129. Late Ovulation: Why It Happens and How to Correct It

Late ovulation isn’t random—it’s often your body’s way of saying conditions aren’t quite right yet. In this episode of Cycle Wisdom, Dr. Monica Minjeur explains why ovulation may consistently happen later, how stress, sleep, metabolism, thyroid health, and insulin resistance affect follicle development, and how to tell a temporary delay from a pattern that needs attention. Through Frida’s story, you’ll learn cycle-timed testing strategies and restorative steps that help bring ovulation back into a more predictable, fertile rhythm—without panic or overcorrection.

If your cycles feel unpredictable or ovulation timing keeps shifting later each month, you don’t have to figure this out alone. At Radiant Clinic, we specialize in cycle-informed, restorative care that identifies why ovulation is delayed and creates a clear plan forward.
Schedule your free discovery call at radiantclinic.com to explore personalized care options.

Transcript

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Welcome back to Cycle Wisdom, where we empower women to restore natural menstrual cycles, to improve health and promote fertility. I'm your host, Dr. Monica Minjeur, and I'm so glad you're listening today. What if late ovulation isn't random, but it's your body's way of saying things are not right yet? Today we're going to decode a few of the different reasons why ovulation can shift to be later than day 20 of your cycle, or how to tell if it's a short-term blip or a bigger pattern. We're also going to discuss practical cycle time steps that bring your fertile window back into a healthy rhythm so that you can more clearly identify when ovulation is happening consistently. So let's start off with a patient story about Frida. Now, Frida was about 33 years old when she came to see us, and she at that time had been traveling twice a month for work as a business consultant. She and her husband had been trying to conceive for almost a year, and Frida said, although she felt like she was doing everything right, it was really challenging to pick out when her fertile window was going to be, and specifically to know her ovulation day. She felt defeated and oftentimes would overcorrect by adding additional steps like checking her LH strips every day of the month, or changing her supplements on a regular basis, or trying to catch a temperature reading that showed a shift. She felt like she was second guessing herself, and her schedule made it much more challenging to clearly identify ovulation and to know what pattern was going to be happening. After two overnight business trips with red eye flights, her ovulation shifted again. This time delaying longer than ever, and she didn't ovulate until cycle day 25. She decided to stop guessing and figure out how she could get her cycles back on track because she knew she needed to be able to clearly identify her fertile window in order to get pregnant. So when Frida came in to see us, she had actually already been charting her cycles. We noticed that she had variable cycles ranging anywhere from 30 to 38 days. Her fertile mucus window appeared later in her cycle, typically somewhere between cycle day 18 to 25, and she had an inconsistent LH surge, which meant it was difficult for her to track those LH positives on strips at home. And finally her luteal phase. So the time from ovulation until when her next period began was a bit short at about 10 days. We discussed different lifestyle factors that could be playing a role with her ovulation quality as well as fertility. She specifically noted a significant amount of travel, which led to jet lag shifts in her sleep schedule, as well as needing to utilize caffeine in the later afternoon in order to be able to stay awake. She had an erratic schedule with her eating and she was mostly doing cardio exercise. But in some cases would go for two or three weeks without any exercise at all. As far as lab work goes, we evaluated frida's, mid luteal phase, progesterone, and estrogen levels. We also determined that she had insulin resistance as well as some troubles with low iron stores. Her pelvic ultrasound was normal, and so we talked about ways that we could work together to help improve her insulin resistance, improve the hormone deficiencies, and in a way that was able to help her to get reset. We specifically talked about different lifestyle shifts that she could utilize in addition to some supplements to help with insulin resistance and dietary changes. And most importantly, we discussed the importance of different things to help with the ovulation quality in order to shift that earlier in her cycle. While we supported her luteal phase again, that time from she ovulated until her next cycle started to make sure that we were allowing enough time for implantation to occur, even if ovulation happened a bit later. Okay, so why does late ovulation happen in the first place? Overall? Late ovulation is typically related to poor follicle function. So a follicle is basically the shell that kind of forms around the outside of that egg that is going to be released in any given cycle. And this follicle starts to develop early in your cycle. So even from the time that you're still having your menstrual bleed. In many cases, ovulation is delayed because you have poor quality of ovulation leading to a smaller follicle. Now our bodies are designed to release an egg when the follicle gets to be a certain size. If that follicle is too small or it's not robust enough to be able to support that ovulation, it typically will wait until it can grow to a bigger size, which in some cases. Just takes more time. In other cases, it can mean that there are certain metabolic factors that are off or hormonal factors, and ultimately it will delay the release of that egg until it finds that the follicle is either a better size or it just gets to be so late in the cycle that it needs to turn things over. When it comes to things that cause that poor follicle function, there are many different things that can throw it off. As we saw with Frida's case, one of the most common things that I see is significant stress and poor sleep function. So especially if you're not getting adequate sleep, if your sleep imbalances off so you're not getting enough of that deep REM sleep, or if you're somebody who's traveling frequently across different time zones, all of these things can throw off the hypothalamic axis, which is what sends the signals to your body in order to secrete other hormones. The other piece of this would be related to stress, and we've talked about this in other episodes, that stress can absolutely delay your body's ability in order to release luteinizing hormone, which is responsible for releasing that egg. Other factors that can play a role with poor follicle function include metabolic issues. So as was the case with Frida insulin resistance, even if your blood sugar is normal, even if your hemoglobin A1C is normal insulin resistance, which typically is one of the very first changes that happens, can delay ovulation and cause ovulation to happen later than it typically would. Illness can also significantly delay ovulation. I talked about this quite a bit in episode number one, 16, specifically with COVID infections, but honestly, any viral infection, any bacterial infection, all of these things create inflammation, and our body instead focuses on recovering from that current illness as opposed to prioritizing development of a follicle. For many women, this lasts just a cycle. But depending upon the illness and when things hit and what that stress level looks like on your body in regards to the illness, it can last up to two cycles or more. Another common reason why we see ovulation and that shifts because of poor follicle function would be in women who are coming off of any sort of hormonal birth control, specifically when it comes to the pill or an IUD or an implant. It can be common for there to be significant variability as to when ovulation happens for up to three to six months after stopping hormonal contraception. In some in women, this returns much sooner, and in some it can take even longer. So ultimately focusing on how do we help to support your body with these ovulatory patterns as we make these shifts. And then finally, subtle shifts in things like your thyroid. Or in iron stores or other vitamin stores can reduce the available energy that your body has, and it can also delay ovulation. So for example, if your body is constantly working in order to try and develop more thyroid hormone, or if it's constantly behind on its vitamins, again your body is going to prioritize self-care before it would prioritize having ovulation happen. So how do we know if ovulation delay is a problem and when do we need to do something about it? So first and foremost, we always want to confirm, not assume. Just because you have a longer cycle doesn't necessarily mean that ovulation is the problem. So we always would focus first on charting your cycles, at least two to three cycles to track what do we observe with cervical mucus. Are we seeing a temperature shift if we're not noticing any cervical mucus, and in some cases adding on urinary LH metabolites in order to evaluate and confirm that ovulation has happened? We also would sometimes time a pelvic ultrasound to assess, do we see a follicle developing? What is the size of that follicle? Does it look like that follicle has released its egg after a presumed ovulatory event? All of these pieces work together to help us to confirm when exactly did ovulation happen. Okay. We also always would want to look at labs. So similar to what we looked at with Frida, we're going to look at what happens with your hormone levels, specifically one week after ovulation, especially in individuals who have a delayed ovulation. This is why it is so incredibly important to make sure that we are timing a lab draw with your cycle one week after ovulation. Rather than just picking a random cycle day, which oftentimes is cycle day 21, in order to check those labs. For many of our women who ovulate later in their cycles, they may not have even ovulated by cycle day 21. And the labs can be very inaccurate if we're not tracking it according to their actual ovulation day. We also would evaluate other markers, things like metabolic issues, so for example, insulin deficiency, insulin resistance, sex hormone binding globulin, as well as our other vitamins like ferritin, vitamin D, vitamin B12, and a complete thyroid panel. We also want to make sure that we're checking DHEA and testosterone and androgens in order to be sure that we understand if there is a delay in ovulation. Is there a possibility that there's an underlying cause, like polycystic ovarian syndrome, insulin resistance? Thyroid deficiency, again, ovulation that is delayed is typically not happening in a void. There is generally some other reason that is delaying that ovulation and especially if it is happening consistently after two or three cycles. We need to understand why that is happening in order to be able to get treatment correct. So once we have identified what the issue is as far as the cause of the delayed ovulation, then it becomes much more straightforward to correct those underlying causes. So, for example, if iron stores are low, or if thyroid is dysfunctional, or if there is insulin resistance, we treat those things accordingly. In general, things that you can do from a lifestyle standpoint are really across the board for everybody, and we want to focus again specifically on how do we improve not only the quality, but also the quantity of our sleep. It can take a couple of weeks to reset your body's internal clock, but ideally focusing on getting morning light. Ideally, within 30 minutes of waking up, we wanna get at least five to 10 minutes of that morning light. Get your morning cortisol firing to tell your body this is a wake time. We also want to try and prioritize a fixed sleep window, and what I mean by this is choose a set bedtime and try and go to sleep within 30 minutes, plus or minus of that sleep window. That really allows your body to get into a good rhythm of understanding. This is bedtime, this is awake time, and again, focusing on all of the sleep habits that we talk about, especially related to getting rid of any artificial light. One to two hours prior to bedtime because that helps improve cortisol functioning. It helps improve our deep REM sleep, and that's when many of our hormones are being produced. And finally, from a sleep standpoint, if you are a caffeine lover trying to cut off any caffeine by noon or midday, that will also help get into that deeper REM sleep without having as many of the nighttime awakenings. Other general areas of focus include improving your metabolism. So in episode 107, I talk a lot about blood sugar, insulin resistance, and how this impacts your hormones. But really the focus here, again, not just for people that have diagnosed insulin resistance, but for all of us, ways that we can improve our metabolism include making sure we get plenty of protein with our breakfast. So that early morning meal. Now, if you are somebody who is. Skipping breakfast altogether, I would suggest focusing first on getting breakfast in, ideally aiming for at least 20 to 30 grams of breakfast. For most women, you may need more, especially if you're more active in the morning. When we focus on getting protein first. It helps to set the stage for a good balance of blood, sugar, insulin, and cortisol early in the day and throughout the day. If you're able to make sure that you're balancing your carbohydrates and your protein with the rest of your meals, that can also be significantly helpful. And bonus points, if you can get a 10 minute walk-in after a meal, that oftentimes will help your body to utilize any excess sugar that it may be producing, which helps to balance insulin resistance as well. We always want to make sure that you're reassessing any labs that you're doing specifically insulin, sex hormone binding globulin, androgen levels, any of those pieces that could play a role with metabolism. After about three months of consistent lifestyle changes in order to discern if the things that you're changing are actually making a difference. And finally, one of the most important pieces for making sure that ovulation is happening consistently would be to evaluate if you are somebody that requires particular supplements or prescription strength medications in order to improve the quality of follicle development. Or to help support your luteal phase after ovulation has occurred Again, we talk a lot about how do we balance this. Many women need to have support in both the follicular phase as well as the ovulatory phase and luteal phase, and some requires assistance in just one section or the other. Again, all of this focus goes back to how do we improve the quality of ovulation earlier in your cycle so that we're hopefully avoiding much more of the issues that come. When we see that, that follicle just gets delayed from ovulating in the first place. So last few questions here that we often get asked in regards to ovulation. What if I'm ovulating late, but my cycles are still regular? Do I need to do anything for treatment? So the short answer to this is not necessarily if your luteal phase is adequate, meaning it's at least 12 to 14 days and you're trying to conceive, this may be normal. We always still want to address any underlying factors that might be showing us. This is why ovulation is delayed, but in many cases you can absolutely still get pregnant with a delayed ovulation as long as that luteal phase is a good length. Another question we get asked, can late ovulation cause a miscarriage? Now late ovulation in and of itself doesn't lead to miscarriage. But again, if there was poor follicle function from the start or underlying metabolic or thyroid or hormone deficiencies that were there that are causing the delay in ovulation, then this absolutely can increase your miscarriage. Again, this is why it's so important to make sure that you are having complete evaluation from a restorative reproductive medicine healthcare professional who understands how to discern what is normal and what is not, so that we can address as many of these things ahead of a pregnancy as possible. Another common question we get is, does this mean I have polycystic ovary syndrome? I was told that irregular ovulation means that I have PCOS. Now, it's certainly possible that late ovulation can mean PCOS, but ovulation dysfunction is not diagnostic in and of itself. Again, we want to combine what we're seeing with your cycle history, ideally with ultrasound evaluation. And assessment to see if you have excess androgens like testosterone. So this may manifest as facial hair growth, excessive acne, body hair growth, or elevated hormone levels from a testosterone standpoint. So just having a late ovulation in and of itself does not mean that you have PCOS. So please don't accept that diagnosis if that's the only sign that you have. And finally, and most importantly, how quickly can I turn things around when it comes to delayed ovulation? Now changing your sleep and nutrition, those shifts we may see even within the very next cycle, because within three to four weeks, we can start to see changes on how your body is doing from a circadian rhythm standpoint and cortisol, and how your hormones are firing Other factors like insulin resistance or thyroid dysfunction, or. Vitamin deficiencies can be a bit slower to change, but typically can still change over the course of two to three months. So again, it is absolutely possible to get that ovulation shifted earlier, to have more clarity as to when your cycles are happening, when you're seeing that fertile window and when you can expect to see ovulation more consistently happening. Imagine if your fertile window showed up on time more consistently because your nervous system was in a better shape, your metabolism was supporting ovulation, and your ongoing plan was simple enough to live with. Over the next few months, your charts can become more clear. Your luteal phase stronger, and your confidence in your cycles more steady. All of these pieces working together help to improve ovulation health and promote fertility.

Speaker: 19:03

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