Can I have menstruation without ovulation?

Generally speaking, we know that women have ovulation and then menstruation, but we need to understand that some women may have menstruation even if they do not ovulate. This situation is called anovulatory menstruation, or functional uterine bleeding. There are many reasons for this situation. Sometimes it is a normal physiological phenomenon, and sometimes some disease factors must be considered. Let us learn about this aspect below.

Can I have menstruation without ovulation?

Women who do not ovulate can also have menstruation, which is medically known as "anovulatory menstruation." This is different from normal menstruation and falls into the category of "functional uterine bleeding". This type of menstruation is characterized by irregular timing and variable blood volume, sometimes a lot, sometimes very little. It is rare for bleeding to occur regularly like menstruation or for bleeding to stop regularly.

This is because the cause of bleeding is different from normal menstruation. It is not due to a simultaneous decrease in estrogen and progesterone, causing part of the endometrium to fall off and cause bleeding. Instead, it is only affected by estrogen. When the estrogen level fluctuates, part of the endometrium falls off and causes bleeding.

Anovulation is a symptom in itself and is one of the symptoms of infertility. Generally speaking, there are no specific symptoms and signs of anovulation. Although anovulation has no obvious symptoms, anovulation caused by different reasons may manifest as similar accompanying symptoms. Some of the accompanying signs and symptoms of anovulation are usually discovered during a doctor's examination and consultation.

Ovulation can be indirectly inferred by measuring basal body temperature, examining cervical mucus, endometrial biopsy and hormone measurement. Finally, a series of endocrine function tests, X-ray angiography, chromosome analysis and laparoscopy are needed to roughly determine the cause of the ovulation disorder.

Causes of non-ovulation

1. Turner syndrome and simple gonadal dysgenesis chromosomal abnormality diseases both have primary amenorrhea as the main clinical manifestation, with increased gonadotropin and decreased estrogen. Pregnancy can be achieved through in vitro fertilization and embryo transfer using eggs donated by others.

2. Premature ovarian failure and ovarian antagonism syndrome: Hypergonadotropic amenorrhea caused by ovarian failure that occurs before the age of 40 is called premature ovarian failure, which accounts for about 20% to 28% of primary amenorrhea and 4% to 20% of secondary amenorrhea. Women with primary amenorrhea or secondary amenorrhea before the age of 30 have elevated levels of endogenous gonadotropin and normal follicles in their ovaries, but are low-responsive to high-dose exogenous gonadotropin stimulation. This is called ovarian insensitivity syndrome or ovarian antagonism syndrome. The causes of both diseases are still unclear, and both present with amenorrhea and anovulation.

3. Polycystic ovary syndrome: often manifested as amenorrhea or infrequent menstruation, long-term anovulation, excessive androgen, and no cyclical fluctuations in estrogen. It is currently a major cause of anovulatory infertility.

4. Unruptured luteinized syndrome: In a normal menstrual cycle or a drug-induced ovulation cycle, an ovarian follicle develops into a dominant follicle, but the follicle does not disappear or maintains growth 48 hours after the LH peak during ovulation, and exists for several days. The granulosa cells have become luteinized, but the follicle has not ruptured.