Ovulation, the release of an egg from the ovaries, is what keeps your periods regular, and, of course, what allows you to get pregnant. If you’re not on birth control, and you’re getting your period every 21-35 days (yeah, 28 days is the norm, but anything in that range is fine), you are most likely a-okay in the egg-laying department. If you’re not ovulating, or at least not on a regular basis, your cycles will be all over the place – mostly super long, like 45 days or more. That’s the most obvious sign that there’s an issue, but there are other ways you can tell you’re not ovulating as well.
Your BBT doesn’t reflect it.
BBT stands for basal body temperature, and when you keep track of it, it can tell you a lot about what’s going on in that uterus of yours. Every morning, the instant you wake up, reach for a thermometer – then record the temperature, ideally at the exact same time every day. If your temperature spikes around midcycle, and stays up until the end, where it drops again when you start your period, you’re ovulating. But if the temperature remains the same with no spike, or fluctuates wildly up and down, you may need to investigate further.
You’re not experiencing physical signs of ovulation.
There are all kinds of bodily signals that your eggs are ripe and raring to go, if you just pay attention. First, your nether-regions will be all sorts of wet and slimy (sorry, but them’s the facts), since the body ramps up production of cervical mucus when you’re fertile to ensure a smooth path for any sperm that happen to be meandering through. Just prior to ovulation, you’ll notice a change in your regular discharge, as it becomes the clear, stretchy consistency of egg whites.
You may also have crampy ovaries, known as “mittelschmerz” or “middle pain,” or a bloated feeling. You might be really horny. And if you can reach your cervix with your fingers (go on and try it, I’ll wait), it feels softer during ovulation – like, say, the way a raw chicken breast feels compared to a cooked one. If you aren’t experiencing any of these midcycle signals, this doesn’t necessarily mean you’re not ovulating, but it’s worth looking into.
Your ovulation predictor kits are never positive.
If you’re trying to get pregnant, chances are you know roughly when you’re supposed to be ovulating each cycle, but ovulation predictor kits (OPK) – available over the counter pretty much everywhere – take some of the guesswork out of it. You pee on a stick (usually for a few days in a row), and the OPK detects the presence of luteinizing hormone, which surges just prior to ovulation. If you think you’re in the right general timeframe but just aren’t getting a positive, it can indicate that somebody (narrows eyes at ovaries) isn’t doing their job.
Now then. If you’re not ovulating, you’re gonna want to know why, and there’s a whole list of things that can mess with your O-game. Such as …
1. Being under tons of stress
2. Being markedly over- or under-weight
3. Poor nutrition
4. Excessive exercise (we’re talking hours a day every day at the gym, not CrossFit two days in a row)
5. Hormonal irregularities
7. Thyroid dysfunction
8. Polycystic Ovarian Syndrome (PCOS)
9. Perimenopause or ovarian failure
10. … And much, much more! *insert infomercial clapping here*
First and foremost, don’t worry. There’s help for those reluctant ovaries, and many ways to kick-start a more timely release of eggs; ovulation issues are among the most treatable causes of infertility. Obviously, the best course of action if you’re not ovulating regularly is to seek advice from your doctor. He or she will order bloodwork to determine your hormone levels, which is something you can’t really know any other way.
You may also have an ultrasound, so that your doctor can check out the physical condition of your uterus and ovaries – shape, size, and whether there are any cysts or other abnormalities present. Not only that, but a doctor will also be able to assess other factors, such as whether you have a healthy body mass index (BMI) or if your stress level may be playing a role. Then together you can hatch a plan of action for those eggs, whether it’s through medical interventions or you go a more natural route.
If you’re wondering what you can do at home, before inviting a doctor all up in your egg-producing biz, there are a few DIY routes to take – especially if you suspect it’s a problem that only you can fix, such as your exercise or eating habits. Supporting your overall health is the best way to ensure optimal fertility, and there are a lot of factors involved, so don’t put all your eggs in one basket (see what I did there?). Consider your entire lifestyle, including …
Make sure you’re getting plenty of complex carbs – whole grains, brown rice, vegetables, beans, high fiber foods. When you eat quick-digesting carbs like sugar and white bread, your body releases insulin into the bloodstream to calm down the ensuing blood sugar spike, and too much insulin can inhibit ovulation. Round it out with protein and healthy unsaturated fats (fewer French fries, more almonds, ugh), and don’t forget a multivitamin with plenty of folic acid. Oh – and drink plenty of water!
Aim for 30-60 minutes of exercise, at least five times a week. It doesn’t have to be anything too strenuous – just something to get your heart rate elevated for a little while, like a brisk walk.
Extra fat cells produce extra estrogen, in some cases enough to suppress the hormones needed to trigger ovulation – almost like a low-dose birth control pill. But if you’re worried about being a few pounds overweight, it doesn’t take a reality show-worthy weight drop to make a profound difference on fertility: research has shown that a loss of 5-10 percent of your body weight can regulate hormones. But it’s not a big girl specific problem, because being underweight can also throw your hormonal balance out of whack. The best BMI for fertility is around 20-25 (there are tons of BMI calculators on the Internet if you’re not sure how to find yours), so aim for as close to that as you can.
Everybody who’s ever had trouble getting pregnant hates hearing “just relax.” But … it’s kind of true (I know. Blah. If only it were as simple as those assholes make it sound!). Excessive stress leads to higher blood pressure and generally unfavorable physical conditions. What’s more, high levels of a stress-related enzyme called alpha-amylase has been proven to impact fertility. So take active measures to combat whatever’s stressing you out the most. Just don’t, you know, stress too much about it.
If you’re a proponent of plant-based wellness, there are a ton of natural supplements that are said to help the body regulate itself, reproductively speaking. Probably the most widely used is Vitex Agnus Castus (also known as simply Vitex, or Chaste Tree Berry), which normalizes hormonal imbalances via the pituitary gland. Red raspberry, red clover, dong quai, saw palmetto, and maca are some other herbal remedies touted for their reproductive benefits.
If you’re not sure what you need, though, there are pre-mixed fertility blends available in supplements, tinctures, and teas – like FertiliTea, Premama, UpSpring, and Pregnitude, just to name a few. However, a warning: herbs can be just as powerful as a prescription, so do your research instead of popping a pill and hoping for the best.
If you’ve addressed all of the above and there still seems to be an issue, your doctor can help you with some more, shall we day, aggressive options, as long as you’ve been having difficulties for at least six months if you’re older than 35 and 6 months if you’re younger. The initial route would likely be clomiphene citrate, known as Clomid or Serophene, the most commonly used prescription drug to induce ovulation. Beyond that, there are injectable drugs such as Follistim and Gonal-F, but luckily, the majority of “problem ovulators” never need to move past clomiphene.
So never fear, Sisterhood of the Underachieving Ovaries: there are lots of ways to kick those slacking suckers into gear. Before you know it, you’ll be popping out eggs faster than the Cadbury Bunny. And instead of looking to Scary Mommy for advice about ovulation, you’ll be looking to Scary Mommy for advice about managing all the things that come afterward.
Don’t worry, we have a great section for moms of multiples, you Fertile Myrtle you. *wink wink*
So, when do I see a doctor?
If you’ve taken stock of your BMI, stress levels, and other factors we’ve laid out above and assessed that you’ve done all you can on your end, then the logical next step is to see an OB-GYN who might refer you to a fertility specialist. Through bloodwork and ultrasounds they’ll be able to tell if you have PCOS, and check if the causes could somehow be connected to your fallopian tubes or uterus. Per the Mayo Clinic, you may benefit from medical advice if you’re 34 years old or younger and have been trying to conceive for a year. That goes down to six months if you’re 35 or older. If you’re 40 or older, a fertility specialist might want to start testing right away.