The importance of ovulation, beyond fertility

What is ovulation?

Ovulation is the main event of the menstrual cycle, a sign that a woman is entering her fertile window. It is such an important part of female physiology that some regard ovulation and a healthy, regular menstrual cycle as the “fifth vital sign” alongside heart rate, blood pressure, temperature and respiratory rate.

What exactly happens when you ovulate?

In simple terms, ovulation can be best described as the release of a mature egg from a woman's ovaries. This egg is then carried into one of the fallopian tubes, where it remains for up to 24 hours awaiting fertilisation. 

Ovulation, is a mid-cycle event that occurs at the end of the what’s known follicular phase of the menstrual cycle and marks the beginning of the luteal phase. 

Hormones have an essential role to play in ovulation. The release of the egg from the ovaries is triggered by a surge in the hormone LH (luteinizing hormone), while the remnants of the follicle that released the egg turn into a temporary organ called the corpus luteum, which produces the hormone progesterone (and oestrogen).  

Progesterone is crucial for fertility and the maintenance of pregnancy. It stabilises the uterine lining, making it “sticky” enough to support implantation. It also provides nutrients to the endometrial (uterine) lining and prepares a welcoming uterine environment where the embryo can thrive.

If the egg that was released isn’t fertilised, the corpus luteum breaks down and progesterone levels (and oestrogen) drop, resulting in the top layers of the thickened lining of the uterus (endometrium) to shed. This manifests as a menstrual bleed. 

When the egg is fertilised, the corpus luteum doesn’t break down and continues to produce progesterone and oestrogen to support a healthy pregnancy. 

But progesterone has a vast number of other important roles, beyond just fertility and pregnancy. It supports the health of our breast tissue, bones, brain and thyroid function. Progesterone also helps to lower  inflammation and supports healthy immune system function.

Simply put, healthy ovulation is not only crucial for making babies, but it has a significant influence over much of a woman’s body function.

How do you know whether you are ovulating? 

~ Fertile cervical mucous during the midway point of your cycle. Fertile mucous has a stretchy egg-white consistency, helping sperm survive and making it easier for sperm to swim up to the uterus. 

~ A 0.3-0.5 degree celsius rise in basal body temperature after ovulation. This increase in temperature happens due to a rise in progesterone and should be sustained throughout the luteal phase of the cycle (for at least 10 days). One of the best ways to measure when you are ovulating is by charting your cycle, which involves waking at the same time each morning and using a basal body thermometer to measure your oral temperature. 

~ An increase in your libido and energy levels, due to a peak in oestrogen and rise in testosterone before ovulation. This can help to increase your chances of pregnancy. 

What if you aren’t ovulating? 

It is possible to have cycles without ovulation, known as “anovulatory” cycles. Anovulatory cycles are missing a luteal phase, so there is no progesterone production, though oestrogen is still produced.

With anovulatory cycles you have a long follicular phase followed by a breakthrough bleed, not an actual period.There are a number of reasons why you might be having cycles without ovulation, including: 

~ Being on hormonal birth control - including the combined oral contraceptive pill, progestin-only birth control such as the mini pill, hormonal IUD or implant

~ Recovering from being on hormonal birth control - it can take 10 months or even longer for ovulation to return! 

~ Polycystic ovarian syndrome (PCOS) 

~ Hypothalamic amenorrhea - from undereating and overexercising

~ Being underweight 

~ Extreme stress or chronic stress 

~ High prolactin levels

~ Low thyroid function

~ Periomenopause 

The issue with having anovulatory cycles long term, is that we miss out on the protective benefits of progesterone. And our risk of infertility, osteoporosis, heart disease, breast cancer and dementia may increase. Anovulatory cycles may also contribute to thickening of the endometrial lining, endometrial hyperplasia and uterine polyps. 

How can we support ovulation and a healthy, regular menstrual cycle? 

~ Find ways to alleviate stress. There are many tools for stress management out there, including meditation, yoga, earthing, time in nature and talking to friends. Or for some people, getting to the root cause of their stress is important. If stress is due to taking on too much, delegating tasks and learning to say “no” may be helpful. 

~ Make sure you’re eating enough and choose a wholefood based diet that is rich in nutrients to provide the cofactors to produce hormones for healthy ovulation

~ Include plenty of bright, colourful vegetables and fruit to provide antioxidants for healthy eggs and ovulatory function

~ Reduce your exposure to toxins. There are many endocrine disrupting chemicals (EDC’s) or xenoestrogens that mimic our hormones and can impact ovulation and fertility. These include BPA in plastic, phthalates in plastic and personal care products, parabens in personal care products and PFC’s from non-stick teflon coated cookware.