Most of the causes responsible for infertility and anovulation are relatively easily identifiable like excessive weight gain or loss, physical exhausting exercise, emotional or intellectual stress or drug abuse, but on the other hand there are other causes more difficult to identify which have an intricate connection with woman’s anatomic and structural dysfunctions of the reproductive and glandular systems.
Excessive exercise associated with weight loss and anorexia can be the cause of anovulation. A prolonged physical stress can create a disruption in the normal menstrual cycle due to the suppression of the hypothalamic gonadotropins input, the hormonal imbalance which cause irregular ovulation –dysovulation. This is believed is to be the genetic mechanism which prevents further life-threatening problems for the potential mother and the fetus. A symptom of this type of anovulation is amenorrhea and life-style changes are required in order to reestablish the normal reproductive function.
Emotional problems can also explain this abnormal dysfunction of the reproductive system as stress and anxiety can trigger this condition, a powerful emotional shock can temporarily affect the brain and cause hypothalamic abnormal behavior, estradiol and gonadotropins decreased levels. Women have to deal with daily variable amounts of stress and some of them aren’t capable of doing this without the help of a psychiatrist or a psychotherapist but after therapy and even medication this problem can be solved. The therapist can discover a subconscious reserve towards procreation or even repressed traumas which psychically disable the woman’s ability to conceive.
Drugs can contribute to the disruption of the hypothalamus-pituitary gland-ovary axis and anovulation, whether it is the Pill- a steroidal oral contraceptive or the long acting Depo-Provera, those drugs are intended to suppress ovulation and thereby to prevent pregnancy but if they can lead to infertility in a long run.
The use of opiate substances also suppresses the gonadotropine secretion which leads to anovulation. Chemotherapeutic treatment leads to temporary or permanent gonad insufficiency. Ethanol also leads to hypothalamic dysfunctions and primary gonad insufficiency.
Another functional problem of anovulation can be premature menopause a hereditary problem which involves the cessation of the normal ovarian function before the age of 40 years.
Blocked ovaries can be responsible for anovulation but not necessarily for infertility. Although a low percentage of women develop this type of abnormality- 5%, this problem can cease without medical intervention.
70% of anovulation cases are caused by hormonal imbalances and the most common imbalance is an insufficient follicle level which leads to the incapacity of developing a viable ovule caused by hypothalamic and pituitary gland dysfunctions.
The malfunction of the thyroid gland can also be the cause of anovulation; hyper/hypo-thyrodism can disturb the reproductive hormonal balance affecting thus the egg release.
Anovulation can be caused by a large range of tumors located in the ovaries, uterus, brain (hypothalamus), hypothalamic tumors or tumors located in the hypophysis (pituitary gland).
Genetic affections also responsible for the primary amenorrhea like Turner Syndrome and other chronic diseases like sarcoidosis and tuberculosis are among the causes of anovulation.