When did you first hear an explanation of your menstrual cycle? Apart from asking my mom or step mom what pads or tampons were upon seeing them in the cabinet, I don’t have a memory of an explanation until third grade. We all had to get a permission slip signed so that we could learn about our “bodily changes”. Boys and girls were sent to separate rooms in the school…I remember the girls were sent to the computer lab.
We were given small booklets that talked about breasts growing, “periods”, and feminine products and hygiene. We were told that a confusing time in our lives was fast approaching and that we would start to bleed, once every 28 days, and that it was okay. We could use pads or tampons, and as long as we were careful to be ready and if we washed ourselves, no one would ever know that we were “on our period.” Most of the talk was focused on the products we would use to take care of this issue. [And they didn't even teach about the good ones!]
Fast forward to middle school. I had started my “period” and managed to avoid getting blood on my pants or “smelling.” I still really had no idea what a period was for other than to tell me I was not pregnant. At that point in my life that seemed like a useless thing to do since I was not having sex. Same story in high school, only add in a small amount of knowledge of an egg dropping and that my period was to get rid of the unused egg each month.
It was not until I was a married woman and thinking about babies that I stumbled upon the book Taking Charge of Your Fertility by Toni Weschler in the book store. I picked it up, thinking that since I was a take charge kinda girl with everything else that I should add my fertility to the list too. This was also after many unsuccessful attempts at finding the right birth control for me (come to find out, my body hates all chemical birth control), so that was in the front of my mind as well.
That book changed my life.
Imagine my surprise when I read that my “irregular periods” were actually pretty normal, and that I was not broken. Every cycle (not month – we work in cycles, not on a calendar) my body was performing a magical and specific dance of hormones. Eggs matured, temperatures changed, ovulation occurred, hormones shifted, my body prepared. I was amazed. I suddenly had respect for my body and did not find my cycles annoying anymore.
WHY had no one explained all this to me? Why was the focus on managing the bleeding and not on the reasons why it even happened? Beyond knowing “period=not pregnant; no period=pregnant” we were told nothing. We were told that we should perform this task like clockwork, every 28 days. No room for error or we were “irregular”, like a badly cut puzzle piece. The focus was on all the things we needed to buy and do in order to cover up the fact that our body performed as expected.
Now, I want to share some knowledge with all of you. I can not cover everything – hence why the book Taking Charge of Your Fertility (TCOYF) is large. But I can give you the basics on how things work and the basics of keeping track of all this.
The Menstrual Cycle: A Carefully Choreographed Dance
I think most of us have the basic knowledge of what the cycle does (generally speaking) – it is the preparation and “dropping” of an egg that then awaits fertilization. If that fertilization does not happen (or if implantation does not happen), you have menstrual bleeding – your period – and a new cycle starts. But lets talk about specifics.
The first hormone that causes things to happen each cycle is the Follicle Stimulating Hormone (FSH). This hormone does just what the same suggests – it stimulated follicles. These follicles are on your ovaries, and each one contains an egg. Generally about 15-20 follicles start to mature each cycle.
During this time period (anywhere from about 8 days into your cycle to more than a month) your estrogen is rising. Shortly after you reach your estrogen threshold (one or two days after), one of the eggs bursts through the ovary and starts the journey down the fallopian tube. Sometimes more than one egg makes it out (fraternal twins or higher multiples – if all are fertilized). The eggs that didn’t “make the cut” dissolve.
This high level of estrogen (which drops off after this peak at ovulation) triggers a surge of Luteinizing Hormone (LH). This surge of LH is what ovulation tests detect and occurs just before the release of the egg during ovulation. [Please note - an LH surge does not mean you *did* ovulate, but rather that your body is preparing to.]
After the egg is released, that follicle that it came from turns into the Corpus Luteum. This will release progesterone for about 12 to 16 days. Normally a woman’s luteal phase (the time from ovulation to the start of a new cycle) does not vary much within that woman by more than a day or two during each cycle. The luteal phase is the one part of our cycles that is locked in for most people and they will have their own “normal” they can depend on.
The progesterone released by the Corpus Luteum is very important. It causes the lining of the uterus to thicken (for implantation) and prevents further egg release that cycle. It also causes a change in your fertility signs (more on that later).
After this 12-16 day period of the luteal phase, if the egg has not been fertilized and implanted, the Corpus Luteum dissolves and a new cycle starts (your “period” comes). The first day of bleeding is the first day of your new cycle.
A Quick Word on Averages
Please note that during this entire post I am going to be speaking in terms of the average cycle. There is a large amount of normal variation within these numbers – and outside them. The 28 day cycle is not a golden rule or number. Each woman has a cycle unique to her – just like the particular color of her eyes or her love of a certain food. Please do not take these average numbers to be the only “normal” and count yourself as abnormal. They are simply for simplification purposes.
Conception is the process of fertilization – sperm meeting egg. When and where does this take place? Once the egg is released by the ovary, it is sucked up into the fallopian tubes quickly – normally within 20 seconds. The ovary is not actually attached to the tubes by the way – they sort of barely meet at the end of the tubes where the “fingers” of the tube stick out to catch the egg. These fingers are called fimbria.
Fertilization has about 24 hours in which to occur. The egg does not sit around waiting for sperm for the entire luteal phase. Around 24 hours is all the chance we get. The egg is fertilized in the lower third of the fallopian tubes, not in the uterus as is commonly thought. The egg will continue its way down the tubes and burrow into the lining about a week after ovulation, on average. If the egg is not fertilized, it dissolves and is absorbed, or it comes out with the menstrual flow.
In order to stop the process of the shedding of the uterine lining, as soon as the egg implants your body starts to make a hormone – I know, another hormone! This hormone is called Human Chorionic Gonadotropin (HCG) and is the hormone that pregnancy tests detect. This hormone not only stops the lining from shedding as normal, but it signals the Corpus Luteum to stick around and keep making progesterone to sustain the lining (which feeds the fetus). This progesterone is important as it sustains the pregnancy until the placenta takes over after several months. [This is why low progesterone causes miscarriage.]
As you can see – this dance of hormones and processes is complex. Complicated steps, but seems effortless and fluid when observed. Our bodies do all this without prompting in most cases, and is just as miraculous as the actual process of growing a baby. Our bodies do a lot of work just to get the egg ready to create the baby, and to maintain the system for many years “just in case”.
Charting: Your View of the Dance
Charting with the Fertility Awareness Method (which is taught in TCOYF) is based on three basic fertility signs. These signs, when charted together, give you a view of what your body is doing and where you are in your cycle.
Waking Temperature (Basal Body Temperature)
This is the fertility sign that gives you a view of what hormones are acting at the moment, and when you have ovulated. It is the “graphic” portion of the fertility chart. To get this information you need to take your temp first thing in the morning before you get out of bed. You need to use a Basal Thermometer for the best results, as they are more accurate than a fever thermometer. They are usually available in the fertility section of your local drug store or WalMart/Target. That would be the aisle with the pregnancy tests and contraceptive devices.
Before ovulation your temperature is lower (between 97.0 and 97.7 on average) due to the temperature suppressing effects of the rising estrogen at the start of the cycle. After ovulation, within a day or so, your temperature will rise due to the heat producing hormone progesterone. If you conceived, the progesterone stays around and your temp stays higher. If you did not conceive, the progesterone stops and your temperature drops as well – a sign that says your menstrual flow will start soon.
A few notes about your waking temperature. 1) You need to take it at the same time each day, trying not to vary it by more than 30 minutes or so. When you first start to chart, try to be as precise as possible in order to get your “normal” readings for a few cycles before messing with anything. 2) You need to take it after at least 3 hours of sleep (this gives your body time to regulate and get to the basal state) and before you get out of bed. Keep it on your bedside table. 3) Your readings may be off if you have a fever, have drank more than a drink or two of alcohol (or if you rarely have alcohol), or are using more warming devices to sleep than you normally do. Illness can also effect the temp in other ways – think about if you normally sleep with your mouth closed, but then sleep with it open because you are congested. This would cause your mouth temperature to be lower in the morning.
There are two ways to get your temperature. Orally – the way you do for a fever, or vaginally. Vaginal temps tend to be more precise for many women and you do not have to worry about the effects of occasional mouth breathing either.
Cervical Fluid, or cervical discharge, is an important fertility sign. In my opinion this is the sign that we should absolutely be taught about from day one of becoming a woman. The normal fluid our body makes – which changes throughout the cycle – is not dirty. It is not defective. It is a sign of where our fertility is at that point. I suggest you begin to think of it as awesome and not dirty (in other words – not “discharge”) because this stuff is cool.
You have several types of fluid. I will work from least fertile to most fertile. First is the lack of fluid – this is called a dry day. This generally means you are not currently fertile. This normally occurs right after menstruation ends, and after your fertile period (ovulation). Then there is sticky fluid. This is the dry feeling fluid that clumps and looks almost like rubber cement (a type of glue). This is also considered not fertile. It usually occurs after menstruation but before ovulation – and sometimes for a few days after ovulation. The next type is creamy – this is usually thick and white or yellowish, and feels and looks like lotion. This is not a fertile fluid, and normally occurs before ovulation, and occasionally after ovulation. All of these types leave no mark in your underwear, or they leave a streak or line.
The first type of fertile fluid is called watery. This is just the way it sounds – like water. Usually clear or only slightly colored, it leaves a round wet mark on your underwear due to the high water content. This is a fertile fluid. Fertile fluid is one in which sperm can survive. You must have a fertile fluid present for sperm to live and move in. This fluid usually shows up around ovulation. If you see this, assume you are fertile. The other fertile fluid is egg white. This is the most fertile fluid and is what you want to look for if you are hoping to conceive. It looks just uncooked egg whites, sometime streaked with pink or yellow but is mostly clear. Sperm love to live in this and can swim well in it. This will also leave a round wet mark in your underwear due to moisture content. It is also stretchy between the fingers – stretching up to a couple inches or more.
A typical pattern of fluid would go like this: Menstrual blood, dry, sticky, creamy, wet/egg white, dry or sticky, menstrual blood. Again – this is just an example and each woman will have her own pattern. After a cycle or two of charting, you will see your personal patterns. Occasionally a woman gets a last surge of fertile fluid just before menstruation. This is not another ovulation but rather a reaction to the drop in progesterone.
This is the one sign of the three that is considered optional when charting. However, I would encourage you to try it. It really does help with charting (especially when your other signs do not seem to match up) and teaches you a lot about your body. It does take practice. My “favorite” way to check my cervix (in other words, the easiest) is to squat down all the way – bum on my ankles – and feel for the cervix. Your cervix is a small “bump” at the end of your vaginal canal or rather at the bottom of your uterus – it feels much like the end of your nose for most of your cycle, only with a dimple in the middle (the cervical os).
When you are not fertile, your cervix is low and firm and closed (keep in mind, those who have birthed children have a slightly open cervix for ever after in most cases). When you are fertile, the cervix moves up higher and becomes soft (like your lips) and opens a bit. It is also very wet when fertile as it puts out a lot of good fertile cervical fluid. To notice these changes, you need to check yourself each day in the same position. You will start to notice after a cycle or two what your normal fertile and infertile patterns are for your cervix.
An amazing site to look at is The Beautiful Cervix Project. This site has collections of photos of real cervices in all stages and ages. Being familiar – and comfortable – with what all portions of our body look like is an important part of embracing the whole woman, our whole self. This project is dedicated to helping with that.
Not every woman has these signs but they are worth charting if you have them. Midcycle spotting, pain or aches around the ovary area (note the side), increased libido, full or swollen vulva, bloating, increased energy, breast tenderness – all are rather common signs during the cycle. If you chart them, you may see a pattern. For instance, women who get midcycle spotting tend to find through charting that it occurs around ovulation. The pain in the ovary area has a name – mittelschmerz – and typically indicates the release of an egg.
I think the easiest way to explain charting as a whole is to show you a chart. I will add one of mine to illustrate.
This is one of my older charts. You can see the lower temperatures before ovulation. The “cross” is the day of ovulation. You see that my temp rose after ovulation and stayed above the “cover line” (the horizontal line) until shortly before the new cycle started. This cycle was 32 days with ovulation on day 2o and a 12 day luteal phase. The blue days are infertile days, the green days represent likely fertile days, and the orange/tan days are the luteal phase.
As you can see on my chart I have a few things that are not typical. First, I tend to have a few random days of fertile fluid before ovulation. I also have what is called a “slow rise” in my basal/waking temperatures. These are both a variation of normal and are normal for me. I am able to line up my typical cues of ovulation to know when I have ovulated – for instance I always get ovulation pain and chart it. This is (for me) a very reliable sign.
Sometimes you might not ovulate. This is called an annovulatory cycle. Most women have these from time to time for various reasons. Stress and illness are two big reasons. I once had a cycle that lasted 147 days – during which my husband and I were apart for my job. After we were under the same roof again, a new cycle started the same week and things went back to normal. Here is an example of an annovulatory cycle for me:
As you can see, the signs are all over the place, and my temperatures never really get a pattern. I may have ovulated around day 34 or so, but no other signs confirmed that other than a slight rise in temperature.
For more information I highly suggest the book Taking Charge of Your Fertility. It really is an amazing resource and goes into full detail of how to chart and how your body works. I have simply given you the starting building blocks. There are several methods of charting fertility, but FAM (Fertility Awareness Method) as taught by TCOYF is my favorite. You can find classes in most major cities about fertility charting as well.
Fertility charting can be used both to help conceive, and to avoid conception. I have used it for both purposes.
When using to avoid pregnancy, and you understand it thoroughly and use it correctly every day, you have only a 2% chance of conceiving within a year. That is if you use condoms during the fertile phase (correctly) or abstain while fertile. [Condoms have a failure rate of around 2%.] If you use other barrier methods during your fertile time then your chances would be close to that of whatever barrier method you choose. Keep in mind that the failure rate and user failure rate are different, and you should research any barrier method you decide to use with FAM. Also, the user failure rate of NFP (Natural Family Planning – which includes multiple types of charting or fertility tracking) is anywhere from 2% to 20% depending on the study you look at. This is not the fault of the method, but rather the user. “Cheating” (not following the rules) is much less forgiving with NFP than it is with other types of birth control.
When using this method to achieve pregnancy it can be very helpful. First and foremost – you learn about your normal. The 28 day cycle and day 14 ovulation is probably the biggest myth of womanhood. That is a “clockwork” example and is simply not true for all women. In fact, you can have a 28 day cycle and still not ovulate on day 14. And as we learned – the egg is only viable for about 24 hours. If you miss the egg, you miss it – and thinking you ovulate on day 14 when you ovulate earlier or later can mean that you miss the egg again and again.
You also start to see your patterns. You notice when your cervical fluid changes and what the fertile period looks like for you. Past cycles do not dictate future cycles – BUT they can help you to get a good guess going of when to time intercourse to catch the egg. Another thing it does is alert you to issues. You would be able to see if you do not ovulate, or if you do not have fertile fluid when you need it. You can catch a short luteal phase (which means the fertilized egg may not have time to implant) and possible issues with progesterone. In other words – you can arm yourself with information and avoid some expensive and time consuming testing.
Please keep in mind that I have only given you the basics here – the building blocks. Now it is up to you to research and read or take a class. Please do not run with this small amount of information and use it to avoid pregnancy, and on the same hand – please don’t chart for fertility just based on what I have written here. My hope is to clear some myths, help you learn, and help you appreciate your body a bit more. Please feel free to post questions below and I will try to answer them as best I can. I am not an expert or teacher, but I have read and researched the subject extensively and used the method in both ways for several years.