How do I know I’m ovulating? And if I’m not ovulating… why not? These are questions our fertility team are asked many times. Female fertility is a complex and beautiful mechanism, often shrouded in mystery and myth. In this blog post, our Norwich natural fertility expert, homeopath and Foresight Practitioner Kathy Payne explains what is ovulation and answers, how do I know I’m ovulating?
What is Ovulation?
Let’s start with a human biology lesson. In women, the key reproductive glands are the ovaries. There are two, positioned on either side of the upper part of the uterus, held in place by fibrous tissue. They produce ova (eggs) and secrete hormones oestrogen and progesterone. Each ovary contains immature ova in protective cavities called follicles. In menstrual cycles (from puberty to menopause) a follicle ripens and releases an ovum into the fallopian tube. This process is called ovulation.
Myths about Ovulation
First, just to bust a couple of myths about ovulation and the ovaries, which will help you to answer the question, How do I know I’m ovulating. Women do not ovulate from alternate ovaries in turn (nature is not symmetrical in that sense). Neither do they all ovulate on Day 14 of their cycle (see my previous blog post, When Can I Get Pregnant, for more information on this).
Now it’s time to get more technical! Hormones influence ovulation. At the beginning of each cycle the pituitary gland (hormone secreting gland in the brain) releases Follicle Stimulating Hormone (FSH) into the bloodstream. This triggers development of a few follicles containing the immature ova in the ovaries.
As the follicles ripen one (sometimes two) becomes dominant. The dominant follicle secretes more and more oestrogen which means:-
- The glands of the cervix produce mucus that is sperm-friendly, sometimes called “fertile mucus”
- The lining of the uterus begins to thicken in preparation for a fertilised egg
- Less FSH is produced to stop the development of any more eggs
Eventually the oestrogen levels peak, which triggers the pituitary gland to produce Luteinising Hormone (LH). LH causes the follicle to rupture releasing the egg into the fallopian tube… and hey presto, this is what we term ovulation. The empty follicle then forms the corpus luteum, which begins to secrete progesterone. The pituitary gland stops producing LH or FSH so ovulation doesn’t occur again in that cycle and cervical mucus becomes thick and sticky to stop sperm entering the uterus. As you can see, there is a delicate interplay of hormones which trigger and support ovulation, which is why our fertility team offer saliva hormone testing to check on your hormone levels, across the whole of your cycle, rather than a snapshot on just one day. This tends to give a much more accurate picture of how your hormones are performing.
If the egg is fertilized by a sperm, it travels down the fallopian tube and implants into the endometrial lining. The corpus luteum continues to secrete progesterone in the early stages of pregnancy. If it’s unfertilized, the egg travels down the fallopian tube and is shed via the uterus. The corpus luteum starts to break down too and stops secreting progesterone: the falling levels mean the endometrial lining disintegrates and is also shed. This is a “period” or “menstruation”.
How Do I Know If I’m Ovulating?
There are natural signs that indicate ovulation. Notice I said “indicate” here. They include: –
- Change in cervical mucus. It changes to a clear colour and egg white consistency and is sperm-friendly
- Change in cervical position and cervical firmness. The cervix opens and softens
- Brief twinge of pain or dull ache that is felt on one side of the abdomen
- Light spotting
- Increase in sex drive
- Basal body temperature chart that shows an appropriate increase in the second half of the cycle
- Breast tenderness
- Abdominal bloating
- Heightened senses of vision, smell or taste
Some women may only notice one or two of these and they are not “proof” of ovulation, merely indicators.
Ovulation Predictors: How do I know I’m ovulating?
Of course there are available means of monitoring ovulation. Most people have heard of the ovulation predictor kits which test urine and many women use these when they are planning a pregnancy so they can time intercourse to maximize chances of conception.
The tests are used to detect Luteinising Hormone (LH). LH rises right before ovulation occurs, so the kits are supposed to detect whether you’re going to ovulate. Again they are not a guarantee that ovulation will occur. Women may have a high LH level if they have certain conditions such as polycystic ovaries, premature ovarian failure (POF), or for women over age 40 who are experiencing perimenopause. Any of these conditions could result in a false positive result on an ovulation predictor test.
There are other kits which test saliva. These are designed to detect the increased oestrogen levels that occur before you ovulate. As your oestrogen levels rise due to the developing follicles in your ovaries, so too does the salt content of your saliva.
Ovulation can also be tracked using ultrasound, but this is not routinely available unless couples are undergoing investigations for infertility.
Why Am I Not Ovulating?
There can be many reasons why a women does not ovulate in a particular cycle or may nor be ovulating at all, including:-
- Taking hormonal contraception i.e. Oral Contraceptive Pill/patches/implants. Some types of artificial contraception are designed to stop ovulation by altering hormonal balance.
- Stress, illness or disruption of normal routines
- Long-term and chronic illnesses e.g. uncontrolled diabetes, cancers and kidney failure, may affect ovulation
- Pregnancy or breastfeeding
- Weight issues – being very underweight or overweight can affect hormone levels, which affect ovulation. Women with anorexia nervosa often do not ovulate.
- Excessive exercise e.g. regular long-distance running, can affect your hormone balance which – in turn – can affect ovulation
- Early/premature menopause
- Polycystic ovary syndrome (PCOS). This can also cause excessive hair growth, acne, and period problems and is associated with being overweight
- Hormone imbalances e.g. too little or too much thyroxine hormone (produced by the thyroid gland in the neck) can affect fertility
- Side-effects from some medicines e.g. chemotherapy medicines. Some street drugs such as cannabis and cocaine can also affect ovulation
- Ovarian issues including genetic or inherited problems.
If you are a woman between puberty and menopause and suspect you are not ovulating on an ongoing basis, speak with your GP or medical care-giver. They can help find a diagnosis before you decide which therapies – conventional and/ or natural – to pursue, if needed.
If you have any more questions about ovulation or other aspects of fertility or you are interested in the support I offer to women and couples please get in touch. You can also check out the range of pre-conception care packages we offer as a team at The Orange Grove Clinic combining nutrition, homeopathy, acupuncture, Foresight programme, lifestyle guidance and more.