by Dr. Lora Shahine Ovulation is a key process in the menstrual cycle where a mature egg is released from the ovary and travels through the fallopian tube for fertilization. It is the most fertile time of the menstrual cycle and the time when women are most likely to conceive. Understanding ovulation and its physical signs can help women track their fertility and increase their chances of getting pregnant if they are trying to conceive. In this blog post, we will discuss the physical signs of ovulation and the different methods of testing for it. 5 Physical Signs of Ovulation Regular, predictable menstrual cycles: It’s amazing anyone has a monthly cycle if you really think through the delicate balance of hormonal communication between the hypothalamus, pituitary gland, ovaries, and uterus that signal release of the egg from the ovary once the uterine lining is ready for embryo implantation and a shedding of the lining of the uterus if no pregnancy occurs. Changes in Cervical Mucus: As ovulation approaches and the estrogen levels from the ovary increase, cervical mucus becomes more abundant, thinner, and stretchier, like egg whites. This is known as fertile cervical mucus and indicates that ovulation is imminent. Women can check their cervical mucus by wiping with toilet paper or using their fingers to observe the texture and consistency of the discharge. Changes in Cervical Position: During ovulation, the cervix softens and moves higher up in the vagina, becoming more open to allow sperm to enter. Women can track these changes by inserting a finger into their vagina and noting the position of the cervix. It is important to wash hands thoroughly before and after checking the cervix to prevent infection. Ovulation Pain: Some women experience a sharp, one-sided pain in the lower abdomen during ovulation. This pain is called mittelschmerz and occurs when the egg is released from the ovary. Women who experience ovulation pain can use this as a sign to predict their fertile window. More interest in intimacy: Higher estrogen levels associated with the ovulatory phase of the menstrual cycle can be associated with increased interest in intimacy. Testing for Ovulation (4 Methods) Basal Body Temperature (BBT) Changes: BBT is the body's resting temperature, which increases slightly after ovulation due to the release of progesterone. Women can track their BBT using a thermometer every morning before getting out of bed. A slight increase in BBT can indicate ovulation has occurred. Ovulation Predictor Kits (OPKs): OPKs are urine tests that detect the luteinizing hormone (LH) surge, which triggers ovulation. LH levels increase about 12-36 hours before ovulation, making OPKs a useful tool for predicting ovulation. Follow the instructions carefully when using OPKs and test daily around the predicted time of ovulation. Once you see a positive result on your ovulation predictor kit – there is no need to continue checking as the surge may be present for a day or a few days - you should consider yourself in your most fertile window. Blood Tests: Laboratory tests can track changes in hormones throughout the menstrual cycle. Estrogen levels increase steadily until ovulation, then slowly drop. LH is the surge hormone from the pituitary gland that is highest 12-36 hours before the actual release of the egg from the ovary. Progesterone is the hormone that is released after ovulation, and a progesterone level of 3 ng/mL or greater is most often a sign that ovulation did occur during that menstrual cycle. Ultrasound: Ultrasound is a medical imaging technique that uses sound waves to produce images of the internal organs. Transvaginal ultrasound can detect changes in the size and shape of the follicles in the ovaries, indicating that ovulation is about to occur. This method is more invasive and requires medical equipment, making it more costly and less accessible than other testing methods. Ovulation is a crucial process in the menstrual cycle, and understanding its physical signs and testing methods can help you track fertility and increase your chance of getting pregnant. If you are not having regular, predictable menstrual cycles and signs of ovulation – please check in with your doctor. Dr. Lora Shahine Dr. Lora Shahine, reproductive endocrinologist at Pacific NW Fertility and clinical faculty at the University of Washington in Seattle, completed her fellowship in reproductive endocrinology at Stanford University and residency in obstetrics and gynecology at the University of California in San Francisco. She is dedicated to educating and advocating for increased awareness of infertility, miscarriage, and the impact on environmental toxins on health through an active social media presence, teaching, clinical research, her books including best-selling, Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss, and her podcast, Baby or Bust. Find her at drlorashahine.com and on Instagram, YouTube, TikTok, and Twitter.