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    Do all women ovulate?
    amymo posted:
    OK this is a weird question but here it goes. Do all women who have normal periods every month always ovulate? Is it possible to have a period but not ovulate?
    Jane Harrison Hohner, RN, RNP responded:
    Deare amymo: Excellent question! A woman can have apparently regular flows and yet still not be having regular ovulations. How can this happen? In a cycle without an ovulation, estrogen stimulation (assisted by the hormone FSH ) will continue to make the lining of the uterus grow thicker and thicker. In the absence of a LH surge, no ovulation will occur. The progesterone level will not rise. When the follicle that contains the un-ovulated egg involutes the woman's blood estrogen level will drop. This triggers much of the lining to be shed. Thus if it takes two to three weeks for the follicle and un-ovulated egg to regress, the woman may have somewhat regular bleeds.

    How often does this happen? In the first year after menstrual periods begin up to 55% of the cycles may occur without ovulations (Mansfield & Emans, 1984). In a study of 20-35 year old women who were had regular cycles but were infertile, an average of 30% of women were not ovulating. Among these 123 women with regular cycles the highest incidence of not ovulating was 41%. This highest incidence occurred among women who had never had a conception. Women who had at least one documented pregnancy had a lower incidence of non-ovulation despite regular periods (Hegab, 1987).

    Lastly, the presence of very regular periods, accompanied by common premenstrual symptoms ("molimena") suggests an ovulatory cycle—especially when there are menstrual cramps. Yet this may not always be the case. In as many as 5% of these "classic for ovulation" cycles, ovulation may not have occurred (Speroff, 1999).

    Bottom line amymo, other than a confirmed pregnancy the only other ways to document an ovulation are to do blood progesterone levels on cycle day 21, or to use ovulation predictor kits which measures for the LH surge. Even basal body temperature charting or watching for cervical mucus changes can have results thrown off by other physical issues (eg viral infection or elevated estrogen levels from PCOS).

    amymo replied to Jane Harrison Hohner, RN, RNP's response:
    Thank you jane
    riggs34 responded:
    yes!, if you have a normal period.

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