Last year, we drove 15,000 miles through the United States for three months to teach about body literacy and informed choice. We called the project The Fifth Vital Sign, because the menstrual cycle is an important indicator of our health, just like blood pressure, heart rate, temperature, and respiratory rate. In addition to teaching, we had the great privilege to hear people’s stories. Throughout our travels, we heard how people used fertility awareness, a tool to listen to and better know their bodies, in every stage of their life—through menarche and menopause, as birth control, as body wisdom, during IUI, and through infertility.
Have you heard of fertility awareness? We’ll run through the basics below.
There are three signs to look out for every day to begin to better understand your menstrual cycle: basal body temperature, cervical fluid, and cervical positioning. You can chart your findings daily on paper or apps like MyDays, Kindara, Clue, Groove; the options are myriad, so check out Appleseed Fertility for reviews.
Basal Body Temperature (BBT) aka resting temperature
Why is our temperature important, and what information will it provide? During ovulation, an egg in the ovary develops inside and eventually breaks through a follicle, or sac. This follicle becomes the corpus luteum and releases a hormone called progesterone. Progesterone heats the body, so a rise in body temperature usually indicates ovulation occurred the day before. Here’s an important note: you may not ovulate on Day 14, aka 14 days after the start of your last period! All of our bodies are different. The ability to give our health care team specific information about our unique bodies can optimize our care.
Temperature patterns can be indicative of much more than ovulation. Consistently low temperatures or high temperatures could be signs of hypothyroidism or hyperthyroidism, respectively. Additionally, for implantation (attachment of the fertilized egg to the uterine wall) to occur, at least 10 days of high temperatures after ovulation are usually necessary. Sometimes we are regularly menstruating and not ovulating. It’s normal to have 2-3 anovulatory cycles per year. BBT can help identify cycles in which we don’t ovulate.
Check your BBT every morning before you sit or stand up, go to the bathroom, or drink water. (We even met someone on tour who hung her thermometer on a string from her ceiling so she saw it first thing in the morning)! You can buy a basal body thermometer from any pharmacy or online, as long as it gives you your temperature to the tenths place (ex. 98.6). Make a note if you’re sick with fever, drank alcohol the night prior, slept less than 3 hours, or traveling, as these changes can affect your waking temperature.
As your hormones, estrogen and progesterone, fluctuate throughout the menstrual cycle, they impact the consistency, color, feel, amount, and abilities of cervical fluid. You may have already noticed these changes by feeling different sensations when you wipe after peeing or observing different kinds of fluid in your underwear. The most fertile type of cervical fluid is called egg-white cervical fluid, named such for its likeness to raw egg whites. It can stretch an inch or more between your thumb and forefinger, causes a lubricative vaginal sensation, and can keep sperm alive for up to five days. Without it, sperm would be unable to survive in the acidic vaginal environment. The presence of fertile cervical fluid usually indicates ovulation will occur. You may notice other types of fluid, oftentimes described as creamy, milky, sticky, and dry, meaning you don’t see or feel any cervical fluid. You may notice different or the same patterns of cervical fluid change each cycle. Keep track of your observations, along with your temperature.
There are various ways to check cervical fluid, but its recommended you do so throughout the day, when you go to the bathroom or take a shower. After washing your hands, you can insert two fingers into the vagina about 4-6 inches until you feel the cervix to draw out the fluid; check it on a tissue paper after you wipe; or look at and touch it on your underwear.
Cervical positioning can indicate where you are in your menstrual cycle. Around ovulation, the cervix, or the neck of the uterus, is usually higher, softer like your earlobe, and open, in order to make room for penetration and allow sperm to more easily enter the uterus. During menstruation, the cervix is generally lower, harder like the end of your nose, and closed.
In the same way you check cervical fluid, get into a comfortable position, perhaps a squat, and insert one or two fingers into the vagina about 4-6 inches until you feel a donut-like shape (hello, cervix!). Write down your findings.
If you have any interest in digging deeper into fertility awareness, we highly recommend the book Taking Charge of Your Fertility by Toni Weschler.
Don’t hesitate to reach out to us at firstname.lastname@example.org with any questions and thoughts. It’s our hope through information sharing, we will all feel more safe, secure, and alive in our bodies.