Everything to Know About Ovulation

So we pop an egg out of an ovary every month, that’s about it, right? The jest of ovulation?  Yes, we do, but there is a whole lot of science behind what our bodies are doing.  Whether you have a cycle every 28 days on the dot, or you are less regular and start at random times, it all revolves around ovulation.  That little egg is the entire reason we have a monthly cycle!  Here’s the breakdown of the uterus:

The Science Behind Ovulating

The hypothalamus, a tiny little piece in the brain that regulates things, monitors the hormone output of the ovaries and synchronizes the normal menstrual cycle. When monthly bleeding ends, the hypothalamus secretes gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland in the brain to release follicle stimulating hormone (FSH) and luteinizing hormone (LH).  These hormones direct an ovary to start making estrogen (mostly estradiol), and stimulate the maturation of eggs in about 120 follicles. I’ll break it down:  The first follicle that ovulates, releasing its egg into the fallopian tube for a journey to the uterus, quickly changes into the corpus luteum, which is a factory for making progesterone, and raises progesterone's concentrations to 200 to 300 times higher than that of estradiol. This huge surge of progesterone simultaneously puts the uterine lining in its secretory or ripening phase, and turns off further ovulation by either ovary. If fertilization does not occur (AKA – you do NOT get pregnant), the ovary stops its elevated production of both estrogen and progesterone. The sudden fall in the concentrations of these hormones causes shedding of the blood-rich uterine lining and bleeding (menstruation). Then, in response to low hormone levels, there is a rise in GnRH and the cycle starts all over again.  Source  

What is the function of the Ovary?


  The ovaries are a pair of female reproductive organs. The size of each ovary is about 1.5 inches long. They are located in the pelvis, one on each side of the uterus. The ovaries are connected to each other by the tubes called fallopian tubes. The ovaries have two major functions:
    • Producing eggs (also called ova)
    • Producing female hormones estrogen and progesterone.
Each month, during the menstrual cycle, an egg is released from one ovary. After the egg is released from the ovary it travels to the oviducts, the funnel-shaped ends of the fallopian tubes where it starts its voyage of more than a few days into the uterus. The mature egg is moved all along on its journey through the fallopian tubes by the muscle contractions similar to ocean waves in the fallopian tube. The internal lining of each fallopian tube has cilia, or moving microscopic hairs. (These “hairs” are what aid the sperm to get to the egg to cause pregnancy.)  Source  

What does ovulation look like?



When do I ovulate? How do I know when I am ovulating?


While most people believe that ovulation occurs on day 14 of their menstrual cycle, it is not always so cut and dry.  There are several things to take into account to determine and pinpoint your exact day of ovulation.  The best way to do this is to track your cycle in more than one way. Following a Natural Family Planning Method by tracking and charting your changing cervix, cervical fluids, and basal body temperature is the surest way to determine ovulation timing.  There are also ovulation kits you can purchase and calendars you can follow, but these methods are far less accurate.

Are ovulation tests reliable?

Ovulation test kits are convenient for the busy woman.  You urinate into a cup, dip the strip and wait for a positive or negative answer; however, there is more to taking the test more accurately.  There is a huge window of error when it comes to these tests.  They may be needed to be taken twice a day to catch the highest rise of lutenizing hormone (LH) before ovulation occurs.  The key is knowing that a positive test does not mean ovulation is occurring at that moment, it means the body is “surging” in preparation to release the egg.  The body may have a false surge, where it does not actually release an egg, so relying solely on an OPK may leave you disappointed. The day of ovulation (when a ripened egg bursts out of its follicle) and the five days before it are the fertile window of the female reproductive cycle. The day before and the day of ovulation are the most fertile days; more than 80 percent of viable pregnancies are conceived on those two days. A hormone called lutenizing hormone (LH) peaks in the blood and urine one to two days before ovulation, at the onset of the most fertile period in the cycle. The length of the LH surge varies from woman to woman, lasting between 10 and 31 hours, which can easily be missed by an ovulation test.

How does ovulation effect the hormones?


The body has a hormonal shift at the time of ovulation.  As you can see, there is a peak in LH and FSH hormones leading up to the moment an egg is released. Once ovulation has occurred, estrogen and progesterone hormones increase (keeping the egg fertile and thickening the uterine lining).



What are the emotional effects of ovulation?

At ovulation, estrogen, endorphins, and testosterone are at their highest levels. They then begin to decrease in the luteal phase. Mood swings that are experienced during ovulation can be defined as rapidly changing, unpredictable moods. During this period, women experience sudden flow of emotions like excitement, humor, sexual desires, anger, irritability, sadness, anxiety, nervousness, rage, or depression. These emotions do not last for a long period of time, as ovulation is over within 12-48 hours. The female reproductive hormones play a vital role in regulating and controlling ovulation and the female menstrual cycle. The rise and fall in the levels of these hormones and especially in the levels of estrogen are mostly responsible for the sudden changes in women's mood during ovulation. Along with mood swings, women also experience several other signs and symptoms of hormonal imbalance. These signs include hot flashes, sweating, heart palpitations, headache, sweating at night, fatigue, dizziness, backache, bloating, etc. You may notice these brief changes, or pass them off each month without thought, but for some women, the effects of ovulation are felt beyond a slight twinge or temperature shift.

Where does the egg go?

If an egg becomes fertilized, it will take 5-6 days to reach the lining of the uterus and implant within its lining. If an egg remains unfertilized, it travels with the endometrium (thickened uterine lining) as it is shed at the start of the menstrual cycle.  



What is the Luteal Phase?

The luteal phase is the post-ovulatory portion of a woman’s cycle (or, the time between when you ovulate, and when you get your period).  The luteal phase is named for the corpus luteum, which is what’s left of the follicle that was housing the egg that got released at ovulation. The corpus luteum produces progesterone, which your body needs to ripen the endometrium (uterine lining).  Progesterone turns the endometrium into a nice soft bed in which a fertilized egg can implant, and a baby can grow. The ripening of the uterine lining happens every cycle after an egg is released, whether or not the egg is fertilized.  If the egg is not fertilized, the corpus luteum stops producing progesterone after about 12 to 16 days. Knowing your luteal phase length is important; a LP that is under 11 days generally cannot support a fertilized egg.  The average LP length is 14-15 days in length.

What is an Anovulatory Cycle?

Quite simply, an anovulatory cycle occurs when a woman skips ovulation. If a woman is not tracking her ovulation, she may not even know it has happened. When anovulation takes place, most women will appear to menstruate as normal, but ovulation will not occur. During the early and late years of menstruation, this is a common occurrence. In these instances, a woman’s body is changing drastically and anovulatory cycles will happen quite often. If a woman is in her prime, it is common to have the odd cycle without ovulation. Common, easily regulated causes for anovulatory cycles are stress, overexertion, and eating habits. The trouble occurs when anovulation is a common theme in a woman’s life. Vitamin D has also been proven to increase fertility in women suffering from anovulation. Your vitamin levels should be checked regularly, and supplementation should occur accordingly to rebalance the body and help trigger ovulation.  Source Studies show that Increased docosapentaenoic acid (DPA) was associated with a lower risk of anovulation. DPA is a dietary omega-3 fatty acid mainly found in fish, fish oil, seal oil and red meat. If you choose to increase your DPA levels through a supplement it needs to be an Omega-3 DPA supplement, as most Omega-3’s do not contain this specific acid. Source Learn all of the best food sources to increase your docosapentaenoic acid level: Source

PCOS as a cause of anovulation:

PCOS refers to multiple cysts on the ovaries and a host of other problems that go along with them, including anovulation (lack of ovulation) and menstrual abnormalities. PCOS occurs when the follicle migrates to the outside of the ovary, but does not "pop" the egg and release it, the follicle becomes a cyst, and the normal progesterone surge does not occur. The lack of progesterone is detected by the hypothalamus, which continues to try to stimulate the ovary by increasing its production of GnRH, which increases the pituitary production of FSH and LH. This stimulates the ovary to make more estrogen and androgens, which stimulates more follicles toward ovulation. If these additional follicles are also unable to produce a matured ovum or make progesterone, the menstrual cycle is dominated by increased estrogen and androgen production without progesterone. This is the fundamental abnormality that creates PCOS. More information on lifestyle and diet changes to aid in PCOS: Source “Polycystic ovary syndrome (PCOS) is a common reproductive disorder that can be diagnosed when two of the following three criteria are present: menstrual irregularity, hyperandrogenism and polycystic ovaries and related disorders have been excluded. Factors such as the individual's body weight influence the severity of the phenotype and risk of metabolic comorbidities. While anovulatory infertility is a common issue among lean and obese reproductive-aged women with PCOS, obesity is associated with resistance to oral ovulation induction agents, lower pregnancy rates and a higher risk of pregnancy complications. Lifestyle modification is recommended as first line therapy among obese women with PCOS in order to optimize their outcomes. Among lean and obese women with PCOS, ovulation induction can be achieved with aromatase inhibitors, selective estrogen receptor modulators, insulin sensitizing agents, gonadotropins and ovarian drilling with varying rates of ovulation, live birth and multiple gestations. Assisted reproductive technologies are reserved for women who do not conceive despite restoration of ovulation or couples with additional factors contributing to their infertility.” Source


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