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Ovulatory Dysfunction


Ovulatory dysfunction means that a woman’s cycle is either irregular or anovulatory. A cycle is considered irregular when the amount of bleeding varies month to month or when the timing of bleeding is unpredictable. In an anovulatory cycle, no ovulation occurs, meaning that no egg is released from the ovaries, and hormones are not produced to accurately tell the uterus how to respond.

Immediately after a period at the beginning of a normal menstrual cycle, the ovaries produce the hormone estrogen, which causes the lining of the uterus, or endometrium, to grow and thicken to prepare the uterus for pregnancy. Ovulation, the release of an egg by one of the ovaries, occurs in the middle of a normal cycle. The hormone progesterone then begins to increase, preparing the endometrium to receive and nourish a fertilized egg. If no pregnancy occurs, estrogen and progesterone levels drop, which triggers the shedding of the lining. The shedding of the lining is what most women call their period. The average menstrual cycle lasts about 28 days.

The most common cause of ovulatory dysfunction is an imbalance of estrogen and progesterone, the hormones that control a woman’s cycle. Women with ovulatory dysfunction may experience very short cycles (less than 21 days), very long cycles (longer than 35 days), or cycles that are completely unpredictable. Other symptoms can include:

  • Bleeding or spotting between periods
  • Heavy bleeding during periods
  • Periods that last for more than seven days
  • Bleeding that doesn’t stop

Ovulatory dysfunction can cause problems with fertility because it can make it difficult for a woman to know when or even if she’s ovulating. It’s also possible for a woman to develop anemia from too much blood loss. The risk for endometrial cancer may also increase with ovulatory dysfunction.

The first line of treatment for ovulatory dysfunction usually involves some type of hormone therapy. In severe cases where symptoms do not improve with hormone therapy, surgery to treat the lining of the uterus or a hysterectomy may be recommended. Some providers may recommend iron supplements or even blood transfusions for women with anemia.