Ovulation is an important part in conceiving and also is an indicator of a woman’s overall health, but how do you know if your ovulating? There are lots of different methods out there for gauging ovulation like ovulation predictor kits (often referred to as opks), cervical mucus, basal body temperature, ultrasound, and progesterone testing.
Well outside of conception why is ovulation even important? It’s important to because this is how our body gets progesterone. Without ovulating your body doesn’t produce progesterone because when you ovulate the egg leaves behind what is called the corpus luteum this is what produces the progesterone. Progesterone plays many important roles in a women’s body including building bone and metabolic reserve to carry us through all the decades after menopause, protecting out bodies from cancer, and protecting our brain health. Dr. Lara Briden states that estrogen and progesterone are just as important to women as testosterone is for men. Which seems pretty obvious as they are part of our natural make up but with the way hormonal birth control is handed out perhaps it’s not so obvious to everyone.
Now that we have established why ovulation is so important let’s take a look at how we can tell if we ovulate. The most commonly recommended test for ovulation is actually the least reliable. If you talk to any Dr. about wanting to conceive one of their first recommendations is to use an ovulation predictor kit. OPK’s are truly terrible in my opinion. This is because they work by detecting an LH surge. LH or luteinizing hormone is what your body produces to stimulate your ovary to ovulate. The reason this is not the best way to tell if you have ovulated is that it is actually telling you that your body is trying to ovulate. There are many reasons (see below) that you may produce LH but not actually ovulate so OPK’s are only good for telling you that you may be ovulating but then again you may not actually end up ovulating.
The second method for determining ovulation is cervical mucus (typically a clear stretchy mucus you can find on your toilet paper after wiping) this is only mildly better than OPK’s once again cervical mucus tells you that your body is getting ready to ovulate. Cervical mucus is a mucus created by your cervix in response to the hormone estrogen in your body. As your body gears up for ovulation estrogen increases and so does your cervical mucus. After you ovulate your estrogen decreases dramatically causing the cervical mucus to dry up. Once again though this doesn’t necessarily mean that you ovulated. You may have attempted to ovulate but the ovary may not have actually released an egg. Many women with PCOS will see their body gear up for ovulation several times with cervical mucus coming and going many times throughout their cycle. Also, women with estrogen dominance may see cervical mucus throughout their cycle even after ovulation making it very difficult to confirm if they ovulated or not.
The third method for determining ovulation is through basal body temperature. This is the best at home method and is generally fool proof and what I recommend all my clients keep track of. This is because due to the natural release of progesterone after your ovary releases an egg your body temperature upon waking actually rises and sustains a higher temperature until your period begins. Through the tracking of basal body temperature (BBT) throughout the cycle it is easy to see if your body has ovulated. The downfall to BBT is that it only tells your after you have ovulated so you can not plan sex for conception around it this why it’s important to combine both the observation of cervical mucus and BBT charting for conception: cervical mucus tells you when your body is gearing up for ovulation and BBT confirms that you have truly ovulated. If you want to learn more about charting your cycle, I recommend the podcast fertility Friday, or the books Taking Charge of Your Fertility and The Fifth Vital Sign. I also highly recommend apps like Kindara and Ovuview for helping you chart your cycles.
The last two methods for confirming ovulation are what you might find an ob/gyn. or reproductive endocrinologist use. They may do what is called a monitored cycle where they routinely check by ultrasound to see if an egg was released from your ovary or they may have you test your progesterone levels after you think you have ovulated to confirm that progesterone is being released into your body. These options are obviously going to give you definitive results but can be very expensive.
Perhaps you have started charting or you’ve had a blood test and you have discovered that you are not ovulating or perhaps you know that you aren’t because you haven’t had your period in months but you are definitely not pregnant. Let’s talk about what could possibly be preventing you from ovulating. The first and most common reason women are being diagnosed with today is PCOS. This condition though has four main root causes 1-insulin resistance, 2-inflammation, 3-stress, and/or 4- post pill syndrome. Insulin resistance and stress both affect the ovaries similarly because when the body is dealing with these it sees it as a life-threatening emergency and shuts down ovulation. Inflammation largely dues to gut health issues typically causes there to be issues with hormonal balance due to used up hormones re-entering the blood stream thus messing with your body’s ability to ovulate. Finally post pill PCOS is caused by an increase of androgens (adrenal hormones) that often occurs when you cease taking hormonal birth control, once again these androgens throw off hormonal balance making it more difficult for your body to ovulate. Some other common causes of anovulation are stress, over exercising, and under-eating.
Finally, let’s talk about how to make sure that you are supporting your body in the right ways to ensure ovulation. First, make sure you are eating a nutrient dense whole foods diet that includes plenty (don’t count calories listen to your body and eat until you are full) of well sourced protein, healthy fats, and moderate amounts of complex carbs. Second, make sure that you are dealing with your stress. Remove what stress you can and then participate in good self-care practices like easy yoga, walking, meditation, baths, reading, simple activities that help bring your body back into a slower rhythm. Finally, do include some exercise slow jogging, resistance training, walking, swimming are all great for helping to keep your body and cycle healthy!