Abnormal uterine bleeding (AUB) is a distressing condition affecting 14-25% of women of reproductive age. One of the underlying causes of AUB is the absence of ovulation, a condition known as anovulation.
When ovulation fails, hormonal imbalances disrupt the normal menstrual cycle, leading to irregularities in the shedding of the uterine lining. This irregular shedding manifests as unpredictable and often heavy bleeding patterns characteristic of AUB.
Understanding the link between anovulation and abnormal uterine bleeding is crucial for effective diagnosis and treatment. This blog explores the mechanisms behind this connection and discusses the implications for women’s health.
What Is Anovulation?
Ovulation is a multifaceted process characterized by the discharge of a fully developed egg from the ovarian follicle. In cases of anovulation, this process is disrupted, leading to a lack of ovulation. Anovulation can result from various factors, including hormonal imbalances.
Without ovulation, the normal hormonal fluctuations necessary for regulating the menstrual cycle are disrupted, leading to irregular bleeding patterns.
Why Anovulation Causes Abnormal Uterine Bleeding
Abnormal uterine bleeding associated with ovulatory dysfunction or anovulatory bleeding (AUB-O) can lead to prolonged, heavy, and painful periods. Here are the causes behind anovulation associated AUB:
A Low FSH and Estrogen Deficiency
Individuals with suppressed Follicle-stimulating Hormone FSH levels and estrogen deficiency may experience amenorrhea, leading to the absence or irregularity in menstruation.
Your healthcare provider will provide an accurate diagnosis by requesting several tests, including complete blood count, liver enzymes, and kidney function. The doctor may also recommend fasting and serum cortisol or a TSH test.
An Estrogen Deficiency and Elevated Gonadotropins
An impaired gonadotropin and estrogen deficiency may cause anovulation-associated abnormal uterine bleeding. These symptoms can cause heavy menstruation, and amenorrhea, and hinder the ovulation process, affecting a woman’s ability to get pregnant.
However, research shows that using gonadotropin to treat fertility issues with estrogen deficiency and a high FSH serum can result in successful pregnancies. Thus, this treatment method can alleviate the symptoms of anovulation and promote healthy ovulation.
How Do I Treat or Manage Anovulation Associated AUB?
Your healthcare provider will request numerous diagnostic tests, including blood progesterone and thyroid levels, a pelvic ultrasound, and prolactin levels. The medical professional will assess the results of these tests and your symptoms to ensure you have anovulation.
After the diagnosis, your gynecologist or obstetrician will tailor a treatment plan to your needs. Most doctors will correct underlying endocrine and hormonal imbalances to promote a healthy ovulation and menstrual cycle.
Who Does Anovulation Primarily Affect?
Women beyond the child-bearing age, between 12 and 51, are at risk of anovulation. You’re likelier to experience abnormal uterine bleeding associated with anovulation if you experience the following conditions:
- You recently got your first-period
- You have a polycystic ovary syndrome diagnosis
- You’re experiencing symptoms of menopause
- You struggle with primary ovarian insufficiency
- You have a low Body Mass Index (BMI)
The Bottom Line
The irregularity of periods is a predominant sign of anovulation, which is a manifestation of dysfunctional uterine bleeding. If you experience heavy and painful menstruation, visit your healthcare provider to discuss symptoms and receive a diagnosis.
Sources
https://www.ncbi.nlm.nih.gov/books/NBK549773/
https://tidewaterobgyn.com/bleeding-during-ovulation/