Which of the following factors is NOT listed as contributing to anovulation?

• A. Too low body weight
• B. Thyroid dysfunction
• C. High stress levels
• D. Moderate exercise

Answer: (D)

Anovulation typically results from disruptions to the hypothalamic-pituitary-ovarian axis, where energy balance, thyroid function, and stress hormones influence GnRH pulses and the downstream release of LH and FSH that drive ovulation.

Very low body weight signals the body to conserve energy, dampening GnRH pulse frequency and amplitude, which lowers LH/FSH and can stop ovulation.

Thyroid dysfunction alters metabolism and regulatory hormones, affecting GnRH and gonadotropin release, leading to irregular or absent ovulation.

High stress levels raise cortisol and CRH, which can suppress GnRH signals and disrupt ovulation.

Moderate exercise, by itself, does not typically disrupt the HPO axis enough to cause anovulation. It’s usually intense or prolonged exercise, especially with inadequate energy intake, that can contribute. So the factor not listed as contributing is moderate exercise.