Saturday, February 12, 2011

Not Ovulating?

There are lots of reasons why a woman wouldn't ovulate, but let's take a step backwards and try and determine whether you are ovulating or not.   If your periods do not come at all, or they are more than 40 days apart, then there is a very good chance that you are not ovulating.  There are also some women who appear to have regular periods but are still not ovulating.  Although this is fairly unusual, it can happen.

There are several ways to determine whether you are ovulating.  The least expensive way is with something called Basal Body Temperature Charts (or BBT's).  You will need a thermometer.  They do make special BBT thermometers, but a digital thermometer will also do.  Do not use the ones that go in your ear.  They can vary depending on how far into your ear you get the probe, and you want a very accurate temperature for this.  There are many websites where you can print out a graph for your temperatures, and some of them will even plot them for you.  There are even ap's for that!  First thing in the morning, before you have gotten out of bed or done anything, take your temperature.  Plot it on the graph.  Do this every morning from the first day of your period until the first day of your next period.  If you are ovulating, you will find that your temperatures hover around the same number until about 14 days from your next period.  They will then dip down for a day, go up to a new temperature, and then hover around that new higher temperature until you get your next period.  If you can see that on your graph, then you are ovulating.  The dip is the day you are ovulating.  If you cannot see that, you may not be ovulating.  It can be hard to interpret these some times, so if you don't see what I just described, don't get discouraged.  Try one more method to see if you are ovulating before you decide.

Another option is to try ovulation predictor tests.  These look just like the home pregnancy tests you can buy, but they are to determine when you are ovulating instead.  Unfortunately, different brands vary in their accuracy.  We have had the best luck with the ClearBlue Easy brand.  They are very accurate, and their digital ones are very easy to read.  They either give you a smiley face, if you are ovulating, or nothing, if you are not.  ClearBlue Easy also makes a hand held computer device (fertility monitor) too.  If you are finding positive tests with the regular "pee-on-the-stick" kind, then you don't really need the fertility monitor.  If you are not having luck with the stick version, then the monitor may be helpful.  You can usually find quite a few of them on eBay.  Inside the box of sticks you will find instructions on when to start testing based on how long you cycle is.  The tests usually turn positive about a day before you actually ovulate.  If you find a positive test, then you are almost definitely ovulating.  If you get your period 13-16 days after the positive test, then you are definitely ovulating.  If you do not get your period in that time frame (and you are not pregnant), then you may have something called PCOS (see below).  PCOS can give you false-positive ovulation tests.  Ten percent of ovulating women will not get positive ovulation tests, unfortunately.  So if you are having regular cycles but can't find a positive ovulation test, you may still be ovulating.  Talk to your doctor.

The final way to determine whether you are ovulating or not is to have your doctor do a blood test to look at your progesterone level.  Progesterone is a hormone that your ovaries make after you ovulate.  The best way to test your progesterone level is to draw the blood about a week before your next period is due.  If your progesterone level is over 3 ng/ml, then you are ovulating.  If your cycles are too irregular to predict when your next one is coming, then it can be drawn 3 weeks or more after your last one.

OK, so now you know how to figure out if you are or are not ovulating.  Lets talk about reasons for not ovulating.  Both underactive or overactive thyroids can affect ovulation.  Other symptoms of thyroid disease include feeling hot when everyone else is cold or vice versa, unexplained weight gain or loss, hair loss, fatigue, nervousness, or skin changes.  It is diagnosed by blood tests and is easy to treat.

 A more uncommon reason for not ovulating is an excess of a hormone called prolactin.  Prolactin is the hormone involved in breast feeding, and so many women with high prolactin levels will also have a milky discharge from the breasts too.  Just like breast-feeding women do not get regular periods, women with high prolactin levels who are not breast feeding will do the same.

Extreme stress or excessive dieting or exercise will also lead to ovulation problems.  A woman's body is designed to decrease her fertility if it thinks there isn't enough food around to support a pregnancy or baby or there is too much stress (perhaps predators chasing you?).  So if a woman has very low body fat or a low dietary fat intake or is under extreme stress, she will stop ovulating.  This is common with marathon runners, ballet dancers, women on death row, and body-builders.  It can definitely happen with less extreme cases too.  Decreasing the amount of exercise, increasing calorie and especially fat intake, or changing the stressful situation can reverse the ovulation problems.

Another very common reason for not ovulating is something called PCOS or polycystic ovarian syndrome.  This is a condition where eggs cannot mature enough to be able to ovulate.  These semi-mature eggs produce a lot of testosterone and other male hormones.  These male hormones feed back to the pituitary (the gland in your head that controls your menstrual cycle), and they confuse your pituitary.  Your confused pituitary send out the wrong hormones to the ovaries (too much LH and not enough FSH), and keep your ovaries from being able to ovulate.  This causes more testosterone production and the cycle just gets worse and worse.  All the sacs with the stuck eggs look like cysts on the ovaries, which is why it's called "polycystic".  Women with PCOS usually have other signs of high testosterone levels such as acne;  hair growth on the face, chest, back or belly; and sometimes even male-pattern balding.  It is a called a syndrome rather than a disease, because what causes it can vary woman to woman.  One of the main causes is insulin-resistance.  This is a condition where a woman's insulin is not working as well as it should.  It can lead to diabetes, when it gets very bad.  The ovary has insulin receptors.  When it sees too much insulin, it stops ovulating and makes male hormones and therefore PCOS.  Women with this condition often times (about 50% of the time) are overweight, and many also have a family history of adult onset diabetes in her older relatives.  PCOS needs to be diagnosed by your doctor.  He or she will do blood tests and perhaps and ultrasound as well.

About 10% of women who do not ovulate have no defined reason why they are not ovulating.  It appears that their pituitaries just do not send out the right signals.  There are also other much rarer hormonal causes.  Most of these will have other signs and symptoms that bring that person to the attention of a doctor.

No matter why you are not ovulating, you need to see a doctor!  If the lining inside the uterus does not shed with a period at least every 6 weeks, it can start to turn abnormal.  It can even turn into cancer.  My cousin died from this type of cancer in her 30's, so this is serious!  If you are not ovulating because of extreme stress, exercising, or dieting; then you are also at risk for osteoporosis and bone breakage.  If your prolactin levels are high, then you may have a tumor on your pituitary.  Although these tumors are usually benign, they can permanently affect your vision if they grow too large.  Thyroid disease and PCOS have implications for the rest of your health as well, so go see your doctor.  Most of these conditions are very easy to diagnose and treat, so why not go see someone today?

22 comments:

  1. Great Post KEEP IT UP
    I've been using HOME CHECK OVULATION TEST KIT for a long time and I still get butterflies when that little smiley shows his face. :) I got one from the internet by searching on Google HOME CHECK OVULATION KIT it was great! You can check my profile if you want to more information

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  2. Women who ovulate regularly do not always see a dip on ovulation day. This is actually quite rare. It is the consistent rise in temperature that determines ovulation.

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  3. I think it should be better to check all the symptoms of ovulation.
    Ovulation Symptoms

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  4. Nice Posting!! Keep it up!!Digital Basal Thermometer is a sensitive device that allows a woman to check her body temperature for charting purposes. A digital basal thermometer is reliable and gives very fast and accurate results.

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  5. Hi

    I have just had a blood test for fertility and seen my gp today and she has said I am not ovulating my hormones are unbalanced and she has refereed me to a clinic along with my husband to be checked. I am 35 this yr and we have been trying for a year now and nothing hence having the blood test. I do have a period each month some days 33 some 27 or low as 25. Could it be at all possible its my medication I have been on for 6 years now due to having cauda Equnia syndrome, I am taking morphine, diazepam, Gabapentin, and Amitriptyline. Any advice would be great

    Debbie

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  6. hi, I am 36 years old. Last year i took a blood test and they confirmed that i was ovulating, Last year October 2012. Since then i have been trying to conceive but have not been able to get pregnant. I am also trying to monitor my periods because in December i had two periods in one month early and late. In january it was once and Feb once. Since my period in Feb i have been monitoring it...Jan 18th to Feb 18th is 32 cycle days. I have been using ovulation strips to test my ovulation and they keep coming back negative. I am just confused.

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  7. im 20 yrs old my hormone levels are very low as there is no ovulation doctor told me the treatment can be done only after marriage i wanted to know if there is any alternative to this

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  8. You can plan your pregnancy by using ovulation kit.This kit is design to detect your hormones and know the right time to get pregnant.Ovulation test kit give accurate and instant Result.

    you can call and order it

    Email- home.check.new@gmail.com

    Call Now! Anu Verma- 011-23357326, 9560506177

    ReplyDelete
  9. Hi. I am 28years old and in past relationships I have never wanted a baby. But I am now with someone who is my soul mate and my best friend and we have been trying for over a year. I have had many blood tests to check if I am ovulating, and they have all come back negative. I have also tried several ovulation tests which again have all been negative. My doctor sent me for a scan/camera to check for PCOS, which once again was negative. He then said that I should loose weight. This threw me as I haf already explained to him that in previous relationships I have not always used protection and have also not been a big size. I would not class myself as 'big,' I am a healthy size 12-14, and have lost almost a stone. I have taken so many pregnancy tests and my heart aches when I only ever see that one line.
    My periods have been irregular ever since I started when I was 13. I can go maybe 6+weeks without a period. I am now just over 2weeks late and have taken another test........again negative.
    I don't think me not ovulating has anything to do with my weight, but I am doing anything I can so that for once I will see 2 lines on my test.
    I am just finding this really frustrating and obviously very emotional.
    Does anyone have any tips?

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  10. I am 25 years old. In February, I went to see a doc because it had been 5 months since my last period. She put me on progesterone pills that I take 10 days each month. My hormone levels were imbalanced. I get a period each month which are horrible and quite painful, but I'm still not ovulating. We did different tests: checked for diabetes, PCOS, and Thyroid disease. All were negative. This is the 4th month on the Progesterone pills. Maybe I should give up the idea of having a baby? It breaks my heart.

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  11. Don't give up Jada.
    I have been thinking and feeling the same but I will not give up the cjance of getting pregnant.
    I am almost 29 and my partner is 35 and we arent getting any younger.
    I have been getting terrible pains in my stomach and this is getting me thinking I have blocked tubes.
    I am back at the doctors on the 3rd of June so hoping to get answers then.

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  12. Now Plan your Good Pregnancy as you like with Homecheck Ovulation kit. It tracks right time for conception when you want.

    ReplyDelete
  13. This was the most informational article I've been able to find. Thank you for spending the time writing it!

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  14. Thank you Dr. Trout. Its been quite the two years. I've been on thyroid medicine and have recently had the dosage upped due to not having a period for 6 months now. I gained 20 pounds on my 108 frame, its devastating to say the least. I don't work out too much but enough to be healthy and slim same with foot intake. Never been a huge eater but enjoy good organic food. I do however love sugar. Reading your post I feel like I am a candidate for all of the sydromes and issues that you mentioned. I just found out today that I have a cyst (Liquid) the size of a tennis ball on my left ovary. Could this be pcos. No extra hair to report. But weight gain, and a heavy case of highs and lows emotionally. I also suffer from anxiety and take medication to keep that in check. Last year when my husband was deployed to Afghanistan I lost 53% of my blood every so slowly, again they reasoned it was stress and pituitary gland issues, got down to 104, can't say I didn't like that, I did. I'm only 5'2 and I'm 37 with two healthy children. I do stress and worry and I haven't handled grief very well but man, this sure is frustrating. There just seems to be no clear answers. I'm sure you are very busy, but if you find you have a bit of time, I would be grateful for a response. Maybe someone else is going through the same thing.

    Respectfully,
    Jeanna

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  15. Thank you Dr. Trout. Its been quite the two years. I've been on thyroid medicine and have recently had the dosage upped due to not having a period for 6 months now. I gained 20 pounds on my 108 frame, its devastating to say the least. I don't work out too much but enough to be healthy and slim same with foot intake. Never been a huge eater but enjoy good organic food. I do however love sugar. Reading your post I feel like I am a candidate for all of the sydromes and issues that you mentioned. I just found out today that I have a cyst (Liquid) the size of a tennis ball on my left ovary. Could this be pcos. No extra hair to report. But weight gain, and a heavy case of highs and lows emotionally. I also suffer from anxiety and take medication to keep that in check. Last year when my husband was deployed to Afghanistan I lost 53% of my blood every so slowly, again they reasoned it was stress and pituitary gland issues, got down to 104, can't say I didn't like that, I did. I'm only 5'2 and I'm 37 with two healthy children. I do stress and worry and I haven't handled grief very well but man, this sure is frustrating. There just seems to be no clear answers. I'm sure you are very busy, but if you find you have a bit of time, I would be grateful for a response. Maybe someone else is going through the same thing.

    Respectfully,
    Jeanna

    ReplyDelete
  16. Hi I am 24 years old I have been trying to conceive for 3 years now I have a 6 year old boy!! I have been attending the hospital to see a specilest for all different test I have had all the bloods done and have had 3 hsgs unfortanly did not fully go ahead as was to pain full :(,, they did tell my I was ovulating and releasing eggs but I have done them ovulating kits and they are telling me im not ovulating? Im really getting frustrated every month I do a test thinkin and hoping I really feel like giving up :( feel free to reply :-) x

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  17. Hi everyone. Since my recent post I went to visit the doctor again who gave me Chlomid tablets to try and help me ovulate. I was told to start taking them on the 2nd day of my next period.....but I wasn't sure when that would be. BUT I started my period 2days after! I am now at day 12 of my cycle and am feeling pain which I am hoping is due to ovulating! Fingers crossed this works. I will keep you all updated. And for everyone else.......don't give up!

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  18. Hi again! Just to let you all know that I had my day 21 progesterone blood test and was amazed at the results. Usually they were a very low 2.1, at the highest 3. but after taking chlomid they are 133! I feel amazing, and can not wait for next week to be able to take a test. I am on day 26 of my very erratic cycle, feeling some slight cramps in my stomach which could be the start of my period, or what other people are saying 'implantation cramps.' But fingers crossed

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  19. hey thanks a lot you solved my all issues about ovulation i am very much confused...thanks a lot..

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