FERTILEMOMS

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HOW DOES THE MENSTRUAL CYCLE OCCUR?
A complex relationship between hormones from the brain (the pituitary gland and hypothalamus) and the ovaries leads to the development and release of an egg from the o***y in a process known as ovulation as well as the growth of the internal lining of the uterus (known as the endometrium) to prepare it for pregnancy.
The hormones signal the endometrium to start to break down and separate from the walls of the uterus in the absence of pregnancy. This becomes shed as menstruation.

EVENTS OF THE MENSTRUAL CYCLE
DAY 1- 5: Menstruation begins on Day 1 of the cycle and is heaviest for the first 3 days.

DAY 6 - 14: Bleeding stops, the lining of the womb (endometrium) begins to prepare for a possible pregnancy. It becomes thicker and enriched with blood and nutrients.

DAY 14 – 25: An egg is released from one of the ovaries (or 2 of the ovaries in which case twin pregnancy may occur) and begins its journey down the fallopian tube to the uterus. If s***m is present in the fallopian tube at this time, fertilization can occur. The fertilized egg will travel to the uterus and attempt to implant in the uterine wall.

DAY 25 – 28: If the egg was not fertilized or implantation does not occur, hormonal changes signal the uterus to prepare to shed its lining and the egg breaks down and is shed along with the lining as menstruation. The next cycle begins on Day 1 of menstrual bleeding.

PHASES OF THE MENSTRUAL CYCLE
MENSTRUAL PHASE: DAY 1-5
This is the first phase of the menstrual cycle. It starts from Day 1 of the cycle to end of the blood flow. The menstruation occurs when the there is no pregnancy, the released egg breaks down and the uterine lining is shed. Some women experience certain symptoms such as bloating, cramps, breast tenderness, irritability, lower back pain, headaches, tiredness etc.

FOLLICULAR PHASE: DAY 1-14
This phase starts from the first day (Day 1) of the menstrual bleeding and ends at ovulation. Signals from the brain tell the ovaries to prepare an egg that will be released. The pituitary gland (located at the base of the brain) produces the hormone follicle stimulating hormone (FSH) which causes several follicles (fluid filled sacs containing eggs) to rise to the surface of the o***y. FSH hormone tells the ovaries to prepare an egg to be released from the matured follicle. One out of these follicles grows bigger than the rest just as the period is ending and becomes the dominant follicle (about 10mm or more) while the others shrink back and are absorbed back into the body. This dominant follicle produces estrogen as it continues to grow. The egg in the dominant follicle matures and is prepared to be released at ovulation. The dominant follicle reaches about 20mm or more to become matured.

OVULATORY PHASE: DAY 14
When the estrogen levels are high enough, they signal the pituitary gland to release luteinizing hormone (LH). The continued release of LH causes a sharp rise or increase in Luteinizing hormone (LH). This is known as LH surge which causes the dominant follicle to rupture and to release the egg. This process is known as ovulation. This happens about 13-15 days before the next menstrual period. The egg can survive for about 24hours after ovulation after which it dissolves.
The estrogen produced by the dominant follicle causes the lining of the uterus to become thicker and more enriched with blood (proliferation). This is sometimes referred to as the proliferative phase. This is a very important phase for pregnancy as it prepares the lining of the uterus to receive the fertilized egg for implantation and continued growth.
The level of estrogen peaks just before the egg is released. The egg released is received by the fimbria of the fallopian tube and enters the tube where fertilization takes place if s***m are present; if not fertilized, it disintegrates after 24-48hours.
Some women who want to pregnancy might want to check their basal body temperature or cervical mucus during this time. There is a noticeable change in the BBT and cervical mucus at this time. The cervical mucus is abundant, clear and stretchy while there is a sharp rise in the BBT.

LUTEAL PHASE DAY 14-28
The level of FSH and LH hormones decreases after ovulation. The ruptured follicle closes over after ovulation to form a mass of cells called the corpus luteum. The corpus luteum produces the hormone progesterone and estrogen. Progesterone level rises and helps to support early pregnancy if the egg was fertilized and pregnancy occurred by signaling the endometrium not to shed; if there was no pregnancy, the corpus luteum breaks down and the level of progesterone and estrogen drops signaling the endometrial lining to shed leading to menstruation.
The uterine lining produces and releases (sometimes referred to as the secretory phase) chemical messengers that will either help support an early pregnancy or will prepare the lining to break down and shed if pregnancy does not occur. If pregnancy occurs, the progesterone level rises and cause the endometrium to stop thickening and to start preparing for the potential attachment of the fertilized egg. Human Chorionic Gonadotropin (HCG) is produced by the body to help keep the uterine lining thick for the fertilized egg to develop into an embryo. The corpus luteum will dissolve into the body in the absence of pregnancy and the levels of estrogen and progesterone drops.
Certain symptoms such as bloating, mood changes, pain, tenderness or swelling of the breasts, weight gain, difficulty sleeping, food cravings and changes in s*x drive might be experienced during this phase.

CERVICAL MUCOUS TESTING
The cells lining your cervical canal secrete mucus and the consistency changes over the menstrual cycle. The cervical mucus changes to a consistency and structure that permits the s***m to travel on its way to meet the egg in the fallopian tube during the fertile window.
Most fertile period: It becomes clear abundant and stretchy (also known as egg white cervical mucus).
Not fertile period: The cervical mucus becomes sticky, cloudy and does not stretch.

HOW DO I TEST MY CERVICAL MUCUS
1. Wipe the va**na with tissue paper and observe the consistency of the mucus by pressing together and opening it up again. The consistency is either sticky or stretchy.
2. Alternatively insert a clean finger into the va**na to obtain a sample of the cervical mucus. Use your thumb and fore finger to see if the mucus stretches or not.

CERVICAL MUCUS AND CYCLE TIMIMG
DAY 1-5: - menstruation
DAY 6-7: - no noticeable mucus
DAY 8-12: - minimal, cloudy, sticky secretions
DAY 13-16: - Abundant clear, wet. Stretchy “egg-white” mucus
DAY 17-20: - slightly wet secretions
DAY 20-28: - no noticeable secretions.

BASAL BODY TEMPERATURE (BBT)
This is your body’s lowest temperature at rest. It is usually measured as soon as you wake up after at least 6 hours of sleep or rest before getting out of bed, eating or drinking anything. It should be taken about the same time every day. BBT ranges between 36.2oc – 36.5oc and increases by 0.5oc at ovulation and stays at this temperature until menstruation.

WHEN TO SEE YOUR HEALTHCARE PROVIDER
1. Very heavy periods
2. Long periods of more than 8 days
3. Periods that comes less than 3 weeks apart
4. Painful periods that cause you to stay at home or away from your daily activities
5. Periods that comes more than 2 or 3 months apart
6. Bleeding between periods
7. Bleeding after s*xual in*******se