Several times a month patients remind me that somewhere in high school health class, a myth is perpetuated about the function of the egg in relation to the menstrual period.
Many of us are taught at an early age that each month we release an egg (this part is true), and if no conception occurs, the egg comes out with the monthly cycle (not true). This misconception leads some of us to wonder what happens to the egg if the tubes are tied, or if we have no period due to an IUD, an endometrial ablation, or a hysterectomy. In reality the egg is a single cell, visible only under a microscope. While we generally release an egg each month, the egg travels into the fallopian tube awaiting fertilization, and if no fertilization occurs the egg simply dissolves. After all it is only one cell. So if the tubes are tied or we have an IUD, the same process still occurs. The egg is produced and simply dissolves since it is not fertilized. If we have a hysterectomy the same process occurs.
The hormones which are produced as a result of egg development and ovulation (egg release) usually cause the lining of the uterus to grow in preparation for pregnancy, and if fertilization does not occur the lining sheds. What we see coming out as menstrual bleeding is a combination of blood and uterine lining, not the egg itself. If we have had a procedure such as an endometrial ablation to get rid of the lining, have an IUD which reduces the formation of lining, or have had a hysterectomy, the hormonal signal from the ovaries will not be successful at causing lining to grow. The egg is still being released, the hormonal signal is still going out, but the uterine lining simply does not grow, so we don’t see bleeding. The egg is still being produced and is dissolving every month without coming out, as it usually does.
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