Over and over again at Natural Womanhood we’ve emphasized how charting your cycles gives you a vital window into what’s going on with your hormonal and overall health. Just what does a cycle chart really tell you? What type of information will a restorative reproductive healthcare provider look for in your chart if you seek medical help?
(Of note: the information contained below applies to women who are not in a transitional season like perimenopause or postpartum.)
Are you ovulating? Monitoring your “fifth vital sign”
The first and most important thing a cycle chart can tell you is whether or not you are ovulating. Coined “the fifth vital sign,” ovulation is an essential barometer of a woman’s well being. The occurrence of ovulation indicates adequate levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), appropriate build up of estrogen, and at least a minimal amount of progesterone (you can have low progesterone and still ovulate).
Three biomarkers are highly suggestive for ovulation. First, cervical mucus observations recorded on the chart should reflect a definitive drying-up after a period of peak-type mucus. Second, basal body temperature should rise after ovulation and stay elevated until the woman’s next period. Thirdly, a positive progesterone test, as tested for with PdG strips like Proov, should let you know when you’ve reached a critical hormonal threshold indicating that ovulation has happened. Progesterone is behind all of these confirming biomarkers, and the only thing that causes progesterone to rise is ovulation. Therefore, recording some or all of these biomarkers of ovulation on your chart can give you a clear picture of your hormonal health.
Interestingly, if you’re ovulating, then you are having true menstruation, since ovulation signals the uterine lining to build up. The shedding of the lining is visible as your period (menstruation). If you’re not ovulating, the uterine lining is not building up, meaning that any bleeding you experience is a bleeding episode or a withdrawal bleed (if on hormonal birth control, which prevents ovulation) or a breakthrough bleed (if you are not on birth control, but experiencing anovulation for some reason).
What your cycle length says about your hormonal health
We’ve all heard that cycles last about 28 days. In a healthy cycle, that’s about right, with some room for variation. According to FEMM’s parameters, any cycle between 24-36 days long is considered normal. A 24-36 day cycle tells us that estrogen is rising appropriately, and hopefully that progesterone is maintaining a high enough level for an adequate amount of time. While cycle length isn’t everything, and we still want to know what’s actually happening in those 24-36 days, it’s definitely an important piece of your hormonal health puzzle. Cycles longer than 36 days suggest that ovulation is being delayed.
Biomarkers from your ovulatory phase: What a healthy pattern should look like
The ovulatory phase (part of the larger follicular phase that comprises the first half of the cycle, approximately) kicks off after menstruation ends. Typically the first few days of this phase are “dry” days, without any observable cervical mucus, though this is not always the case. Some women start out with transition cervical fluid (less stretchy, perhaps pasty, sticky, or tacky, white or opaque but still estrogenic nonetheless), while others go straight into very estrogenic cervical fluid (very stretchy/abundant/clear). In general, about 6-7 days of cervical fluid are expected.
An experienced fertility awareness instructor or restorative reproductive healthcare provider will always want to see more days (hopefully twice as many) of more-estrogenic fluid than less-estrogenic fluid. There should be a nice, steady rise in estrogen over the week leading up to ovulation. The build-up should be clear, with no fits and starts. If days of estrogenic fluid are interspersed with dry days, something about your estrogen rise is impeded.
Monitoring your luteal phase = keeping tabs on your progesterone
The luteal phase consists of the days following ovulation until the next menstruation (period). The luteal phase is usually fairly stable from cycle to cycle and is a progesterone-dominant time. This phase usually lasts from 9-16 days. For someone in their late 30’s and older as well as breastfeeding moms, shorter luteal phases are considered normal. But otherwise, a luteal phase really shouldn’t be shorter than ~12 days. If the luteal phase is shorter than 12 days, a woman will often experience headaches and other PMS symptoms like breast tenderness, depression, or anxiety.
Progesterone is the counterpart of estrogen. While estrogen often takes center stage in discussions about female hormones because of its mood and libido-boosting effects, progesterone plays just as important a role in women’s reproductive health. Progesterone (which literally means pro- gestation) helps prepare the body for pregnancy and balances out the stimulating effects of estrogen, which is important without regard to pregnancy intention.
In appropriate levels, progesterone soothes, repairs, and heals. The luteal phase is the “rest and reset phase” of the cycle, which is necessary for overall well being. A shortened luteal phase with or without breakthrough bleeding (bleeding occurring outside of menstruation) is a telltale sign of low progesterone.
What your period is trying to tell you about your health
Menstruation is the most familiar part of the cycle for many women. Even if they haven’t charted their biomarkers per se, they have been living with their periods since puberty. Generally, according to FEMM’s parameters, menstrual bleeding should last 4-7 days, with no more than three days of heavy bleeding, defined as a need to change your menstrual product every two hours.
Quality of menstruation is such an easy-to-monitor and informative piece of your chart because it is literally the byproduct of estrogen and progesterone levels from the previous cycle. Heavy bleeding often goes hand-in-hand with extended estrogen exposure, since estrogen is responsible for proliferating the endometrium. Bleeding should be bright red, not brown, with minimal or no clots.
When to seek outside help
If you feel that your cycle is off in any of these areas, bring it up to a certified Fertility Awareness educator or a Restorative Reproductive Medical (RRM) practitioner. If you are just getting into charting your cycle, know that there’s a learning curve. Charting your cycles for several months before approaching a medical provider will help you and your fertility awareness instructor to differentiate whether something abnormal is going on or whether you were perhaps confused about what biomarkers (like cervical fluid) you were observing.
Medical providers trained in NaProTechnology, Neo, and FEMM are skilled at identifying cycle charting patterns indicative of possible infertility, low progesterone, likelihood of miscarriage, and more. Even before blood draws, imaging, or more invasive options like laparoscopic surgery, your cycle charting gives your healthcare provider clues for where to start a work-up, as well as a basis for forming a treatment plan. What’s more, the body literacy you gain from charting your cycle can help you become a better self-advocate for shared decision-making when it comes to your health.