Anovulatory bleeding

The anovulatory cycle is a menstrual cycle characterized by varying degrees of menstrual intervals and the absence of ovulation and a luteal phase. In the absence of ovulation, there will be infertility. The anovulatory cycle is a menstrual cycle characterized by varying degrees of menstrual intervals and the absence of ovulation and a luteal phase. In the absence of ovulation, there will be infertility. While the normal menstrual cycle in the human typically lasts 4 weeks (28 days, range 24–35 days) and consists of a follicular phase, ovulation, and a luteal phase, followed by either menstruation or pregnancy, the anovulatory cycle has cyclelengths of varying degrees. In many circumstances, menstrual intervals are prolonged exceeding 35 days leading to oligomenorrhea (cycle >35 – 180 days interval), or even longer, amenorrhea. In other cases, menstruation may be fairly regular (eumenorrhea), or more frequent (intervals < 21 days), or there may be a loss of menstrual pattern (menorrhagia, dysfunctional uterine bleeding). Normal menstrual bleeding in the ovulatory cycle is a result of a decline in progesterone due to the demise of the corpus luteum. It is thus a progesterone withdrawal bleeding. As there is no progesterone in the anovulatory cycle, bleeding is caused by the inability of estrogen — that needs to be present to stimulate the endometrium in the first place — to support a growing endometrium. Anovulatory bleeding is hence termed 'estrogen breakthrough bleeding.