Anovulation is a condition that manifests itself through a menstrual cycle where oocytes are not produced, meaning the woman is not ovulating. This does not mean that the woman is going through menopause – even if there are several anovulatory cycles –, but that there are other underlying issues that cause anovulation. In most instances, anovulation is treated through medication, such as intravenous estrogen, birth control pills, oral contraceptives or other types of hormones. However, there are more severe cases of chronic anovulation which are in fact symptoms of other more serious illnesses. These cases need a more thorough investigation and are sometimes cured with anovulation surgical treatment.
An anovulation surgical treatment can consist of less invasive methods, such as curettage or suction dilation, but in other instances more profound surgery is required. For example, surgery can be applied in instances of a macroadenoma of the pituitary where severe symptoms such as headaches, diplopia or bitemporal hemianopsia are observed. If tests indicate the presence of a malignant or benign neoplasm with adrenal or ovarian origins, the specializing doctor will probably propose an exploratory laparotomy, followed by resection and staging.
Sometimes, anovulation is a symptom of polycystic ovary syndrome whose manifestations can lead to menstrual irregularity and hyperandrogenism, where the person suffers from a sort of gender confusion caused by hormonal and chromosomal imbalances. Though almost 70% of cases respond to medical treatment, the rest remain anovulatory and thus anovulation surgical treatment is tried. This is represented by laparoscopic surgery with the purpose of inducing or re-inducing ovulation. Operations resembling laparoscopic surgery that aimed to bring back menstruation in afflicted women have existed since the 1930s, yet the methods gradually changed as other more important and efficient discoveries were made.
Other types of anovulation surgical treatment include ovarian wedge resection and ovarian drilling; these two methods have really high success rates, with almost 80% of women who go through one of them experiencing ovulation almost immediately. In cases of acute blood loss, doctors opt for dilation or curettage, even though they are not purposefully intended for that. More acute cases can only be “cured” through hysterectomies though, as a last resort solution to stop anemia caused by severe blood loss. Other types of surgery are sometimes practiced as well, usually when anovulation is only a secondary effect of a larger issue; for example, bariatric surgery is used to treat severe obesity which, in turn causes a cease of ovulation or even amenorrhea.