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When should you suspect an ovulation disorder? What are the causes?

No periods, or cycles under 24 or over 45 days, suggest an ovulation disorder. Causes include PCOS, hypogonadism, POI and some medications.

1 min read

If you have no periods or very irregular cycles, particularly if your cycle is shorter than 24 days or longer than 45 days, you likely have an ovulation disorder.

Main Causes of Ovulation Disorders

  1. Polycystic Ovary Syndrome (PCOS)
    • The most common ovarian disorder affecting ovulation.
  2. Hypogonadotropic Hypogonadism (brain-related ovulation dysfunction)
    • Caused by impaired brain signaling that regulates follicle selection in the ovaries.
    • Potential causes:
      • Brain tumors
      • Radiotherapy to the brain
      • Certain medications
      • Genetic factors
    • Severe weight loss, restrictive eating, or intense physical activity can also disrupt the hypothalamic-pituitary axis, leading to low FSH and LH levels, which can stop ovulation.
  3. Hypergonadotropic Hypogonadism or Premature Ovarian Insufficiency (POI)
    • Previously called “early menopause”, this condition is due to excessive depletion of ovarian follicles.
  4. Medication-Induced Amenorrhea (Absence of Periods)
    • Some medications can suppress ovulation and menstruation, including:
      • Neuroleptics (antipsychotics)
      • Progestin-based treatments

If you suspect an ovulation disorder, a medical evaluation is recommended to identify the cause and explore treatment options.

A pelvic ultrasound helps:

  • Measure uterine size and assess its structure (cervix and uterine body).
  • Identify fibroids (benign growths in the uterine muscle).

General information, not a diagnosis: talk to your doctor about your own situation.

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Written by

  • Prof. Arash Rafii

    Professor of Obstetrics, Gynecology and Genetic Medicine

    Sidra Hospital

  • Prof. Michaël Grynberg

    Professor of Reproductive Medicine, Obstetrics and Gynecology

    Antoine Béclère and Jean Verdier University Hospitals

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