How Do You Compare?



Understanding Menstrual and Basal Temperature ChartingUsing Charting To Pinpoint Ovulation, Thyroid, and Period ProblemsMost women diagnosed with Polycystic Ovary Syndrome (PCOS) presented to their health professional/s with certain signs and symptoms, mainly menstrual cycle irregularities. In my book, Conquer Your PCOS Naturally, I discuss PCOS in detail. However, in this report, I discuss the “ins and outs” of menstrual and basal temperature charting and the most common problems associated with PCOS. The simple and important process of charting reveals much about your current hormonal status. This report will help you:learn how to chart your menstrual cycle,discover how your lifestyle affects your hormones,learn how your mood, energy, and emotions change with different hormonal fluctuations; andlearn about the common problems that women with PCOS experience, and how to overcome these problems. Charting provides you with an important tool, not only for taking charge of your hormonal health, wellbeing, and fertility (either to conceive or to reduce your chances of conception), but also for identifying and resolving PCOS problems. By charting your menstrual and basal temperature, as you implement positive and powerful lifestyle changes, you can observe hormonal changes as they show in your charts. I will compare the changes that can come with altered hormonal balance to an ideal menstrual cycle, to help shed light on your current situation.How Do You Compare?As a woman with PCOS, it's possible that you have never experienced an ideal cycle. But by looking at the similarities and differences between your cycle and the ideal cycle, you can pinpoint specific problem areas and focus on how to correct your particular menstrual idiosyncrasies.MenstruationIt doesn't take any real detective work to figure out if you aren't menstruating. However, one of the challenges for women with PCOS may be to determine when, exactly, a cycle starts, because of the lack of obvious cycle ‘markers’. It is possible to spontaneously ovulate, even without a period. By charting, you will discover if it is likely you are ovulating, and when.OvulationWomen with PCOS often don’t ovulate, or ovulate infrequently. Charting your temperature, along with the qualities of your cervical mucus, will allow you to pinpoint ovulation. We'll talk more about this shortly.ImplantationIf you ovulate, you have an opportunity to conceive. But ovulation is not the end of the cycle. If you are noticing the signs of ovulation – a temperature spike paired with fertile cervical fluid - pay attention for a cycle or three to the period of time after ovulation and before your next period. This part of your cycle is known as the luteal phase. During this phase, an increase in the hormone progesterone occurs (as indicated by the ‘P’ in Picture 1 on page 8). In an ideal cycle, the right quantity of progesterone is released. Progesterone ensures the endometrial lining is thickened and structurally sound, so that a fertilized egg can implant healthily. The luteal phase ideally lasts a minimum of 12 days (usually between 12 and 16) after ovulation. Progesterone is a heating hormone. The pregnancy saying ‘to have a bun in the oven’ is quite appropriate! In an ideal cycle, your temperature will remain raised for twelve or more days, before menstruation approaches and your basal body temperature (BBT) drops back down. If you become pregnant, however, this temperature will remain raised, a great indicator to watch when trying to conceive.Many women with PCOS struggle with good progesterone production, which can shorten the luteal phase. Without adequate progesterone, which can result from a lack of ovulation, or a poor quality corpus luteum (what is left of the follicle after ovulation), the luteal phase will not be sufficient in length. This can affect the next part of your cycle and make it difficult for implantation to occur. If conception does occur, it can lead to the likelihood of early miscarriage. Why? An important function of progesterone is to maintain the endometrial lining. Poor progesterone levels result in the breakdown of the endometrial lining, and the egg will be carried away as this lining is lost.The Ideal Menstrual CycleLet’s take a look at an ideal cycle. This will give you something to compare your charts to and help you discover where your cycle may be going wrong.The first day of your period is considered the first day of your cycle.The ‘ideal’ cycle is usually described as 29 ? days long (from the first day of your period to the day before your next period). It is the same length as the lunar, or moon cycle. However, there is often variability in cycle length between women, and in an individual woman. The first half of your cycle (from day 1 of your period to ovulation) is called the follicular phase. The second phase (from ovulation to the day before the next bleed) is called the luteal phase. Some researchers refer to more than 2 phases, breaking them down further into follicular, ovulatory, luteal and menstrual phase (menstruation). Although the follicular phase and luteal phase are often described as being the same in length, this is frequently not the case. “Among regularly cycling women, there is considerable normal variability in the phases of the menstrual cycle. The follicular phase contributes most to this variability.” The luteal phase tends to be stable, giving us a useful indicator of hormonal health. A longer cycle results in better IVF (in vitro fertilisation) pregnancy and birth rates than a shorter cycle. As women with PCOS usually have longer cycles, this is at least some good news about fertility probability, whether natural or assisted.Ovulation prior to day 18 is important. This ensures that fertilisation does not occur with an aged egg.The luteal phase should be at least 12 days to allow time for implantation of a fertilised egg.There should be virtually no symptomatic concerns throughout a cycle. This is a completely natural event and should be relatively uneventful. There will be a short-lived drop in temperature immediately following ovulation. However, you will most likely not detect this in your temperature charting.In the luteal phase, there should be an increased basal temperature (the temperature you are tracking every morning) of between 0.1 – 0.5 degrees Celsius.How to predict ovulationOvulation is a healthy part of an ideal cycle. When you ovulate, this indicates that your hormones are more likely to be working well. Ovulation charting helps you discover more about your hormonal health, not just whether you are ovulating. We will talk about this more shortly.Ovulation is usually a subtle process. Some women feel a slight twinge at the moment the egg is released, known as ‘Mittelschmerz’, German for ‘middle pain’ and known in medical terms as ‘ovulation pain’ or ‘mid-cycle pain’. The latest research shows it may take 15 minutes for ovulation to occur. Want to become pregnant?The two most important things to know when you are trying to conceive are whether you are ovulating, and when. Initially, ovulation tracking lets you determine where you are in regard to ovulation, and where you need to head.The time around ovulation is the most fertile zone in your cycle. This is important, as well-timed intercourse around this period is critical for achieving a successful and natural conception.Accurate ovulation prediction results by comparing cervical mucus changes, basal body temperature, and your emotions.Picture 1: Menstrual Cycle Hormonal, Ovulation, Endometrial & Temperature ChangesCourtesy: MetagenicsBelow are methods you can use to accurately predict ovulation.1. Basal Body Temperature (BBT)Your basal body temperature (BBT) is your body temperature when you are completely at rest. This temperature is taken using a special basal body thermometer or fertility thermometer (Note: a fertility thermometer is more accurate, and so is recommended whether you are trying to conceive or simply assess your hormonal balance and thyroid function). Basal body temperature will start rising as ovulation occurs (as progesterone is produced), and will continue to rise until it reaches its highest point. The rise in basal body temperature is by up to 1 degree Fahrenheit (0.5 degree Celsius) following the time of ovulation. This rise in temperature should be sustained for more than 3 days to confirm ovulation, but sustained for 12+ days in an ideal cycle.You should take your basal body temperature starting from the first day of your cycle and record it as ‘Day One’. Record your temperature in the morning as soon as you wake up. Place the thermometer under your tongue while you are still resting in bed, before any movement. Take this temperature at the same time every day, as changing the time you take your temperature will cause inaccurate readings.To understand your ovulation patterns, your fertile days and what your hormones are doing, you need to chart your BBT for three to four months. For easier tracking, it is better to maintain a separate chart for each cycle. Your temperature needs to be recorded on a chart similar to the one within The PCOS Diary – From Struggle To Success. You can click to to download further copies of the ovulation chart I use in practice. Here you will also find detailed charting instructions, which are important to follow.2. Cervical Mucous (CM) TestingPicture 2: Hormone Levels Changes And Their Effect On Cervical Mucus (‘Mucus’) Amount, Consistency And ColourCourtesy: MetagenicsCervical mucus is normally produced at the mouth (cervix) of your uterus. The qualities of the mucus change, depending on where you are in your cycle. It may be clear and wet, translucent and stretchy, thick and flaky, dry, or you may have none. Other qualities of this mucus such as its colour, amount, and consistency will be affected by the hormonal changes that occur around ovulation. These changes will help you predict ovulation.Check for the presence of mucus and the consistency of any mucus prior to urinating. You can collect it with toilet paper or between your thumb and forefinger from your vaginal opening. Make sure to wash your hands first.Check the cervical mucus for these factors:Consistency: Describe the consistency of the cervical mucus, depending on how it feels: dry, moist/damp, or wet. The wetter it is, the more fertile you are.Amount: The amount of cervical mucus will increase as you near ovulation.Texture: The texture of the cervical mucus can vary from none or pasty in the non-fertile phases, to creamy or milky in the stages after ovulation, to clear, stretchy (like raw egg whites) at ovulation. Each woman is different and mucus may also vary from cycle to cycle.Picture 3: Drawing Of Different Types Of Cervical Mucus Medical-Cervical mucus has different functions depending on the stage of your cycle. The quantity, quality, and pH level determines whether the mucus acts to help or hinder the passage of sperm.Immediately after your period, the cervical mucus will either be non-existent, or it will be dry. This is not a fertile time in your cycle. As your cycle continues and the level of oestrogen increases, so too does your mucus. It will begin to increase in quantity and become wetter and more slippery. Around ovulation, it will appear similar to egg white. This type of cervical mucus is often referred to as egg white cervical mucus, or EWCM.If you are not producing cervical mucus, the chance that you are ovulating is limited. If you don’t ovulate, you can’t conceive. This may be helpful if you are trying to avoid conception. However, a lack of cervical mucus also indicates that your hormones aren’t functioning well. I will discuss hormonal issues later. As with your basal body temperatures, it is best to chart your cervical mucus qualities for three to four months to understand your ovulation pattern.3. Ovulation Prediction Kits (OPKs)Your body experiences a surge in luteinizing hormone (LH) just before ovulation, which usually follows in the next 24?48 hours after this surge. Ovulation prediction kits, which can be used at home, may help you assess your LH levels, and in turn, the most fertile days of your cycle.Note: Ovulation predictor kits may give inaccurate results in women with PCOS (due to the often high level of LH) and those with hypothyroidism (more common in women with PCOS). For this reason, it may be more accurate to chart your cycle.4. Take a cue from your emotionsYou need not only rely on tests and charts to determine when you are ovulating; your emotions and feelings are also indicators of ovulation. Research has shown that a woman’s interest in flirting with her partner and in sexual intercourse increases just before ovulation. Men are also found to be more protective and possessive of their partners during the most fertile phase of the woman’s cycle. So, alongside the temperature taking, chart plotting and mucus testing, be attentive to your feelings and desires. How to Predict Ovulation by Comparing Basal Body Temperature, Cervical Mucus Changes and Your EmotionsLook at your chart. To confirm ovulation, you should see a spike in your temperature, and notice egg white cervical mucus. It is only when you see these things together that you have strong evidence that ovulation has occurred. As I mentioned above, you may also notice around this time in your cycle that you feel flirty and sexy. By regular charting of each of these indicators, you can assess your ovulation probability.Time it well!When you understand your own fertility rhythms, using the above methods, you are in a better position to either enhance your chances of conception or avoid it – depending on your wishes. Once you know when you are most likely to be fertile, you will know when to have sex (or not to have sex, if you wish to avoid pregnancy). Remember, an egg is viable only for a period of 24 hours after ovulation. However, the most fertile period of your cycle is during the 5?6 days before ovulation and ends 24 hours after you have ovulated. After intercourse, the sperm can survive for up to five days inside your reproductive tract. This is the main reason behind this wider window in your fertile period. Having intercourse during this fertile period significantly increases your chances of getting pregnant, and avoiding intercourse significantly reduces your chances. However, take note: Some studies have shown that women can conceive outside their fertility window as well.Notes About Conception AttemptsWaiting to ‘build up sperm quantity’ may actually damage the sperm. Having sex too frequently may also reduce the chances of conception. So, aim for intimacy every 2 or 3 days. If your aim is conception, don’t make the process mechanical. You don’t need to wait for your fertile period to enjoy each other and connect. Relax, and remember you are creating a new life with the one you love. Be romantic, spontaneous, go away on a holiday, spend the day in bed, give each other massages, and try new things. An orgasm helps a woman conceive. Enjoy the practice!Your Thyroid, Ovulation, and ChartingThe thyroid is a small, but very important, gland in your neck that affects not only your overall health, but also your menstruation, ovulation, and fertility. The thyroid, among other hormones, produces a hormone called thyroxine, and the pituitary produces a hormone called TSH (Thyroid Stimulating Hormone). As I noted in an earlier section, hypothyroidism (an underactive thyroid) is common in women with PCOS. If you have hypothyroidism, your thyroid usually does not make enough thyroxine (T4), and the pituitary gland in your brain makes more thyroid stimulating hormone (TSH) to signal the thyroid to make more T4. A high TSH level (above 2/2.5 mIU/L) indicates possible low T4 production and hypothyroidism.I discuss hypothyroidism in this report because it can cause ovulation problems and decreased follicle stimulation hormone (FSH) levels, which cause problems that I discuss later in this report. Hypothyroidism causes immature follicles and unreleased eggs. Conversely, too much thyroid hormone (hyperthyroidism) can cause miscarriage and unexplained fertility. In addition, the health of your thyroid may also significantly alter your body temperature.“Generally, the average temperature of an adult with a healthy thyroid and a healthy metabolism is 98.6 degrees Fahrenheit or 37.0 degrees Celsius, and that occurs around mid-afternoon or 3 pm. So if you take your mid-afternoon temp and find it in low 98′s or even in the 97′s, you have been given a strong clue that you may be hypothyroid?and/or undertreated (or your low cortisol is keeping you hypothyroid). And a few report their mid-afternoon temp being in the 96′s. BRRRR.Another temperature clue occurs first thing in the morning before you rise from your bed. Dr. Broda Barnes, a doctor who paid attention to clinical presentation and prescribed the pre-reformulated Armour, found that a healthy before-rising morning basal temp should be between 97.8 – 98.2 (using a mercury thermometer under the arm for ten minutes). If it’s higher, you may be hyperthyroid, and if it’s lower, you are most likely hypothyroid. If using an oral thermometer in the mouth and want to compare it to the way Broda Barnes did the underarm, leave in your mouth for five minutes, then subtract 1/2 degree from your result to make it closer to underarm temp taking — the latter which is usually lower.” (Note: this will vary with menstrual cycle stage.)- addition to altering your temperature, hypothyroidism may change your how your genes are expressed to those resembling a PCOS pattern. Further, thyroid autoimmune dis-ease, in which your body creates anti-bodies that destroy the thyroid, is three times more common in women with PCOS and is a major reason behind unexplained fertility problems, which can effect ovulation and implantation.Women with PCOS should have their thyroid hormone levels checked by their primary care physician. For more detailed information about the relationship between the thyroid and PCOS, please see Chapter 9 of my book, Conquer Your PCOS Naturally. Troubleshooting: Common Issues Revealed By ChartingHow Do You Compare?If you have PCOS, it's possible that you have never experienced an ideal cycle! But by looking at the similarities and differences between your cycle and the ideal, you can pinpoint specific problem areas and focus on tactics to repair the hormone imbalances that are causing your particular menstrual idiosyncrasies.MenstruationIt doesn't take any deep detective work to figure out if you're not menstruating. One of the biggest challenges for women with PCOS attempting natural fertility planning is to determine when, exactly, a cycle starts, without the obvious menstrual markers. It is important to remember, however, that you might ovulate even if you haven't had a recent period. Charting your basal body temperature and cervical mucus will help you determine if ovulation is occurring, even if you don't know where your cycle starts or ends (sounds strange, I know!).Irregular or lack of menstrual bleeding is, of course, a sign that your hormones aren’t working well. Common hormone irregularities that interfere with regular periods, and ways to identify which are more likely in your case, include: Excessive levels of testosterone. This can also cause excessive facial and body hair growth, acne, anger and unexpressed anger, depression and scalp hair loss.Insulin resistance. This can also cause the symptoms of excessive hair growth, plus tiredness, energy slumps, hot flushes, fatty liver disease, skin tags, and acanthosis nigricans (skin discolouration).If you suspect that testosterone levels or insulin resistance may be interfering with your periods, and you have not had these factors tested, see your primary health care physician. He or she can provide you with the testing and follow-up advice you need. My two special reports, Resistant Hormone Causes Weight Gain & Stops Women With PCOS From Shedding Unwanted Pounds and Common PCOS Weight Loss Super Secret Revealed reveal the correct testing for both insulin and thyroid issues (you can discover more at ). OvulationCharting your basal body temperature along with your mucus findings will allow you to pinpoint ovulation, with a peak above 97.8 degrees Fahrenheit, which should last for approximately two weeks.ImplantationIf you are ovulating, you have the opportunity to conceive! If you are noticing the signs of ovulation - temperature spike paired with fertile cervical mucus - pay attention for a cycle or three to the post-ovulatory period.Many women with PCOS struggle with progesterone production, which causes difficulties during this stage. Without sufficient progesterone, the luteal phase will not last long enough for successful implantation to occur. (As noted earlier, at least 12 days after ovulation is needed for this to occur.)As I noted earlier, women with PCOS are also more likely to suffer from thyroid autoimmune disease, which has been shown to interfere with successful implantation.What If…1. I'm not menstruating at all.Start charting now, today. Don't wait! Don't worry about what ‘cycle day’ it is, just start keeping track of all the signs and symptoms. Get your digital thermometer out and keep it by your bedside so you remember to make it part of your routine. Pay attention to your body to see how you're feeling, and note changes to your cervical mucus over time. You may not notice anything at first but keep it up while you work on improving your insulin resistance, and overall health under the supervision of your primary health physician. A balanced, sensible diet, regular exercise and sleep, and a healthy emotional life affect menstruation. Make any necessary changes to your lifestyle and track the affect it has on your menstrual cycle. 2. I'm menstruating, but not ovulating.So, at least you know when your cycle starts! If you seem to have some kind of a cycle, or at least menstruate with any kind of regularity, but you haven't seen that tell-tale temperature spike signifying ovulation, it is possible that a few good lifestyle changes could kick start ovulation for you. For example, losing 5 – 10% of your body weight is an effective way to boost insulin resistance and restore ovulation.3. My temperature readings are all over the place!There are several reasons why you might be struggling to find any pattern in your temperature charts. There are important steps to take in order to ensure that your temperature taking results are accurate, so spend a bit of time evaluating your process.Here are some easy tips for solutions:Be sure you are taking your temperature at the same time every day. If you sleep in, your temperature will be higher than usual. If you are up early, it will be lower. Try picking a time in line with when you are typically up, at the earliest point. On weekends, you can always go back to sleep after taking your readings. If you can't help waking up early, or late, edit your temperature accordingly: lower your recorded BBT by 0.25 degrees for every hour you wake up early and raise it by the same amount for every hour you wake up late. Be sure to mark on your chart that this is an approximation due to sleep schedule disturbance.If you have been using a digital thermometer, be sure to check the power source! A low battery can cause false readings. Some women do not respond well to digital thermometers, so you can also try a glass ‘basal body thermometer’ to see if it yields different results. Take your temperature with these for a full five minutes to get the best accuracy.You can switch from oral to vaginal temperature taking upon waking, but be sure to use one method consistently throughout your cycle. No switching back and forth!Remember that there are a few things that can cause your basal body temperature to shift. If you had a night out drinking, your temperature is likely to be higher. If you typically eat a low-carb diet, it may be lower on most days, but higher on days when you eat quite a few carbs. Obviously, a fever will skew your results! And, be sure you are getting at least three hours sleep each night, or make notes on your chart if you don't. Keeping track of possible factors changing your temperature will help you better evaluate your chart at the end of each cycle.4. My luteal phase is too short.One of the most common problems that women with PCOS encounter when they are both menstruating and ovulating is a short luteal phase. If you have noticed that your luteal phase is shorter (less than 12 days), your temperature drops earlier than 12 days after the spike, and you have an early period, this is called a luteal phase defect. This can be due to low FSH (in the follicular phase), low progesterone levels (in the luteal phase) or low active thyroid hormone levels ().Low FSH levels will cause the follicle to not develop. Then, ovulation either doesn’t occur (and so progesterone production is not increased), or if it does, as discussed earlier, progesterone levels will be low because of the poor quality of the corpus luteum. Without sufficient progesterone, the luteal phase shortens, resulting in early breakdown of the endometrial lining and miscarriage.In addition, women with PCOS typically have high LH levels. Ideally, women have a 1:1 ratio of LH and FSH in the early part of their cycle. But in women with PCOS, LH levels are often two or three times higher than their FSH levels. This unbalanced ratio disrupts ovulation, and therefore, also progesterone production. Approximately 24 hours before ovulation occurs, there is a surge in LH levels, which helps release the egg from the ovary. High prolactin levels may also cause luteal phase problems. Prolactin is a hormone produced by the pituitary gland, stimulating milk production after a woman has a baby. Women who are not pregnant or nursing should have low levels of prolactin. High levels of this hormone can prevent ovulation or, in milder cases, a woman may ovulate regularly but not produce enough progesterone after ovulation. As discussed earlier, low progesterone levels create an endometrial lining that is less able to support implantation.When the luteal phase is shorter than 12 days, implantation becomes impossible. Women who are actually able to conceive often experience early miscarriage because of this, sometimes without even knowing. When they have their period at the expected time, many women simply assume that their attempts at conception failed.By charting both basal body temperature and cervical mucus, you will gain great insight into the likelihood that you have ovulated or not, and into the health of your hormones and thyroid. The length of your post-ovulatory luteal phase will give you an indication of which hormones may or may not be an issue for you. Knowledge is PowerAs I've discussed in this report, several factors -- your overall health, diet, hormonal health, and emotional state -- affect menstruation, and therefore, also your ability to ovulate and conceive. Charting your menstrual and basal temperatures, and the factors that affect it, as well charting your cervical mucus, will give you a visual picture of your cycle and what may be occurring in your body. When you know where your most pressing health issues lie, you can take the appropriate steps needed to overcome them.From PCOS to perfect health, with love,Dr. Rebecca Harwin‘The PCOS Expert’ for tailored one-on-one help.Head to for your free special report, How To Have Healthy Babies, Even With Polycystic Ovary SyndromeHead to for your free special report, How To Lose, Ugly Unwanted Fat & Gain A Sexy, Healthy BodyIf you are ready to discover the unique ‘Conquer Your PCOS – The 12 Week Action Plan’, an advanced blueprint designed to help you conquer your PCOS from the comfort of your own home, head to now ................
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