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Delayed or absent ovulation can happen to most women from time to time it sure did with me, however, if it happens quite regularly then it is likely connected to a hormone imbalance which can be driven by multiple factors. Some of the most common factors are stress, poor sleep, over-exercising, low-calorie diet, low body weight, poor diet, nutritional deficiencies, thyroid issues, thyroid medications, an autoimmune condition, adrenal issues, PCOS, and an infection. So investigating these areas with your health practitioner is a good idea to rule any of these problems out.
Normal ovulation can occur anytime from day 14 - 21. Ovulation later than day 21 is considered late and the quality of the egg may not be that viable so the chances of conceiving that cycle are reduced.
One of the most influential ways to promote regular ovulation is through nutrition as we need to be supplying our bodies with the nutrient building blocks to synthesise and regulate hormones on a daily basis. Eating a clean, nourishing whole food diet is the best starting point. Choose food made lovingly from scratch and limit refined sugar and processed carbohydrates, even if they are gluten free ones. A diet rich in fresh fruit and vegetables (aim for 8 servings a day) gluten free whole grains, moderate organic meats and poultry, fish, organic dairy, nuts, seeds, legumes, and healthy fats is recommended.
A lack of ovulation can lead to low progesterone in the second half of the menstrual cycle, so getting tested for progesterone at around day 21 is a useful indicator of whether ovulation has actually occurred. I would also recommend looking at doing a DUTCH test to test all your reproductive hormones if this occurs quite regularly. Please contact me if you would like further information on DUTCH testing options.
The female hormone system is very complex so it is important to support your hormonal health in general with good nutrition and lifestyle choices.
Foods for a healthy hormone balance
To support hormones a good general rule is to have a good source of healthy fat and protein with each meal.
Good examples of healthy fats are organic butter, coconut oil, eggs, avocado, bone broth, meat stock, fish, and nuts. Fats are the building blocks to make hormones, transports cholesterol, helps to reduce inflammation.
Protein – grass-fed meat, organic chicken, organic dairy products (e.g. kefir, yogurt, cheese, milk) organic eggs, fish, shellfish, nuts, seeds, beans, and legumes. Protein is the building block of body cells and tissues and provides amino acids essential for egg production and hormone production. If you suffer from endometriosis it is recommended not to have too much red meat.
Ground linseed – add to smoothies and breakfast cereals. Contains Lignans which help to balance estrogen and progesterone.
Cruciferous vegetables - kale, broccoli, cauliflower, cabbage, Brussel sprouts. Helps the body to detoxify excess estrogen which can lead to estrogen dominance.
If hypothyroid avoid RAW brassica’s as they contain a compound called goitrogens which can block the uptake of iodine by the thyroid gland. This natural compound is destroyed by heating, fermentation is ok (e.g. sauerkraut)
Leafy Green Vegetables - spinach, kale, mesclun, rocket. A good source of Folate and essential for liver health.
Fibre – fruits, vegetables, dark leafy greens, beans, whole grains. Fibre helps assist the body in getting rid of excess estrogens and xenoestrogens.
Carbohydrates are the body's main fuel source so it is not recommended to follow a low carbohydrate diet and to have at least have 1 – 3 servings a day. Low GI carbohydrates are actually important for fertility as a sufficient amount of energy is required for reproduction to be able to take place and maintain balanced hormones and blood sugar levels.
Avoid sugar and refined carbohydrates – these are empty calorie foods that do not nourish the body in any way and are inflammatory foods.
Avoid soy unless fermented soy like Miso and Tempeh. Soy has estrogen-mimicking properties that can have a negative impact on hormone balance. If hypothyroid avoid soy as this has a negative effect on the thyroid.
Drink plenty of filtered water
The most important nutrients for ovulation are the B complex vitamins especially B6 and B12, vitamin D, Iron, and Essential Fatty acids so it is important to make sure you are not deficient in any of these as vitamin and mineral deficiencies can lead to delayed ovulation. Taking a preconception multivitamin with activated B vitamins is a good idea to ensure you are getting a top up of all the nutrients you need.
Managing stress
As well as nutrition is it also important to look at stress and how it is managed as high levels of stress can trigger the body to make excess stress hormones such as cortisol. Excess cortisol inhibits the body’s production of reproductive hormones such as estrogen and progesterone and can lead to hormone balances and a lack of ovulation. It is important to do regular moderate exercises like walking or yoga but to avoid excessive strenuous exercise as this is stress for the body which can interfere with ovulation. In addition, if you are trying to lose weight and are on a low calorie or low carbohydrate diet and still exercise excessively, this is a hormonal disaster if you are trying to conceive.
Infertility is a stressful journey and so it is important that you take the time for self-care and support yourself as much as you can. I found charting and testing raised my stress and anxiety levels so I gave up on these quite early on and just went with the flow, checking for ovulation signs such as increased cervical mucus. You have to do what is right for you though and if charting and testing don’t stress you out too much it can be a very useful tool.
Meditating for 10 minutes every day really helped my stress levels and made me more aware of my body and what it was trying to tell me, so I recommend this as a way of balancing out the stress of testing. I used the meditation app Headspace but there are many others out there that you could use. The important thing is giving your brain that time out which helps to give you a sense of calm and clarity.
I also found restorative yoga at night before bed super helpful for my stress levels. I would choose 4 – 5 poses (mainly fertility boosting ones like legs up the wall or butterfly) and would hold these poses for a minute or two while breathing deeply. My evening practice would only take me about 15 minutes or so but I felt so much better for doing it. I encourage you all to explore a regular restorative yoga practice to bring some calm in amongst all the stress and to boost your circulation and fertility at the same time.
I support couples trying to conceive with their preconception wellbeing plans, focusing on nutrition, lifestyle, gut health, stress, hormones, thyroid, and adrenal health, etc so please get in touch if I can be of assistance.
For further information, check out my book Healing from Unexplained Secondary Infertility which is now available on Amazon.
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