As you may have heard, a ‘textbook’ menstrual cycle is generally described as being 28 days in length, with ovulation occurring on day 14 of each cycle. However, as you might have experienced, menstrual cycles can vary in length, as can the day of ovulation. What’s more, there may be some cycles when you don’t ovulate at all – this is known as anovulation.
To understand anovulation, let’s first explore what happens in a cycle where ovulation does take place. Typically, you ovulate around two weeks before the first day of your next period. This means that if your menstrual cycles are longer than 28 days, you probably ovulate later than day 14. The same goes for shorter cycles – you may find you ovulate earlier, although it can vary from person to person, and from one cycle to the next [1].
At the point of ovulation, your ovary releases an egg ready for fertilisation. This results in an increase in the hormone progesterone to help your uterus prepare for implantation of the fertilised egg. Around 14 days later, you’ll get your period or if fertilisation was successful, you’ll be pregnant.
If you’re unsure about whether you are ovulating or not each month, this article will help you understand some of the signs and symptoms to look out for, as well as some of the main causes of anovulation, and how to begin addressing anovulatory cycles.
What happens during an anovulatory cycle?
Anovulatory cycles (meaning): Menstrual cycles where ovulation doesn’t occur, an egg isn’t released and your body doesn’t make additional progesterone.
The sequence of events that results in anovulation varies from person to person, depending on the underlying causes. In some cases, your body gets ready for ovulation but is unable to proceed In this situation, your hormones (follicle-stimulating hormone, estrogen, and luteinising hormone) begin preparing your body to release an egg, but the conditions aren’t suitable for ovulation so an egg isn’t released. This may be due to reproductive hormone levels being insufficient, among other reasons. Because ovulation doesn’t occur, your body also doesn’t begin producing any extra progesterone to maintain an optimal uterus lining in preparation for the implantation of an egg.
Another scenario where anovulation may more commonly occur is in perimenopause, the time in which you transition to menopause, marking the conclusion of your fertile years. During perimenopause, the number of follicles, which contain the egg cells, you have in your ovaries declines dramatically and as a result, you may not ovulate consistently each cycle.
While having an anovulatory cycle can be disappointing, each new menstrual period marks the beginning of a new cycle and a fresh opportunity for your body to attempt ovulation. In fact, even if you are healthy and well, you’ve probably experienced anovulatory cycles. They’re actually fairly common and often go unnoticed, particularly around the time you get your first period, as well as menopause [1]. Anovulatory cycles after miscarriage are also quite common and it can take 29 to 50 days following a loss for you to begin ovulating again [2].
How does anovulation affect fertility and your chances of getting pregnant?
Because you don’t release an egg, this frustratingly means you are unable to get pregnant on cycles where you don’t ovulate. While the occasional anovulatory cycle can be normal, experiencing them regularly may impact your chances of pregnancy. Anovulation is a leading cause of female infertility, with around 30 percent of infertility being due to anovulation [3].
Depending on the cause, ovulation can return the following cycle or may require treatment if the underlying issues are more complex. The important thing to know is that while having anovulatory cycles can be worrying, there are options available to help you ovulate, which we’ll explore in a later section of this article.
What are the signs and symptoms of an anovulatory cycle?
Anovulatory cycles can be easy to miss, but there are a few things that can help work out whether you are ovulating.
The first thing to look out for is your cervical mucus. During a cycle where you ovulate, you’ll notice an increase in clear, wet, and slippery vaginal discharge in the lead-up to ovulation. It will become similar to the consistency of raw egg whites around the time of ovulation [4].
However, if you don’t ovulate, you may find your cervical mucus doesn’t follow this pattern and it may be thicker or creamier [5]. Some women experience no cervical mucus and feel dry throughout their cycle – this can also be a sign of anovulation [6].
Another thing to pay attention to is the length of your cycle, from the first day of your period to the day before your next period. While healthy cycles can vary from 21 to 38 days without being a cause for concern, if your cycle is shorter or longer than this, it could be due to anovulation [1].
One symptom that won’t give you much of an answer is cramping and pain. While further research is needed, the experts don’t currently believe cramping can tell you whether or not you’ve ovulated [7] [8].
How does anovulation affect my period?
You might be thinking, “Does an anovulatory cycle mean no period?”
Well, in the event you don’t ovulate, you’ll generally get a period at the beginning of your next cycle. Although, anovulation may cause your period to be a bit lighter or shorter than usual - a small silver lining!
So far, there is limited data that shows that women who go through anovulatory cycles are less likely to experience mid-cycle bleeding or spotting. However, more research is needed to confirm this [9].
Sometimes it might appear that you have skipped a period as your menstrual cycle is twice as long as usual without a period taking place during this time. Often, there is nothing to worry about and your cycle will correct itself once you get a period at the end of your cycle. However, if you used to have a regular cycle and you don't have your period for three months, or you have irregular cycles and haven't had your period for six months, it may be classified as amenorrhea [10]. If this sounds like your situation, it’s important to consult your healthcare professional to help understand why this might be happening.
What causes anovulation?
The short answer is, there are many potential causes of anovulation. Possible causes include:
- Hormonal disruptions, commonly caused by stress, strenuous exercise or having a high or low body mass index
- Polycystic ovarian syndrome (PCOS), which can be associated with insulin resistance and obesity
- Primary ovarian insufficiency or diminished ovarian reserve, which refers to a reduced number of eggs in the ovaries
- Thyroid and adrenal disorders [11]
Another possible reason is birth control methods that work by stopping ovulation or affecting your hormones – it’s their job to prevent ovulation so pregnancy doesn’t occur. Makes sense!
Diet and lifestyle are also important factors when it comes to ovulation. Emerging research suggests having a diet focused on nutrient-rich plants, unsaturated fats, and low-GI carbohydrates can have a positive influence on your ovulation [12]. There is also some evidence that suggests moderate alcohol consumption may increase the rate of anovulatory cycles, although more research is required to better understand why this is the case [13, 14].
Are there any tests I can take to confirm ovulation?
Yes! There are lots of ways you can check if you are ovulating. One option is to get blood tests to measure your hormone levels. For example, low progesterone, LH or FSH levels in your blood may be a sign of anovulation. You’ll likely need to get several blood tests at different points in your cycle to get an accurate idea of when you ovulate or to identify any hormonal imbalances. Of course, this may come at a cost, will require some forward planning, and isn’t ideal if you’re squeamish around needles!
A second option is to test your body temperature orally or vaginally using a thermometer, as your temperature rises sharply at ovulation and remains high until your period if ovulation is successful. You’ll need to check your temperature at the same time every day and it can be affected by things like alcohol, stress, room temperature, and medications [15].
Another way to tell if you’ve ovulated is to measure your progesterone levels in your saliva. Research shows saliva samples are a highly accurate and convenient way to measure progesterone, which can help detect if you ovulate [1]. Up until recently, the only way to test your saliva was to collect samples and send them to a lab for evaluation. However, you can now test your saliva at home using inne’s test strips and minilab.
It's an absolute game-changer. inne’s tracking system works by measuring your progesterone throughout your cycle to confirm whether you ovulate and to help pinpoint your exact ovulation day.
If you’re experiencing anovulatory cycles, what can you do?
If you’re not ovulating regularly, there are a number of ways to support your body – of course, this varies depending on the cause of your anovulatory cycles.
First, make sure you have a healthy lifestyle and are exercising regularly. Adopting a healthier lifestyle has been shown to improve ovulation and your chances of getting pregnant [16].
Aim to have a well-rounded diet full of fresh fruit, vegetables, meat, fish, and whole grains. At the same time, try to reduce the amount of refined carbohydrates in your diet – these are found in foods such as cake, white bread, and fast food.
If you require further support, your healthcare professional may prescribe medications to help kick start ovulation. Of course, you should always seek medical advice from your healthcare professional regarding a medical condition
Whether you are currently on your fertility journey or simply want to become more familiar with your cycle and ovulation patterns, a great place to start is by using the inne minilab. Better understanding your cycle and whether you are ovulating regularly, can help you to feel empowered to make decisions about your body and your fertility.
References
1. Schmalenberger KM, Tauseef HA, Barone JC, et al. How to study the menstrual cycle: Practical tools and recommendations. Psychoneuroendocrinology. 2021;123, 104895. doi:10.1016/j.psyneuen.2020.104895
2. Sapra KJ, McLain AC, Maisog JM, et al. Successive time to pregnancy among women experiencing pregnancy loss. Human Reproduction. 2014;29(11), 2553-2559. doi:10.1093/humrep/deu216
3. Hakimi O, Cameron LC. Effect of exercise on ovulation: A systematic review. Sports Medicine. 2017;47(8), 1555-1567. doi:10.1007/s40279-016-0669-8
4. Attar E, Gokdemirel S, Serdaroglu H, et al. Natural contraception using the Billings ovulation method. The European Journal of Contraception & Reproductive Health Care. 2002;7(2), 96-99. doi:10.1080/ejc.7.2.96.99
5. Scarpa, B., Dunson, D. B., & Colombo, B. Cervical mucus secretions on the day of intercourse: an accurate marker of highly fertile days. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2006;125(1), 72-78. doi: 10.1016/j.ejogrb.2005.07.024
6. Vigil P, Ceric F, Cortés ME, et al. Usefulness of monitoring fertility from menarche. Journal of Pediatric and Adolescent Gynecology. 2006;19(3), 173-179. doi:10.1016/j.jpag.2006.02.003
7. Bann S, Goshtasebi A, Shirin S, et al. A one-year observational cohort study of menstrual cramps and ovulation in healthy, normally ovulating women. Scientific Reports. 2022;12(1), 1-9. doi:10.1038/s41598-022-08658-3
8. Seidman LC, Brennan KM, Rapkin AJ, et al. Rates of anovulation in adolescents and young adults with moderate to severe primary dysmenorrhea and those without primary dysmenorrhea. Journal of Pediatric and Adolescent Gynecology. 2018;31(2), 94-101. doi:10.1016/j.jpag.2017.09.014
9. Dasharathy SS, Mumford SL, Pollack AZ, et al. Menstrual bleeding patterns among regularly menstruating women. American Journal of Epidemiology. 2012;175(6), 536-545. doi:10.1093/aje/kwr356
10. Klein, D. A., Paradise, S. L., & Reeder, R. M. Amenorrhea: a systematic approach to diagnosis and management. American Family Physician. 2019;100(1), 39-48. https://pubmed.ncbi.nlm.nih.gov/31259490/
11. Luciano, A. A., Lanzone, A., & Goverde, A. J. Management of female infertility from hormonal causes. International Journal of Gynecology & Obstetrics. 2013;123, S9-S17. doi: 10.1016/j.ijgo.2013.09.007
12. Jurczewska, J., & Szostak-Węgierek, D. The influence of diet on ovulation disorders in women—A narrative review. Nutrients. 2022;14(8), 1556. doi: 10.3390/nu14081556
13. de Angelis C, Nardone A, Garifalos F, et al. Smoke, alcohol and drug addiction and female fertility. Reproductive Biology and Endocrinology. 2020; 18(1), 1-26. doi:10.1186/s12958-020-0567-7
14. Rachdaoui, N., & Sarkar, D. K. Effects of alcohol on the endocrine system. Endocrinology and Metabolism Clinics. 2013; 42(3), 593-615. doi: 10.1016/j.ecl.2013.05.008
15. Su HW, Yi YC, Wei TY, et al. Detection of ovulation, a review of currently available methods. Bioengineering & Translational Medicine. 2017;2(3), 238-246. doi:10.1002/btm2.10058
16. Silvestris E, de Pergola G, Rosania R, et al. Obesity as disruptor of the female fertility. Reproductive Biology and Endocrinology. 2018;16(1), 1-13. doi:10.1186/s12958-018-0336-z
