Background: The inability to conceive is emotionally distressing and indeed a very painful struggle in which the pain stays with the individual every day. Hormonal disorders are the leading cause of infertility globally. They do not only include the hypothalamic pituitary ovarian axis but also the none-reproductive endocrine glands. Hormonal management helps promote ovum maturation, which triggers ovulation, increasing the likelihood of conception. Case presentation: We report a 36-year-old African lady who presented with an inability to conceive for six years since marriage and it was associated with an irregular menstruation cycle length of twenty-four to thirty-six days. She had anovulatory cycles for seven years, and high Prolactin levels. Her body mass index was 34.4kg/m2. She had visited several hospitals in and outside Tanzania without success in conceiving. At Bugando Medical Centre we managed her case by diet, fertility awareness, and medical management. She conceived after three months of treatment. Conclusion: Anovulatory cycles with abnormal bleeding patterns are a major cause of infertility in reproductive woman. Basic hormonal profiles are essential to confirm where the problem is. Prolactinemia and insulin resistance affects ovulation. Fertility awareness, lifestyle changes, and medical management will bring back happiness to most women with subfertility secondary to hormonal disorders.