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ovulation egg and uterus

In a typical natural menstrual cycle, ovulation occurs in each cycle for women. After ovulation, the level of oestrogen drops then raise again in the second part of period. At the same time progesterone raise and keep at a high level. Two weeks later, both hormones retreat and menstruation start. Usually after ovulation you will have period in two weeks unless pregnant.

However, can you still have period without ovulating?

It is possible to have a period without ovulating. Sometimes although follicles in the ovaries develop periodically, even with menstrual cramps but the follicles do not rupture to release mature eggs, and there is no formation of a corpus luteum in the ovaries. This condition is known as anovulatory bleeding, anovulatory menstruation, or anovulatory cycle.

Causes for anovulatory menstruation

There are various factors that can cause anovulatory cycles, including hypothalamic hypoplasia, or delayed development, imperfect regulation between the hypothalamus, pituitary gland and ovarian axis, decreased ovarian reserve, stress, hormonal imbalances, polycystic ovary syndrome (PCOS), thyroid disorders, extreme weight loss or gain, and certain medications. Those can all can cause abnormal uterine bleeding.


Symptoms of anovulatory menstruation are abnormal bleeding, variable amount, prolonged cycle or repeated irregular vaginal bleeding. Some people’s period seem to have certain time pattern and thinks that they have normal menstruation period. However no evidence of ovulation can be found through ultrasound or basal body temperature.

Typical anovulatory dysfunctional uterine bleeding may have several months of amenorrhea before menstruation, followed by heavy vaginal bleeding, which often changes to vaginal bleeding after a few days. The bleeding can last for a few days or for a couple of weeks. It may even cause anaemia.


The diagnosis of anovulatory menstruation can be judged mainly through clinical examination. It can be checked by observing the thickness of the endometrium and vaginal discharge. According to whether the menstruation has regularity and the symptoms and signs associated with menstrual period cycle, we can generally diagnose whether it is anovulatory menstruation.

To confirm the diagnosis of anovulatory menstruation, the diagnosis can be confirmed by colour Doppler ultrasound or blood test for endocrine examination. You can do an ultrasound during ovulation to see if there is follicle development and mature follicle rupture. You can also have blood test to see if oestrogen, luteinising hormone, and progesterone have risen to determine whether it is anovulatory menstruation.

If the cycle length and flows are normal, the menstruation bleeding come and end in time, and it is usually ovulatory menstruation.

How does it affect my fertility?

Anovulatory cycles can be associated with fertility challenges. Conditions like polycystic ovary syndrome (PCOS), which commonly causes anovulatory cycles, can affect fertility by disrupting hormonal balance and impairing the release of mature eggs.

When you don’t ovulate, sometimes the lining of the uterus (endometrium) may continue to grow, resulting in a heavier or prolonged period when it is eventually shed.

If ovulation does not happen, you can’t conceive during that cycle. It is important to know whether you are ovulating or not if you are trying to get pregnant. You can check ovulation at home. If still not sure it is always advisable to consult with a healthcare professional for an accurate diagnosis and appropriate management of any menstrual irregularities and fertility challenges.

Chinese medicine acupuncture in conjunction with conventional medicine for anovulatory bleeding can be a complementary approach that may provide additional benefits. Integrating both traditional and modern approaches can provide a comprehensive approach to reproductive health.

Almond Wellness Centre

At Almond Wellness Centre our registered acupuncture Chinese medicine practitioners have the expertise and experience working with women who have issues with their period and fertility challenges. We integrate acupuncture Chinese herbal remedies with your conventional hormone therapies, and provide a more holistic approach to addressing hormonal imbalances.

More to read

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Menstrual Cycle and Traditional Chinese Medicine

Having two periods in one month? You may just have ovulation bleeding 一个月来两次月经?你也许只是排卵期出血