When it comes to hormone health (and especially fertility), ovulation - or the release of a mature egg from a follicle each month - is often front and centre. Ovulation is a key piece of the menstrual cycle, because it's the release of this egg that makes it possible for us to get pregnant.
Besides that, ovulation also triggers a hormonal shift that can tell us a lot about our overall health and provide clues about potential hormonal imbalances.
Now you may have heard that the magic number for ovulation is day 14, and while it's true that we'd like to see it take place sometime around then, it doesn't need to be exact. A few days on either side of day 14 is perfectly normal in my books, especially if you're seeing that you ovulate consistently on the same day each month.
However, seeing ovulation significantly before or after day 14, not seeing it at all, or experiencing severe pain alongside ovulation are all signs that there may be hormonal issues at play - and here's why.
Early Ovulation
Early ovulation is defined as releasing an egg earlier than day 11 (remember that the menstrual cycle begins on day 1 of your period, so this means you would ovulate less than 11 days after your period started).
Ovulating early means that the egg has less time in which to mature and that the uterine lining has less time to thicken in preparation for a potential pregnancy. There may also not be enough time for the body to make enough estrogen to allow for cervical fluids to thicken, and it's this thick cervical mucous that helps allow sperm to survive long enough to reach the egg.
Now, if pregnancy isn't your goal, the fertility aspect may not concern you right now, but early ovulation can be a sign of high stress and/or approaching menopause, so seeing it consistently can be an indication that it's time to dig deeper into your hormone health.
You can help your body manage stress and/or you can be proactive about your hormone health going into the menopausal transition, which can go a long way to making it much less disruptive.
And if pregnancy is your goal? I'd definitely encourage you to work with a professional to help bring things into balance and to maximize your chances of conception.
Late Ovulation
Late ovulation is defined as releasing an egg later than day 17 (this means you'd be ovulating more than 2 weeks after your period started).
It's not entirely clear yet what the underlying reason is, but I learned during my clinical placement with a doctor who specializes in fertility that late ovulation is associated with lower egg quality. (I would speculate that this may be due to the factors that cause late ovulation, but we can't say for certain at this point).
Late ovulation can be caused by stress, liver congestion, or imbalances in adrenal or thyroid hormones (such as adrenal fatigue or hypothyroidism), so seeing ovulation consistently past day 17 is a good sign that it's time to evaluate your hormone health.
And if you're currently trying to get pregnant or you'd like to get pregnant soon, I'd recommend working with a professional to make this process as easy and efficient as possible.
No Ovulation
No ovulation means we're not releasing an egg at all during the month, which means we also don't trigger the hormonal shift (a large rise in progesterone and a small rise in estrogen) that takes place after ovulation.
This means we have no chance of getting pregnant but it also means that we're being exposed to estrogen without any exposure to progesterone, and this imbalanced estrogen and progesterone situation is, according to Dr. Lise Alschuler, a professor of clinical medicine in Arizona, a risk factor for hormonal cancer.
Now, if you notice that you had one month where you didn't ovulate and you know you were significantly more stressed than usual, but then your menstrual cycle went back to normal, that's not typically cause for concern. But, if you're skipping ovulation multiple months a year or you haven't ovulated for several months in a row, I'd suggest investigating why.
No ovulation has some similar underlying causes to other ovulation issues, including high stress and adrenal or thyroid hormone imbalances, but it can also be caused by overexercising, having too little body fat, or a hormonal condition called polycystic ovary syndrome or PCOS.
In any case of no ovulation (also called anovulation), I'd recommend working with a professional, but especially if you're trying to get pregnant, because it can take a while for periods to resume if you've lost them, and getting expert guidance can help expedite this process.
Severe Pain at Ovulation
While it is normal to experience either no pain or minor discomfort (like a small twinge in the lower abdomen or in the low back) at ovulation, noticing severe pain can be a sign of a condition called endometriosis, which has a hormonal component.
Endometriosis involves the growth of tissue that's similar to the uterine lining outside the uterus in places where it shouldn't be, such as on the ovaries and fallopian tubes. It can negatively affect fertility and cause severe pain at ovulation and menstruation, and while there is an immune piece of the puzzle, there is also a hormonal piece involving estrogen and inflammation.
A full diagnosis typically involves a hormone test and a biopsy, but noticing severe pain at ovulation can be a first sign to start looking deeper. In this case, working with both medical and holistic professionals can be quite helpful, and it is something I'd recommend in any case but especially if the pain is disrupting your daily life and/or you're planning to get pregnant soon.
Next Steps
So, now that you know the basics of ovulation issues - how do you figure out if you have one? A great way to start learning about your menstrual cycle and estimate when you ovulate is to use basal temperature charting, which you can learn about in my previous blog post here:
https://www.kristintalkshormones.com/post/basal-temperature-charting-101-track-your-hormones-at-home
And if you still have questions? I'm here to help! Feel free to reach out to me here: