Tracking ovulation with PCOS is an essential tool I can every single one of my clients to use.
“I really wish someone would have explained all of this to me as a teen”. This is a recurring thought I’ve had for years! I remember almost nothing from the 4th grade “period talk” or the 7th grade sex-ed class. No one taught me how to track my menstrual cycle or how to know if I’m ovulating. No one taught me how to know if something was wrong and that super painful periods were not normal. No one taught me how to truly care for my body and work WITH it through the cycle.
Until I took initiative and learned about fertility awareness methods, what happens within the menstrual cycle and how my body responds throughout it, I never really understood what was going on with my body. I just stayed confused. But it did NOT have to be this way, and I wish I would have known how to track by cycle and signs of ovulation with PCOS from the start!
Understanding fertility awareness methods with PCOS is essential in understanding what’s happening with your body and how to care for it! Fertility awareness methods are especially essential for tracking ovulation with PCOS.
Let’s start with the basics of the menstrual cycle as a refresher!
One important note: Throughout your cycle, different processes are taking place in both your uterus and ovaries.
A “normal” cycle length is 21-35 days. With PCOS, cycle length can vary significantly depending on a number of circumstances, which can make it difficult to pinpoint what and when each phase is happening.
Menstruation: Day 1 of your menstrual cycle is the first day of your period. This is the shedding of your uterine lining. Normally this will last 3-7 days. How it’s different with PCOS: The length may be normal, short, or long with PCOS. It may be light, normal or heavy flow. It may not happen at all or happen infrequently.
Follicular phase: From Day 1 to ovulation, the ovaries are preparing for an egg to be released. Within the ovaries are fluid-filled sacs called follicles that contain an egg. Follicle stimulating hormone from the pituitary gland signals to the ovaries to prepare an egg to be ovulated. The chosen follicle produces estrogen, which peaks just prior to ovulation. How it’s different with PCOS: Low levels of FSH, commonly seen in those with PCOS, cause poor egg development and therefore affect ovulation. This phase may be long in those with PCOS.
Proliferative phase: After menses, the uterine lining is thickened again as estrogen levels rise. This prepares a place for an egg to be implanted and grow. How it’s different with PCOS: Estrogen levels may be high or low for those with PCOS. The uterine lining may continue to thicken if there is no period to shed it.
The MAIN EVENT: Ovulation! An egg is released from the ovary. Prior to releasing the egg, high estrogen levels signal the brain to increase luteinizing hormone. How it’s different with PCOS: No ovulation or anovulatory cycles are common among those with PCOS. High androgens, low FSH/high LH, and low progesterone may contribute to lack of ovulation.
Luteal phase: After ovulation, the chosen follicle in the ovary turns into a corpus luteum that produces estrogen and progesterone. Progesterone levels peak mid-way through this phase. Normally, the luteal phase will last about 14-days, but may vary. Progesterone and estrogen levels will decline as the corpus luteum breaks down, and menstruation will happen. However, if fertilization of the egg occurs, progesterone will continue to stay elevated. How it’s different with PCOS: Progesterone is commonly low in those with PCOS. Estrogen may be high or low, and premenstrual symptoms may be strong.
Secretory phase: The uterine lining secretes chemical messengers, such as prostaglandins, to prepare itself for egg attachment if fertilization occurs or to break down if no fertilization occurs.
Why is tracking ovulation important with PCOS?
Tracking your menstrual cycle can help you:
-understand your body (body literacy)
-know why you are feeling certain symptoms
-help determine if you are ovulating
-help you care for your body throughout your cycle
-know when something isn’t quite right and to get help
-get pregnant or avoid pregnancy
Ovulation is the main event of the menstrual cycle. If ovulation isn’t happening, something’s not right! Knowing if and when you are ovulating with PCOS can help you determine if you need to make changes to balance your hormones. Tracking ovulation can also help you maximize your chances of pregnancy with PCOS.
Methods to cycle tracking
There are many ways to track your cycle and determine if and when you ovulate with PCOS.
You may choose one method, combine them, or follow a certain model. I highly recommend finding a Fertility Awareness Methods or Natural Family Planning class in your area or online.
Here’s what to do to start tracking ovulation today:
Get an app that allows you to input basal body temperature and/or cervical mucus consistency, and possibly symptoms.
Track your basal body temperature. After ovulation your temperature will rise slightly by 0.5-1.0 degree Fahrenheit for at least 3 days. This signals ovulation has occurred. To do this you will need a basal body temperature thermometer. Take your temperature around the same time each morning before getting out of bed, and without having gotten up within the last 3 hours. Record it. Another way to do this is to use a wearable device, such as a Tempdrop, that measures your temperature for you.
Pay attention to cervical mucus consistency. During and right after your period, you may not notice cervical mucus. Throughout the follicular phase it will begin to be thick, sticky and cloudy white mucus, until nearing ovulation. Around ovulation, mucus should be stretchy, clear, egg-white consistency. This is your most fertile time. After ovulation it will start to dry back up again and become sticky once again until menses.
Test hormone levels. Similar to a pregnancy test, you can also do urine-based ovulation predictor kit to predict ovulation via hormone levels found in your urine. However, those with PCOS often have high luteinizing hormone (LH) which can create false-positive tests. Instead, you can use a Proov test which can confirm if ovulation has happened by measuring progesterone levels. Although this doesn’t tell you if ovulation is coming, it does tell you if it has happened which is helpful information to know!
Track start and end dates of your cycle. You may also benefit from tracking when you have sex.
At the end of each cycle (and throughout) take a look a the BIG picture. What changes and patterns do you see. Compare each cycle. Are there any patterns or differences? This can help you understand what is happening (or not happening) during your cycles!
Tracking Ovulation Can Help You Know When To Ask For Help
It may be time to ask for help if you notice your cycle is shorter than 21 days or longer than 35 days, there is no rise in temperature or fertile cervical mucus, you have strong premenstrual symptoms, you have pain throughout your cycle, you have difficulty knowing when/if ovulation is happening, you have difficulty getting pregnant, or if you have any other concerns.
I recommend using fertility awareness methods to ALL my clients with PCOS. It’s incredibly empowering, provides so much information, and truly helps you work WITH your body! If you’re tired of feeling like your body is “broken” and want to care for your body with confidence, book a discovery call to learn if my 1:1 Peace with PCOS Nutrition Coaching Program is a good fit for you!
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