Anovulation: etiology, evaluation and management

Every woman begins and ends her years of cyclic menstrual function with periods of anovulation, with or without vaginal bleeding. Many women, however, experience anovulation during their reproductive years. It may be an occasional problem or a chronic condition. In some cases, the anovulatory state requires only a little time or minimal pharmacological intervention to correct. Once homeostatis is achieved, the system returns to its cyclic function. Other cases of anovulation result from serious pathology or congenital anomalies which may be difficult to diagnose and even more difficult to correct. The right medical intervention can usually return the woman to a state of good overall health, but pregnancy may not always be achievable. This article reviews the physiology of ovulation, the reasons for its failure, the diagnostic process and the latest in therapeutic management.