What is the underlying issue in anovulatory bleeding?

Anovulatory bleeding occurs when the menstrual cycle experiences a lack of ovulation, which can lead to imbalances in hormone levels and result in irregular bleeding patterns. The correct answer points to a failure of the corpus luteal cyst to form.

In a normal menstrual cycle, after ovulation, the ruptured follicle transforms into the corpus luteum, which secretes progesterone. Progesterone is crucial for stabilizing the uterine lining (endometrium) and preparing it for possible implantation of a fertilized egg. If the corpus luteum fails to form, progesterone levels will remain low, provoking an unstable endometrium that can result in erratic shedding and hence abnormal bleeding. This is often a key characteristic of anovulatory cycles.

In contrast, excessive progesterone release would not be a cause of anovulatory bleeding since elevated progesterone would typically result from successful ovulation and further influences a stable endometrial lining. Hormonal imbalance due to stress can contribute to irregular menstrual cycles but is not the direct mechanism behind anovulatory bleeding characterized by failure of ovulation. Uterine fibroids, while they can also cause bleeding, are structural abnormalities rather than functional hormonal issues; thus, they do not address the fundamental