Are You Ovulating?
As a fertility doctor, I get asked questions about ovulation all the time. How do you know if you're ovulating? What are the signs? When should you be concerned? Today, I’m breaking it all down for you in a way that’s easy to understand.
The Basics of Ovulation
Ovulation is the process where your ovary releases an egg, making it available for fertilization. The number one sign that you're ovulating is having a regular, predictable cycle. If you can look at a calendar and know within a few days when your period is coming, that’s a great indicator that you’re ovulating. However, if you're on birth control pills, you are not ovulating. The pill works by preventing ovulation, so any bleeding you experience is not a natural period but a withdrawal bleed due to hormonal changes. Your ovaries contain a vault of eggs, and each month, a group of eggs is recruited. Follicle-stimulating hormone (FSH) is sent from the brain to stimulate one follicle to grow. As this follicle matures, it produces estrogen, making you feel great during this phase of your cycle. When estrogen reaches a high level for an extended time, the brain responds by releasing luteinizing hormone (LH), which triggers the follicle to rupture and release an egg. This is ovulation.
How to Know If You’re Ovulating
Some people can feel ovulation, known as Mittelschmerz, which is a cramping pain in the middle of the cycle. Others rely on physical signs or tests to confirm ovulation. Here are some common methods:
1. Cervical Mucus Tracking
Estrogen increases cervical mucus production, making it stretchy and clear like egg whites.
Checking cervical mucus by stretching it between your fingers can help identify ovulation.
Factors like dehydration or medications can affect mucus quality, so be mindful of those influences.
2. Ovulation Predictor Kits (OPKs)
OPKs detect the LH surge that happens before ovulation.
Testing between 10 AM and 2 PM daily can help pinpoint the surge.
A positive result means ovulation is likely to happen within 24 hours, so time intercourse accordingly.
3. Progesterone Testing
A blood test measuring mid-luteal progesterone levels can confirm ovulation.
Ideally, this test is done one week after ovulation.
If progesterone is over 3 ng/mL, you likely ovulated.
4. Basal Body Temperature (BBT) Tracking
Progesterone raises body temperature, which can be tracked daily.
Temperature rises about three days after ovulation, making this a retrospective tool.
Wearable devices can make BBT tracking easier.
When to Be Concerned
Having irregular cycles or other symptoms may indicate an underlying issue. Here are red flags that suggest you should see a doctor:
Irregular Periods: If your cycles range from 25 days one month to 40 days the next, ovulation may not be consistent.
No Periods: If you’re not on hormonal birth control and not getting a period, this is a concern.
Spotting in the Luteal Phase: Frequent spotting may indicate a progesterone issue.
Very Short or Long Cycles: Cycles over 40 days or extremely short luteal phases could signal ovulation disorders.
Known Conditions: If you have PCOS, thyroid issues, or elevated prolactin, testing early can help with proactive fertility management.
Why Ovulation Matters for Fertility
The egg only lives for about 24 hours after ovulation, while sperm can survive up to five days in the reproductive tract. This means timing intercourse around ovulation is critical for conception. If using OPKs, have intercourse on the day of the positive result and the following day. If tracking cervical mucus, aim for intercourse when mucus is at its peak stretchiness.
Understanding ovulation is key to knowing your body and fertility. If you suspect ovulation issues, a fertility specialist can provide deeper insights using ultrasound and hormonal testing.
