menstrual symptoms
The menstrual cycle is a cyclical and orderly sequence of events resulting from the interaction of the hormones secreted by the hypothalamus gland, the pituitary gland and the ovaries.
When this process functions normally follicles develop and ovulate and the lining of the uterus develops to support the embryo. Any disruption can result in fertility problems.
anovulation
Anovulation is the absence of ovulation while amenorrhea is the absence of menstruation. Anovulatory women can still have periods. When a woman is not having her period it could be because she is not ovulating (releasing mature eggs). If a woman is recording her daily basal body temperature (BBT) and there is no change, it may be because she is not ovulating. Shortened or extended cycles are also indicative of ovulatory problems and should be evaluated as well (usually cycles outside the range of 25-35 days).
It is difficult to accurately determine whether or not a woman is ovulating without using testing kits or seeing a healthcare provider. One of the following infertility diagnoses may be the cause of amenhorrhea:
- Anovulation
- Hyperprolactinemia
- Polycystic ovarian syndrome (PCOS)
- Premature ovarian failure (POF)
- Uterine/vaginal birth defects
excessive bleeding
Determining whether a woman’s menstrual flow is excessive is a subjective assessment. A woman knows better than anyone what constitutes a normal period for her so when a woman thinks her period is heavy, it most likely is.
Speroff et al, authors of Clinical Gynecologic Endocrinology and Infertility, say that the normal duration of a period is four to six days (with variance from two to seven days). In that time, the normal volume of menstrual blood shed is 30 milliliters. If a woman bleeds more than 80 milliliters, that is considered high. The problem faced by most women is that measuring their own blood level is next to impossible. A good rule of thumb for most women is that bleeding may be excessive if you have to change your pad or tampon every 1-2 hours. If this has occurred for more than two cycles in a row, then you should consider having an evaluation by your healthcare provider.
Excessive bleeding during menstrual periods may suggest one of the following infertility diagnoses: