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What is Ovulatory Dysfunction?

When trying to track Ovulation you may come across the term ‘ovulatory dysfunction’, which is directly related to an imbalance of hormones. A little on the technical side, it relates to two areas of the brain and the role they play in regulating the fertility hormones FSH and LH. The two areas of the brain are called the hypothalamus and pituitary glands and they regulate your fertility hormone levels and if the function is disrupted causing inadequate FSH and LH at the beginning of your menstrual cycle, it will lead to ovulatory dysfunction. There are various causes of ovulatory dysfunction, with all of them involving a deficiency of FSH and LH and include:

 

Premature ovarian failure: A woman is born with all of her eggs already within her ovaries, with the passing of each menstrual cycle, hundreds of eggs die because only one of them will go on to become a mature viable follicle. Premature ovarian failure is a disorder that leads to a more rapid depletion of eggs, causing a woman to lose more eggs each cycle than normal women. Premature ovarian failure is believed to be as a result of a genetic abnormality.

 

Menopause: As a woman ages her cycle becomes more irregular due to the smaller amount of eggs remaining in her ovaries. And as all women reach menopause, they are no longer physically able to release eggs, and infertility due to ovulatory dysfunction is a common occurrence as a woman approaches the menopause.



Hypothyroidism & Hyperthyroidism: Hypothyroidism is a condition where a person does not produce enough thyroid hormone, whereas in contrast Hyperthyroidism means  the production of too much thyroid hormone. These are diseases of the thyroid gland. While still not 100% clear as to why they cause ovulatory dysfunction, it is thought it may be due to a higher level of estrogen in women with these disorders. Increased levels of estrogen negatively impact the growth of the follicle and the increase of LH and FSH that is necessary for the release of the egg.



Hyperprolactinemia: In order for a woman to produce breast milk, the hormone prolactin needs to be present. Hyperprolactinemia is the production of too much prolactin which causes a decrease in FSH and LH. A decrease in FSH and LH prevents the follicle from maturing, resulting in ovulatory dysfunction.



Polycystic Ovary Syndrome (PCOS): PCOS is the process of follicles not maturing and because the follicles don't mature they may develop into ovarian cysts. Women with PCOS unfortunately, may not ovulate for months at a time. A theory of why PCOS prevents ovulation suggests that the high levels of LH found in women with PCOS contributes directly to ovulatory dysfunction.


Eating Disorders: Both Anorexia and bulimia directly contribute to ovulatory dysfunction by changing the normal activity of LH. As we know LH levels fluctuate during a normal menstrual cycle, however in anorexic and bulimic women LH does not alter as it should resulting in irregular or absent periods. As women suffering from these eating disorders gain weight and eat correctly, their cycles should return to normal.


Excessive Exercise:
 Often high performing female athletes that exercise and train excessively lose their menstrual regularity. The combination of dietary and hormonal changes and the physical stress of exercise have a negative impact on the menstrual cycle.

Medications: As discussed many medications used to treat inflammation and pain such as ibuprofen can interfere with regular ovulation. Birth control pills prevent ovulation but do not usually affect fertility once stopped, however, many medications such as anti-psychotics and opioids can affect ovulation because their effect on the brain can lead to hormonal imbalances.


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