Ovulatory dysfunction

Anovulation also may occur at any time during the reproductive years due to a pathologic cause. The most common causes of non-physiologic ovulatory dysfunction and their prevalence rates11 are ... 

PCOS, while responsible for 70% of the cases of ovulatory dysfunction, occurs in approximately 4% of women.12... 

Hickey M, Dwarte D, Fraser IS. Superficial endometrial vascular fragility in Norplant users and in women with ovulatory dysfunctional uterine bleeding. Hum Reprod 2000 15(7) 1509-14. 

Ovulatory dysfunction manifests itself in the presence or absence of normal menses, making it difficult to diagnose. Metabolic diseases of many kinds can effect ovulatory function, including ones that result in androgen excess. PCOS, which results in androgen excess, is the most common cause of anovulation and has been discussed in detail earlier in the chapter. In women with hirsutism, CAH should be considered. A 21-hydroxylase deficiency or 3-p-hydroxysteroid deficiency may be present in up to 26% of cases.Ovulatory dysfunction can also be secondary to liver or thyroid disorders. 

Brettenthaler N, De Geyter C, Huber P, et al. Effect of Insulin Sensitizer Pioglitazone on Insulin resistance, Hyperadrongenism, and Ovulatory Dysfunction in Women with Polycystic Ovary Syndrome. J of Clin Endocrinol Metabolism. 2004 89(8) 3835-3840. 

Morrell MJ, Hayes FJ, Sluss PM, Adams JM, Bhatt M, Ozkara C, Warnock CR, Isojarvi J. Hyperandrogen-ism, ovulatory dysfunction, and polycystic ovary syndrome with valproate versus lamotrigine. Ann Neurol 2008 64(2) 200-11. 

Reproductive System. Severe exposure to lead has been associated with sterility, abortion, still births, and neonatal deaths [25], although there are no epidemiologic data [77]. Women working in lead industries were found to have a higher rate of ovulatory dysfunction, and men with moderately increased lead absorption were found to have decreased fertility. 

Stenchever MA, Droegemueller W, Herbst AL, Mishell DR. Abnormal uterine bleeding Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In Stenchever MA, ed. Comprehensive Gynecology. 4th ed. St. Louis Mosby 2001 1079-1097. 

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