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    Ovulation disorders and their medications

    Written on 17 June 2019

    Ovulation refers to the release of an egg during menstruation in females. Issues with the ovulation process can lead to infertility or difficulty conceiving. some types of ovulation disorders are:

    Polycystic ovarian syndrome
    A woman with polycystic ovarian syndrome (PCOS) has enlarged ovaries, often with small, fluid-filled cysts on them. It can lead to a hormone imbalance that can disrupt ovulation.

    Other symptoms can include insulin resistance, obesity, abnormal hair growth, and acne.

    PCOS is the leading cause of infertility in women.

    Hypothalamic dysfunction
    This happens when the production of the FSH and LH hormones is disrupted. These are the hormones that stimulate ovulation. This can affect the menstrual cycle.

    Irregular menstrual cycles and amenorrhea, which means not menstruating at all, are common.

    Causes of hypothalamic dysfunction include excessive physical or emotional stress, extremely high or low body weight, or substantial weight gains or losses.

    Excessive exercise, low body weight, and tumors of the hypothalamus can also lead to hypothalamic dysfunction.

    Premature ovarian insufficiency
    This is when egg production stops prematurely, due to a drop in estrogen levels.

    It can be due to an autoimmune disease, genetic abnormalities, or environmental toxins.

    It typically affects women before the age of 40 years.

    Hyperprolactinemia, or excess prolactin
    In certain situations, such as the use of medication or an abnormality in the pituitary gland, which produces hormones, women can produce excessive amounts of prolactin. This, in turn, can cause a reduction in estrogen production. Excess prolactin is a less common cause of ovulatory dysfunction.

    Ovulation can be induced by fertility drugs.

    These medications are known to regulate or trigger ovulation. Doctors may prescribe the following to treat anovulation, or the cessation of ovulation..

    • Clomiphene citrate (Clomid): This oral medication increases pituitary secretion of FSH and LH, stimulating ovarian follicles.
    • Letrozole (Femara): This works by temporarily lowering a woman's level of the hormone progesterone to stimulate ovum production.
    • Human menopausal gonadotropin or hMG (Repronex, Menopur, Pergonal) and FSH (Gonal-F, Follistim): These injectable medications are known as gonadotropins and stimulate the ovary to produce several eggs for ovulation.
    • Human chorionic gonadotropin or hCG (Profasi, Pregnyl): This matures eggs and subsequently triggers their release during ovulation.
    • Metformin (Glucophage): This medication is typically used in women with PCOS to treat insulin resistance and increase the chances of ovulation.
    • Bromocriptine (Parlodel) and Cabergoline (Dostinex): These medications are used in cases of hyperprolactinemia.

    Be aware that taking fertility drugs can increase your chances of having twins or triplets. The above may trigger side effects, including:

    • abdominal pain
    • hot flushes
    • heavy menstrual flow
    • tenderness in the breasts
    • vaginal dryness
    • increased urination
    • spots
    • insomnia
    • mood swings

    If these become severe, a doctor may be able to suggest other options.

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