your body’s follicle-stimulating hormones stimulate follicles within the ovaries to grow. As this growth occurs, they begin producing estrogen, which causes the lining of the uterus to thicken. Once the follicle matures, it releases a mature egg, a process known as ovulation. However, if the follicles fail to release a mature egg, ovulation doesn’t occur, but the uterus could still shed its lining, resulting in an anovulatory cycle. 

What happens if you don’t ovulate?

Usually, when an egg isn’t released, the leftover follicle goes away, and a structure called the corpus luteum doesn’t form. This leads to low levels of progesterone in the second half of the menstrual cycle, meaning there is no luteal phase and its related symptoms.

During ovulation, you should notice slippery, stretchy, and clear cervical mucus resembling raw egg whites. Pasty or thick mucus in the middle of your menstrual cycle could be a sign of reduced fertility. Additionally, after ovulation, progesterone raises your basal body temperature when resting, so if you’re not seeing changes to your BBT, you may not be ovulating.

Can you get pregnant when you’re not ovulating?

Unfortunately, it’s not possible to get pregnant if you’re not ovulating because pregnancy requires the fertilization of a sperm and an egg. Without ovulation, no egg is released for the sperm to fertilize, so conception cannot occur.

What causes anovulation?

We’ve already established that it is possible to appear like you’re having regular periods but not ovulating, but why does anovulation occur? There are a few reasons why you may experience anovulation.

Weight and lifestyle

Being overweight or underweight can lead to numerous health conditions due to hormonal imbalances. For those with higher body weight, lowering your BMI can help improve fertility and overall health. Maintaining an active lifestyle is important. However, excessive exercise for more than one hour daily can increase anovulation risks. 

Stress and anxiety

Our long-time Hormonas know stress and anxiety can play a huge role in hormonal regulation. In fact, it’s one of the possible reasons for not ovulating. Increased stress can impact hormone levels, and you can skip ovulation if your stress levels are severe enough.

Pregnancy and breastfeeding

Female bodies have a natural mechanism that prevents ovulation during pregnancy, as the desired event has already happened. Therefore, there is no need for ovulation within the next 40 weeks. A similar process occurs during breastfeeding; due to hormonal influences, ovulation is typically absent for the first 6 to 8 months. However, it can begin earlier or later than this timeframe.

Medications

Certain medications can impact ovulation, including hormonal birth control, antidepressants, chemotherapy, steroids, and antipsychotics.

PCOS

Polycystic ovarian syndrome, or PCOS, is the top cause of anovulation. This ovulation inhibition is due to a hormonal imbalance where the body has high levels of male hormones or androgens. 

Hashimoto’s disease

Hashimoto’s is an autoimmune disease that may lead to hypothyroidism, which inhibits the thyroid from producing adequate hormone levels. Low thyroid hormone levels can disrupt ovulation and lead to anovulatory infertility.

Perimenopause

This is a physiological aspect of aging, not a pathology or disease. Women who are approaching menopause or are postmenopausal experience anovulation.

Pituitary gland issues

The pituitary gland releases follicle-stimulating hormones (FSH) and luteinizing hormone (LH), but when it isn’t working properly, it can cause anovulation. Without enough of these critical gonadotropins, your follicles cannot mature an egg. 

Signs and symptoms of anovulation

Since we’ve established that you can have a period and not ovulate, it’s time to discuss the signs and symptoms of anovulation. 

Signs of anovulation

If you suspect you’re getting a period without ovulation signs, you should look out for the following:

• Irregular periods – Although you can get your period without ovulating, over time, if your anovulation continues, your periods may become irregular. 
• Changes to cervical mucus – Thick, pasty cervical mucus in the middle of your cycle is another example of how you can tell if you have an anovulatory cycle. 
• Missed periods – Women who are not pregnant and miss one or more periods could have amenorrhea (when you don’t have periods for more than 90 days), which signals anovulation. 
• Excessive bleeding – Unusual menstrual bleeding that is commonly excessive can indicate anovulation.

Dangers of anovulation

If you’ve experienced anovulation, you’re probably wondering not only “Why did I not ovulate this month?” but “Does it come with any risks?” While occasional anovulation may not be a big deal, if it happens frequently, it can lead to certain complications. These include:

• Endometrial hyperplasia – If you don’t have enough of the hormone progesterone, it could limit your uterus’s ability to thoroughly shed its lining. This condition is called endometrial hyperplasia. If this occurs, it will thicken, increasing your chance of developing endometrial and uterine cancer; however, please keep in mind that these conditions are rare. 
• Reduced fertility – If you’re not ovulating, it may take longer to get pregnant, and some women may require medical assistance.

Anovulation treatment and prevention

Now that we’ve answered the question of whether it is normal to not ovulate every month, it’s time to discuss anovulation treatment options and prevention. Please note that you should always discuss questions like, “Why am I not ovulating but having regular periods?” with your doctor so you can work together to find the right treatment plan for your unique situation.

Lifestyle changes

If your anovulation is caused by a low or high body weight, changing your diet and exercise routine can be very helpful. Many women choose to meet with a nutritionist to develop a healthy eating plan. For those with higher BMIs, exercise is a great way to increase muscle and decrease fat. However, excessive exercise can worsen anovulation, so moderation is key. If pregnancy is not on your immediate agenda, further interventions are not needed for you.

Medications

Once your doctor has diagnosed anovulation and you are in the process of fertility treatment, you may decide to use medications to induce ovulation. However, please note that these medications are not needed if you are not struggling with infertility. Common medicines include:

• GnRH antagonists and agonists – These synthetic hormones control the release of LH, preventing spontaneous egg release when undergoing fertility treatments. 
• Clomiphene citrate – Women taking this medication have an 80% chance of ovulation and a 40% chance of becoming pregnant.
• Follicle-stimulating hormone – If you don’t conceive on clomiphene citrate or can’t produce your own FSH, your doctor may prescribe this medication. 
• Human chorionic gonadotropin (hCG) – HCG is often combined with follicle-stimulating hormone and clomiphene citrate treatments as it causes the ovaries to release a mature egg and prevent false positive pregnancy tests.

Surgery

This option applies only to those who are struggling with infertility. Women with PCOS who haven’t responded to treatment may undergo a surgical procedure called ovarian drilling. While rare, it’s performed laparoscopically and can reduce the amount of the hormone testosterone produced by the ovaries. Lower testosterone levels can encourage egg production in the ovaries. 

Anovulation can be discouraging, especially if you’re trying to get pregnant. Learning that you can have a period without ovulating is surprising to many women, but understanding what to look for and how to treat it can help you make the right treatment decision. The Hormona app specializes in providing women with the tools and insights they need to take control of their hormonal health. It provides valuable insights that make it easy to understand your body and feel your best.  

FAQ

Anovulatory bleeding vs period – what is the difference?

You may not even notice the difference unless your periods are heavy.   

How do I know I’m ovulating?

There are a few signs that you may be ovulating; they include:

• Clear, thin cervical mucus resembling raw egg whites
• Ache in the lower abdomen, on one side
• A rise in basal body temperature

Does late ovulation mean a bad egg?

Ovulating late might produce a lower-quality egg, which could make it harder to get pregnant. 

Who can experience anovulation?

Any child-age-bearing woman can experience anovulation, including young girls who are starting their first periods and older women approaching menopause.

Is it possible to not ovulate for one month?

Yes, you could experience anovulation or not ovulating for a month without any serious reasons.