Normal ovulation occurs every menstrual cycle (almost every month) and is associated with some subtle signs and symptoms in some women. They can also be used to track ovulation, which is especially helpful for women trying to conceive a pregnancy. After ovulation, the egg or ovum can survive in the female reproductive tract for up to 24 hours; This is called the “fertile window”. Whereas after intercourse the sperm can remain in the female tract for a few days. Therefore, having unprotected sex on the day of ovulation or the week before it can potentially result in the conception of pregnancy.
Signs and Symptoms of Ovulation
While ovulation is a change that occurs in the ovaries, subtle signs and symptoms of activity can be seen throughout the body. Some of the physical signs and symptoms of ovulation are:
- Vaginal discharge or fertile cervical mucus: The discharge is usually more viscous and sticky leading up to ovulation and thinning thereafter.
- Ovulation pain, mid-cycle pain: In some women, ovulation can cause pain in the lower abdomen and one side of the pelvis. It usually arises suddenly and subsides within hours, although it can sometimes last for two or three days. If severe, the pain can be confused with appendicitis and requires imaging studies such as ultrasound.
- Breast tenderness: Mild analgesics and supportive bras can help ease breast pain.
- Fall and rise in core body temperature: The body temperature varies throughout the day. Basal body temperature, measured immediately after waking up in the morning, is a good way to compare changes for days. The basal body temperature usually decreases before ovulation and remains high for two weeks thereafter.
- light bleeding or spotting
- It increases the tendency of sex.
How many ways can I track ovulation?
Whether to conceive or prevent pregnancy, ovulation tracking can have helpful effects. There are homemade options available to track ovulation, with varying degrees of accuracy. Fertility tracking methods that employ the physiological changes expected of ovulation are called fertility awareness-based methods. Some examples commonly used by women include, but are not limited to:
- Calendar Method: This method is not the most accurate, but it is the easiest to use. The average duration of the luteal phase, which is the period between ovulation and the onset of menstruation, is considered to be 14 days (for a menstrual cycle that lasts between 21 and 35 days). By plotting the length of the menstrual cycle at 6 months, the expected cycle length can be averaged and the date of ovulation can be calculated by subtracting the length of the luteal phase (usually 14 days).
- Basal body temperature (BBT) method: Although this is a difficult task, measuring body temperature with a thermometer and recording it can help find out when ovulation has occurred. Before ovulation, a woman’s basal body temperature usually averages between 97°F (36.1°C) and 97.5°F (36.4°C). The body temperature drops slightly before the egg is released from the ovary. Then, the body temperature rises from 97.6 °F (36.4 °C) to 98.6 °F (37 °C) 24 hours after the egg is released. A sustained increase in basal body temperature (BBT) over three days is taken as a predictor that ovulation has occurred. To use the basal body temperature (BBT) method for fertility monitoring, you need to track and record your morning body temperature for at least three months.
- Cervical mucus method: Cervical mucus is thick and sticky in the first phase of the menstrual cycle when the uterus is preparing to host pregnancy, to prevent sperm from entering outside the reproductive tract. As ovulation approaches, the mucus consistency becomes thinner and more watery to allow sperm to enter. By recording the continuum of vaginal discharge, daily ovulation can be predicted with reasonable accuracy.
- Cervical position method: The position, firmness, and openness of the uterine mucus is called position. The position of the uterine mucus changes during the menstrual cycle. At the beginning of the cycle, the uterine mucus is strong, closes, and after ovulation settles down in the vagina, moves up, opens slightly, and becomes soft to the touch. The method of correctly checking the condition of the uterine mucus can be learned from the gynecologist.
- Symptothermal method: The symptomatic method is considered the most accurate of all fertility awareness-based methods, as it combines basal body temperature (BBT), cervical mucus, and calendar methods to predict the fertility window.
- Ovulation Prediction Kits: Similar to home urine pregnancy test kits, these kits are strips that detect the presence of the luteinizing hormone (LH) in the urine. An increased level of LH (luteinizing hormone) usually indicates that ovulation will occur within 12 to 36 hours. These tests should be used for at least 10 consecutive days to increase the accuracy of the results.
- Saliva ferning test kits: Another home test kit to monitor ovulation is the saliva fern test kit, it comes with a viewer used to view the accumulated saliva. Characteristic fern crystals, which resemble those of a fern plant, are seen if ovulation has occurred.
Broadly speaking, ovulation disorders can be described as two types: Oligoovulation (irregular ovulation) or anovulation (lack of ovulation). The causes of ovulation dysfunction can be related to the hypothalamus, pituitary gland, ovaries, or any other hormonal imbalance. A thorough screening of ovulation disorders is important for treating infertility and improving a woman’s overall health. Some common ovulation disorders are described below:
- Hypothalamic Dysfunction: The hypothalamus is the most important hormone-releasing center in the body. Regulates the production of all other hormones including the pituitary gland. If the hypothalamus is inactive, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) will not be secreted. Without these two hormones, follicles in the ovary would not develop, leading to anovulation.
- Hyperprolactinemia: Prolactin one of the main hormone secreted by the pituitary gland. Sometimes, due to pituitary dysfunction or a tumor, the level of prolactin in the blood can be very high. This causes reduced estrogen in the ovaries and inhibition of ovulation leads to infertility.
- Polycystic ovarian syndrome: the most common endocrine disorder in young women, is also the most common cause of ovulation dysfunction. Polycystic ovary syndrome (PCOS) is related to obesity, insulin resistance, metabolic syndrome, and genetic factors. Patients have irregular or absent menstruation and ovulation, among other symptoms of hyperandrogenism (increased male sex hormones) such as acne and hirsutism. On ultrasound, small fluid-filled cysts can be found on the ovaries. Combined oral contraceptive pills are the most commonly used therapy to regulate the menstrual cycle.
- Primary ovarian failure: Some women may experience premature or primary ovarian failure when the ovaries stop working and produce eggs before the age of 40. This can cause irregular ovulation, with occasional ovulatory cycles. This unit is not the same as premature menopause, in which the menstrual cycle stops permanently for 12 months or more. However, symptoms of primary ovarian failure may be indistinguishable from premenopausal symptoms.