In addition to the alteration of menstrual periods and infertility, chronic anovulation can cause or exacerbate other long-term problems, such as hyperandrogenism or osteopenia.
Also possible is increased body mass and facial hair, which is relatively easy to treat, and is often associated with PCOS, or polycystic ovary syndrome.
Ovulatory menstrual periods tend to be regular and predictable in terms of cycle length, duration and heaviness of bleeding, and other symptoms.
In contrast, anovulation usually manifests itself as irregularity of menstrual periods, that is, unpredictable variability of intervals, duration, or bleeding.
Thyroid dysfunction can halt ovulation by upsetting the balance of the body's natural reproductive hormones.
[3] A rare form of HA that presents as primary amenorrhea can be due to a congenital deficiency of GnRH knows as idiopathic hypogonadotropic hypogonadism or, Kallmann syndrome if it is associated with anosmia.
Dr Barbieri of Harvard Medical School has indicated that cases of anovulation are quite frequent in women with a BMI (body mass index) over 27 kg/m2.
Dr. Freundl from the University of Heidelberg suggests that tests which use LH as a reference often lack sensitivity and specificity.
[2] The World Health Organization criteria for classification of anovulation include the determination of oligomenorrhea (menstrual cycle >35 days) or amenorrea (menstrual cycle >6 months) in combination with concentration of prolactin, follicle stimulating hormone (FSH) and estradiol (E2).
Diagnosis of anovulation cause involves hormone level tests, in conjunction with an assessment of associated symptoms.
A patient history and physical exam should include history of onset and pattern of oligomenorrhea or amenorrhea, signs of PCOS such as hyperandrogenism and obesity, eating disorders, causes of excessive physical or mental stress, and breast secretions.
[11][12] Weight loss also generally results in improved menstrual regularity and pregnancy rates in women with PCOS.
[13] It is well recognized that insulin resistance can be part of the sequelae of PCOS and if present, contribute to anovulation.
[15] The main ovulation induction medications include: In women with hypogonadotropic hypogonadism suspicious for functional hypothalamic amenorrhea, treatment should be centered around weight gain, reducing intensity and frequency of exercise, and stress reduction with psychotherapy or counseling.
[17] If anovulation persists following lifestyle modifications, ovulation can be induced with pulsatile gonadotrophin-releasing hormone (GnRH) or gonadotrophin (FSH & LH) administration.
[10] For women with POI that desire pregnancy, ovulation induction strategies should be avoided and assisted reproduction, such as in vitro fertilization (IVF) with donor oocytes, should be offered.
[10] For anovulatory women with hyperprolactinemia without symptoms, they can forgo treatment and continue with close follow up and medical observation.
[18] In rare cases, endoscopic transnasal transsphenoidal surgery and radiotherapy, may be required to resect and shrink a prolactinoma if greater than 10 mm in size.
Importantly, individuals should be able to conceive following normalization of serum prolactin levels and shrinking or removal of the tumor.
[10] Corticosteroids (usually found in anti-inflammatory drugs) can be used to treat anovulation if it is caused by an overproduction of male hormones by the adrenal glands.