The menstrual cycle can be a useful indicator when examining overall health. Changes or atypical patterns in the menstrual cycle are important to note and understand, as they can have far-reaching implications.
Ovulation, the phase where the ovary releases an egg which then travels down the fallopian tube and waits to be fertilized by sperm, is a key part of this cycle. Ovulation typically occurs around mid cycle, for example for a regular 28-day menstrual cycle ovulation should occur around day 14.
What is anovulation?
The Cleveland Clinic compares ovulation to “an orchestra, with hormones acting as the instruments.” When one ‘instrument’ (or hormone) is off, it disrupts the entire song. This is called anovulation, when an egg is not released from the ovary during the menstrual cycle. Anovulation is a common factor of infertility, usually caused by a hormonal imbalance.
Anovulation affects young people who are just beginning to menstruate, people who are entering perimenopause (before they transition into menopause), and those who have polycystic ovary syndrome (PCOS). It also impacts those with a very low body mass index (BMI), and those with primary ovarian insufficiency (POI).
Signs and symptoms of anovulation include irregular periods, heavy or light periods, amenorrhea (no periods), lack of vaginal discharge during what would be the ovulation phase, and an irregular basal body temperature.
Anovulation is most often caused by an imbalance of hormones, particularly those involved in ovulation. These include the following:
- Gonadotropin-releasing hormone (GnRH)
- Follicle-stimulating hormone (FSH)
- Luteinizing hormone (LH)
Other hormones, like testosterone and prolactin, can make their mark on the cycle as well.
Stress and the body:
Stress is, of course, normal. It’s something that everyone experiences in their life to varying degrees. It is by all accounts a natural human reaction to the situations we encounter in life. As The Cleveland Clinic puts it, our bodies are designed to experience and respond to this biological phenomenon. Stress is there for a reason.
There are a variety of types of stress, including acute, chronic, traumatic, environmental, psychological, and physiological. According to the National Library of Medicine, not all forms of stress are detrimental. Stress can propel us toward necessary action, and how we respond to stress is a helpful indicator of our overall mental wellbeing.
Acute stress is a short-term reaction to challenging circumstances. It leads to temporary changes in the body, like an increased heart rate.
Chronic stress is experienced over an extended time period, and can have overarching physiological consequences, like heart disease, as well as psychological impacts, like anxiety and depression.
Traumatic stress is a result of events like disasters, accidents and abuse that overwhelm a person’s ability to cope, while environmental stress happens when a person is challenged by their surroundings, whether that be noise, pollution or unsafe living conditions.
While stress is not always ‘bad’, it can have significant negative effects on the body, especially if the body is under a consistent state of stress. The reproductive system is no exception.
Stress and the reproductive system:
Chronic stress can impact the “orchestra” of hormones needed for the menstrual cycle to complete itself, and can subsequently decrease fertility. This occurs when the secretion of the gonadotropin-releasing hormone is suppressed, which in turn reduces the release of the luteinizing hormone and follicle-stimulating hormone from the pituitary gland.
Essentially, the delicate balance of ovulation can be disrupted by stress, leading to impaired ovarian function.
Chronic stress can lead to irregularities in the menstrual cycle, as well as anovulation and infertility. Stress may also impact sex hormone levels, contributing to conditions such as PCOS.
Mental health impacts:
Infertility has clear repercussions when it comes to the psychological wellbeing of the person experiencing it, and stress is believed to impact the reproductive system in return.
If your healthcare provider believes that stress could be contributing to your anovulation, they may recommend techniques like meditation, yoga, or deep breathing. They may also refer you to a therapist to help you better cope with life’s stressors.
Conditions like PCOS are stressful in and of themselves, so working on lifestyle factors like diet and exercise may help with those symptoms, which in turn can reduce stress and may help with anovulation.
Next steps:
Keeping track of your menstrual cycle and using ovulation test strips are simple ways to identify if you may be struggling with anovulation. If you notice any irregularities, make sure to consult a healthcare provider, who can then put you on a path forward with lifestyle recommendations or medication, if applicable. Hormonal imbalances aren’t always curable, but there are steps to take to increase your chances, particularly as it relates to fertility. Reducing stress is just one factor of many when it comes to improving one’s reproductive health, but it’s an important and worthwhile consideration when trying to cultivate a healthier, happier life.