Problems with ovulation are common causes of infertility and menstrual disorders in women. Many ovulation difficulties are associated with weight problems - being too heavy or too light for your height. It is known that if you are over or under weight getting back to an average weight for height will improve your chances of achieving a pregnancy. Indeed, many scientific studies have shown that being able to get back to average weight is more effective and safer than using ANY medication.
Polycystic Ovary Syndrome
Disorders of the hormones Insulin and Testosterone are common causes of a lack of ovulation. Polycystic Ovary Syndrome is the best example of such a disorder. The name implies that there are large cysts on the ovary but this is not the case. About 65% of women have multiple small incomplete ovulation cysts present in their ovary. The condition is commonly associated with being overweight. But up to 40% of women with PCOS are a normal weight. Insulin and Testosterone are closely related hormones; Insulin governs the production of Testosterone in the ovary and in turn, Testosterone is converted to the hormone Oestrogen. Any disorder that interferes with Insulin action or the conversion of Testosterone to Oestrogen will have a profound effect on ovulation and reproduction. Polycystic Ovary Syndrome has all of these effects. The condition is associated with a family history of Diabetes Mellitus and an increased risk of developing this disease. Diet control and management similar to diabetics, followed by fertility tablets (for example - Clomiphene) are the best forms of treatment for the ovulation disorder of this condition. Laparoscopic ovarian drilling or IVF are options for women who do not fall pregnant following clomiphene treatment.
| Ultrasound of ovary with PCOS | Microscopy of ovary with PCOS | ||
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Hypothalamic dysfunction
A number of ovulation disorders are due to less than perfect function of the areas of the brain that control the cycling mechanism of menstrual cycles. The area called the Hypothalamus is responsible for initiating ovulation. Excessive exercise, physical stress and under eating with weight loss such as in anorexia nervosa all affect this area of the brain and can reduce ovulation. Most commonly, however, there is no identifiable reason for the dysfunction and it is associated with a simple developmental variation from normal. Often it is not possible to correct this brain function, but it is reasonable to replace the missing hormones by tablet or injection.
Excess Prolactin
One particular cause is due to an excess production of the hormone Prolactin from the pituitary gland. This can be caused in by an under active Thyroid gland, but most commonly is caused by not enough production of the neurotransmitter Dopamine in the brain. Medications that mimic the action of Dopamine can therefore correct the problem.