By Lindsay Meisel | Published Feb 26, 2018 | Last updated Aug 30, 2019 ✓ Fact checked Show
Breakthrough bleeding: is it your period or something off about your period? Turns out that it’s tricky It’s bleeding that seems like your period, but it’s not. You may think that if you have period-like bleeding, then you definitely ovulated earlier that cycle. But this is not necessarily true. If you’re getting a regular menstrual period, it most likely means that ovulation also happens regularly. Women who track their cycles closely know that if ovulation is delayed for some reason, it usually means that menstruation will be delayed, too (that’s why we sometimes say that there’s no such thing as a late period). But it’s also possible to have an anovulatory cycle, or a cycle where you don’t ovulate, but you still get your period. When this happens, you may experience breakthrough bleeding, which seems like a normal period, but technically is a bit different. What causes bleeding when I don’t ovulate?To explain this, we have to revisit the hormones of the menstrual cycle. In a normal menstrual cycle, estradiol (the main estrogen hormone) increases steadily during the first half of the cycle. Estradiol helps to build up the uterine lining. Increasing estrogen levels help to trigger ovulation, which is the release of an egg from a follicle in the ovaries. After ovulation, the spent follicle transforms into something called a corpus luteum, which secretes the hormone progesterone. Progesterone levels are high during the second half of the cycle. This is important because one of the primary purposes of progesterone is to provide structure for the uterine lining built up earlier in the cycle. If the egg is not fertilized, then the corpus luteum shrinks and stops secreting progesterone. Without progesterone maintaining the uterine lining, it can no longer be maintained within the uterus, so it sheds in the process you will recognize as your period. If you did not ovulate, no corpus luteum is formed, and no progesterone is secreted. So, while the first half of your cycle was spent building up the uterine lining, there isn’t a hormone signal for maintaining it without ovulation. The uterine lining still has to be shed, and you can still experience bleeding that looks similar to your period. Although scientists still don’t understand exactly why this extra tissue needs to be shed, one possible explanation is that building and supplying the uterine lining with new blood vessels requires a considerable amount of extra energy. Without a reason to sustain it (like implantation), the unnecessary tissue breaks down to conserve energy, which leads to bleeding and resetting the next cycle. Nonetheless, breakthrough bleeding is NOT the same as your period. Menstruation is bleeding that results from a drop in progesterone. Breakthrough bleeding of this type results from a drop in estrogens. The take-home message: it is possible to experience bleeding during your cycle whether you ovulate or not. So, if you’re trying to track your ovulation and don’t observe a biphasic temperature shift, you may still experience breakthrough bleeding because of an anovulatory cycle. Why does anovulation happen?Anovulatory cycles seem to be most common when the body is adjusting after a major change in hormones. Women may experience these cycles when they first begin menstruating, are coming off the pill, have just given birth, or are approaching menopause. But, you can still experience a few anovulatory cycles outside of these times because factors like stress or suddenly beginning a vigorous workout schedule can temporarily disrupt ovulation. Chances are every woman will experience a few cycles of anovulation at some point in her life. However, if you experience recurrent anovulatory cycles, then it is important to talk to your doctor. Recurrent anovulation can be a sign of polycystic ovarian syndrome (or PCOS), or when ovarian cysts cause hormone imbalance and irregular cycles. If you’re concerned that you may have PCOS, talk to your doctor about getting tested for it. Is breakthrough bleeding the same as implantation bleeding?If you’re trying to conceive and observe some spotting, you might wonder if it’s breakthrough bleeding or implantation bleeding. However, there is no evidence that implantation bleeding happens. Spotting is more likely to indicate you’re not pregnant than you are. By Lindsay Meisel | Feb 26, 2018  Lindsay MeiselWhen you're trying to get pregnant, you start paying more attention to your menstrual cycle than usual. And if you're having trouble getting pregnant despite having a cycle that appears normal, you may be wondering what's going on. In a typical cycle, the hormones in your brain tell your body to prepare for the release of
an egg. Then your egg is released from your ovary into the fallopian tubes. If the egg is fertilized within 12 to 24 hours after being released, it will attach to the wall of the uterus within 5 days, and you'll start growing a baby. If fertilization doesn't happen, you'll shed the uterine lining during your period. Anovulation is anything that interrupts the ovulation process. Anovulation is responsible for about 30% of fertility problems in women. Anovulation is a complex process that involves a lot of organs, glands, and hormones, so there are a lot of potential causes. Some of these include: Polycystic ovarian syndrome (PCOS). This is the most common cause of anovulation. PCOS causes women to ovulate irregularly or not at all. Sometimes PCOS is associated with elevated levels of
testosterone, which can also cause excessive hair growth and acne. Premature ovarian insufficiency (POI). This occurs when a woman's ovaries fail before she is 40. It's sometimes called premature menopause. Some medical conditions and exposures can cause POI, but for many women the cause is unexplained. About 5% to 10% of women with POI will conceive naturally and have a normal pregnancy. Hypothalamus or pituitary gland
dysfunction. These glands produce hormones that are responsible for ovulation. Anything that interferes with the normal function of these glands, such as a benign pituitary gland tumor, can cause anovulation. Diminished ovarian reserve (DOR). At birth, women have all of the eggs they will ever produce. It's normal for a woman's egg supply to decrease over time. Women with DOR have fewer eggs remaining than normal. This can have medical, surgical, or
congenital (present at birth) causes, or it can be unexplained. Women with DOR will produce fewer eggs with fertility treatments but may still be able to conceive naturally. Functional hypothalamic amenorrhea (FHA). This condition can be caused by stress, excessive exercise, or low body weight. It is sometimes associated with anorexia, an eating disorder. Menopause. This is a naturally occurring decline in ovarian function that happens
around the age of 50. Menopause is defined as not having had a period in one year. Some women experience other symptoms as well, such as hot flashes, difficulty sleeping, and mood changes. Sometimes there are no symptoms of anovulation. Having normal menstrual cycles doesn't always mean that
ovulation is occurring. However, some symptoms of anovulation can include: Your doctor will listen to your symptoms and history and perform a physical exam. They may also do some tests and imaging studies, including:
Depending on the results of your exam, other tests may be needed, such as testing the lining of the uterus. How Is Anovulation Treated?The treatment for anovulation will depend on the cause. For some women, lifestyle modification may be enough. Others may need medical or surgical treatments. Lifestyle modification. Diet and exercise changes can be helpful for women whose anovulation is caused by either a high or low body mass index (BMI). In either case, nutritional counseling may help. Women whose anovulation is caused by excessive exercise will benefit from exercising less, while women with a high BMI may benefit from exercising more. If stress is causing anovulation, stress management and relaxation techniques may help. Medicines. Ovulation induction is the use of fertility medicines to treat anovulation. This can also be used on women who are ovulating to increase the chances of pregnancy. Most pregnancies occur within three cycles of this treatment. Commonly prescribed medications include:
Surgery. If you have PCOS that doesn't respond to other treatments, your doctor may do a procedure called ovarian drilling. This is a minimally invasive procedure that is done laparoscopically, which means it is done with small incisions with the aid of a tiny camera. Ovarian drilling works by making small holes in the ovaries. This reduces the amount of testosterone that the ovaries produce. Lowering the amount of testosterone can help the ovaries produce an egg every month and start regular menstrual cycles. What are the signs of a woman not ovulating?A menstrual cycle that's too long (35 days or more), too short (less than 21 days), irregular or absent can mean that you're not ovulating. There might be no other signs or symptoms.
Does having a regular period mean I ovulate?Normal menstruation indicates that you are ovulating; however, there are other reasons why you may not be able to get pregnant, and these should also be evaluated.
Why I am not getting pregnant though I have regular periods?Ovulation disorder
Sometimes women don't ovulate regularly and consistently. Sporadic menstrual cycles can be caused by conditions such as polycystic ovary syndrome (PCOS), hormonal imbalances or obesity. Ovulation can also be impacted by excessive exercise, stress or low body weight.
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Why am i not ovulating but having regular periods
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