Many women are coming to terms with how important it is to get to know their menstrual cycle. And so they track their period, whether it’s popping it into an app, making a note of it in their diary or adding it to their tracker. They may also keep notes of any other symptoms they experience. And this a great way to start to get to know your cycle. I have written about this in The Beginners Guide to Menstrual Cycle Tracking.
But our period is not the main event within our menstrual cycle. In actual fact, it is ovulation that we need to be paying attention to.
The egg (which will survive for 12-24 hours) enters the fallopian tube where it may be fertilised before moving to the uterus.
So obviously, ovulation is important for conception, right? But ovulation is not just about making babies.
Firstly, regular ovulation is a sign of health. After all, ovulation is only possible when the endocrine & reproductive systems are functioning normally.3 In a nutshell, only healthy bodies ovulate.
If there are any major issues in the body, our reproductive system is the first to tell us. Which makes sense doesn’t it? Evolutionary wise I mean?
If our body is not healthy enough, if we are experiencing high levels of stress, or if we are in danger, this is not the time to have a baby (remember that our body doesn’t care if we actually want a baby or not, this is simply physiology).
And so our reproductive systems shut down and places the energy that would have been used on attempting to create another life into caring for our own.
Despite the fact that healthcare providers often focus on bleeding patterns when it comes to reproductive health (ie your period), very little attention has been paid to ovulation in reproductive age women.4
And that’s a shame seeing as it’s ovulation that is crucial for maintaining optimal health during our reproductive years. Which is exactly what The Centre for Menstrual Cycle and Ovulation Research aims to prove.5
According to their research which is led by Dr. Jerilynn C. Prior, regular menstrual cycles with consistently normal ovulation during the premenopausal years will prevent osteoporosis, breast cancer and heart disease in women.
Although progesterone is produced in small quantities by the adrenal glands, the majority actually comes after an egg has been released during ovulation. The follicle (the little sac that that the egg was housed in) now becomes a temporary endocrine gland known as the corpus luteum. And it is this corpus luteum that produces the hormone progesterone.6
And progesterone, you see, is important for us for so many reasons including supporting the health of our breasts, heart, and nervous system, regulating our moods, as well as creating healthy brain function (which is why we can feel so much brain fog during perimenopause as progesterone levels decline). 7
Another reason that progesterone is so important is that it also mitigates the effects of oestrogen. Oestrogen is a hormone of growth as it thickens the lining of the uterus in preparation for pregnancy.
Oestrogen also has many other different functions in the female body. After all, there are oestrogen receptors on pretty much every cell in our body.8 And so it also provides protection for our brain, bones, heart and vulvovaginal health amongst a whole host of other benefits.9
But, as with anything we can have too much of a good thing. So if there is too much oestrogen it can go astray which is what happens in hormonally driven breast cancer and endometriosis.10
So we need our body to make what it needs and no more. Which is where progesterone comes in. To use an analogy, where oestrogen is like the fertiliser you put on your lawn, progesterone is the lawnmower that the body uses to keep the growth in check.11 And again, as you now know, we only get progesterone if we ovulate.
An ovulatory cycle is a menstrual cycle in which ovulation takes place and an egg has been released. An anovulatory cycle is a menstrual cycle in which ovulation does not occur and hence no egg is released.12
Anovulation can be caused by weight loss or weight gain, excessive exercise or illness.13 It can also be caused by psychological stress. As Dr. Jerilynn C. Prior puts it “A woman must be in good emotional, nutritional and social health to regularly ovulate. It makes sense that a woman who is under emotional stress is less likely to ovulate”.14
Although it’s normal for most women to experience a couple of anovulatory cycles each year,15 and more so as we enter perimenopause,16 we need to remember that not only is ovulation a sign of health, it’s also vital for optimal health. And so if we are not ovulating, if we are experiencing anovulatory cycles, this is an indicator of hormonal imbalance within our body and needs investigating. 17
Many women I have worked with believed that they didn’t need to track ovulation as their periods were regular and they didn’t experience anything out of the ordinary. They had normal periods and cycles. So that means that they must be ovulating, right? Wrong.
You can actually have a ‘period’ even without ovulation in what is called an anovulatory bleed.18 Notice how I put the ‘period’ in quotation marks. That is because if you do not ovulate, then you do not technically have a period. You can only experience a true menstrual period after ovulation.
During the first half of the menstrual cycle, the ovaries release oestrogen which rebuilds the endometrial tissue and restores the base of our uterus after our last period.
During the second half of the cycle, and as a result of ovulation, progesterone is produced. Progesterone takes the functional layer that was laid down by the oestrogen and makes it receptive to implantation by causing the uterus lining to mature. It’s a bit like oestrogen building the foundations of the house whilst progesterone furnishes it.19
If we do not conceive during ovulation then both oestrogen and progesterone levels drop and we have a true menstrual period to release both the house and the furnishings (i.e. the uterus lining).
And so again a true period is where the uterus releases its lining after both oestrogen and progesterone have done their job.
If we bleed without ovulation this is believed to be caused by a disturbance in the hypothalamic-pituitary-ovarian axis (HPO-Axis) and is not caused by a normal functioning reproductive system.20
Ovulation, not menstruation, is the key event within our menstrual cycle. Not only is regular ovulation a sign of health but it also helps us to maintain optimal health including helping to prevent osteoporosis, breast cancer and heart disease in women.
Ovulation is also necessary for the production of progesterone which is vital for keeping oestrogen in check as well as providing protection for our brain, bones, heart and vulvovaginal health.
Being able to recognise and track ovulation provides us with insight into our own bodies and can allow us to take proactive steps towards maintaining optimal health.
So the question remains, if we do not know if we are ovulating, how can we find out?
This is where advanced menstrual cycle tracking techniques come in, including Tracking Your Basal Body Temperature, monitoring your cervical mucus and paying attention to your cervix position. As we will see, all 3 change throughout our cycle and it is by using these biomarkers that can help us recognise ovulation and evaluate our own health status.21
Fact: women start with five hundred thousand follicles but only around 500 of these will be released during our lifetime (Vigil et al., 2017)↩︎
The luteal phase, the second half of the menstrual cycle is relatively constant (roughly 14 days). So if you have a longer cycle you will ovulate later.↩︎
Hendrickson-Jack, L. (2019) The Fifth Vital Sign: Master Your Cycles & Optimize Your Fertility. Fertility Friday Publishing Inc.↩︎
I need to thank Michelle Lyons for this one!↩︎
And remember, no egg released means no progesterone is produced.↩︎
Prior, J.C. et al. (2015) ‘Ovulation Prevalence in Women with Spontaneous Normal-Length Menstrual Cycles - A Population-Based Cohort from HUNT3, Norway’, PloS One, 10(8), p. e0134473. Available at: LINK.↩︎
I need to thank Michelle Lyons for this one!↩︎