The female reproductive system is so amazing, but because of its continual fluctuations, it can also be a little difficult to follow. I want to help explain what is happening in the different stages of your reproductive cycle and how to track ovulation. This will be important if you are trying to conceive.
Understanding The Phases Of Your Cycle
The first day of your period. This begins with the shedding of the thickened uterine lining (or endometrium). Menstrual fluid is made up of blood, endometrial cells, and mucus. Some women will spot a day or two before, but Day 1 will start on the day in which your menstrual blood begins to flow. If you start to bleed in the evening, the next day will be considered Day 1. If you are tracking your cycle this is the day to start. Ideally, menstruation should last 4 days, but it may last anywhere between 3 and 7.
The follicular stage begins at the start of your period, and will last until ovulation. Prompted by the hypothalamus, the pituitary gland releases follicle stimulating hormone (FSH). This hormone stimulates the ovary to produce around five to 20 follicles (tiny nodules or cysts), which bead on the surface.
Each follicle houses an immature egg. Usually, only one follicle will mature into an egg, while the others die. The growth of the follicles stimulates the lining of the uterus to thicken in preparation for possible pregnancy.
Ovulation happens about mid-cycle, or about 2 weeks before your period. This is when a mature egg is released from the surface of the ovary. During the follicular phase, the developing follicle causes a rise in the level of estrogen. The hypothalamus in the brain recognizes these rising levels and releases a chemical called gonadotrophin-releasing hormone (GnRH). This hormone prompts the pituitary gland to produce raised levels of luteinising hormone (LH) and FSH.
Within two days, ovulation is triggered by the high levels of LH. The egg is funneled into the fallopian tube and towards the uterus by waves of small, hair-like projections. The life span of the typical egg is only around 24 hours. Unless it meets a sperm during this time, it will die.
After the egg has burst from it's follicle during ovulation, that ruptured follicle stays on the surface of the ovary. For the next two weeks or so, the follicle transforms into a structure known as the corpus luteum. This structure starts releasing progesterone, along with small amounts of estrogen. This combination of hormones maintains the thickened lining of the uterus, waiting for a fertilized egg to stick (implant).
If a fertilized egg implants in the lining of the uterus, it produces the hormones that are necessary to maintain the corpus luteum. This includes human chorionic gonadotrophin (HCG), the hormone that is detected in a urine test for pregnancy. The corpus luteum keeps producing the raised levels of progesterone that are needed to maintain the thickened lining of the uterus.
If pregnancy does not occur, the corpus luteum withers and dies, usually around day 22 in a 28-day cycle. The drop in progesterone levels causes the lining of the uterus to fall away (menstruation.) The cycle then repeats.
Ways to Track Ovulation
There are a few different ways to determine the time at which you ovulate. The best time to conceive is within the 3 days leading up to and including ovulation day. Most women will ovulate around day 14 if they have a 28 day cycle. Keeping notes over the course of a few cycles is helpful to determine your most fertile time of the month. There are a bunch of free phone apps that you can use to help record your findings.
Use An Ovulation Predictor Kit
Testing your hormone levels with an ovulation predictor kit (OPK) is one method. There are two kinds of kits that you can buy: The most common type tests your urine, and the other tests your saliva. Both show a positive result in the days before you ovulate, giving you time to plan ahead for baby-making time.
The pee-on-a-stick test indicates when your level of luteinizing hormone (LH) has gone up, which usually means one of your ovaries will soon release an egg. With the saliva test, you use a microscope to spot a pattern in your dried saliva that indicates the rise in estrogen which happens in the days before ovulation. Most of the women I've treated have used the pee-on-a-stick test. The kits are available at drugstores without a prescription.
Track your Basal Body Temperature (BBT)
Seeing subtle changes in your basal body temperature will show you patterns that are helpful clues as to when you are ovulating. Using this method requires you to buy a basal body thermometer which can be bought online or in most pharmacies. This is a special thermometer which measures temperatures on a finer scale than a regular thermometer. By taking your temperature first thing in the morning each day, before getting out of bed, you'll be able to track a dip and an increase in your temps which will give you information about when you are ovulating. The slight dip in temperature followed by an increase shows that ovulation has happened and you have entered the luteal phase of your cycle.
I have most of my fertility patients use this technique because different patterns in temperature can tell me how and when to make changes in your treatment plan throughout your cycle. Looking at a BBT chart can give us lots of good information if you are having difficulty getting pregnant.
Check Your Cervical Mucus
Your cervical mucus (vaginal discharge) will change throughout your cycle, and around the time of ovulation it will change into a more hospitable fluid that helps the sperm on its way to an egg. Most women will find more abundance in vaginal fluid during ovulation which will be clear, slippery, and stretchy in texture, much like raw egg whites.
Cervical Movement and Changes
Another way to check for ovulation is by feeling the position and surface of your cervix. Using clean hands, you can feel where your cervix is positioned and textural changes. When you are not ovulating, your cervix will be lower and a little more hard on your finger tip. When you are getting ready to ovulate, the cervix will be higher, softer, and more slippery. Your cervix can move about during the day, so feeling these differences are best done around the same time each day, preferably in the morning.
Once You've Determined When You're Ovulating
Once you've tracked a few cycles, you can probably see the time that you ovulate each month, if you are ovulating regularly. Although the 2 days before and the day of ovulation are your most fertile, you can still become pregnant within a 6 day window which ends the day after ovulation.
If your findings suggest that you aren't ovulating, or not ovulating regularly, you should consider using Chinese Medicine. We can often pinpoint the reason why your cycle isn't regular, from a Chinese Medical perspective and then help regulate your cycle with acupuncture, nutritional advice, and herbal medicine.
If you live in the Austin area and would like to see a specialist of Acupuncture & Fertility, contact Sarah Johnson L. Ac. to set up an appointment.