WHAT IS OVULATION?
Ovulation is the time of the month when your ovary releases an egg to be fertilized. It usually happens mid-cycle, about 12-16 days before your next period will start. However, the exact day can vary month to month.
Ovulation is a necessary process for fertility to occur, because if your ovaries aren’t releasing an egg to be fertilized then pregnancy can’t be achieved. Ovulation is also just important for overall hormone health, because if you aren’t ovulating (anovulation), then your hormones aren’t balanced.
All of the eggs that you have are found in your ovaries. During the first half of the month one egg is slowly maturing in your ovary. Towards the middle of your cycle your estrogen levels begin to rise, which allows your uterine lining to thicken for pregnancy prep. The estrogen rise signals your body to increase the luteneizing hormone (LH), and the LH surge is what triggers your ovary to release a mature egg, aka ovulation. Ovulation occurs within 24-36 hours after the LH surge, and if the egg isn’t fertilized by sperm within 24 hours of being released from the ovary, pregnancy is not achieved. Your body then sheds the thickened lining of your uterus as it is no longer needed, and this is what we call a period.
OVULATION SIGNS
There are a number of ways to know when your body is ovulating, although the signs can be subtle.
LH test strips
The LH surge is what triggers your ovary to release a mature egg. Ovulation occurs within 24-36 hours after the LH surge. These strips test your urine for the LH hormone and as you get closer to ovulation the LH levels will rise and the strip will show a darkening line. This is one of the easiest ways to get an idea of when you are ovulating and can be very helpful for women trying to conceive.
Consistently using LH strips over a few months will help you gain confidence in tracking ovulation with this method. You can find these strips at the drug store or grocery store.
Basal Body Temperature
Basal body temperature, BBT, is your body temperature when you are at rest. It fluctuates throughout the month depending on your hormone levels. As progesterone rises around ovulation, your BBT will also rise. Then, right before your period starts your progesterone levels drop and your BBT will drop as well, unless you’re pregnant. If you’re pregnant progesterone levels stay high and you won’t notice the drop in BBT.
BBT needs to be taken at the same time every single day in order to get a good idea of what your baseline temperature is. It must be taken right after waking up, before you get out of bed. The rise in temperature around ovulation is very subtle, less than a degree. Because of that you need a thermometer that measures to the 1/10th of a degree at least, so that the subtle change is caught.
After a few months of charting your BBT you will begin to notice the pattern of how your temperature rises and falls, making this technique helpful for pinpointing the time of the month that ovulation will occur.
Change in Cervical Mucous
You may have noticed that your vaginal discharge changes in amount and texture throughout the month. This is in relation to ovulation. As your body approaches midcycle, your cervical mucous will become thinner and more slippery, almost egg-white in texture. This consistency makes it easier for sperm to get through your cervix and reach the egg your body has released during ovulation.
After ovulation, your discharge will become thicker and more dry as it no longer needs to help support sperm in the passage to the egg.
Change in Cervix Position
The location of your cervix will move subtly, in relation to where you are in your cycle. It also feels slightly different to the touch. Your cervix is slightly higher before ovulation and it feels softer and more open at this time. Remember, this is the time of the month when your body wants to get pregnant so it is going to do little things to help this happen.
At times of the month when you aren’t fertile, your cervix will be slightly lower, firmer, and closed.
SUBTLE SIGNS OF OVULATION
Increased sex drive- Estrogen is associated with increased sex drive and remember how we said estrogen increases right before ovulation? Well, that’s nature’s way of increasing your chances of getting pregnant.
Ovulation pain aka Mittelshmerz- some women notice that they feel a sharp pain on one side of their abdomen around ovulation time. This occurs as your ovary releases an egg. It can last for a few hours although not every woman notices this subtle sign.
Light spotting- some women notice light spotting during ovulation
Breast tenderness
Abdominal bloating
REASONS WHY YOU’RE NOT OVULATING
The most common reason women don’t ovulate is because they have PCOS, polycystic ovarian syndrome. Ask your doctor about the signs and symptoms of PCOS to determine if this could be a cause of anovulation for you.
Other reasons for anovulation include thyroid dysfunction. Your endocrine system is all connected so if one area of hormones is out of whack chances are it’s going to be affecting your other hormones as well.
Anovulation may also be due to stress, undereating, overexercising, being overweight, hyperprolactinemia, birth control pills and other hormonal contraceptives, diminished ovarian reserve, and certain medications. Talk to your doctor about determining the cause of an ovulation.
HOW TO SUPPORT OVULATION
The following are some suggestions that can help support balanced hormones and healthy ovulation.
Nutrition and Lifestyle
Avoid Xenoestrogens
Limit alcohol
Limit caffeine
Eat more high fiber foods
Eat more leafy greens
Eat more fermented foods
Herbs and Supplements
NAC
Vitamin C
Melatonin
Myo-Inositol
Vitamin B6
Vitex
If you suspect you aren’t ovulating or you’re struggling with symptoms of hormone imbalance or infertility, talk to your doctor to determine the best course of treatment.
Sources:
Su Hsiu, Yi Yu-Chiao, Wei Ting-Yen, Chang Ting-Chang, Cheng Chao-Min. Detection of ovulation, a review of currently available methods. Bioeng Transl Med. 2017
Steward, KL. Raja, A. Physiology, Ovulation, and Basal Body Temperature. Stat Pearls. 2021.
Sandhu JK, Waqar A, Jain A, Joseph C, Srivastava K, Ochuba O, Alkayyali T, Ruo SW, Poudel S.Oxidative stress in polycystic ovarian syndrome and the effect of antioxidant N-acetyl cysteine on ovulation and pregnancy rate. Cureus. 2021
Tamura H, Jozaki M, Tanabe M, Shirafuta Y, Mihara Y, Shinagawa M, Tamura I, Maekawa R, Sato S, Taketani T, Takasaki A, Reiter RJ, Sugino N. Importance of melatonin in assisted reproductive technology and ovarian aging. Int J Mol Sci. 20202
Monastra G, Unfer V, Harrath AH, Bizzarri M. Combining treatment with myo-inositol and D-chiro-inositol is effective in restoring ovary function and metabolic balance in PCOS patients. Gynecol Endocrinol. 2017
Arentz S, Abbott JA, Smith CA, Bensoussan A. Herbal medicine for the management of polycystic ovarian syndrome (PCOS) and associated oligo/amenorrhea and hyperandrogenism; a review of the laboratory evidence for effects with corroborative clinical findings. BMC Complement Altern Med. 2014
Hutz RJ, Carvan MJ 3rd, Larson JK, Liu Q, Stelzer RV, King-Heiden TC, Baldridge MG, Shahnoor N, Julien K. Familiar and novel repoructive endocrine disruptors: xenoestrogens, dioxins, and nanoparticles. Curr Trends Endocinol. 2014
Medenica S, Nedeljkovic O, Radojevic N, Stojkovic M, Trbojevic B, Pajovic B.
Thyroid discunction and thyroid autoimmunity in euthyroid women in achieving fertility. Eur Rev Med Pharmacol Sci. 2015