The information in this article is built on my previous article on the menstrual cycle. If you haven’t already read that one, you may want to review it before starting this one. It will make this one easier to follow.
This article is mostly about cervical mucus and Basal Body Temperature charting. Pretty exciting stuff! Some of my patients love getting more information and following how they are progressing. They have no problem with taking and recording their temperatures and mucus characteristic. Other patients absolutely, positively do not like it and tell me it just is one more thing to remind them, on a daily basis, that they are still not pregnant. If that is how you feel, please preserve, because both of these are great tools for pinpointing the Traditional Chinese Medicine diagnosis, determining where you are in your cycle and what treatment is best for you. There is much more to it than just knowing your fertile days.
Fertile Mucus, what it looks like and what it is for
Fertile mucous is very stretchy. When you test it, there should be a single strand of mucus that you can stretch between your fingers for about an inch. It is very interesting to me, as a practitioner of Traditional Chinese Medicine, because it tells me about the Kidney Yin and how it is developing. The structure of the mucous changes throughout the cycle. As the estrogen increases, it changes the nature of the cervix and the mucous that is produced.
It is very important to have fertile mucus because it helps the sperm get through the cervix. The vagina has a very acidic environment, which kills most of the sperm, but the fertile mucous protects them and helps carry them through the cervix. Another interesting thing that occurs before ovulation is that the cervical crypts widen and deepen so they can retain sperm for several days. Sometimes the sperm can get as far as the cervix and find a little spot to rest for a while, before continuing the long trip up to the fallopian tubes.
Ovulation Predictor Kits
If you are using an ovulation predictor kit, you might find that you get a better reading if you do not use the first morning urine. The kit is measuring the Luteinizing Hormone, which is synthesized in the early morning hours while you are still asleep. You won’t get an accurate reading on what constitutes the LH surge until 4 to 6 hours later, so it is best to do it between 10 am and 8 pm. Do it at the same time each day. It is also better not to drink lots of water just before you test your urine, because lot of water can dilute it too much. When you get the positive LH surge, you know that an egg will be released in the next 12 to 36 hours. If you have an irregular cycle, testing for LH is a very good way of determining your fertile time. Your fertile time is before you ovulate. It is usually about two days before you actually ovulate, and hopefully, when you have the stretchy egg white fertile mucus. You want to give the sperm time to make their long trip and be ready when the egg is released into the fallopian tubes.
BBT, basal body temperature, is a great tool to monitor your cycle. Take your temperature first thing in the morning when you wake up, before getting out of bed. As much as possible, take it the same time every morning. If you are taking it at an unusual time, if you are sick, had alcohol the night before, or did not get your usual amount of rest, be sure to note that on the chart. Most of my patients use an app to record their temperatures. FertilityFriend.com has a good one.
A typical temperature chart starts with the first full day of the period, followed by the follicular phase during which the follicles are developing and the temperature is lower. The luteal phase is after ovulation and the temperatures are higher. The temperature rise between the follicular and luteal phases is an indicator that ovulation is occurring, and your body is switching from Yin (follicular) to Yang (luteal). The temperature average change should be about 0.4 degrees Centigrade, or .7 Fahrenheit between the follicular and luteal phases. Sometimes, for some women, there is a dip before the rise, but not always.
The temperature during the follicular phase needs to be low, but not too low. If it drops well below 36 Centigrade, 96.8 Fahrenheit, it could mean that your thyroid is not functioning properly. From the standpoint of Traditional Chinese Medicine, we strengthen the Yang to warm the body and raise the temperature.
If the follicular phase is too long, it means that ovulation is delayed. In Traditional Chinese Medicine, that means there wasn’t enough blood or Yin in that early part of the cycle, the nourishment stage. If it takes too long for an egg to ripen, we work to provide more nourishment, more Yin and more blood.
If the follicular phase is consistently short, only 8 or 9 days, the egg may not have enough time to mature sufficiently. We treat this by clearing heat and calming the mind in addition to nourishing Yin and blood.
Another very common pattern we see in the follicular phase is instability, with temperatures going up and down a lot. The temperature should be somewhat steady, but it is never as steady as it is in the luteal phase. Some big peaks can be caused by lack of sleep or alcohol the night before, or even a mild fever. Higher temperatures in the follicular phase could also occur because of emotional upset. Traditional Chinese Medicine terms this Fire in the Liver or Heart channel. When we see a strong saw tooth pattern, we work to clear the heat, and calm the mind so that ovulation will be smooth.
Once the temperature has gone up, we expect it to stay up for about 13-14 days, but 11-12 days is OK. The corpus luteum which is formed on ovulation produces progesterone. It is the production of progesterone that raises the temperature at ovulation. Progesterone acts on the temperature regulating centers in the hypothalamus. Once the temperature has gone up and stayed up, we can be sure that ovulation has occurred. The temperature rise is affected by the progesterone rise.
Sometimes we will get a short luteal phase, and therefore a short cycle. This luteal phase defect is caused by low progesterone levels. Clinically this is one of the easiest ones to treat
When there not much of a temperature rises in the luteal phase, it shows weak ovulation and weak Kidney Yang. In this case we treat Kidney Yang and Kidney Yin so that the Kidney Yang has a strong foundation build upon. If the temperature rises well at the beginning of the luteal phase, but quickly declines, it also shows Kidney Yang deficiency, sometimes with a Spleen Qi deficiency. This is often seen with premenstrual spotting.
If the Luteal Phase too long, more than 16 days, it may not be a problem at all. When the temperature stays up, it often means you are pregnant.