It is estimated that approximately 64% of women of childbearing potential in the United States use some form of birth control, and hormonal birth control methods are popular with them. Methods such as birth control pills, hormonal intrauterine devices (IUDs), and injectable contraceptives such as Depo-Provera are commonly used. According to the Centers for Disease Control and Prevention (CDC), about 28% of women who use birth control opt for the birth control pill, making it one of the most widely used methods.
But more and more women are realizing that hormonal birth control comes with a host of side effects that often render them useless: extreme weight gain, mental health issues, gut disorders, decreased sex drive, PCOS, and even infertility. Birth control affects all women differently, but it’s becoming more common for women to skip the pill and opt for a greener world. However, many of these women are still trying to prevent pregnancy. How do they do that without having to rely on synthetic hormones?
It all starts with properly tracking your cycle and getting to know your body’s biomarkers. Your body will never lie to you, which is good news, but you need to learn the signs to look out for so you can better understand your cycle, balance your hormones, prevent pregnancy, or get pregnant sooner. And the best place to start is your cervical mucus.
What is cervical mucus?
Cervical mucus is fluid secreted by the cervix, the passage that connects the uterus and vagina. This mucus undergoes various changes throughout the menstrual cycle and performs various functions such as moisturizing, protecting against infection, and aiding in conception. The consistency of cervical mucus changes during the different phases of the menstrual cycle. Monitoring these changes can be part of natural family planning methods and can also indicate underlying health conditions.
“Cervical mucus is the only biomarker that alerts you to the opening of your fertile window.”
“Cervical mucus is the only biomarker that alerts you to the opening of your fertile window!” Mairead Suthoff, a veteran fertility awareness educator, tells Evie. “It’s also consistent in how it changes right after ovulation to again indicate a period of ‘infertility’.”
Suthoff says there are other biomarkers that can help you “build a more complete picture of cycle health,” but cervical mucus is “the one biomarker that does it all.” You may have heard of another biomarker called luteinizing hormone (LH), which plays a crucial role in a woman’s menstrual cycle. The level of LH produced by the anterior pituitary gland rises about midway through the menstrual cycle, triggering ovulation, or the release of a mature egg from the ovary. This “LH surge” is a key indicator of fertility and marks the most fertile days of a woman’s cycle. LH strips are over-the-counter test kits that can be used to detect this increase in LH levels in the urine. These strips can help women find the optimal time to conceive, usually 24 to 48 hours after the LH surge.
However, these strips are not very useful for birth control. “LH doesn’t alert you to your fertile window early enough to avoid pregnancy, and a positive LH surge doesn’t guarantee ovulation,” explains Suthoff. Then there is the basal body temperature.
Basal body temperature (BBT) is the body’s lowest resting temperature and is usually measured right after waking up and before any physical activity. In a woman’s menstrual cycle, the BBT undergoes significant changes, which are mainly influenced by hormonal fluctuations. During the first half of the cycle, the follicular phase, BBT remains relatively low. After ovulation, which is triggered by a surge in luteinizing hormone (LH), progesterone levels rise, causing a noticeable increase in BBT, usually by around 0.5 to 1°F. This rise in temperature persists throughout the luteal phase until menstruation begins. Tracking BBT can help identify the fertile window as the rise in temperature will confirm that ovulation has occurred. However, it’s important to note that BBT detection “is only useful as retrospective data for determining ovulation,” and Suthoff says it “can be affected by things like illness, alcohol, and poor sleep.”
Cervical mucus is the gold standard for determining your fertile window.
That’s why cervical mucus is the gold standard for determining your fertile window, whether you’re trying to prevent pregnancy, conceive, or better track your cycle to better understand your hormones.
“The cells at the base of your womb, in your cervix, respond to changes in hormones, particularly estrogen and progesterone,” explains Suthoff. “So, over the course of an entire cycle, you could (and many women do) rely solely on cervical mucus patterns to tell when you’re fertile or not. The cervical mucus patterns alert you to your fertile time of the month.”
You can tell if your patterns are normal, and you can even use cervical mucus patterns to detect certain diseases, such as STDs, cancer, infections, endometriosis, and more.
How does the cervical mucus change over the course of your cycle?
First of all, it is important to know the basic phases of your cycle: menstruation and a fertile window with ovulation. During this period, there is bleeding and “shedding of the uterine lining that formed in the previous cycle.” Your fertile window, on the other hand, is when your eggs are maturing in the ovaries and preparing for ovulation. It’s the only time of the month when you can get pregnant.
Your cervical mucus patterns will change throughout your cycle.
“Ovulation occurs at the end of the fertile window and is the release of a mature egg,” adds Suthoff. “The luteal phase is the part of the cycle that occurs after ovulation and is the most stable phase. It is dominated by the activity of progesterone.”
Your cervical mucus patterns will change throughout your cycle. Since there isn’t much hormonal activity during your period, you won’t notice a lot of mucus during the period. “Shortly after your period ends, your fertile window opens in response to signals from the brain that go to the ovaries, telling them to mature some eggs,” says Suthoff. “Estrogen is produced from these maturing eggs. When estrogen levels rise in response to follicle stimulating hormone (FSH), the cells in the cervix begin to produce moist mucus due to low estrogen levels.” As FSH levels rise, mucus becomes more lubricious, clearer, and stretchy.
This is known as “peak-type mucus” and is commonly referred to as “egg white” texture because it actually resembles raw egg whites. This is when you are in your fertile window. So if you want to prevent pregnancy, either abstain from intercourse or use a barrier method. And if you want to get pregnant, now is the time to get busy.
After ovulation, the remaining cells in the ovaries produce progesterone, which “stimulates the cervix to produce a thick mucus that can appear scant and creamy.” Often this mucus is not even noticeable. Then you know your fertile window is finally over.
“To sum it up: menses, dry, wet, protein, dry — that’s the usual pattern of a normal cycle,” says Suthoff.
Write down what you observe each day.
How to track your cervical mucus
It’s really easy. You just start by “paying attention to the sensation,” says Suthoff. When you walk around, when you sit, when you use the toilet – just ask yourself what you’re feeling down there. is it humid Wet? Dry? Suthoff says you can wipe yourself before going to the bathroom because you’re afraid of missing out.
“Don’t think about it too much or analyze what you see too much,” she advises. “[In] In the first two to three cycles, most women are more confused than confident. After you’ve done a few cycles, you’ll start to see some patterns and gain more confidence in what you’re observing.”
Write down what you observe each day. You can use an app or an old-fashioned notebook. If you’re still feeling lost after a few cycles, it’s best to work with a certified trainer who can guide you and help you decode the signals your body is sending you. This can be especially useful if you are coming off hormonal birth control as not much mucus is seen when taking the pill. “That’s by design,” Suthoff suggests. Hormonal birth control pills “break the connection between the brain and the ovaries” so there are no hormonal fluctuations, which means there are no changes in the mucus.
“When you see mucus, it may be more friable and sparse, which is often just due to cell detachment,” she says. “The body is constantly renewing cells. There may also be bursts of mucus, especially if the pill is not taken. Every woman reacts differently and every birth control method is a little different.”
However, if you are currently taking the pill and planning to stop in the near future, Suthoff recommends that you start recording while you are on the pill anyway. Just so you can get used to it and recognize what signals your body is sending you.
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