Most people think of anovulation as a medical condition that only matters when you’re trying to get pregnant. In fact, it is an indicator of your body’s hormonal health, metabolic balance, and overall well-being.
Anovulation Explained
Ovulation is when an ovary releases an egg during your monthly cycle. This process is not only important for people trying to get pregnant, but it also helps keep hormones balanced and supports overall health.
Anovulation occurs when you do not ovulate. When this happens, your body misses certain hormone changes, especially the rise in progesterone. Progesterone helps balance estrogen and supports several aspects of health.
Anovulation is a common condition and accounts for approximately 25% of infertility cases¹. It can be tricky to detect because it may happen only occasionally. Some months, you might not ovulate, and normal ovulation can return the next month. Also, having a menstrual bleed does not always mean you have ovulated.
Tracking your cycles and paying attention to symptoms can help you identify possible signs of anovulation.
Signs and Symptoms
Many women can have an anovulatory cycle without even realizing it. Aside from changes in your menstrual cycle—like missed or irregular periods—there may be no apparent symptoms. That’s why it’s sometimes easier to look for signs that you are ovulating instead. Here are a few things to watch for:
- Irregular periods: If the number of days between your periods changes from month to month, your cycle is irregular. While the average cycle is about 28 days, it can be a few days shorter or longer and still be normal.
- Very heavy or very light flow: A heavy period means soaking through pads or tampons quickly—such as needing to change them every hour for several hours in a row—or bleeding for more than seven days. A light period may be just spotting or very minimal flow.
- No periods at all (amenorrhea): Skipping one or more periods (and not being pregnant) could be a sign of not ovulating.
- Changes in cervical mucus: Around ovulation, vaginal discharge often becomes clear, slippery, and stretchy like raw egg whites. If you don’t notice this type of mucus, you may not be ovulating.
- No temperature shift: Your basal body temperature (your body’s resting temperature) usually rises slightly after ovulation. If your daily readings stay about the same all month, it could mean you’re not ovulating.
Can an AMH test in a fertility assessment sufficiently diagnose anovulation?²
The Anti-Müllerian Hormone (AMH) test provides valuable insights into a woman’s ovarian reserve. Generally, higher AMH levels suggest a larger quantity of eggs, while lower levels may indicate a diminished ovarian reserve.
While the AMH test shows the number of follicles, it does not confirm whether a mature egg is released. It is possible to have normal or even high AMH levels, as in the case of women with Polycystic Ovary Syndrome (PCOS), and still experience anovulatory cycles where no egg is released.
To diagnose anovulation, doctors combine AMH testing with other hormonal assessments. A progesterone blood test, typically done about a week before the expected period, helps confirm whether ovulation has taken place. It is because progesterone levels rise after ovulation. Ultrasound monitoring allows visualization of follicle growth and ovulation. Additional hormone tests measuring luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyroid hormones, and prolactin are essential for a complete assessment of ovulatory function and overall fertility health.
Rippling Effects of Anovulation
1. Hormonal Balance
When you don’t ovulate, your body does not make its usual levels of progesterone to balance out the estrogen in your system, and you may experience heavier periods, bloating, sore breasts, and mood swings.
2. Bone Strength
Estrogen and progesterone work together to maintain bone density. Without regular ovulation, bone-building slows, potentially increasing the risk of osteoporosis later in life.
3. Heart and Metabolism
Anovulation, especially when linked to conditions like PCOS, can increase heart disease and metabolic risk.
4. Mental Well-being
Progesterone’s calming effects on the brain help with sleep, anxiety, and emotional stability. When ovulation doesn’t occur, these benefits are lost — and some women notice increased irritability, restlessness, or insomnia.
When to Seek Medical Advice
If your cycles are consistently shorter than 21 days, longer than 35 days, or unpredictable, talk to your doctor. Likewise, if you see no signs of ovulation for several months in a row, early evaluation can uncover the cause and help prevent long-term health consequences.
Reference:
¹ Walker MH, Tobler KJ. Female Infertility. [Updated 2022 Dec 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556033/
² Capuzzo M, La Marca A. Use of AMH in the Differential Diagnosis of Anovulatory Disorders Including PCOS. Front Endocrinol (Lausanne). 2021 Feb 3;11:616766. doi: 10.3389/fendo.2020.616766. PMID: 33633686; PMCID: PMC7901963. https://pmc.ncbi.nlm.nih.gov/articles/PMC7901963/
