Infrequent Periods & Ovulation: Causes, Concerns & What to Do

Question
Dear Brenda,
I am a 36 nearly 37 y.o. female gravida 3, para 1, miscarriage 1, abortion 1.  
My husband and I would like to have a second however, we're having difficulty
(>6 months of trying).  My periods are regular 29 days, however, the bleeding
is extremely scant (use a pantiliner only), my thought are that i'm not
ovulating.  Also, I breastfeed my son for 10 months (he's now 2.5), but I can
still get a little drop of milk from my breasts if expressed.  My thoughts are
that I may have hyperprolactemia or a thyroid disorder?  What do you think..
Why would i have such a small amount of blood during my period.  Please
note, I'm not pregnant--I take pregnancy tests all of the time.

Answer
Dear Andrea,

If ovulation does not occur in a woman, no egg is released from the ovary, and hence technically there should be no bleeding or periods in the woman at all in that month. So if a woman is not pregnant and does not get her periods, it is typical that no ovulation has taken place. This is known as anovulation or anovulatory cycle. Most often, women who do not ovulate also do not menstruate, a disorder known as amenorrhea, or do not menstruate regularly (oligomenorrhea). Because of this tendency, scant, erratic, short and/or painless menstrual cycles can sometimes alert a woman or her doctor that there might be an anovulation problem. If your periods are only recently scant, it may be related to excess androgen production - PCOS or high glucose, etc,... The fact that you are having regular periods every 29 days would typically indicate that you are ovulating. However, because they are scant, there may be a possibility of an ovulation issue.

Some potential causes for anovulation include:
-Hormonal imbalances (most probable)
-Strenuous or excessive exercise
-Stress/Anxiety
-Weight Loss/excessive dieting
-Hypothalamic dysfunction
-Hyperprolactinemia
-Polycystic Ovarian Syndrome (PCOS)
-Luteal phase defects
-Dysfunction of the pituitary gland, adrenal gland, or ovaries
-Primary ovarian failure, resistant ovary syndrome and autoimmune oophoritis
-Possible long-term use of certain medications such as oral contraceptives

You can invest in an Ovulation Predictor Kit (available at most drug stores) to try to help determine when/if you are ovulating during the next cycle. If the test does not give you a positive ovulation reading, then I would suggest seeing your doctor for assistance. Your doctor can run some blood tests during your cycle to determine whether you are ovulating. If necessary, a medication may be ordered to try to "kick start" your cycles again.

I hope this has helped you and answered your questions. I wish you well.

Brenda