Anovulatory Cycle: How to Recognize, Prevent, and Treat It

Ovulation plays a central role in fertility, making it possible for pregnancy to occur. While it’s common to associate monthly bleeding with a healthy cycle, that isn’t always a reliable sign that ovulation has taken place. You can experience regular bleeding even in the absence of ovulation, which can feel confusing or discouraging when you’re trying to conceive. Gaining a clearer understanding of what’s happening in your body can help you feel more empowered and supported. In this article, we’ll walk through what anovulation is, how it affects your cycle and fertility, and how to move forward with informed, compassionate care.

What Is an Anovulatory Cycle?

Ovulation is when the ovaries release one or more eggs to potentially be fertilized by a sperm during your fertile window. In comparison, anovulation is when no egg is released from the ovaries. This means not only do you not experience your fertile window, so you cannot get pregnant, but you also do not menstruate. You may still bleed, however, as the necessary hormonal releases during ovulation did not take place, it won’t be a true period.

Why Ovulation Matters

As a part of the menstrual cycle, ovulation has an impact beyond pregnancy. Ovulation is not just responsible for the release of an egg (although that is its main job) and a part of the fertile window. It’s also responsible for changes in progesterone, which affects a woman’s mood, metabolism, and even her bone health! When there’s a problem with ovulation, it can disrupt the rest of the cycle. Think of the menstrual cycle as a hormonal relay race; without the previous person in the race, there’s no way to start the next section. In this case, without ovulation, you can’t move onto the luteal phase. If you’re TTA, this is often the outcome you’re hoping for. However, if you are TTC, then a lack of ovulation also means that you cannot get pregnant. For most women, there are similar signs of ovulation, such as a shift in their Basal Body Temperature (BBT) or egg white-like discharge during ovulation. If you are tracking your menstrual cycle, it can also be a good idea to track your ovulation symptoms, including your BBT during ovulation.

Signs You Might Not Be Ovulating

All women are individuals, so while there are some universal ovulation symptoms, the combination, intensity, and specifics are unique to you. The easiest way to see if you aren’t ovulating is to track your ovulation symptoms (including physical, emotional, and hormonal when possible). 

When you know your ovulation symptoms, you can see when they aren’t happening, indicating anovulation. That is easier said than done, though, and it also assumes you have tracked or are aware of your ovulation symptoms. Some people still appear to have regular cycles even with an anovulatory cycle, so they don’t know they might need to track this information. This is understandably frustrating if anovulation is affecting your cycle or your fertility. 

If you haven’t tracked your ovulation symptoms, these are some more universal (and some less obvious) anovulatory symptoms:

Common Symptoms of Anovulation

• Irregular periods. Generally, a cycle should be relatively consistent (lasting around 28 days), but if you are finding that your cycle length varies wildly, an anovulatory period could explain why.

• Missing periods (amenorrhea). Remember the relay race? Menstruation can’t start properly without ovulation.

• Very heavy or light bleeding. These can be a sign of some hormonal imbalances, which can also lead to a lack of ovulation in the cycle.

• No cervical mucus changes. Your cervical mucus is tied heavily to your cycle, so if it’s not changing, that’s a signal that not all of the events of your cycle are happening.

• No BBT spike. Tracking your BBT with a thermometer like the Mira Basal Body Thermometer will give you the most accurate BBT results.

• Mood swings, fatigue, or low libido can also be signs you haven’t ovulated. If these signs are concerning you or are stopping you from living your life in the way you are used to, speak to your doctor.

Why Am I Bleeding If I'm Not Ovulating?

This can seem confusing at first glance. It’s no wonder people in this situation ask, “Why am I not ovulating but having periods?”. Usually, there’s no reason for monthly bleeding if it’s not menstruation. However, as you have read, menstruation can’t start without ovulation. Any bleeding that comes without ovulation is not menstruation and is called anovulatory bleeding or abnormal uterine bleeding (AUB). AUB happens because although ovulation is part of the control mechanism for progesterone, anovulation doesn’t stop other hormonal systems. Estrogen can still build in the uterine lining without progesterone. But without progesterone balancing out the estrogen, this can lead to an excessive amount of uterine tissue being created, and after a sudden drop in estrogen, it can lead to some bleeding.

What Causes Anovulation?

As with any hormonal condition, there are several potential causes. The most obvious being a hormonal cause, such as a hormonal imbalance. The menstrual cycle is, at its heart, a hormonal cycle. Any disruptions to your hormones will affect your cycle, including ovulation.

Hormonal Causes 

It’s not too surprising to think that a hormonal effect could be caused by a disruption or dysregulation in a woman’s hormones. The most common contributors are Polycystic Ovarian Syndrome (PCOS) and thyroid problems (both overactive and underactive thyroid conditions can disrupt ovulation). Another condition that might catch some people off guard is high prolactin. Prolactin is the hormone responsible for lactation and breast development. This is helpful for when you are pregnant and preparing to give birth, but less so when you are TTC, as prolactin suppresses the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), both of which are important for ovulation and your cycle as a whole.

Lifestyle Triggers 

Most people know that chronic stress isn’t good for them, but may not realize that it also affects ovulation. Another area to consider is your weight, since fat is part of the body’s hormonal system, meaning that too much or too little can disrupt this system. If you are looking into losing weight, do not over-exercise, as this can also affect your hormones. Find the balance that works for you and try not to feel stressed about juggling these factors.

External/Medical Causes

Several medications can stop ovulation, some of which are the intended effect, and others where it is an unintentional side effect. Hormonal birth control often works to disrupt LH and FSH, which blocks ovulation. Other medications, like endocrine disruptors and non-steroidal anti-inflammatory drugs (NSAIDs), can also stop ovulation.

How Is Anovulation Diagnosed?

If you are concerned, there are several steps you and your fertility expert can take to diagnose the problem. First of all, you may be asked to track your hormones at home. Using a tracking device such as the Mira Hormone Monitor and connecting it to the Mira App is the easiest way to do this, rather than manually tracking your cycle with the calendar method.

Other tests may include BBT tracking, tracking cervical mucus patterns, doing an ultrasound, LH testing, and a progesterone blood test. Most of these (aside from the ultrasound) can be done at home, and the Panorama Lab Test can be used to test for 5 crucial hormones that affect reproductive health, including Anti-Mullerian Hormone (AMH), a hormone produced by the ovaries that indicates ovarian reserve.

However, you and your clinician decide to find the diagnosis, it will likely require multiple ovulation cycles. This can be frustrating and anxiety-inducing if you feel like you’re just stuck waiting to find out what is happening to you. Find people to lean on or a support group of women experiencing fertility struggles, so you can get the support you need. 

How to Treat Anovulation

The good news is that there are ways to treat it! There are various treatments, ranging from lifestyle adjustments to medication. It may be worth trying lifestyle adjustments first before considering natural changes, and then medication (but if you are concerned, always consult your physician).

Lifestyle Changes That Help

Some of the best changes anyone can make are in their lifestyle.

We all know that when we’re stressed, our body fills up on adrenaline and cortisol so we can go into fight or flight mode when needed. When someone is chronically stressed, though, that means there is an oversaturation of stress hormones. These hormones can imbalance other hormonal cycles, including the menstrual cycle.

What you put into your body can be incredibly important. Balancing your nutrition and finding the right weight support can improve all areas of your health and well-being. This isn’t just about losing weight either, as gaining weight might be the right thing for you.

Sleep is an area some people overlook. According to the NHS, sleep hygiene isn’t about having a bath before bed; it’s about how you sleep, when you sleep, and how your decisions in the day affect how restful your night is. Health professionals often recommend establishing a bedtime routine and keeping your bedroom dark and cool for optimal sleep. It is also recommended that an adult gets 7-9 hours of sleep a night.

Natural Support Options

Natural options are a very appealing choice for many people, and there’s no reason they can’t be used alongside other forms of treatment and self-care.

What you put into your body will alter the outcomes that it gives you. When looking into how to kickstart ovulation or trying natural remedies for PCOS and other hormonal imbalances, this is the place to start. Targeted nutrient support can be a great help, and increasing your intake of vitamins, such as magnesium and B vitamins, can be a beneficial way to support your menstrual cycle. If you are restricted on what you can eat for dietary or religious reasons, there’s no harm in opting for vitamins and supplements, like the Mira PCOS Supplements, which are designed to give you all the nutrients needed to balance your hormones.

If you can experiment with your diet, choosing an anti-inflammatory diet can help with hormonal conditions. Finding anti-inflammatory foods can be rewarding, especially when you find a new favorite food. Also, look into what you drink. Tea is a popular anti-inflammatory drink, and there are many varieties. If you’re looking for a place to start, the Mira Fertility Tea is designed not only to be delicious but also to support your menstrual health and fertility.

Tracking your basal body temperature using a thermometer like the Mira Basal Body Thermometer can also be an easy way to determine if any changes you’re making are effective. This works best when combined with other tracking methods to get the whole picture of what is working for you.

Medical Options (When Needed)

For some people, medication will not be necessary. However, for others it will be, and there’s no shame in that. As long as a health professional monitors the prescriptions, there’s no reason to worry about taking medication. The most common medications used are:

• Clomiphene (Clomid) is a medication designed to increase the chances of ovulation.

• Letrozole is a medication used to stimulate ovulation.

• Metformin is a drug used for diabetes, but there has been success in using it for PCOS and women with insulin resistance in combination with other medications to induce ovulation.

• If nothing else is working and you are TTC, then In Vitro Fertilization (IVF) or Intrauterine Insemination (IUI) may be offered as a way around the problem.

In some cases, such as with PCOS, you may need long-term support and management plans. Finding what works for you and your body, medical or otherwise, is the most important thing.

When to Talk to a Doctor

Discussing a health condition with a doctor can be daunting. These kinds of conditions often require a fertility expert whom you can lean on and trust to make the decisions that are right for your individual circumstances. If you need help knowing where to start, the fertility experts at the Hormone Health Clinic for Fertility can be there to support and guide you as you are learning about your options. If you have been tracking your cycle and don’t see ovulation for 3 months or more, or you aren’t pregnant after 6-12 months of trying, it’s a good idea to speak to your doctor.

Conclusion

There are ways to help fix periods without ovulation, and there are plenty of people who are experiencing it. Find a good support group that can be with you through the trials and tribulations of this condition, and a good fertility expert who can stick by you through the ups and downs.

Frequently Asked Questions

Can you have a period without ovulating?

No. While you might experience some bleeding, without ovulation, it isn’t a true period.

How do you define ovulating?

Ovulation is defined as the part of the menstrual cycle where an egg is released from the ovaries. Once released, it then makes its way down the uterine tubes where it can be fertilized by a sperm.

What is anovulatory bleeding?

Anovulatory bleeding is a phrase often used to describe a menstrual cycle where ovulation has not occurred but what appears to be a period has occurred. This is why anovulatory cycles can be so confusing, as many individuals think that their menstrual cycle is regular even though they are not ovulating.

When do women ovulate?

In general, ovulation typically occurs midway through the menstrual cycle. However, every cycle is unique and it is considered normal to ovulate anytime between days 10 to 21 of the menstrual cycle.

How to know when you are ovulating?

There are multiple methods you can try at home to track ovulation. This includes the calendar method, BBT method, cervical mucus method, and direct hormone tracking with Mira.

Why am I not ovulating?

There are several factors that can interfere with our body’s ability to ovulate. For example, individuals who have just started menstruating and those who are close to menopause may not ovulate regularly or at all. Coming off of birth control and a few months after experiencing pregnancy loss are also associated with irregular ovulation.

Other factors that may prevent ovulation include hormone imbalance, stress, poor diet, being over/underweight, and frequent use of NSAIDs.

Why am I not ovulating but having periods?

Even if ovulation has not occurred, the endometrium may still shed, leading to bleeding. This may look like a ‘normal’ period, but it is technically not the same as normal menstrual bleeding.

Can you get pregnant without ovulation?

No. It is not possible to conceive without ovulation. During ovulation, an egg is released from an ovary into the uterine tube for fertilization. Without an egg available, there is nothing for sperm to fertilize and conception cannot occur.
However, there are many treatments available that can help stimulate ovulation. To learn more, check out our article 7 Ways to Increase (or Encourage) Ovulation Naturally.