What are the first signs of anovulation?

When ovulation does not occur, periods may arrive far apart, stop for a while, or become difficult to predict. Some people have bleeding that is unusually light or heavy. Changes in cervical mucus or basal temperature may be absent, but tracking signs at home cannot diagnose the cause by itself.

Anovulation can occur with polycystic ovary syndrome, changes in weight or exercise, low energy availability, thyroid problems, raised prolactin, or the transition towards menopause. It is a pattern with several possible causes, so a clinician may use history, blood tests and ultrasound to investigate.

Record the first day and length of each period, unexpected bleeding, medicines, major changes in weight or exercise, and symptoms such as acne, excess facial hair, nipple discharge or hot flushes. Arrange an assessment if cycles are repeatedly irregular or pregnancy has not occurred when you expected. Treatment targets the cause; options can include ovulation induction or treatment for PCOS when appropriate.

Seek prompt assessment for very heavy bleeding, faintness, severe pelvic pain, a positive pregnancy test with pain or bleeding, or new nipple discharge with headaches or vision changes. These symptoms may need care beyond an ovulation assessment.

Ask: Do my cycles suggest absent ovulation? Which blood tests are useful? Could PCOS, prolactin, thyroid function, energy balance or another condition be involved? How will fertility treatment be monitored, and how should irregular bleeding be managed?