Your PCOS Diagnosis is Not a Life Sentence
12 Apr 2018
12 Apr 2018
I am always amazed and somewhat saddened by how many women do not know anything about their cycles. When we learn about them from our moms or in school it is typically as simple as “every month you get your period…deal with it”. The truth is, when it comes to getting pregnant it is crucial that we know our cycle, inside and out.
Our body presents us with lots of ‘hints’ as to our fertility. We just need to know what we are looking for.
I wrote a blog last year called Period 101: Understanding Your Cycle in 3 Easy Steps. I recommend that you also give it a read. But before we get into tracking your cycle to improve your fertility, I am going to give you a really brief lesson from Period 101.
Most people split the menstrual cycle into two phases: follicular and luteal.
During the follicular phase, one lucky follicle matures and prepares to be released for fertilization. Your estrogen starts to increase, causing a thickening of your uterine lining and your vaginal discharge will start to change as well.
Your pituitary gland releases a surge of Lutenizing Hormone (LH) to trigger ovulation – your estrogen starts to decrease, your progesterone starts to increase, and you enter the luteal phase.
The follicular phase can be variable lengths for all women, however, the luteal phase should be 12-14 days. The follicle becomes your body’s main progesterone source, but after 14 days if fertilization (“egg meets sperm”) does not occur, it loses that power to produce progesterone, it rapidly declines, thus triggering your period.
So how do we keep all of this straight?
You first want to start to downloading an app. I personally like Kindara, which is fertility specific. You can track your cycle, your discharge, your basal body temp if that’s your jam, symptoms, sex, pregnancy or ovulation tests. Plus, it is extremely user friendly. There are so many period trackers in the app store so download a couple and figure out which one you like best.
So the basics of tracking your cycle for every women, even if you are not trying to get pregnant, is this:
Day 1 is considered the first day of bleeding. If you are someone who spots for a couple days before you really consider your flow to start (you need to book an appointment, because this is a sign of low progesterone) but you want to mark Day 1 as the day of actual flow, not the spotting.
You’ll want to keep track of how long you are bleeding for. In the apps you can mark “heavy, moderate or light” flow and spotting. Most women find they will bleed for 3-4 days and then some light spotting after. If the spotting lasts long that Day 7 of your cycle, this is another sign of hormone imbalance.
Now, if you are starting to track your cycle so you can start making babies, there are a few more steps to cycle tracking. We really want to pay attention to when you are ovulating. Most blogs and books will tell you that you ovulate on Day 14 of your cycle – however this isn’t usually the case for most people.
Remember earlier we said the luteal phase has a set length of 12, but hopefully, 14 days. This means the longer the follicular phase is, the later you can ovulate, and vice versa if it’s shorter.
Luckily, our body does give us some clues as to when it’s ovulating so as long as we know what to watch for we can quickly figure out A. if we are actually ovulating at all and B. when is this.
The second thing you’re going to track in your app is your vaginal discharge. My patients always chuckle a little when I talk so freely and openly about vaginal discharge, the truth being I have this conversation quite frequently. It’s essential for anyone starting their fertility journey to know as a good portion of women who are having difficulty conceiving it’s because of a timing issue – meaning they aren’t having sex during their optimal fertile window. By tracking their cycles and discharge, and knowing exactly when you are the most fertile, you have a higher change of G– obviously.
If you have been on the oral birth control pill or the IUD you likely don’t notice much vaginal discharge at all. This is because your body doesn’t have the natural hormone fluctuations but just a steady low dose to keep you from ovulating. Your body doesn’t need to produce the mucous necessarily for fertility.
After your period you’ll notice a few dry days and then a thicker, white and maybe sticky discharge. As you approach ovulation, this discharge will begin to thin out and increase in amount. What we are watching for is fertile cervical mucous which looks like raw egg whites. It’s stretchy, clear and profuse. Women tend to feel more wet and slippery around ovulation when you wipe. You should have this for 2-3 days for optimal fertility.gG
After this the discharge will thicken back up and be more white before you have a couple dry days prior to your period.
This fertile mucous around ovulation is necessary for pregnancy to occur. Its function is to increase the vaginal pH to keep the sperm alive as well as to help them swim higher up in the vaginal canal to reach the egg. When it’s missing, or women have no clue what I’m talking about when we go over cycle tracking, that is a key sign to me that you may either not be ovulating or you’re not producing enough fertile mucous to achieve pregnancy. Several things to rule out of this is the case are: low estrogen, low progesterone, high testosterone, PCOS, unhealthy body fat percentage (too low, too high).
If you or someone you know is having difficult conceiving, feel free to contact the clinic or book an appointment online.
Happy Baby Making!
Dr. Kelsey Duncan, ND
1. https://sites.google.com/site/medicnote/ob-gyn/menstrual-cycle
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12 Apr 2018
12 Apr 2018
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