Ask Dr. Annie K: Ovulation

 

How do I know when I am ovulating?

Love+Medicine

Your question is a very good one.

There are many reasons why someone would want to know about ovulation. These can be women and their partners who are trying to get pregnant, those who are trying to avoid getting pregnant, and anyone who is curious to know more about how women’s bodies work.

Ovulation is when an egg is released from the ovary.  This happens every month in women with regular cycles. Ovulation usually happens around day 14 in women with regular 28-day cycles. But it can happen any time between day 11 to 21, day 1 being the first day of the last menstrual period. The egg lives for 12 to 24 hours after leaving the ovary, while sperm are viable for several days. If sperm enters the egg during that “fertile period” pregnancy can happen.

When you ovulate can change from month to month. It is not an exact science. Predicting when ovulation is happening is the basis for Fertility Awareness. Fertility Awareness-based methods are not reliable forms of contraception but may be helpful for women trying to get pregnant.

The body goes through changes during ovulation. Getting to know these changes can help you figure out if you are ovulating. 

Basal Body Temperature (BBT)

Prior to ovulation, body temperature falls. After ovulation, a woman’s body temperature rises as a result of an increase in progesterone. Because temperature changes can be influenced by things like stress, illness, poor sleep, inaccurate readings, etc., this alone is not a reliable method to predict ovulation.

Changes in vaginal discharge

During ovulation, the consistency and look of vaginal discharge is noticeably different in most women. Normal discharge is white, cloudy and not stretchy. During ovulation it is more like egg whites – it is clear and when stretched out, it will not break.

Mittelschmerz (German for “middle pain”)

Happens in about 20% of women. There may be a twinge or cramp in one side of the lower abdomen, close to the ovary where the egg is released. If you pay attention to your body mid-cycle, you may feel it. Sometimes it is subtle pain but for some women, it is very painful. 

The cervix never lies

“The cervix never lies” is an old medical school phrase. It can tell you a lot! In the case of ovulation, the cervix softens and opens a bit. This may be nature’s way of preparing it for the entrance of sperm. It is closed and more firm at other times. Some women can feel these changes by using their fingers. 

Increase in sex drive

Some women notice an increase in their sex drive during ovulation as a result of a surge in hormones. This may be evolution’s way of priming women to feel most aroused when they are most likely to get pregnant. 

There are apps, (many apps!) that claim to predict ovulation. Most of these apps are designed for women trying to get pregnant. 

I have done some research regarding which apps are most reliable. The American College of Obstetricians and Gynecologists (ACOG) recently published a review of cycle-tracking apps and have determined that they cannot 100% accurately predict ovulation. However, ACOG did offer suggestions of apps they comfortably recommend at this time: Clue, Glow, and Pink Pad Period Tracker Pro are the top three. 

Understanding the fascinating process of ovulation is essential for all women and their partners. The basis for most contraceptive methods is to stop ovulation – now you know why. Learning when you ovulate is part of knowing and appreciating the female body. 

How Hard Can It Be? Understanding Erectile Dysfunction

As part of my series on the Aging Male, Love and Medicine will tackle erectile dysfunction (ED) – failure of the penis to remain erect in order to reach sexual satisfaction. Most men have experienced this at one time in their lives.  Men are embarrassed, anxious and depressed when their penis isn’t working.  They report frustration because they can’t please their partner. For men in healthy relationships, their partner’s needs matter a lot.

I interned in a sleep lab in graduate school. Sleep studies were used to differentiate psychogenic ED from physiological ED. A normal man spends about two hours in a tumescent state while asleep, having three to four erections a night. A man with psychogenic ED would probably be not far from the norm; a man with physiological ED would remain soft. Diabetic men spent nights in the sleep lab while erections were recorded and it was there that the first correlation between ED and diabetes was discovered.

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Ask Dr. Annie K: Legitimizing Mental Illness

I recently felt the need to take a mental health day off work. I had to tell my boss I was also feeling physical illness symptoms in order to justify my absence. Why does society act as if leave from work is only justified if I am physically ill?

– Anonymous

Dear Reader,

You have touched on a very sensitive topic for me. What you are describing is having to “legitimize” your illness by adding physical complaints. 

Unfortunately, even in this day and age, mental illness is treated differently than other illnesses. It is considered a weakness to have a mental health problem. People expect you can just “get over it.” Just eat healthy, exercise, breathe and it will go away.

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Ask Dr. Annie K: Post-Menopause

 

I am 5 years post menopausal and feel like crap. Going through menopause was/is one of the worst thing that has ever happened to me. I went through at the early age of 43 🙁 I haven’t felt like me in years. I have always exercised and I eat a very healthy diet comprised mainly of veggies, but I’m fatter then I’ve ever been and gaining by the years. I am so tired of people telling me this is a normal part of aging! I have seen plenty of older women that still look and feel amazing. How do I know if my hormones are out of whack? What can I do if they are? I don’t like to take any medications if possible.

Love+Medicine

Thank you for asking about this very important issue, one that troubles many women. Our knowledge and understanding of menopause is pretty pathetic, considering all women go through it!

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Hello darkness, my old friend.

I can appreciate the change of season by the end of summer. I am drawn to the orange, brown, maroon tones of fall fashion. I love to climb up on a chair to retrieve the crockpot that has been stored over the summer. Pumpkin, sweet potato and squash replace the tomatoes, zucchini and corn in the basket in the kitchen. Logs are collected and stacked up by the fireplace. The paddle board and outdoor furniture are tucked safely away from the elements. The outdoor shower pipe is shut off, hopefully in time for the first freeze.

This is the time of year when darkness sets in early, before we get home from work. The temperature is cold. The predominant color is gray. The decrease in hours of natural sunlight is dramatic.

All of these external changes effect us internally. Humans and other animals are extremely sensitive to changes in the environment. This is a good thing, we want to be in tune with nature. We need to recognize the changes and adjust.

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