Femia > Health Library > Your cycle > Health > Why am I not ovulating but still having periods? Understanding anovulation
Why am I not ovulating but still having periods? Understanding anovulation
- Updated Nov 28, 2024
- Published
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- If your ovaries fail to release an egg, ovulation hasn’t occurred, and you can’t get pregnant during that cycle.
- Anovulation can cause bleeding resembling a period.
- Anovulation can be caused by a variety of conditions, including stress, polycystic ovary syndrome (PCOS), thyroid issues, and perimenopause.
Without ovulation, you can’t conceive naturally during that cycle.
Anovulation occurs when the ovary fails to release an egg. When this happens, there is no chance of conceiving during that cycle. Some women miss periods during anovulation, which offers a clue that something might be amiss.
However, you can bleed after an anovulatory cycle; though it isn’t technically a period, it can be easily mistaken for one.
Femia helps millions of women track their cycles and fertile windows
What is ovulation?
Ovulation normally occurs once during each menstrual cycle, usually around its midpoint (day 14 if you have a 28-day cycle). During ovulation, an egg is released from an ovary and travels down the fallopian tube towards the uterus. The egg can survive for up to 24 hours.
Your fertile window begins five days before ovulation (because sperm can survive up to five days inside your body waiting for an egg) and finishes the day after ovulation occurs. If sperm reaches the egg during this fertile window, you might conceive.
Can you have a period without ovulating?
Technically, you can’t menstruate without ovulating first. However, changing hormone levels mean many women experience bleeding that they (understandably) mistake for a regular period. This bleeding is often referred to as a withdrawal bleed.
An AUB may be lighter or heavier than your regular period, which may be a hint that it’s not a run-of-the-mill cycle. These bleeds can also be irregularly timed, so tracking your cycles can help you notice if it occurs and give you a better idea of what’s happening in your body.
👉Find out more: PMS vs pregnancy symptoms: How to tell the difference?
Why am I not ovulating but having periods?
You’re not having a true period, though it may seem that way. If you aren’t ovulating, what you’re experiencing are withdrawal bleeds caused by hormonal changes. You must ovulate to have a period, which is why the bleeds you have when on the contraceptive pill are described as withdrawal bleeds rather than periods.
So, if you’re wondering “can you have a period and not ovulate?”, the answer is technically no—but you can have a bleed that resembles one.
What is anovulation?
Anovulation occurs when the ovaries fail to release an egg for ovulation. Instead of releasing a mature egg, the eggs are reabsorbed into the body.
Anovulation can be a temporary condition—if it lasts for over a year, it is known as chronic anovulation, which is a common cause of infertility. The good news is that it’s usually a treatable condition, and the sooner you get a diagnosis, the sooner you can start treatment.
Hormonal imbalances can cause anovulatory cycles. Several hormones are necessary for ovulation, including Follicle Stimulating Hormone (FSH), Luteinising Hormone (LH), estrogen, and progesterone. If any of these hormones are out of balance, your body might fail to ovulate.
This is also how certain hormonal contraceptives work, by disrupting the ovulatory system and preventing ovulation. For example, some IUDs, contraceptive pills, patches, and shots all cause anovulatory cycles.
Other causes of anovulation include:
- PCOS;
- Excessive exercise;
- Eating too few calories;
- Being overweight;
- Being underweight;
- Stress;
- Thyroid or pituitary disorders;
- Certain medications;
- Premature ovarian failiure;
- Hormone imbalance such as hyperprolactinemia.
Signs and symptoms of anovulatory cycle
It’s not always easy to tell whether you’re ovulating. Sometimes, this issue isn’t picked up until fertility testing, but there are anovulation symptoms and signs of not ovulating you can look out for, including:
- Irregular periods;
- Heavier or lighter bleeding than usual;
- A lack of ovulatory cervical mucus;
- No temperature changes as expected during your cycle;
- Not getting pregnant after a year of trying.
Tracking basal body temperature (BBT)
If trying to conceive, you may be tracking your basal body temperature to help you time sex. This can be one way to identify an anovulatory cycle. During an anovulatory cycle, you won’t record temperature spikes as you would expect during a menstrual cycle. Instead, your temperature will remain consistent throughout. This is a sign that you haven’t ovulated, and you should make an appointment to consult with your OBGYN.
You might also uncover anovulatory cycles if you’re tracking ovulation by taking note of your cervical mucus. A period without ovulation signs, such as cervical mucus, could indicate an anovulatory cycle.
👉Find out more: Can you get pregnant on your period? Understanding the odds and timing
Monitoring cervical mucus
Cervical mucus changes during ovulation, allowing sperm to travel easily to the waiting egg. The cervical mucus of ovulation is slippery, clear, and stretchy. It is often compared to raw egg whites because of its consistency. If you are tracking your cervical mucus daily and don’t notice any of this type of mucus, it could be a sign of anovulatory cycles, and you should contact your OBGYN to discuss.
Ovulation pain and its reliability
Some women also consider a lack of ovulation pain as a sign of anovulatory cycles. However, not all women have or notice ovulation pain each month, so this is an unreliable method of trying to figure out whether you’re ovulating.
If you’re trying for a baby, the fact you aren’t getting pregnant could be a sign of anovulatory cycles. Often, women will first uncover the condition after failing to conceive.
If you are under 35, you should make an appointment to see your OBGYN if you haven’t been able to conceive after a year of trying. If you are over 35, you should make the appointment after six months of trying. If you are over 40 or have underlying reproductive health conditions or red flags for infertility, such as very irregular periods, you should see your OBGYN as soon as you decide to start trying for a baby.
Why am I not ovulating?
If you’re trying for a baby, hearing your body is slowing you down can be frustrating. Each cycle counts, so you’re likely desperate to understand why you’re not ovulating. Common causes of anovulation include stress, thyroid issues, PCOS, excessive exercise, weight issues, and perimenopause.
Unsurprisingly, your hormones play a crucial role in your reproductive system. A hormonal imbalance could be causing your anovulatory cycles, so it’s essential to see a doctor as soon as possible to discover the cause of your missed ovulations.
If you have intermittent anovulatory cycles, you may ovulate the next month without having to make any lifestyle changes. If, however, you have chronic anovulation, you can make changes to encourage ovulation and improve your reproductive health.
What happens to your eggs if you don’t ovulate?
If you’re wondering what happens to your eggs if you don’t ovulate, you might be surprised to hear you usually lose more than one egg monthly. While only one egg matures and is released during ovulation, around 15–20 eggs are activated each cycle. The winning egg matures and gets released during ovulation, and the body reabsorbs the remaining follicles in a process known as atresia.
While the idea of losing eggs might sound scary, especially if you suffer from chronic anovulation, it’s important to remember you are born with more than enough eggs. You were born with around two million eggs. You lose around 1,000 per month to cell damage but will still have plenty of eggs left over.
Chronic anovulation isn’t good news when you’re trying to conceive, but once you have a diagnosis, you can start treatment to kickstart ovulation again.
How does anovulation affect fertility?
If you don’t ovulate, you can’t get pregnant, so anovulation is may not be the news you want to hear. It can be distressing to hear you’re not ovulating when you are trying for a baby, but you’ll be relieved to hear there are treatment options available to you.
If you think you might be having anovulatory cycles, you should consult with your OBGYN for advice. There are lifestyle changes you can make to treat anovulation, plus medication options if those don’t work. Your doctor will want to determine the cause of your anovulatory cycles before using medication.
👉Find out more: How to recognize signs of high fertility in a woman: A detailed guide
Diagnosing anovulation
When you attend your consultation, your doctor will take a medical history and ask questions to learn more about your fertility. They may ask whether you’ve been tracking ovulation signs such as basal body temperature and cervical mucus. If you haven’t been tracking these, they may ask you to do so from now on.
Your doctor might take a few steps to understand what’s happening with your body:
- Blood tests. They may check your hormone levels to see if there’s an imbalance that could be affecting ovulation.
- Ultrasound exam. This allows them to look at your pelvic organs, checking for signs of ovulation and any potential issues.
- Progesterone challenge. Your doctor might suggest this test to check how your body responds to progesterone. Here’s how it works:
- You’ll take progesterone for a set number of days.
- If you have a “withdrawal bleed” (similar to a period) after stopping the progesterone, it suggests your uterine lining is building up but not shedding regularly.
- If you don’t have bleeding, it might indicate lower estrogen levels or other issues.
This combination of tests helps your doctor get a clearer picture of what might be affecting your cycles and fertility.
How is an anovulatory cycle treated?
Once you’ve established the likely cause of the anovulatory cycles, your healthcare will advise you on treatment options.
Lifestyle modifications: Weight and exercise
Being overweight, underweight, and not getting enough calories can cause anovulation. If this is a possible cause, your healthcare provider will support you in managing your weight and eating a healthy diet for optimal fertility. If excessive exercise is to blame, you’ll have to switch to moderate exercise to see if your cycles return to normal.
Managing stress
Some women find stress is the cause of their anovulatory cycles; if this is the case for you, you’ll need to learn some stress management techniques. It’s not always possible to cut stress entirely (if only!), but there may be small steps you can take to make your daily stress feel more manageable. Mindfulness, yoga, therapy, spending time in nature, and taking regular exercise can all help to reduce stress.
Addressing underlying health conditions
Underlying health conditions cause some cases of anovulation, so your doctor will want to treat these, too. If the lifestyle changes don’t help to restart ovulation, your doctor may prescribe medication to trigger ovulation.
Assisted reproductive technology: IVF
If anovulatory cycles are preventing you from getting pregnant, in vitro fertilization (IVF) may be used for an assisted pregnancy. During IVF, egg follicles are manually extracted from the ovaries without ovulation occurring. The eggs are then fertilized with sperm and allowed to develop for a few days before being inserted into the uterine lining.
Femia helps millions of women track their cycles and fertile windows
Questions from Femia community
Can I still get pregnant during an anovulatory cycle?
No, it’s not possible to conceive during an anovulatory cycle. Without ovulation, there is no egg for the sperm to fertilize; therefore, pregnancy can’t occur. It’s worth tracking your symptoms, such as cervical mucus and basal body temperature, throughout your cycle to identify any potential signs of skipped ovulation.
What’s the difference between a regular period and bleeding during an anovulatory cycle?
The bleeding following anovulatory cycles tricks some women into thinking they’re menstruating. Changing hormone levels cause an irregular bleed, which isn’t technically a period but may happen around the time women are expecting their period. This bleed might be heavier or lighter than a regular period. These bleeds are often irregularly timed, so if you have irregular periods, this could actually be a sign of anovulatory cycles.
Can anovulation be temporary?
Yes, temporary anovulation is known as intermittent anovulation. This is most common around the time of your first and last periods. Intermittent anovulation can also be caused by stress, weight changes, and illness, so there are lifestyle tweaks you can make to encourage ovulation.
If you haven’t ovulated for 12 months, this is known as chronic anovulation. Contact your doctor to discuss treatment options for this as soon as possible. If you want to get pregnant, you’ll need to treat your anovulatory cycles first.
The bottom line
Anovulation is a common condition that can impact fertility. Though this might sound scary, the good news is there are treatments available. Understanding your cycle and tracking bodily changes throughout the month can help you identify anovulation early. Your doctor will then be able to work with you to figure out the cause and recommend treatment options.
Anovulatory cycles can be linked to weight issues, stress, and excessive exercise, so there are lifestyle changes you can make to improve your reproductive health. Your doctor will look for underlying health conditions and treat any that could be preventing ovulation. There are also medications available that can trigger ovulation, which your doctor may suggest to help you conceive.
While reading about anovulation might sound scary when you’re trying for a baby, having a diagnosis is a good thing. Once you have a diagnosis, you have treatment options available to help you conceive.
References
- Hamilton-Fairley, Diana, and Alison Taylor. “Anovulation.” BMJ (Clinical research ed.) vol. 327,7414 (2003): 546-9. doi:10.1136/bmj.327.7414.546 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC192851/.
- Hsiu-Wei Su et al. “Detection of ovulation, a review of currently available methods.” Bioengineering & Translational Medicine (2017) https://doi.org/10.1002/btm2.10058.
- Holesh JE, Bass AN, Lord M. Physiology, Ovulation. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441996/.
- Jones K, Sung S. Anovulatory Bleeding. [Updated 2023 Jul 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549773/.
- Rolaki, Alexandra et al. “Novel trends in follicular development, atresia and corpus luteum regression: a role for apoptosis.” Reproductive biomedicine online vol. 11,1 (2005): 93-103. doi:10.1016/s1472-6483(10)61304-1 https://pubmed.ncbi.nlm.nih.gov/16102296/#:~:text=During%20atresia%20and%20luteolysis%2C%20granulosa,apoptotic%20process%20prior%20the%20ovulation.
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