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Understanding how your menstrual cycle works will improve your chances of successfully getting pregnant — or avoiding pregnancy — depending on your goal. It’s important to know when ovulation occurs and the factors that can affect fertility.
Starting around middle-school age, young women and girls across the United States learn the basics of their menstrual cycle — and what it means when they get that once-a-month bleed. But doctors note that more in-depth education — covering all phases of the menstrual cycle, including ovulation — is less common.
Dr. Amy Taneja, a board-certified OB-GYN and director of medical affairs at Organon, who is based in St. Petersburg, Florida, explains, “Some women and girls have a foundational understanding of their menstrual cycle, but they may lack detailed knowledge about the timing of ovulation and different phases of the menstrual cycle.”
Patients could benefit from more education on these topics, particularly if they are sexually active. Understanding your ovulation timeline can help you make more informed choices around your reproductive health and future planning, whether you’re trying to conceive or avoiding getting pregnant, Taneja says.
She adds that tracking ovulation may likewise benefit people who live in contraceptive deserts — areas lacking access to health care centers with contraceptive resources — by empowering them to make informed decisions about their health and sex life in the absence of other support.
[READ: What Is Nonhormonal Birth Control?]
What Is Ovulation?
Ovulation is the process in which an ovary releases an egg, which then travels through the fallopian tube toward the uterus. The egg’s release is triggered by a hormone in the ovaries called luteinizing hormone, which surges right before ovulation. Known as the LH surge, this hormonal activity prompts an egg to rupture from the ovary and start moving through the fallopian tubes. While that may sound scary, it is a natural and healthy indication of fertility.
Once in the fallopian tube — and if you’ve recently had unprotected sex — the egg has the opportunity to encounter sperm and become fertilized. If your egg becomes fertilized, the fertilized egg can then journey to the uterus, where it may implant and begin growing into a baby. If the egg is unfertilized, it will not implant in the uterus but instead prompt your body to shed the uterine lining, resulting in what we know as a period.
Sperm can live in a woman’s reproductive tract for up to five days after sex, while an egg is viable for up to about 24 hours after ovulation. For those trying to get pregnant through intercourse, having sex starting about five days before ovulation up to one day after is often recommended, as this “fertility window” is when pregnancy is most likely to occur.
[READ: Can You Get Pregnant on Your Period?]
When Do You Ovulate — and How Long Does Ovulation Last?
Ovulation happens fast — once you release an egg, it can only survive for up to 24 hours.
Because this is such a short-lived event, it may be difficult to predict exactly which day your body is ovulating — especially if you have an irregular period.
Cycle length and ovulation timing
On average, the length of a menstrual cycle is 28 days. But per individual, this duration has a broader range — lasting anywhere from about 21 to 35 days. Ovulation is said to happen at about the midpoint of the cycle, but that’s not an exact equation, either.
As a good rule of thumb, Dr. G. Thomas Ruiz, a board-certified OB-GYN and lead OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, California, recommends estimating the timing of your ovulation day by counting backward by 14 days — note, half of 28 — from day one of your menstrual cycle, which is the first day that you bleed. He explains that the counting-backward technique tends to be effective because patients often experience more variability in the first half of their cycle, or pre-ovulation, than the second half, or post-ovulation, which is more static.
Irregular periods and ovulation timing
If you have irregular periods, you may have a hard time pinning down your ovulation day by counting alone. Instead, Ruiz suggests looking for extra assistance by downloading a period tracking app, which may help you sort through fluctuations, or — even better — by booking an appointment with your OB-GYN. You can also show your OB-GYN data from your period tracking app so they can help you understand your situation.
In some cases, people with irregular periods may be anovulatory — meaning that their bodies are not ovulating and they may need assistance, like hormonal medications, to help their bodies release an egg and get pregnant, if that is their goal. Tracking your irregular periods and having a conversation with your OB-GYN can help you figure out if you are or are not ovulating, and what next steps you wish to take.
[READ Pregnancy Checklist]
How to Time Sex With Ovulation for Pregnancy
If you are sexually active and trying to get pregnant, you’ll want to time intercourse with your ovulation day. But because it can be hard to know exactly which day this is, it’s a good idea to have sex on multiple days just in case.
Some experts recommend having unprotected sex from about five days before ovulation up to one day after to increase your chances of getting pregnant. In doing so, you’re optimizing your “fertility window,” and maximizing the chances that viable sperm and a viable egg are both present in the reproductive tract.
Ruiz recommends prioritizing sex for about the week surrounding your estimated ovulation day if you are trying to get pregnant. This doesn’t mean you have to have sex every day, but to be intentional about having sex during this time.
“I tell patients who are trying to have kids that you want to make sure to have unprotected intercourse every other day through that window, so that you don’t miss the actual ovulation date,” Ruiz says. “There’s a range of days when you could be ovulating, (so) these are your highest probability days to get pregnant if you’re having sex.”
If you’re having unprotected sex in this window and not getting pregnant, be gentle with yourself. While you are at an increased likelihood for pregnancy in this window, pregnancy is not a guarantee and multiple factors including your and your partner’s reproductive health status may play a role in your ability to get pregnant.
Conditions That May Affect Ovulation
Not all women ovulate, be that due to health conditions or challenges like being too low or high body weight. If that sounds like you, it’s important to remember that you’re not alone and that ovulation is not a reflection of your worth or your status as a woman.
However, if one of your goals is to get pregnant, consider talking to your OB-GYN about your specific concerns and any steps you can take to increase your chances of ovulation and fertility — or explore fertility treatment options if you’re facing challenges of infertility.
Conditions that may affect ovulation
Polycystic ovary syndrome
PCOS causes hormonal imbalances that may impact different aspects of ovulation, including your body’s ability to produce eggs or properly release them from the ovaries.
Endometriosis
Endometriosis can cause inflammation and scarring in the uterus, which can impact ovulation. In some cases, endometriosis may impair the body’s ability to produce eggs or impair the egg’s transportation process through the fallopian tubes.
Amenorrhea
Amenorrhea occurs when someone does not get a regular period and are in normal reproductive age. This can include someone who is 16 or older and has never gotten a period — referred to as primary amenorrhea — or someone who has not had three or more periods in a row after previously having a regular period — referred to as secondary amenorrhea.
Because ovulation — if not resulting in pregnancy — leads to a period, having amenorrhea can imply that you are not ovulating. However, while it is less likely, researchers note that some people with amenorrhea can still ovulate and get pregnant. Especially if you want to avoid pregnancy, it is important to be mindful of this if you have amenorrhea and are sexually active.
Amenorrhea is not a stand-alone diagnosis and is often a symptom of another health condition that you are experiencing.
Some health conditions that can cause amenorrhea and may impact ovulation, include:
— Eating disorders, like anorexia nervosa
— Uncontrolled diabetes
— Thyroid disease
— Autoimmune diseases
— Hyperandrogenism
— RED-S
— PCOS
— Gonadal dysgenesis, which is a condition where the ovaries do not develop properly
— Kallmann syndrome, which is a disorder that delays or prevents puberty
Do You Ovulate on Birth Control?
Taking hormonal birth control will prevent your body from ovulating and stop your body from producing a natural period. While you may still bleed, this is called “withdrawal bleeding” and is caused by a drop in hormone levels during the placebo or break weeks of the pill cycle. By stopping you from ovulating, hormonal birth control decreases your chances of getting pregnant when you are sexually active.
If you decide that you want to try to get pregnant, or want to support your body’s natural ovulation process for other reasons, you may want to talk to your doctor about stopping birth control.
Does plan B work during ovulation?
Plan B, a form of emergency contraception, works differently than hormonal birth control. Rather than stopping you from ovulating altogether, the drug delays ovulation if it hasn’t occurred yet. If you have unprotected sex in your ovulation window but not exactly on your ovulation day, this delay in ovulation can reduce the risk of fertilization if sperm are present and prevent you from getting pregnant.
However, if you have already ovulated when you take Plan B, the emergency contraceptive will not be able to do its job in preventing a potential pregnancy because it cannot stop fertilization or implantation.
[READ: 7 Things to Know About Home Pregnancy Testing.]
How to Know When You’re Ovulating
Ovulation is a once-a-month occurrence, and it may sneak up on you if you’re not prepared for it. If you don’t know what to look for, you might even miss it when it comes.
Understanding ovulation signs and symptoms, if you experience these, can help you better pin down when ovulation occurs in your body. Cycle tracking and leaning into tools like blood tests, temperature checks and test kits can also help you figure out when you are ovulating.
Ovulation signs and symptoms
Ovulation can be discrete, in that most people don’t experience signs or symptoms that alert them when it’s happening. Some people do, however, and you may experience mild to extreme discomfort during ovulation.
For instance, some people may experience severe and sudden pain in the abdomen during ovulation. Such instances are rare but dangerous, and severe pain is a sign to call your doctor for help. Sharp abdominal pain could indicate an ovarian cyst or a ruptured ovarian cyst, which warrants a trip to the emergency room.
Some people may also experience cramping during ovulation. Ovulation cramps tend to be confined to the ovaries and can feel like a dull ache in the lower abdomen that can last for about 24 hours, Ruiz says. These are different sensations than period cramps, and in many cases less extreme, as period cramps can be felt throughout the entire uterus, he adds.
So long as you are not in pain, ovulation cramps are usually not worrisome. They can even come with bonuses, such as alerting you of when you are ovulating.
“I have some patients who know when they’re ovulating because they can feel the cramping from their ovary,” Ruiz says. “For those women who know they’re ovulating and are trying to get pregnant, obviously, it’s a huge advantage.”
He adds, however, that the majority of patients do not feel these sensations and are not aware that they are ovulating.
Some people may also notice changes in their discharge during ovulation. During this time, discharge may be more wet, stretchy and mucusy.
Cycle tracking for ovulation
To help you estimate your ovulation day, you can utilize apps like Natural Cycles, which is a Food and Drug Administration-cleared contraception method app available for download onto your phone. Though Natural Cycles is approved for use to prevent pregnancy, it can also help you get pregnant because these apps rely on data you provide them about your cycle and symptoms to help predict events like your next period and your most fertile days.
Temperature checks for ovulation
Natural Cycles and other period-tracking apps also provide opportunities for you to log your daily basal body temperature, which can be another indicator of when you are ovulating. Your BBT is your body’s lowest temperature after a period of rest. This number should be relatively consistent most days, but should rise a tiny bit — about four-tenths of a degree — when you ovulate.
You don’t have to go to a doctor’s office to check your BBT; you can do this your own. To get started, simply take your temperature as soon as you wake up — before you’ve done anything, including getting out of bed. To best check ovulation, you’ll want to take your BBT each morning — not just the day you think you are ovulating. That way, you can better understand your typical BBT range and what fluctuations to look out for during ovulation.
LH testing for ovulation
Testing your LH levels — which can be done through a urine test — can help you predict when you’re about to ovulate. LH is that hormone that surges right before ovulation, propelling your egg into motion. If your LH surge levels are high, you are likely about to ovulate.
Progesterone testing for ovulation
Progesterone is produced by the ovary after ovulation. So, checking your progesterone levels — which can be done through a blood test — about seven days after your estimated ovulation day can help you understand if you are ovulating. If your progesterone levels are a 10 or higher, this suggests you have ovulated.
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Ovulation: Symptoms and Calculating When It Happens originally appeared on usnews.com
