Everything You Need to Know About Menstrual Cycles and Ovulation
Menstrual Cycles: The Basics
Ovulation is a key part of your cycle, but it's essential to understand what a menstrual cycle involves. It starts on the first day of menstrual bleeding and ends just before the next period begins. The duration of cycles typically ranges from 24 to 38 days, with only 10 to 15% of women having a 28-day cycle exactly. Around 20% of women experience irregular cycles. The cycle duration can be particularly variable at the beginning of menstruation and before menopause. It's important to understand that an irregular cycle is one with a variance of more than 7 days.
Hormonal Regulation of the Menstrual Cycle
The menstrual cycle is controlled by a complex interaction of several hormones:
- Luteinizing Hormone (LH)
- Follicle-Stimulating Hormone (FSH)
- Estrogens
- Progesterone
These hormones, produced by the pituitary gland and the ovaries, regulate the development of follicles, ovulation, and the preparation of the uterus for potential fertilization.
Phases of the Menstrual Cycle
Follicular Phase
This phase starts with menstrual bleeding. Estrogen and progesterone levels are low, causing the shedding of the endometrium (the uterine lining). FSH stimulates the development of follicles, with one becoming dominant and producing estrogen. This phase typically lasts 13 to 14 days but can be much longer. The follicular phase is responsible for menstrual cycle irregularity since ovulation can occur earlier in some cycles and later in others. In contrast, the luteal phase duration, which we will discuss later, varies little; thus, it is the follicular phase that frequently causes irregular cycles.
Ovulatory Phase
This phase is marked by a surge in LH, triggering the release of the egg (ovulation). It lasts about 16 to 32 hours and ends with the egg being released, ready to be fertilized for about 12 hours. Ovulation generally occurs between 16 and 32 hours after the LH peak. To confirm ovulation reliably, the temperature method (or Symptothermal method) is the most accurate. This part of the cycle is crucial, whether trying to conceive or not, as it influences the luteal phase and premenstrual syndrome experienced during the second half of the cycle.
Luteal Phase
This phase begins after ovulation and lasts about 14 days (up to 17 days). The ruptured follicle becomes the corpus luteum, producing progesterone to thicken the endometrium. If the egg is not fertilized, the corpus luteum degenerates, leading to a drop in hormones and the onset of menstruation.
Menstruation corresponds to the monthly shedding of the endometrium, the inner lining of the uterus, accompanied by bleeding. Menstruation starts at puberty (menarche) and stops at menopause, defined as one year after the last menstrual period. Outside of pregnancy and menopause, menstruation usually occurs monthly. Menstrual bleeding typically lasts between 4 and 8 days, with blood loss ranging from 6 to 70 ml per cycle. A sanitary pad or tampon can hold up to 30 ml of blood. Unlike blood from wounds, menstrual blood does not clot, except in cases of heavy bleeding.
Ovulation Symptoms
Ovulation is the process by which a mature egg is released from one of the ovaries. Once released, the egg travels down the fallopian tube, where it can be fertilized by sperm if they are present. If the egg is not fertilized, it disintegrates and is shed from the body during menstruation.
Ovulation Pain
Some women experience pain in their lower abdomen mid-cycle, which can vary in intensity. This pain occurs on the side of the ovary that released the egg and can last from a few hours to a whole day. It is caused by the release of luteinizing hormone (LH), which triggers the release of the egg from the follicle and causes muscle contractions in and around the ovary.
Ovulation pain is usually less intense than menstrual pain but can cause:
- Twinges: In the lower abdomen, often on one side.
- Cramps: Sometimes intense.
- Bloating: Symptomatic of ovulation.
These pains usually last for a day or two. If the pain persists or occurs at another time in the cycle, consult your gynecologist to rule out any pathological causes (such as polycystic ovary syndrome, endometriosis, ovarian torsion, etc.).
Ovulation and Spotting
Ovulation spotting is a light blood loss that occurs when an egg is released from one of your ovaries, typically around the middle of your cycle, 11 to 16 days before your next period. This bleeding usually lasts 1 to 2 days.
Ovulation bleeding occurs due to a sudden hormonal change: the drop in estrogen after its pre-ovulatory peak, replaced by a rapid rise in progesterone. This variation can cause a slight shedding of the uterine lining, resulting in light bleeding. Another cause could be the rupture of blood vessels during the release of the egg.
Differentiating Ovulation Spotting from Other Bleeding
- Ovulation Bleeding vs. Menstruation: Ovulation spotting is lighter, clearer, shorter, and occurs about 14 days before your period.
- Ovulation Bleeding vs. Implantation Bleeding: Implantation bleeding, occurring 6 to 12 days after conception, is an early sign of pregnancy. It happens later in the cycle compared to ovulation spotting.
Ovulation and Cervical Mucus
Cervical mucus is produced by the cervix under the influence of menstrual cycle hormones. Often confused with vaginal discharge, cervical mucus plays a crucial role in female fertility.
Role of Cervical Mucus
Cervical mucus has three main functions:
- Filters and selects the healthiest sperm.
- Protects sperm from vaginal acidity.
- Helps sperm reach the egg.
Cervical Mucus Changes Throughout the Cycle
Cervical mucus changes in consistency, color, and amount throughout the menstrual cycle:
- After Menstruation: Hardly visible or sticky, sometimes dry.
- Follicular Phase: Increasingly creamy and milky.
- Ovulation: Clear, slippery, and stretchy, resembling raw egg white.
- After Ovulation: Becomes thick and sticky again.
To observe your cervical mucus:
- Collect it with toilet paper or directly from the cervix.
- Assess its consistency and stretchiness.
- Note your observations in a journal or a dedicated app.
dry or absent / creamy / wet but not stretchy / egg white or watery
Ovulation Without Cervical MucusCervical mucus is essential for the survival and transportation of sperm. Without it, fertilization is not possible, even if ovulation and unprotected intercourse occur at the right time.
Poor quality cervical mucus can reduce the chances of conception, potentially leading to infertility. The pH of cervical mucus, ideally between 7 and 8.5, is crucial for protecting sperm. Tests can evaluate its quality, and if issues are found, methods like artificial insemination or IVF can be considered.
Factors Affecting Cervical Mucus
The quality and quantity of cervical mucus can be influenced by various factors such as:
- Age
- Hormonal disorders
- Diet and hydration
- Stress and sleep
- Medications and supplements
- Hygiene products and lubricants
- Infections and illnesses
Increasing and Improving Cervical Mucus Naturally
- Increase water intake: Staying hydrated is crucial.
- Diet: Maintain an optimal pH by consuming fruits and vegetables, healthy fats like omega-3s, and vitamins B, C, A, and D. Limit foods that increase body acidity, such as sugar and dairy.
- Evening Primrose Oil: Helps increase cervical mucus quantity.
- Vitamin E: Can boost cervical mucus production.
- Omega-3s: Promote vaginal secretions.
- Probiotics: Improve the quality of cervical mucus.
Other Symptoms of Ovulation
- Fatigue: Supplements like Luminaissance can help.
- Headaches: Often due to hormonal fluctuations; vitamin E supplementation may help.
- Abdominal pain: Feeling bloated, colic, or cramps.
- Bloating and gas: Avoid foods that produce gas, like legumes.
- Lower back pain
- Increased libido
- Heightened sense of smell
- Vaginal sensitivity and swelling
- Diarrhea
- Slight increase in body temperature: Occurs just after ovulation. Tracking basal body temperature over several months can help determine the ovulation date, known as symptothermy.
- Breast tenderness: Caused by increased progesterone production, preparing the body for a potential pregnancy.
Signs of Successful Fertilization
The primary sign of successful fertilization, when the ovum has been fertilized and implantation has begun, is a missed period. It may be accompanied by early pregnancy symptoms such as:
- Nausea, dizziness
- Food cravings
- Aversion to smells
- Swollen and sensitive breasts
- Fatigue
- Feeling warm
- Abdominal pain, digestive issues
- Uterine cramps
- Acne
- Skin pigmentation changes
- Weight gain
A pregnancy test, followed by a visit to a gynecologist for an ultrasound, will confirm the pregnancy.
Ovulation Disorders
An ovulation disorder is a dysfunction in the ovulation process in women, manifesting as either anovulation or dysovulation.
Types of Ovulation Disorders
- Anovulation: Total absence of ovulation, which can be temporary or, rarely, permanent.
- Dysovulation: Ovulation occurs but is of poor quality, potentially preventing the production of a viable ovum.
Signs of Poor Quality Ovulation Suspected in cases of missed periods (amenorrhea) or irregular periods (dysmenorrhea). Women with irregular periods may ovulate unpredictably or not at all.
Causes of Ovulation Disorders
- Hyperprolactinemia (high prolactin levels)
- Nervous system disorders controlling the ovarian cycle, such as psychological shock
- Polycystic ovary syndrome (PCOS)
- Ovarian insufficiency (aging ovaries)
- Hormonal secretion anomalies
- Ovulation disorders post-miscarriage: A miscarriage doesn’t directly cause ovulation disorders. However, if the ovum was of poor quality, it may indicate underlying dysovulation. After a miscarriage or voluntary termination of pregnancy (IVG), cycles may be slightly prolonged, with often delayed ovulation.
Diagnosis of Ovulation Disorders Diagnosis is based on:
- Clinical interview and examination
- Hormonal assays
- Ovarian ultrasound to observe follicle number and size
Treatment of Ovulation Disorders Nutritional deficiencies can negatively affect ovulation. It’s crucial to maintain good health and consider plant-based supplements that boost ovulation, such as Isis Phase 1. The treatment depends on the cause, with natural solutions to stimulate fertility or medication available for more serious issues.
- Ovulation Inductors: Similar to assisted reproduction treatments (ART).
- Medications to regulate prolactin: For issues related to high prolactin levels.
- Weight loss: If the disorders are due to obesity.
- Ovarian insufficiency: No effective treatment currently exists.
A disrupted or absent ovulation means an ovum is rarely, if ever, released, preventing fertilization and conception.
To increase the chances of pregnancy, it’s essential to know your cycle well and note any anomalies for discussion with your doctor. It’s also important to understand that ovulation disorders can be temporary, with solutions available to naturally or medically stimulate fertility.
Can You Ovulate During Your Period?
Ovulation signs are often masked by menstrual symptoms like bloating and blood-mixed mucus. Ovulation can occur during periods if they are long or the cycle is short.
Fertilization During Periods
Very short cycles or long periods may allow fertilization during periods. With a short cycle, ovulating on the 7th day is possible, and since sperm live for 5 days, only the first two days of the cycle are safe from fertilization.
Ovulation on Birth Control
Contraceptive pills, especially continuous progestin pills, don’t always prevent ovulation. They mainly act by altering cervical mucus and the endometrium. Ovulation may occur, but conception is prevented by mucus thickening and endometrial changes. If a pill is missed, there’s a risk of fertilization if ovulation occurs.
