Ovulatory dysfunction, is a disorder in which ovulation does not occur regularly. Ovulation is the term used to define the release of an egg from the ovary. This process is essential for pregnancy to occur. Ovulation is a complex process and depends on an adequate amount of appropriate hormones at appropriate times of the menstrual cycle. Anything that disrupts the hormonal regulation of the female cycle may result in ovulatory dysfunction.
Ovulatory dysfunction can occur in any woman that has undergone puberty. Women who have reproductive organs that did not develop fully may not be capable of ovulating. Ovulatory dysfunction is very common in women approaching menopause. Once menopause sets in, women stop ovulating. As many as 30-40% of all women may experience ovulatory dysfunction. This is one of the most common and most manageable causes of infertility.
The ovaries contain thousands of eggs, which are housed in small sacs called follicles. In order for ovulation to occur, one of these follicles must grow to a mature size. Various hormones play an important role in this growth and maturation process. The levels of hormones fluctuate throughout the menstrual cycle but must always be at the appropriate level at the appropriate time for a normal menstrual cycle. LH (luteinizing hormone) and FSH (follicle stimulating hormone) are two hormones needed for a follicle to grow to maturity. Estrogen, FSH, and LH levels must rise in order to release the egg. After the egg is released from the ovary, it travels to the uterus through the fallopian tubes, where it may get fertilized if sperm are present. The uterine wall thickens to allow implantation of a fertilized egg. If a viable sperm does not fertilize the egg, then the lining of the uterus sheds and menses occurs. This marks the start of a period and a new menstrual cycle.
In women with ovulatory dysfunction, ovulation does not occur consistently. Most causes of ovulatory dysfunction are related to an imbalance of hormones. Organs within the brain (the hypothalamus and pituitary glands) play an important role in regulating amounts of FSH and LH. Inadequate amounts of FSH and LH in the beginning of the menstrual cycle can cause ovulatory dysfunction. Therefore, any changes in how the hypothalamus and pituitary function can affect ovulation.
There are numerous causes of ovulatory dysfunction. The hypothalamus and pituitary regulate FSH and LH. Most of the causes of ovulatory dysfunction in some way affect the hypothalamus or pituitary glands and cause deficiencies of FSH and LH.
Premature ovarian failure: This is a disorder that leads to a faster depletion of eggs within the ovaries. A woman is born with all of her eggs already within her ovaries. With each menstrual cycle, hundreds of eggs die because only one of them can become a mature follicle. Women who have premature ovarian failure lose more eggs each cycle than normal women. Therefore, these women typically reach menopause before women without premature ovarian failure. Premature ovarian failure is believed to be due to a genetic abnormality.
Increasing age(Menopause): Eventually all women reach menopause, the stage of their life that they can no longer release eggs. As a woman ages and approaches menopause, her cycle becomes irregular because of the small amount of eggs remaining in the ovaries. Infertility due to ovulatory dysfunction is common as a woman approaches menopause.
Hypothyroidism and hyperthyroidism: These are diseases of the thyroid gland. Hypothyroidism means a person does not produce enough thyroid hormone. On the other hand, hyperthyroidism is too much thyroid hormone. It is not entirely understood how these diseases cause ovulatory dysfunction. It may be due to the higher amounts of estrogen in women with these disorders. High levels of estrogen interfere with the growth of the follicle and the increase of LH and FSH that is required for release of the egg.
Hyperprolactinemia: Prolactin is a hormone that is needed to produce breast milk. Too much prolactin (hyperprolactinemia) causes a decrease in FSH and LH. A decrease of these hormones prevents maturation of the follicle thereby causing ovulatory dysfunction. High levels of prolactin also interfere with other hormones that are needed for ovulation.
Polycystic ovary syndrome (PCOS): PCOS is another ovulatory disease that is due to follicles that do not mature. Since they don't mature, the follicles sometimes develop into ovarian cysts. Women with PCOS may not ovulate for months. The reason PCOS prevents ovulation is not completely clear. One theory suggests that the high levels of LH found in women with PCOS contribute to ovulatory dysfunction.
Eating disorders: Anorexia and bulimia contribute to ovulatory dysfunction by altering the normal activity of LH. LH levels continually fluctuate throughout a normal menstrual cycle. However, in anorexic and bulimic women LH does not fluctuate as it should and causes irregular or absent periods. As these women gain weight and eat right, their cycles begin to return to normal.
Excessive exercise - Female athletes that exercise excessively often lose their menstrual regularity. Dietary changes, hormonal changes, and the physical "stress" of exercise all appear to contribute to menstrual changes.
Medications - Some medications used to treat inflammation and pain, such as Motrin® or Aleve®, can interfere with ovulation. Birth control pills also prevent ovulation but they do not contribute to infertility after a woman stops taking them. Some medications cause an increase in prolactin, which may then lead to hyperprolactinemia. These medications include anti-psychotics and opiods. Illicit drugs affect ovulation because their actions within the brain lead to hormonal imbalances.
How Do I know if I suffer from infertility due to Ovulatory Dysfunction
One of the most common signs of ovulatory dysfunction is irregular menstrual periods. The time between 2 periods may range anywhere from 26 to 70 or more days. Each cycle is very unpredictable - one may be 30 days and the next may be 65 days. It is difficult to know if ovulation takes place during these irregular cycles unless a woman monitors her basal body temperature (BBT) or uses a urinary ovulation detection kit. Ovulatory dysfunction may only be recognized when the woman experiences difficulty conceiving. It is important to remember however, that a woman may not ovulate even though she has very regular, consistent cycles.
How does Ovulatory Dysfunction contribute to Infertility?
In order for a woman to become pregnant naturally, an egg must be released from the ovary, i.e. ovulation. Furthermore, sperm must be present to fertilize the egg. For this to occur, intercourse must be timed around the anticipated time of ovulation. Women with ovulatory dysfunction may have difficulty predicting the time of ovulation since it is irregular. It is very important to determine if and when ovulation is occurring in order to get pregnant.
Natural Bioidentical Progesterone Cream
The proper amount of natural progesterone is crucial to a woman who is trying to become pregnant. Natural Bioidentical Progesterone prepares the uterine wall for implantation of the fertilized egg. Without adequate progesterone, the egg will be expelled. Natural Bioidentical Progesterone treatment can also help to induce fertility when there appears to be ovulatory dysfunction.
Natural Alternatives for Anovulation
Anovulation is the absence of ovulation, or failure of an egg to rupture from the ovary at mid-cycle. The cause is lack of progesterone.
The ovaries continues to produce Estradiol, (the principle estrogen of fertility), thus causing an imbalance between estrogen and progesterone. This is called estrogen dominance, an excess of estrogen, when unopposed or unbalanced by progesterone.
Bioidentical Progesterone Cream (Progensa 20)
Bioidentical progesterone cream will balance unopposed estrogen levels and when they are in balance ovulation should returned within 3 cycles.
Herbal Relief (ProSoothe)
ProSoothe is an all natural herbal formula that contains several herbs that work synergistically. Dandelion and vitex,(chaste tree) helps the body remove exogenous,(external excess estrogen)from hormone therapy or contaminated food,(xenosteroids).
Milk Thistle (Silymarin)
Milk Thistle yields three main active compounds known collectively as Silymarin, which work in a number of ways to restore liver health. We are exposed to many toxins like chemicals and excess hormones which greatly affect our overall health and build up in the liver, when this happens the liver does not function as well as it should and it is not able to clear the excess estrogen from our bodies and it contributes to the imbalance of progesterone.