You're just menstruating, every month. So your ovulation is fine, right? Not always. Many women don't know that you can menstruate without having ovulated. That's called an anovulatory cycle, or simply anovulation.
If you want to get pregnant, this is important information. Without ovulation, no egg is released and therefore no fertilization can take place. In practice, I often see women who have been having sex "at the right time" for months, while their body didn't ovulate at all that month.
In this blog, I explain what it means if you don't ovulate, why this can happen, what signs you can recognize, and what you can do yourself. You'll also read which vitamins and minerals are important for healthy ovulation, and why.
What is an anovulatory cycle?
An anovulatory cycle is a menstrual cycle in which ovulation does not occur. The egg follicle does not fully mature, or the egg follicle does not rupture. Therefore, no egg is released.
In a healthy cycle, the following happens:
- Follicular phase: under the influence of FSH, follicles grow and your estrogen rises. Your uterine lining thickens.
- Ovulation: a surge in the hormone LH causes the most mature follicle to rupture.
- Luteal phase: the empty follicle becomes the corpus luteum and produces progesterone. This hormone prepares your uterus for implantation.
- Menstruation: without pregnancy, progesterone drops and the lining is shed.
In anovulation, step 2 is missing. As a result, the corpus luteum is also missing, and you produce hardly any progesterone in that cycle. It is precisely this difference that you often notice in your body. Want to know more about what a balanced cycle looks like? Then also read What is a healthy cycle?
Can you menstruate without ovulation?
Yes. This surprises many women. The bleeding after an anovulatory cycle is technically not a real menstruation, but a withdrawal bleed or breakthrough bleeding. The lining is built up by estrogen and is shed when estrogen fluctuates or drops. From the outside, it just looks like menstruation, although the bleeding is often different in character: very light, or conversely very heavy, or at an unexpected time.
How often does a cycle without ovulation occur?
More often than you think. An occasional cycle without ovulation is normal, even in healthy women with a regular cycle. In a large American study among healthy women between 18 and 44 years old, about 8% of the cycles were anovulatory, and over 13% of the women had at least one cycle without ovulation in two months. Anovulation also occurs more often just after your first menstruation and in the years leading up to menopause.
Does it happen regularly or for months in a row? Then we speak of chronic anovulation. According to the Dutch guidelines of gynecologists (NVOG), the diagnosis of anovulation is made in 20 to 25% of couples with an unfulfilled desire for children. It is therefore one of the most common reasons why getting pregnant takes longer. The good news: it is also one of the best-treated causes.
Why does your ovulation not occur? The most important causes
Your ovulation is the result of a finely tuned cooperation between your brain (hypothalamus and pituitary gland), your ovaries, and the rest of your body. Your body sees ovulation as a luxury: it only happens when the system feels safe and well-nourished. If one link gets out of balance, ovulation may not occur.
1. PCOS (polycystic ovary syndrome)
PCOS is the most common cause of anovulation. About 5 to 15% of women of childbearing age have PCOS. Many small follicles mature at the same time, but not a single one grows through to ovulation. Often, elevated testosterone and insulin resistance play a role. Characteristics are a long or irregular cycle, acne, and increased hair growth. Read more in our blog PCOS: what can you do?
2. Stress and an overloaded nervous system
Prolonged stress increases cortisol. Your brain then gets the signal that it is not a good time to get pregnant and inhibits the release of the hormone GnRH. As a result, FSH and LH are not stimulated as well. Think of work pressure, poor sleep, emotional events, or the tension of the desire for a child itself.
3. Too little energy: underweight, strict dieting, or excessive exercise
If your body structurally receives less energy than it consumes, it shuts down reproduction first. This is seen in underweight, crash diets, intense exercise (for example, running or crossfit), or a combination thereof. Even in women with a normal weight, intense training without sufficient food can disrupt ovulation.
4. Overweight and insulin resistance
It can also go wrong on the other side of the scale. A lot of fat tissue produces extra estrogen, and high insulin levels stimulate the ovaries to produce more testosterone. Both disrupt the maturation of the egg follicle. A weight loss of 5 to 10% can already restore ovulation in cases of overweight.
5. Thyroid problems
Both an underactive (hypothyroidism) and an overactive thyroid (hyperthyroidism) can disrupt your cycle. Your thyroid regulates your metabolism and works closely with your sex hormones. A thyroid problem is therefore always ruled out in the investigation of anovulation.
6. Elevated prolactin
Prolactin is the hormone that stimulates milk production. An elevated level (hyperprolactinemia) inhibits ovulation. This is the cause in 5 to 10% of cases. It can be caused by a benign pituitary tumor, certain medications, or stress.
7. Stopping the pill and breastfeeding
After stopping hormonal contraception, your body sometimes needs a few months to initiate ovulation on its own again. Also during breastfeeding, ovulation often does not occur due to high prolactin.
8. Age and a declining egg supply
Towards menopause (perimenopause), cycles become anovulatory more often. Also in early menopause (POI), ovulation does not occur. In this case, FSH is actually elevated.
9. Nutrient deficiencies
For every step in your cycle, your body needs building blocks: B vitamins for your hormone balance, iodine and selenium for your thyroid, zinc and vitamin D for your ovaries. A deficiency is rarely the only cause, but it can be just the missing link. Further on, you will read which nutrients are the most important.
No ovulation: what signs and symptoms do you recognize?
A cycle without ovulation does not always feel different. Yet your body often gives hints. If you recognize several of these signs, it is worth mapping out your cycle better.
- An irregular cycle: shorter than 21 days, longer than 35 days, or different every month.
- Missing menstruation: sometimes no bleeding for months (oligo- or amenorrhea).
- Atypical bleeding: very light and short, or conversely heavy and prolonged, because progesterone does not stabilize the lining.
- No fertile cervical mucus: you do not notice clear, stretchy mucus ("egg white mucus") halfway through your cycle.
- No temperature rise: your basal temperature remains flat throughout the cycle instead of rising by 0.2 to 0.5 °C after ovulation.
- Ovulation tests remain negative: or they are positive for days, which often occurs with PCOS.
- No ovulation pain or breast sensitivity: symptoms that normally belong to progesterone, such as tender breasts before your period, do not occur.
- Symptoms of estrogen dominance: because progesterone is missing, you may suffer from mood swings, bloating, headaches, or tender breasts.
- Signs of PCOS: acne, oily skin, more hair growth on the chin or stomach, or difficulty losing weight.
- Not pregnant for a long time: despite regular unprotected sex.
Many of these symptoms overlap with a progesterone deficiency. That is logical, because without ovulation you produce hardly any progesterone. In the blog How do you recognize a progesterone deficiency? you can read more about that.
How do you know if you do or do not ovulate?
A cycle app that predicts your ovulation based on your cycle length says nothing about whether you actually ovulate. It only calculates an average. If you want to be sure, combine these methods:
|
Method |
What do you measure? |
What does it say? |
|
Basal body temperature |
Your temperature every morning upon waking |
A sustained rise of 0.2 to 0.5 °C indicates ovulation, retrospectively |
|
Cervical mucus |
The mucus in your underwear or when wiping |
Clear, stretchy mucus shows that you are approaching ovulation |
|
Ovulation test (LH test) |
The LH peak in your urine |
Predicts ovulation within 24 to 36 hours, but does not prove it |
|
Progesterone in blood |
Progesterone approximately 7 days after the suspected ovulation |
A clearly elevated value confirms that ovulation occurred |
|
Ultrasound |
Growth and rupture of the egg follicle |
The most direct measurement, via a general practitioner or gynecologist |
My advice: keep track of your temperature and mucus for at least three cycles. This way you see a pattern instead of a single snapshot. On our page calculate ovulation and in the blog How can you calculate your ovulation? you can read how to approach this.
Note: ovulation does occur, but the period after is too short? Then there may be a short luteal phase. Read more about that in Short luteal phase: can you get pregnant?
No ovulation: what can you do yourself?
The cause determines the approach. Yet there are a number of steps that almost always help to support your ovulation naturally. These are the pieces of advice I give most often in my practice.
1. Eat enough, and eat regularly
Your body only ovulates when it feels safe. Do not skip meals and do not diet if you want to get pregnant. Eat three full meals with protein, healthy fats, and fiber. Think of eggs, legumes, fatty fish or algae oil, nuts, olive oil, whole grains, and lots of vegetables.
2. Keep your blood sugar stable
Especially with PCOS or insulin resistance, this makes a big difference. Limit sugar, white pasta, white bread, and soda. Always combine carbohydrates with protein or fat. Start your day with a savory, high-protein breakfast instead of just fruit or a croissant.
3. Work towards a healthy weight, gradually
In cases of underweight, gaining weight helps; in cases of overweight, losing weight helps. In cases of overweight, a weight loss of 5 to 10% can already restore ovulation. Do it gradually: a crash diet gives your body the signal of scarcity.
4. Exercise smartly, not extremely
Walking, yoga, cycling, and strength training are ideal. Are you training very intensely and your cycle is disrupted? Then dial back the intensity for a few months and eat extra.
5. Actively reduce your stress
Consciously plan in rest. Sleep 7 to 9 hours, go to bed at fixed times, walk outside, and try breathing exercises or yoga. Precisely the pressure of a desire for a child can cause stress. Talk about it, with your partner or with a professional.
6. Stop drinking alcohol and smoking
Alcohol affects your hormones and your ovulation. Smoking accelerates the loss of eggs. Also read our blog about alcohol and fertility.
7. Limit endocrine disruptors
Substances such as BPA and phthalates in plastic and personal care products can affect your hormone balance. Do not heat food in plastic, use glass or stainless steel, and choose fragrance-free personal care where possible.
8. Supplement your nutrients
Even with a healthy diet, it is difficult to get everything your body needs around a desire for children. That is why a good pre-conception supplement is an important foundation. In the following section, you will read which nutrients matter. More about the role of hormones you can read in Why hormone balance is important before you get pregnant.
Which vitamins are important for your ovulation?
No single vitamin is a miracle cure that restores your ovulation on its own. But your hormones are made from building blocks from your food. A deficiency in one of these substances can get in the way of a healthy cycle. These are the nutrients I pay the most attention to in cases of anovulation:
|
Nutrient |
Why important for a desire for children |
What is it in? |
|
Folic acid (active folate, 5-MTHF) |
Needed for cell division and the development of your baby's neural tube. Active folate can be used directly by your body, even if you do the conversion less well (MTHFR variant). |
Green leafy vegetables, legumes |
|
Vitamin B6 |
Contributes to the regulation of your hormone balance. Important for a healthy luteal phase and the production of progesterone. |
Chicken, fish, banana, potato |
|
Vitamin B12 |
Works together with folate in cell division and contributes to the formation of red blood cells. Extra important if you eat little or no animal products. |
Meat, fish, eggs, dairy |
|
Vitamin D |
Your ovaries have receptors for vitamin D. A deficiency is common in women with PCOS and is associated with disrupted ovulation. In the Netherlands, a large part of the women have low vitamin D in the winter. |
Sunlight, fatty fish, eggs |
|
Zinc |
Contributes to normal fertility and reproduction and to a normal testosterone level. Zinc is involved in the maturation of the egg. |
Pumpkin seeds, meat, shellfish |
|
Iodine |
Needed for the production of thyroid hormones. Your thyroid is essential for a regular cycle. |
Iodine-enriched bread, oily fish |
|
Selenium |
Protects your cells against oxidative stress and contributes to normal thyroid function. |
Brazil nuts, fish, eggs |
|
Magnesium |
Relaxes your nervous system, supports your energy metabolism and stable blood sugar. Especially useful during stress. |
Nuts, seeds, cocoa, green vegetables |
|
Iron |
Contributes to oxygen transport and reduces fatigue. A deficiency is common with heavy blood loss. |
Red meat, legumes |
|
Omega-3 (DHA and EPA) |
Inhibits low-grade inflammation and is a building block for cell membranes, including those of the egg cell. Important later for the development of your baby's brain and eyes. |
Oily fish, algae oil |
|
Coenzyme Q10 |
Supplies energy to the mitochondria, the powerhouses of your cells. The egg cell is the cell with the most mitochondria in your body. |
Meat, fish, nuts |
My strong advice on supplements
- Start early. An egg cell takes about three months to mature. What you do now will be reflected in the egg cells in three months' time. Therefore, start at least three months before you want to get pregnant.
- Always take folic acid. The advice in the Netherlands is to start taking folic acid at least four weeks before you get pregnant, until eight weeks into the pregnancy. In practice, I recommend starting as soon as you are planning to conceive.
- Choose active forms. Your body can directly use methylfolate (5-MTHF), methylcobalamin (B12) and pyridoxal-5-phosphate (B6).
- Choose one complete base. Stacking individual bottles quickly leads to too much of one thing and too little of another. A supplement specially formulated for conception prevents this.
- Get your blood tested if in doubt. Vitamin D, ferritin (iron stores), B12 and your thyroid levels are easy to measure.
- For PCOS: ask about inositol. Myo-inositol can improve ovulation and cycle regularity in women with PCOS. The evidence is promising but not yet conclusive. Discuss it with your doctor, midwife or orthomolecular therapist.
Vitamins for getting pregnant: the pre-conception supplements from MomPwdr
As a midwife and hormone therapist, I have seen how often women planning to conceive only use a bottle of folic acid. That is a good start, but your body needs much more around the time of conception. That is why we developed the MomPwdr Vitamins for Getting Pregnant (Pre-conception), especially for the period in which you want to get pregnant.
The pre-conception bundle consists of three parts:
- Vitamins & Minerals: a complete multivitamin with, among others, 700 µg of active folate (Quatrefolic 5-MTHF), vitamin B6 as pyridoxal-5-phosphate, B12 as methylcobalamin, 50 µg of vitamin D3, zinc, iodine, selenium, iron and choline.
- Vegan Omega 3: algae oil with 386 mg DHA and 129 mg EPA, without fish and without heavy metals.
- Cal/Mag + Q10: magnesium bisglycinate, calcium and 50 mg coenzyme Q10 for the energy of your cells.
Why I recommend this bundle for a cycle without ovulation:
- All the nutrients from the table above in one daily routine, without having to puzzle it out yourself.
- Bioactive forms that your body can directly absorb and use.
- Zinc contributes to normal fertility and reproduction and vitamin B6 to the regulation of the hormonal balance.
- Developed with midwives and fertility specialists, 100% vegan, gluten-free and made in the Netherlands.
- You can continue when you are pregnant, and switch to the vitamins for the first trimester.
You take five capsules per day, with or immediately after a meal. Ideally, start three months before you want to get pregnant, so that your egg cells have time to benefit from the improved nutritional status.
View the MomPwdr Pre-conception supplements
Frequently asked questions about a cycle without ovulation
Can you get pregnant without ovulation?
No. Without ovulation, no egg cell is released that can be fertilized. However, ovulation can be absent in one cycle and occur normally in the next. An occasional cycle without ovulation does not mean that you are infertile.
Can you have a period without ovulation?
Yes. You can have bleeding that resembles a period, while there was no ovulation. This is a withdrawal bleed, because the estrogen levels drop.
How do I know if I have ovulated?
The most reliable ways are a rise in your basal temperature, a progesterone measurement in your blood about a week after the suspected ovulation, or an ultrasound. An ovulation test predicts ovulation, but does not prove it.
Is a cycle without ovulation normal?
Occasionally, yes. Healthy women with a regular cycle also sometimes have an anovulatory cycle, for example due to stress, illness or travel. If it happens often or for months at a time, have the cause investigated.
Can you stimulate ovulation naturally?
You can greatly improve the conditions for ovulation. Eat enough and regularly, keep your blood sugar stable, work towards a healthy weight, reduce stress and supplement your nutrients with a good pre-conception supplement. In the case of a medical cause, treatment may also be necessary.
Which vitamins help with absent ovulation?
Important nutrients are active folate, vitamin B6, B12, vitamin D, zinc, iodine, selenium, magnesium, omega-3 and coenzyme Q10. For PCOS, myo-inositol can be an addition. A complete pre-conception bundle combines the most important substances.
How long does it take for supplements to have an effect?
Allow at least three months. This is how long it takes for an egg cell to fully mature. Your cycle may sometimes become calmer sooner.
Can stress cause ovulation to be absent?
Yes. Prolonged stress inhibits the hormones that control ovulation through your brain. Even a short period of high stress can delay or skip ovulation.
Finally: listen to your cycle
Not having ovulation may feel like a setback, especially if you really want to get pregnant. But your cycle is a messenger. It tells you how your body is doing. If you learn to recognize the signals, you can take targeted steps: eat enough, reduce stress, get the right nutrients and seek medical help where necessary.
It does not all have to be perfect. Every conscious choice helps your body take a step closer to balance. A good start begins even before pregnancy, because every child deserves a fair start.
Ready to prepare your body? Start today with the MomPwdr Pre-conception supplements.
Sources
- NVOG, Guideline Anovulation and desire for a child
- Health and Science, PCOS: what is it?
- Mumford et al., Human Reproduction, Sporadic anovulation in regularly menstruating women (BioCycle Study)
- Prior et al., PLoS One 2015, Ovulation prevalence in women with normal-length cycles
- Pundir et al., BJOG 2017, Inositol treatment of anovulation in women with PCOS
- Amphia Hospital, Patient information ovulation induction
