Cycle Tracking

Whether you’re using the natural family planning method, considering conception soon or trying to conceive now, knowing about your individual menstrual cycle pattern is invaluable! Not only can it aid in knowing when you ovulate but it can also give you clues to reproductive dysfunction! 

The menstrual cycle can be broken up into 3 phases, follicular, ovulation and luteal phase. During these phases we see a dance of different hormones, rising and falling, to communicated with each other and the reproductive tissues. While this process is vital for conceiving and carrying a baby, its impact is much more widespread. Dysfunction throughout the menstrual cycle can effect all areas of the body: GI, Endocrine, Cardiovascular, Neurological, and Psychological. We can see dysfunction causing excessive PMS symptoms like heavy bleeding, spotting between cycles, clots with period, anxiety, depression, painful periods, pain with sex, I can go on and on. SO, even if you’re not ready to have a baby, knowing your menstrual patterns and associated symptoms can be empowering and enlightening.

In functional medicine, we want to get to the root cause of dysfunction. With this knowledge, we are given to opportunity to focus in specific areas to support optimal function of the reproductive system.

Follicular phase:

STARTS: First bleeding day of menses until ovulation.

 What’s happening:

• Estradiol and FSH rise following menses.

• Estradiol secreted from the ovaries, helps prepare the uterus to carry a baby- want nice fluffy endometrium

• FSH/LH: secreted by the pituitary gland in the brain to communicate with ovaries who’s job it is to influence ovulation. 

• FSH: stimulate egg growth in the ovaries peaking just before the egg is release from the ovary.

• LH also influences menses and triggers release of egg

Ovulation:

STARTS: between days around day 14 +/-  4 days.

What’s happening:

• Estrogen peaks causing a surge in luteinizing hormone. This spike causes ovulation or the release of the mature egg from the ovary. 

• Following ovulation, estradiol, FSH, and LH fall, and progesterone increase to support a pregnancy if conception occurred after ovulation. 

HOW TO TRACK OVULATION:

• Temperature: You should notice a spike in basal body temperature(BBT) around ovulation.

  • Before ovulation, a woman's averages between 97°F to 97.5°F. After ovulation, it rises to 97.6°F to 98.6°F .

  • checK BBT by taking temperature every morning, at the same time every day before getting out of bed.

  • You should notice a biphasic change to temperature, pre-ovulation being lower than post ovulation.

• Cervical mucus: You may also notice a change in cervical mucus around this time. Cervical mucus around ovulation helps with ideal pH and sperm movement. Mucus right before ovulation is clear and it feels slippery, the consistency of raw egg whites — and can be stretched between your fingers. 

• Ovulation Prediction Kit (OPK): It helps determine the time in the menstrual cycle when getting pregnant is most likely. The test detects a rise in luteinizing hormone (LH) in the urine. A rise in this hormone signals the ovary to release the egg. The egg should be released ~36 hours post-LH surge.

  • Do OPK tests daily on days 10-18 to begin with, can narrow this down as you have a more predictable ovulation window.

Luteal Phase: 

START: Following ovulation until menses, roughly 10-14 days in length.

What’s happening:

• Progesterone rises and peaks ~5 days following ovulation. 

• Progesterone is secreted from ovaries. Triggers the endometrium lining of the uterus to thicken in preparation to receive a fertilized egg. Necessary for maintaining pregnancy after conception and implantation.

• Estrogen relatively low in relation to progesterone

• FSH/LH at its lowest of the cycle

• During this phase, estrogen dominance can be more apparent.  This can be demonstrated in lower levels of progesterone in relation to higher than normal levels of estrogen during the luteal phase!

If you’ve been tracking your cycles and notice a lack of ovulation, short luteal phase, PMS symptoms, no period at all, or estrogen dominant conditions (PCOS, endometriosis, fibroids), schedule an appointment with me so we can get to the root cause of your menstrual dysfunction!

Have more question? What you need to know about preconception health

—Athena Newell, MSN, FNP-C