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Ovulation disorders are a common cause of female infertility. The World Health Organization (WHO) estimates that they affect around a quarter of infertile couples.  Ovulation disorders cover a wide range of conditions that cause a woman to ovulate infrequently or not at all. An average menstrual period lasts for 28 days, although every woman is different and it may be different each month. A “regular” menstrual period can last between 24 to 38 days. 
Ovulation disorders may be caused by problems in the ovary or issues with the regulation of reproductive hormones in areas of the brain. Luckily, there are medications like Clomid to help with female fertility issues. Keep reading to learn more about the most common ovulation disorders, including their causes and symptoms.
Polycystic Ovary Syndrome (PCOS)
a. What is Polycystic Ovary Syndrome?
Polycystic Ovary Syndrome (PCOS) is the most common cause of female infertility. PCOS can cause skipped or irregular menstrual periods. Periods that do occur may be heavier than usual as the uterine lining has been building up for a long time. PCOS causes small sacs that contain fluid to grow on the inside of the ovaries. These sacs contain an egg, although these eggs do not mature enough to trigger ovulation.
Although the cause of PCOS is unknown, Scientists believe that it may be related to hormone imbalance. This imbalance affects insulin in the body and causes an increase in testosterone. Women with polycystic ovary syndrome have higher amounts of male hormones than usual. Although women do produce some testosterone naturally, a hormone imbalance can cause skipped periods, irregular periods, and ovarian cysts. 
In addition to infertility, PCOS may also contribute to serious medical conditions such as heart disease and diabetes. PCOS symptoms typically first develop during puberty, although they may occur later in life. An excess of male hormones can cause physical symptoms such as severe acne or excess facial and body hair. Other symptoms of PCOS may include weight gain, headaches, darkening skin, or baldness.
Premature Ovarian Failure
a. What is Premature Ovarian Failure?
Premature ovarian failure (POF or primary ovarian insufficiency, POI) is an ovulation disorder that occurs when the ovaries of a woman under 40 stop producing eggs normally. Menopause often naturally begins at around the age of 40 but POF may occur at any age once menstruation begins.
POF is not the same as premature menopause. Premature menopause is the stopping of menstrual periods before the age of 40 and results in the woman no longer being able to become pregnant. Women that have POF may still have occasional periods and may even become pregnant.
Similar to polycystic ovary syndrome, the cause of premature ovarian failure is not currently known. However, researchers believe that POF may be caused by the small sacs in the ovaries not functioning properly or ceasing to function earlier than usual. Other causes for POF include autoimmune disease, chemotherapy or radiation therapy.
The primary symptom of premature ovarian failure is skipped or irregular menstrual periods and is often the first sign of POF. POF may already be diagnosed by the time other later symptoms occur. This is because many women may see a doctor if they are struggling to become pregnant. Symptoms of POF that may occur later are similar to symptoms of menopause. These include hot flashes, painful sexual intercourse, vaginal dryness, night sweats, and irritability.
a. What is Hypothalamic Amenorrhea?
Hypothalamic amenorrhea is another ovulation disorder that results in irregular or skipped menstrual periods. The hypothalamus is a small area of the human brain. It helps to stimulate many body processes, including hormone production, as well as regulating body temperature and sleep cycles.
A hypothalamic disorder prevents the hypothalamus from working correctly. The hypothalamus has a wide range of functions, so hypothalamic disorders may be hard to diagnose. 
Hypothalamic amenorrhea is caused by a problem with the hypothalamus area of the brain. The hypothalamus produces gonadotropin-releasing hormones (GnRH). These hormones signal for other hormones to be produced so that the egg can mature and ovulation can begin. If the hypothalamus stops producing this hormone, ovulation and menstruation can stop.
Several factors can cause the hypothalamus to stop releasing GnRH. These include stress, low body weight, excessive exercise, not eating enough calories, or other medical conditions. 
The most noticeable symptom of hypothalamic amenorrhea can be missed periods, often for several months. However, other symptoms can include very light menstrual bleeding, low libido, often feeling cold, depression, anxiety and sleeping problems. Hypothalamic amenorrhea can be caused by excessive exercise and inadequate calorie intake. Therefore, low energy and increased hunger may also be signs of hypothalamic amenorrhea. 
a. What is Hyperprolactinemia?
Hyperprolactinemia or excess prolactin is another ovulation disorder that is caused by hormones produced in the brain. Prolactin is produced in the pituitary gland in the brain and both men and women usually have small amounts of this hormone in their blood. In women, prolactin helps to regulate menstrual periods.
Around one in three women who are of childbearing age and have ‘normal’ ovaries but have irregular periods have hyperprolactinemia.  High levels of prolactin can interfere with the production of other hormones. In women, this can result in irregular or missed periods.
It is not always possible to diagnose the cause of hyperprolactinemia. However, some common causes can include medical conditions such as pituitary tumors or underactive thyroid. Excess prolactin can also be caused by external factors such as nipple stimulation, chest irritation, medication side effects, severe stress, and certain foods like asparagus and apricots. 
Like other ovulation disorders, missing or irregular periods are a key symptom of hyperprolactinemia. In women, other symptoms can include breast milk production in women that are not pregnant or nursing, painful sexual intercourse, or vaginal dryness. 
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