"Graeme is one of the most knowledgeable, reliable and empathic clinicians I have known. His practice is evidence based and patient centred, and he is the 'go to' person for difficult clinical cases." WL (UNSW)
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“We now have much better diagnostics for ovulation, including AMH tests which can predict the time of menopause and tell us what ovarian reserve remains.”
How does ovulation work?
There are three phases in a woman’s monthly menstrual cycle, controlled by two types of hormones: follicle stimulating hormones (FSH) and luteinising hormones (LH). If the hormonal balance is disturbed for any reason the menstrual cycle may become irregular or cease altogether.
Ovulation is the moment when the egg is released from the dominant follicle in the ovary. This would typically happen on day 8 of a 28 day cycle.
What are the causes of ovulation problems?
According to clinical classifications, there are seven main types of ovulation problems:
- If you don’t ovulate at all, or ovulate less than every six months
- If there is between 6 weeks and 6 months between your periods. For these first two groups, Polycystic Ovarian Syndrome (PCOS) may be the cause. Anxiety, or significant weight gain (or loss), may also lead to irregular ovulation.
- Complete ovulation failure, such as due to early menopause
- Genetic reasons for having no periods, such as chromosomal imbalance
- Pituitary gland overproduces the hormones responsible for ovulation.
- There is a tumour in the pituitary gland (this is typically benign)
- You may have another form of brain tumour that is affecting ovulation function.