We know that one of the hallmarks of PCOS is an irregular menstrual cycle. Our periods are often erratic or even non existent. That means that ovulation is infrequent. That’s not particularly helpful if you are trying to conceive. So, let’s talk about ovulation tracking with PCOS. Because, there is some good news.
Okay, so let me paint a little picture for you. Hubby and I decide that we are ready to start trying for a baby and I happen to be having a conversation with one of my girlfriends and she shares the news that they too are trying for a family.
So, naturally we swap stories. I share some of my anxiety and trepidation about the struggle that may lie ahead of me in light of my PCOS. She tells me that she’s invested in some ovulation predictor kits to help identify when she might be fertile to aid conception.
And it sounds great in theory, right? It makes sense. If you know when you have ovulated, you can time intercourse and increase your chances of conceiving.
But, there’s a problem with this scenario for me. Firstly, I don’t ovulate as frequently so how do I even know when to use the OPK’s? Secondly, OPK’s don’t actually work for women with PCOS.
To really understand ovulation tracking with PCOS, we need to have a basic understanding of how ovulation actually works.
How Ovulation Works
What is ovulation?
Let’s take it right back to basics. When we’re talking about ovulation, we’re talking about the release of a mature egg from the ovary.
Now, getting the egg to reach maturity and be released from the ovary is the result of a complex interaction of multiple hormones. We need to understand a little bit about these hormones to understand why OPK’s are not a good option for women with PCOS.
The hormones involved in Ovulation
We know that a “normal” menstrual cycle is roughly 28 days and ovulation usually occurs 12-16 days after the first day of your last period.
Now, in the beginning half of your cycle, Follicle Stimulating Hormone is released and multiple follicles (eggs) are developed. Only one of these will reach maturity. As the egg matures, it produces oestrogen.
Once your pituitary gland detects the surge of oestrogen, it releases luteinizing hormone, which causes the egg to be released from the ovary (1).
A PCOS Menstrual Cycle
Okay, so that sounds good right. That is what we are aiming for our bodies to do. But there is a problem. We have PCOS and our menstrual cycle is pretty erratic. Generally speaking, we tend to be oestrogen dominant and our levels of luteinizing hormone remain higher than normal.
So, we don’t get that spike in LH to signal ovulation and we don’t get ovulation occurring frequently. We just get lots of little follicles being developed that don’t reach maturity giving our ovaries that polycystic look, like they’ve been adorned with a string of pearls.
How do Ovulation Predictor Kits Work?
So now that we know a little bit more about how ovulation works, how do ovulation predictor kits work? Well, firstly, they are urine sticks and they look for signs of LH in urine. Basically, they’re designed to look for that spike in LH that signifies that ovulation is about to happen.
Ovulation Predictor Kits and PCOS
Can you see the problem? OPK’s are looking for a spike in LH but our LH levels tend to be elevated all the time. Ideally you would like Follicle Stimulating Hormone (FSH) and LH to be in a ratio of 1:1. However, in women with PCOS its more likely to be 2:1 or even 3:1.
What that means is that we are more likely to get false positives with OPKs. They are not an accurate indication of ovulation in women with PCOS.
So, where does that leave us? How can we accurately track ovulation?
Tracking Basal Body Temperature to Monitor Ovulation
Now, this is a method that I have mentioned and used before (see here). Basically, it involves taking your temperature at the same time every morning before you get out of bed.
The theory is that if you take your temperature as soon as you wake up, you will have your basal body temperature (your temperature at rest, without any physical activity).
Now, you may be wondering what on earth this has to do with ovulation. Let me explain.
How tracking basal body temperature works
Let’s go back to the story of the menstrual cycle. We got to the point where an egg is released from the ovary. What happens next?
Okay, bear with me cause this is important.
Well, once the egg is released, what is left of the follicle becomes the corpus luteum. And the corpus luteum produces progesterone in preparation for possible pregnancy and implantation.
Now, progesterone causes a rise in our core body temperature. And that is exactly what we’re looking for in basal body temperature tracking (or BBT).
Once we have seen this sudden rise in temperature, and it is sustained for a couple of days, we can assume that ovulation has occurred.
BBT Tracking and PCOS
So, it all sounds good in theory, right? Well, there are a couple of things that we need to be aware of. Firstly, BBT tracking is not 100% fool proof.
You see, your BBT can be affected by a number of things. For example, alcohol can cause your temperatures to be slightly higher than normal, a restless night will also have an impact, as will taking your temperature at different times every day (2).
Also, it takes a lot of work and commitment to wake up at the same time every morning and record your temperatures consistently.
The other thing to bear in mind is that BBT tracking will only tell you that you have ovulated, it will not tell you when your are going to ovulate. It does not predict when ovulation will happen.
Thankfully, there is a better option available and we’ll get on to that shortly. First, though, let’s have a look at other signs that ovulation is impending.
Cervical Mucous as a Sign of Ovulation
What is Cervical Mucous?
Cervical mucous is a fluid secreted by the cervix, in response to oestrogen. As oestrogen levels rise, so does the level of cervical mucous. It also has a really important job. It helps to provide a safe and happy environment for sperm to survive (3).
How does cervical mucous change throughout the cycle?
So, as your hormones levels rise and fall throughout your cycle, so does the cervical mucous change throughout the cycle. Here is a really helpful image of what we should be looking for when it comes to cervical mucous (from Mama Natural).
Cervical Mucous and PCOS
But there is something else to consider, with our PCOS. Just as our hormonal profile doesn’t follow a typical hormone profile, so our cervical mucous doesn’t necessarily follow what you would expect.
We can have times of increased egg white cervical mucous and yet not have any ovulation. So, relying on cervical mucous alone is not a great idea.
Cervical position as a sign of ovulation
One final way to monitor our cycles and possible ovulation is to monitor the position of our cervix throughout our cycle. Now, I have a confession to make (and call me prudish if you will). I am not the hugest fan of finding my cervix and secondly, I have no idea what I’m feeling or what I should even be looking for! So, I have never used this method to track my own ovulation.
How does the cervix change throughout the cycle?
Just as the cervix produces cervical mucous in response to oestrogen, so the position of the cervix changes in response to oestrogen.
In the beginning of the cycle, when estrogen levels should be lower, the cervix is hard, closed and pointed down. As oestrogen increases and ovulation is impending, the cervix softens, opens and moves up. This allows easier passages of the sperm to the fallopian tube.
Cervical Position and PCOS
Remember, just as cervical mucous can change dramatically in women with PCOS, so can the position of the cervix. This is not necessarily going to be a reliable of sign of ovulation in women with PCOS.
So where does that leave us? We can’t rely on cervical mucous or the position of our cervix. BBT tracking is a better option but it won’t predict ovulation. It will just tell us when ovulation has occurred.
Are we doomed to never be able to plan for ovulation and know when our fertile days are? Thankfully, there is an amazing piece of equipment and software that is super easy to use, far more accurate than BBT and will help to predict when ovulation will happen…
Using Ovusense to Track Fertility with PCOS
You may be wondering what Ovusense actually is. Well, Ovusense is an advanced cycle monitoring system. It consists of a medical grade vaginal sensor that is inserted over night. It reads your core body temperature every five minutes and syncs with an app on your phone each morning to give you an average core temperature reading.
Wanna know one of the coolest features of Ovusense? Not only will it tell you when you have ovulated, it will also predict ovulation about 24 hours in advance. This is huge for women with PCOS!
It is one of the only things that we can use to accurately predict when ovulation may happen. This is key in enhancing your chances of conceiving, if that is your aim.
Is Ovusense helpful if you are not trying to conceive?
This is a question that I am often asked. Should I be eating this way I don’t want to conceive? Is Ovasitol still helpful, even if we’re not trying for a baby? How will Ovusense help me if I don’t want to get pregnant?
Well, here’s the thing. I am not trying to conceive and I found Ovusense incredibly informative. You see, just because you may have a regular cycle, does not mean that you are ovulating every month.
And ovulation is a really good indicator that your hormones are balanced and that your PCOS is more or less under control. So, I don’t use Ovusense as a fertility monitor. I use it as a monitor of my cycle and general PCOS.
How is Ovusense different from Basal Body Temperature Tracking?
This is a question that I have asked myself. The main difference is that Ovusense reads and tracks core body temperature while BBT tracks basal body temperature. Core body temperature will detect the smallest variances in temperature in response to progesterone and it is this sensitivity that enables Ovusense to predict ovulation.
Basal body temperature tracking is not nearly as sensitive to these small variances in temperature. So, it can only confirm when ovulation has already taken place, not when it will happen.
How does Ovusense work?
There are two main components to Ovusense. There is the vaginal sensor that is inserted every night as well as an app that is needed to analyse data from the sensor. When you purchase an Ovusense fertility monitor, you will receive the monitor and a free 30 day subscription to the Ovusense app. You can also pay for the monitor and a 12 month subscription to the app.
Where can I get an Ovusense Fertility Monitor?
So hopefully, if you have been following PCOS Diet Support for a little while, you will know that I feel really strongly about only sharing with you the things that work for PCOS, the things that have evidence behind them and the things that I use myself.
Ovusense is one of those things. You can get your Ovusense here and if you use the coupon code “TARRYN” at checkout, you will get 25% off your Ovusense. This is an affiliate link and I will earn some revenue from this, the proceeds of which go to the maintenance of this website.
What additional support will I get from Ovusense?
Ovusense is a really wonderful company that genuinely seems to care about its users. When you purchase your Ovusense monitor, you will also get a free consultation with a fertility nurse. She will look at your Ovusense data and charts and support you in your journey to conceiving.
It is recommended that you have 3 months work of data from your Ovusense monitor before setting up the appointment so that she has some data to work from.
Summing it Up
I think its about time to wrap this all up. Basically, when it comes to ovulation tracking with PCOS, we have looked at:
How ovulation works and some of the basics of the menstrual cycle
Why ovulation predictor kits don’t work for women with PCOS
Tracking basal body temperature to monitor ovulation in PCOS
Monitoring cervical mucous and position to monitor ovulation
Why some of these methods are not accurate for women with PCOS, given the fluctuations in PCOS hormones
Ovusense and how it can accurately predict ovulation in women with PCOS
Remember, if you would like to track ovulation and improve your chances of conceiving with PCOS, you can get your own Ovusense here.
If you have tried ovulation monitoring using any of the methods we have spoken about or you have used Ovusense yourself, I would love to hear from you! Leave me a comment below and let me know what your experience has been with ovulation tracking with PCOS!