Can menstruation occur without ovarian follicles?

Menstruation is a common physiological reaction that occurs in the female body. When women reach a certain age, their bodies will naturally experience menstruation. However, there are often some special situations during menstruation, including menstrual disorders. This situation can be caused by various reasons. So, can menstruation occur without follicles?

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.

Bleeding related to pregnancy: Dysfunctional uterine bleeding often causes amenorrhea and bleeding for a period of time, while various bleeding related to pregnancy such as miscarriage, ectopic pregnancy, hydatidiform mole, etc. also have a history of amenorrhea, but at the same time there are pregnancy reactions and a positive pregnancy test. B-ultrasound examination is helpful for differentiation. If differentiation is difficult, diagnostic curettage can be used for differentiation.

Choriocarcinoma: It often occurs secondary to miscarriage or delivery, with continuous irregular vaginal bleeding, positive early pregnancy test or continuous positive blood H(X). B-ultrasound, hysteroscopy, pelvic angiography, etc. are all helpful for differentiation.

Endometrial polyps and submucosal fibroids: manifested by increased menstrual volume and prolonged menstrual period, but normal cycle and biphasic basal body temperature. They can be differentiated by hysterosalpingography and hysteroscopy.

Women who do not ovulate can also have menstruation. This situation is medically called "anovulatory menstruation." Anovulatory menstruation is different from normal menstruation and falls into the category of "dysfunctional uterine bleeding". Anovulatory menstruation can have various clinical manifestations. The most common symptom is irregular uterine bleeding, which is manifested as irregular menstrual cycles, varying lengths of menstrual periods, irregular or increased menstrual flow, and even heavy bleeding. There is generally no abdominal pain or other discomfort during the bleeding period. Anemia often occurs when the amount of bleeding is large or the duration is long. Heavy bleeding can also lead to shock.

Anovulatory menstruation mainly occurs in middle-aged and elderly women and adolescent women. The ovarian function of menopausal women gradually weakens, mainly because they stop ovulating and then all the follicles stop growing. Adolescent women may have immature or delayed development of the hypothalamus-pituitary-ovarian axis, which causes follicles to grow and develop in the ovaries but no ovulation.