Anovulatory Cycle

00:01 Anovulatory cycle.

00:04 Excess estrogen.

00:06 Don’t know what that does to the endometrium? It thickens it, thickens it, thickens it.

00:11 Hence, we call the first phase of your menstrual cycle, the follicular phase or a.k.a. proliferative phase.

00:20 Next, after your – Let’s say, if ovulation was to take place progesterone comes into play and the spiral arteries are then kept patent by progesterone.

00:30 Read that first sentence.

00:31 It’d explain everything that I just said.

00:33 The pathophysiology is in the underlined statement.

00:39 Anovulatory cycle causing dysfunctional uterine bleeding.

00:44 You have excessive estrogen stimulation without development of the progesterone.

00:50 Failure of ovulation, anovulatory, but you’ll have – or the female, unfortunately, is going to experience what? Dysfunctional uterine bleeding.

00:58 Next, Usually due to subtle hormonal imbalances during menarche or perimenopausal period, the bottomline is this: Anovulatory cycle, if your patient is suffering from dysfunctional uterine bleeding, you’re having or she’s experiencing hormone imbalance between estrogen and progesterone.

01:20 At least know that much before taking your boards for anovulatory cycle.

01:25 Is it common? Extremely.

01:30 Differential diagnoses: Rarely may result from endocrine disorders, but still nonetheless, know it.

01:37 If your patient has thyroid disease, adrenal disease or pituitary tumors, isn’t this messing up your hormones? Take a look at these. All of these are hormonal pathologies.

01:49 And so therefore, it could bring about anovulatory cycles.

01:55 Other causes, these are ovarian lesions.

02:00 What if you have a functioning ovarian tumor and here, a particular one that I need you to keep in mind is something called a granulosa-theca cell tumor.

02:09 A granulosa-theca cell tumor, we’ll talk about that in greater detail.

02:13 We’ll also refer to something called Meigs syndrome.

02:15 This is a functioning ovarian tumor.

02:18 The ovary's functioning, but then it’s causing anovulatory cycle along with dysfunctional uterine bleeding.

02:26 Or you could have polycystic ovaries.

02:28 So meaning to say that at some point, when we talk about polycystic ovarian syndrome, there’s every possibility that there might be multiple, multiple, multiple cysts in the ovary.

02:37 Tell me, please. Are you going to have proper ovulation? No, you do not.

02:42 Could you have bleeding? Sure.

02:45 But it might be dysfunctional.

02:48 Generalized metabolic disturbances resulting in anovulation.

02:52 Oftentimes, obese females will complain or or will express infertility.

03:00 Malnutrition and chronic systemic diseases all may result in anovulation.

03:06 Important list of differential diagnoses, rare.

03:10 Most of the time, it will be hormonal imbalance.

03:13 However, I’ll walk you through a couple of categories as well.