A normal ovulatory menstruation cycle a woman ovulates every cycle. After ovulation, the level of estrogen 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 have still 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 phenomenon of menstruation without ovulation is called anovulatory menstruation, or anovulatory cycle.
Generally speaking, anovulatory menstruation is caused by hypothalamic hypoplasia, or delayed development, imperfect regulation between the hypothalamus, pituitary gland and ovarian axis, decreased ovarian reserve, hormonal disorders, or long-term emotional stress and fatigue. 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 color Doppler ultrasound or blood test for endocrine examination. You can do a ultrasound during ovulation to see if there is follicle development and mature follicle rupture. You can also have blood test to see if estrogen, luteinizing 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.