-REGULAR MENSTRUAL CYCLES
-CHANGE IN BBT
-CHANGES IN CERVICAL MUCUS SECRETION
-CHANGES IN THE POSITION OF THE CERVIX
-MID CYCLE PAIN
These are symptoms and signs of ovulation that are commonly experienced by women who ovulate regularly in each menstrual cycle. These signs starting from the most universal to the least common are:
REGULAR MENSTRUAL CYCLES
The only universal sign of regular ovulation is the presence of a regular menstrual cycle. Because it is the only consistent sign of regular ovulation, regular menstrual cycles are hence referred to as ovulatory cycles. They can also be used reliably to calculate one’s fertile period. On the contrary, irregular menstrual cycles are referred to as anovulatory cycles as they are more often associated with the absence of ovulation and can not be used to calculate one’s fertile period. For more information on this, see UNDERSTANDING YOUR FERTILE AND YOUR SAFE PERIOD and see NORMAL AND ABNORMAL MENSTRUAL CYCLES to know more on how to confirm if you have a regular menstrual cycle.
CHANGE IN BASAL BODY TEMPERATURE (BBT)
The BBT is the lowest body temperature taken at rest. It is taken usually while sleeping or immediately after waking up before getting out of bed. This is because normal daily activities generate heat and increase the body’s temperature. The BBT is constant throughout your cycle but jumps up by about 0.5 to 1.0 degree Fahrenheit (F) a day or two after ovulation. This is due to the effect of the progesterone hormone released by the corpus luteum, remaining so till the beginning of the next menses. To learn more about this, see MENSTRUAL CYCLE, OVULATION AND MENSTRUATION; EXPLANATION OF BASIC PHYSIOLOGY. By plotting the BBT using a digital thermometer and recording the values against your menstrual calendar starting from the beginning of your menstrual cycle till the beginning of the next cycle for at least three consecutive menstrual cycles, you will be able to determine accurtely the exact day of your cycle that you normally ovulate. Your ovulation day is about a day or two before the sustained increase in the BBT. Remember, it is important to take your temperature each morning at the same time, as soon as you wake up, preferably with the help of an alarm, right before you even sit out of your bed.
While tracking your BBT is one of the best ways to detect if and when you ovulate, this method involves a lot of diligence and the result can only be extrapolated after confirming the presence of a change in your BBT in at least one menstrual cycle and then use it subsequently to plan your fertile period in subsequent menstrual cycles. In women with irregular cycles and anovulatory cycles, a change in BBT is usually absent and even when it is present, it is unpredictable and haphazard, never following a specific pattern, compared to women with regular menstrual cycles where a change in BBT usually occur on a particular day of the menstrual cycle (e.g. every day 16 or day 17) with a variation of one or two days prior to or after that particular day of the menstrual cycle, in subsequent menstrual cycles.
CHANGES IN CERVICAL MUCUS SECRETION
In the first half of the menstrual cycle, also known as the follicular or proliferative phase of the menstrual cycle, the oestrogen hormone produced by the ovarian follicles increases causing changes in the texture of the cervical mucus. As ovulation draws nearer, the water and salt content of the mucus secreted by the cervix increases significantly, peaking just before ovulation thus providing the most conducive environment for sperms to swim up the cervix after sex. The vaginal acidic environment is generally hostile to the sperms but towards ovulation, the cervical secretion provides an alkaline medium in which the sperms can thrive and swim upward to the released egg favouring reproduction. Subsequently after ovulation, the cervical secretion under the influence of the progesterone hormone becomes scanty, thick and quickly dries up, protecting the ensuing pregnancy, if any from the ascent of any infection and sperms through the cervix.
In other to appreciate these changes, use your finger to touch the cervix daily, soon after your menses and you will feel that the consistency of your cervical secretion changes from dry, to sticky, to creamy, turning egg white few days prior to ovulation and then to a very watery and stretchy discharge at the peak of fertility very close to ovulation. Immediately after ovulation, the cervical secretion however, rapidly becomes sticky and dries up until the beginning of another cycle. These changes in cervical mucus secretions are not always present in all women despite ovulating regularly. This may be due to local factors affecting the cervix which may alter the secretion of the cervical mucus. Also, even though these changes in cervical mucus secretion are highly suggestive of an imminent ovulation, it doesn’t always culminate in ovulation and therefore cannot be used as a confirmation of ovulation. An example of such is seen in women with PCOS, an anovulatory disorder, in which despite the initial changes seen in cervical secretion, they fail to ovulate. Hence, the use of cervical mucus tracking should only be used in the context of a regular menstrual cycle where it is more closely associated with regular ovulation.
CHANGES IN THE POSITION OF THE CERVIX
The cervix also responds to changes in the menstrual cycle. As ovulation gets nearer, changes occur in the position and texture of the cervix with which ovulation may be predicted. At the beginning of your menstrual cycle and after ovulation, the cervix is closed, dry, feels firm like the tip of your nose, and lies aa bit low within your vagina. At the most fertile period of your menstrual cycle, around the period of ovulation, the cervix becomes softer, feeling just like your lips when touched, at the same time moving higher up within your vagina, opening up and becoming very wet. This is famously dubbed as 'SHOW' (soft, high, open and wet). To appreciate these changes, clean your hands and feel your cervix everyday at the same time of the day starting from the end of your menses to the beginning of the next. With practice, you will become used to the changes and be able to predict your most fertile period. However, local factors and diseases may prevent the natural changes that occur in the cervix and may make it unreliable in predicting ovulation in rare instances.
MID CYCLE PAIN
Mittleschmerz refers to the German word for mid cycle pain. It is a cyclical lower abdominal pain felt around the middle of the menstrual cycle barely lasting a day often perceived on alternate sides in consecutive menstrual cycles. This may be due to the inflammatory changes associated with ovulation in the ovary or to the irritation of the surrounding structures within the pelvis caused by the release of fluid along with the egg from a ruptured or burst follicle during ovulation. Because the process of ovulation alternates between the two ovaries in consecutive menstrual cycles, the mid cycle pain may be felt in alternate sides in consecutive menstrual cycles in some women. However, it may also be felt also as a vague lower abdominal pain without alternating any sides in some others. The severity of the pain is highly variable, subjective and is highly depended on an individuals’ pain threshold. But in most cases, mid cycle pain is highly tolerable. Rarely, it may be debilitating, necessitating an urgent review by a Gynecologist to exclude other more sinister causes of pain. While it may be a reliable sign of ovulation, it is only felt in a fraction of women and even in the same individual it may not be felt regularly despite regular ovulation. For more information or an online consultation, please CHAT WITH OUR CONSULTANTS.
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