Abnormalities in ovulation have different levels of severity and
may occur for a variety of reasons. If there is a lack of ovulation,
there will often be a lack of menstrual flow (called amenorrhea).
If there is a less complete disruption of ovulation, there may
be irregular menstrual intervals.
Causes of ovulatory dysfunction that result in menstrual changes
can be categorized into ovarian, pituitary and CNS-hypothalamic.
Amenorrhea may additionally be caused by non-ovulatory problems
such as anatomic abnormalities that either do not allow for the
growth of the uterine endometrium (such as following an hysterectomy)
or do not allow the shed lining to exit the body via the vaginal
vault (such as with an imperforate hymen).
A different set of medical concerns exist if the woman has "never
menstruated" (primary amenorrhea) as opposed to the absence
of menses in a woman who has previously had a spontaneous menstrual
flow (secondary amenorrhea). Any female who has not had a menstrual
flow by the age of 14 in the absence of secondary sexual characteristics
(such as breast development) or the age of 16 (regardless of secondary
sexual characteristics) should consult a gynecologist or infertility
specialist with training in reproductive endocrinology.
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