Anovulation: All you need to know

Tampons on top of calendar marking menstrual cycle.

Jennifer Berry   
by Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT
The menstrual cycle involves a
delicate dance of hormones in a woman’s body. Hormone levels must rise and fall
at certain times to achieve ovulation. Ovulation happens when an ovary releases
an egg in preparation for pregnancy.

In some menstrual cycles, an
egg does not mature, and a woman does not ovulate. This is known as
anovulation. Anovulation may cause irregular menstrual cycles or no periods at

Some medications, conditions,
and external factors that affect hormone levels can cause anovulation.
Sometimes, a woman may have
one anovulatory cycle and then go back to a regular cycle. Other times, it is a
chronic problem.
When anovulation occurs, a
woman cannot get pregnant. For women who have completed menopause, this is
quite normal.
Women of childbearing age do
not usually experience anovulation unless something has disrupted the body’s
hormone levels or damaged the ovaries.


Women who ovulate regularly
often see signs that occur during each cycle. They may experience the

  • increased amounts of cervical
  • a drop and subsequent rise in
    resting body temperature in the middle of the menstrual cycle (around day
  • periods that occur regularly
Women with very irregular
periods, or who do not see signs of ovulation, may wish to try an
over-the-counter ovulation predictor kit. These kits measure levels of hormones
in a woman’s urine to determine when she is ovulating.
A doctor may also be able to
test a woman’s hormone levels or carry out an ultrasound scan to view the

Hormonal contraceptives
Some birth control methods
contain hormones that are designed to stop ovulation and prevent pregnancy.
They may include synthetic forms of the hormones progesterone and estrogen, and
some contain only synthetic progesterone.
These types of birth control
methods include:

  • birth control pill – taken by
    mouth daily
  • birth control patch – applied
    weekly to a particular part of the body
  • vaginal ring – placed inside
    the vagina once a month
  • birth control implant –
    inserted under the skin of the arm, lasting up to 3 years
  • intrauterine device (IUD) with
    hormones – placed inside the uterus for 3 to 5 years
  • birth control shot – given as
    an injection in the arm every 12 weeks
These drugs interfere with the
ovaries’ ability to grow and release an egg. As a result, the woman will have
anovulatory cycles while taking the medication.
It is important to note that
some IUDs contain copper rather than hormones. Copper does not cause
anovulation; instead, it interferes with a sperm’s ability to reach an egg.
Many packs of birth control
pills contain 21 active tablets and seven placebo tablets. A woman who takes
this type of birth control pill may still have a period during the week that
she takes the placebo pills, although it is lighter than a regular period and
is not caused by ovulation. Other methods may cause spotting or breakthrough
Each method of birth control
stops ovulation differently. Women should discuss their options with a
healthcare provider to determine the best choice.
Side effects of drugs

Certain medications designed
for other purposes can still stop ovulation. They include:

NSAIDs (non-steroidal
anti-inflammatory drugs)

NSAIDs include many
over-the-counter pain relievers, such as ibuprofen and naproxen. One study
suggested that NSAIDs can cause anovulation after taking them for just 10 days.

Herbs and natural remedies

Some herbs contain
hormone-like substances that can disrupt ovulation. If someone is trying to get
pregnant or is not ovulating regularly, they may wish to discuss any herbs or
supplements they are taking with their doctor.

Skin creams and other topical
products with hormones

Some products contain estrogen
or progesterone that are designed to fight aging or help with problems such as
premenstrual syndrome (PMS). These products can be absorbed into the body,
causing anovulation or hormone imbalances.


Steroids are a type of hormone
that can reduce inflammation. They can also interfere with the hormones needed
for ovulation.
Cortisone and prednisone are
common types of steroids that are prescribed for a variety of illnesses, such
as allergies, lupus, asthma, and more. Topical steroids are used on the skin to
treat inflammation and allergic reactions.
An article in the Annals of
the Rheumatic Diseases found that half of the women who received a steroid shot
had an irregular menstrual cycle afterward.

Epilepsy or seizure drugs

These medications may
interfere with ovulation and the menstrual cycle, according to an article in the
Journal of Human Reproductive Sciences.
Some epilepsy drugs may also
cause congenital disabilities, so people taking these drugs should discuss
pregnancy plans with their doctors.

Cancer treatments

Chemotherapy, radiation, and
cancer drugs can cause permanent damage to the ovaries.
If someone is trying to get
pregnant and has not had success, they may wish to discuss their medications
with a doctor. In some cases, the doctor can prescribe an alternative medicine
or may consider a drug to encourage ovulation.
Health conditions

Certain health problems can
interfere with the body’s proper balance of the hormones that are critical to
ovulation. These include conditions that affect the thyroid, adrenal,
hypothalamus, and pituitary glands. All of these glands play a role in the delicate
hormonal balance that leads to ovulation.
Polycystic ovarian syndrome
(PCOS) affects up to 20 percent of women of childbearing age, according to the
National Institutes of Health.
Women with this condition
usually have too much insulin and testosterone, which may disrupt the hormonal
balance and lead to anovulation.
Fortunately, these
hormone-related conditions are often treatable. Many women may be able to
achieve ovulation with proper medical treatment.
Weight gain or loss may also
be closely linked to ovulation as the hormone estrogen relies upon a healthy
body weight for normal levels. A study in Human Reproduction found that women
who were either very underweight or overweight had decreased estrogen levels,
which can lead to anovulation and fertility problems.
Women who exercise excessively
or who have high levels of stress may also experience anovulation because of
disrupted hormone levels.
Anovulation may also occur
with premature menopause, also known as premature ovarian insufficiency. A woman
may be diagnosed with this if she stops ovulating before age 40.
The cause of premature
menopause is often unknown, though some medications and conditions can cause
it. Some women who are experiencing early menopause can be treated with
medications to stimulate ovulation and achieve pregnancy.
Treatment and outlook

For many women, anovulation
becomes an issue when they want to get pregnant, or they have irregular
menstrual cycles.
Because many different factors
influence a woman’s hormones and menstrual cycle, there is no one solution for
treating anovulation. In many cases, however, the underlying cause of
anovulation or the issue that is affecting hormone levels can be diagnosed and
treated. Treatment can lead to pregnancy or more regular menstrual cycles if
If a woman suspects that she
is not ovulating, she should see her doctor to explore any potential health
problems and to work toward a healthy hormonal balance.
Kayode Ojo
Kayode Emmanuel Ojo is the Co-Founder and Managing Director at SHEFFA Limited. He is presently studying Computer Science at the National Open University, Victoria Island, Lagos.