for many women, that they are about to ovulate. Tenderness leading up to ovulation tends to be tingling in nature, because of the oestrogen effect. Tenderness that comes on towards the end of the cycle, influenced by the progesterone effect, is usually characterized by a heavy and full feeling, rather than tingling.
Spotting
In a very few women it is normal for them to experience a little mid-cycle spotting, or to have pink – coloured cervical mucus because of this spotting. For those women this is an indicator of peak fertility, but because it is so uncommon is not often listed as a fertility indicator. In addition, any mid – cycle spotting or bleeding must be reported to your doctor and checked out, as it can be an indicator of infection or disease. Make sure you are up to date on your smear tests.
What if my LH surge does not relate to my secretions?
An LH kit shows that ovulation is about to happen (within the next 24 hours). Cervical secretions give you about 5 days’ warning. To optimize your chances of pregnancy, have sex from the time your secretions start (this is the start of the fertile time). Normally the LH kit will become positive after you have had fertile secretions for a few days. Do not wait for a positive result from a urine sample – by the time you get this you are nearing the end of your fertile time. If you do have a positive LH test, continue to have regular sex for at least two days afterwards.
What if all of the LH tests are negative?
This can be very alarming for women, as you only get five test sticks, and if you have no idea about your fertility you won’t even be sure of when to start testing. If a woman has an irregular cycle, ovulation could vary anywhere between days 14 and 28, or even earlier or later than this, making it very hard to pinpoint exactly.
The LH sticks may not work for some women, for example some women over 40 may have higher LH readings. Similarly, some women with PCOS may have raised LH levels. If you use the sticks and find that you do not see any negative days – i.e. all your test results are positive – this may be a sign that you have an abnormally high LH level throughout your cycle. This should be checked by your doctor.
Ovulation does not occur in every cycle. It can be affected by factors such as age, the amount of time since you last gave birth, whether you are breastfeeding, how long it has been since you stopped taking the Pills, your body weight and stress levels. It is quite common not to ovulate in around 1 out of every 10 cycles. If you have two or more consecutive cycles where you do not think you have ovulated, see your doctor.
Why is my doctor going to check my progesterone levels?
Your doctor may do a progesterone test to check for ovulation. This is commonly called a Day 21 progesterone test. Doctors aim to test for the hormone progesterone about halfway through the second half (luteal) phase of your cycle – and for a woman with a cycle of 28 days, halfway between day 14 and 28 is Day 21. However, this only gives an accurate reading if your cycles are 28 days long. For shorter cycles the test may need to be done earlier, for longer ones, later. To time this test more accurately – and if you are aware of your fertile secretions – aim to get the test done about a week after your peak secretion day (i.e. one week after the secretions change back from being clear, wet and stretchy to being thick, white or dry again). If you are taking your temperature regularly, aim to have your progesterone test about six to seven days after your temperature rose to its higher level.
If you are told that a progesterone test shows you are not ovulating, this is not necessarily all doom and gloom. It simply means that you did not ovulate during that particular cycle. The test may need to be repeated to get an idea of whether this was an isolated incidence or a common occurrence for you.
What does it mean if my secretions do not get to the raw egg white stage?
Some women never notice egg – white type secretions yet conceive quite normally. It is the quality of the secretions high up in the cervix that count for the sperm. Avoid feeling inside your cervix to check for secretions, as this can be quite drying. As we get older the amount and quality of secretions reduces – so you may have noticed that these secretions were more abundant in your younger years. A reduction in secretions could be related purely to your observations – or may be related to slightly lower oestrogen levels. Many women never see the really stretchy type of secretion – but feel wetter only.
Can I use saliva, KY jelly or egg whites for lubrication during intercourse if I am dry?
No, unfortunately saliva has been found to be quite detrimental to sperm. In laboratory conditions, sperm cannot swim if they are in contact with saliva or any other lubricant – either water – or oil – based – all of these have some effect on sperm motility (movement). Although this has not been tested in women (and would be quite hard to study!), one has to assume that the effect would be the same in the body. Saliva of course contains an enzyme, ptyalin, which starts the digestive process – digesting carbohydrates – so this is not good news for the sugars contained in sperm or their swimming fluids!
Lubricating gels block the sperm. Egg whites are protein and can trigger an allergic reaction in some women.
I don’t seem to have many secretions, yet they seemed plentiful when I was younger. Is this common?
Yes, as we get older the quantity and quality of our cervical secretions are reduced. This is one of the reasons why fertility rates are lower in older women. The other factor is often that when young we are often unaware of the significance of these secretions and may even be quite alarmed by them. Sometimes women feel the secretions are a sign of infection – or that they may have damaged themselves somehow.
It is also common for women to report that as soon as they start to look out for the secretions, they no longer seem to see them. The amount of secretions will vary from woman to woman and sometimes from one cycle to the next in the same woman. If you are having sex around your fertile time (which is of course pretty vital) then often some of your natural secretions will get mixed in with the seminal fluid, which then comes away a few minutes after you have sex (even if you are lying flat) and can give you the impression that you’ve fewer secretions than you really have.
What if I spot between periods?
This depends on when the spotting is occurring. The first thing to remember is that ANY unusual bleeding or spotting must be checked out by your doctor. It is important to keep your cervical smears up to date, as these check not only for pre – cancerous changes but also for signs of infection.
If any spotting has been checked out medically and you are told that there is no concern medically, the following information may be helpful. Some women get spotting towards the end of a period – this may be quite normal as the period dries up. Some women have spotting leading into a period. This should be recorded at the end of the cycle – with the new cycle (Day 1) starting on the first day that you notice fresh red bleeding. If you consistently get some spotting for a day or so before your red bleed starts (pre – menstrual spotting), this may be an indication that your progesterone level is falling and may require medical help.
Very occasionally women who are observing cervical secretions report slight spotting tingeing the wet stretchy secretions – this is nothing to be concerned about (provided you are having regular smear tests) and may simply be due to the fact that you are more aware of your secretions than ever before!
Some women notice a tiny spot or so of blood (or even more) around the time implantation is occurring – so this could be a very positive sign.
I seem to have a long cycle and have secretions nearly all of my cycle.
Although most women report that they are dry immediately after a period and when approaching the next period, some will observe secretions for most, if not all, of the cycle. Again, if you suspect any infection, get this checked by your doctor.
Quite a common reason for secretions throughout