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Do You Suffer from Irregular Menstrual Cycles?

Apr 05, 2013 02:59PM ● By tina

There are many factors which can cause anovulatory cycles in women of childbearing age

Sponsored by Fertility Specialists of Texas

Written by Dr. Rebecca Chilvers

If so you may be one of the 10-15% of reproductive aged women who have what are known medically as anovulatory cycles.  Anovulation is a condition that results in a menstrual cycle where an egg is not released and thus there is no ovulation.  Understandably, this can make it difficult to conceive a child, and in fact, approximately 40% of women seen in infertility clinics have this diagnosis.

Anovulation or sporadic ovulation can be caused by many factors:

·       Hormonal imbalance of the thyroid gland

·       Hormonal imbalance due to elevated prolactin (the hormone responsible for milk production, naturally elevated during breast feeding but not normally otherwise)

·       Stress

·       Significant weight loss or weight gain

·       Decline in the number of remaining eggs in the ovaries

By far, the most common cause of anovulation seen in women of childbearing age is polycystic ovary syndrome or PCOS.  This syndrome is characterized by irregular menstrual cycles and evidence of elevated androgen hormones, the hormones classically thought to be “male” hormones like testosterone and androstenedione but which are also produced by women, just usually at lower concentrations.  Though variations in symptoms exist, the classic presentation of a woman with PCOS is someone who has struggled with being overweight and who may have acne, facial hair, or hair loss.  Oftentimes the patient has a family history of diabetes, since this disorder commonly has insulin resistance as a key element.  Patients with PCOS accompanied by insulin resistance are at increased risk for diabetes as well as for heart disease and may have elevated cholesterol, so they often need to make long term, preventative lifestyle changes.  However, in regards to their fertility, women with PCOS tend to have an abundance of eggs compared to women of the same age without the condition; they just usually need assistance to ovulate.  For those women with PCOS desiring conception that are overweight, weight loss is also recommended as this can help to restore hormonal balance and more frequent ovulatory cycles and will make a subsequent pregnancy safer for mother and child. 

The good news for women with anovulation due to many different causes is that fertility medications are highly successful in helping women achieve ovulation and conception.  Treatments for such women involve fertility pills such as Clomid or Femara, fertility injections such as gonadotropins (recombinant FSH and LH hormones), or In Vitro Fertilization (IVF). Typically the lower tech options of pills or injections are tried first with success depending on the patient’s age and other factors, but sometimes IVF is considered more rapidly if a patient with PCOS, for instance, has a high risk of twins or triplets on the other therapies.

If you believe that you may have the condition of PCOS or another form of anovulation and are trying to conceive, it may be time to see a reproductive endocrinologist who can do a thorough evaluation and recommend a treatment plan to achieve pregnancy.  At Fertility Specialists of Texas, we are trained specifically to help women with irregular or absent ovulation and are available for consultation at three convenient locations, the newest of which is located in Grapevine, Texas.  It is our goal to help women achieve a healthy pregnancy and to bring new babies into their lives.