by Judith G. Cobb, MH, CI, NCP
This article is not meant to diagnose or prescribe. It is meant for educational purposes only. Judith Cobb, Cobblestone Health, and Nature’s Sunshine Products accept no responsibility for results you get, whether good or bad, from using this information. Always seek the guidance of a qualified health professional.
Many years ago I was teaching an herbal class. In it we were discussing fertility and pregnancy, and I taught the information in this article. Afterwards, a female student, who was a medical lab technician in her early 30s, thanked me for the class. She said that she and her husband had been trying to conceive for several months with no luck, and now she understood why. They had been timing their intimate encounters at exactly the wrong times of the month because she did not understand fertility at all. Now, with easy access to this type of information on the Internet, women, especially, know more about how their bodies work, but the sheer mass of information makes understanding difficult. This article will untangle the plethora of information and help you make sense of the confusion.
Women have obvious indicators of their ability to reproduce. The first and last menstrual cycles bookend the female reproductive years, although the presence of menstrual cycles does not guarantee fertility.
The menstrual cycles bring with them a myriad of symptoms that can often be easily grouped into fertile and non-fertile phases. This information can prove invaluable in helping fertile couples plan their families, less fertile couples achieve pregnancy, and infertile couples see where their challenges may be.
Predicting Ovulation. The first day of menstrual flow is considered to be the first day of the cycle. In a ‘typical’ (is there really such a thing?) 28-day cycle there will be three to five days of menstrual flow, followed by a few days with very little vaginal moisture or lubrication. Once the flow is finished, the lining of the uterus begins to rebuild to accommodate and nourish an embryo if fertilization occurs later on in the cycle. Generally, by about day ten, a woman will notice a vaginal discharge. It begins as a ‘tacky’ substance. The consistency changes over the next few days to become much more slippery, much more abundant, and very stretchy, like an egg white. When the mucous stretches ten cm (four inches), fertility is at its peak. To optimize the chance of conception, intercourse should happen every 36 to 48 hours during these ‘wet’ or ‘mucousy’ days. Then, usually quite suddenly, the mucous will be gone (although this is much less obvious if semen is present), and the fertile time is over. The take-away here is: vaginal mucous predicts impending ovulation.
Confirming Ovulation. Basal metabolic temperature can be used to confirm that ovulation has happened. Basal temperature is the lowest temperature the body reaches in a 24-hour period. Typically, this is just shortly before waking up. Using a basal metabolic thermometer (available at most larger drug stores), which has been prepared the night before and left on the bedside table, the temperature is taken upon waking and before getting out of bed or engaging in any activity at all – including but not limited to rolling over to kiss your sweetheart good morning. It is important to take the temperature within a half-hour of the same time each day. If you normally arise at 6:00 AM, your temperature-taking window is 5:45 – 6:15 AM, even on weekends (but you are free to go back to sleep afterward if you like!) It is important to note the difference between a basal metabolic thermometer and a standard fever thermometer. The basal thermometer spans only a few degrees, marked in tenths of a degree. This is very precise! A fever thermometer covers several degrees, marked in fifths of a degree. In temperature charting for conception, variations smaller than tenths of a degree can be important. Having the right kind of thermometer makes analyzing your data so much more accurate and easy.
Taking the temperature vaginally is the most accurate way. The thermometer stays in place, in your vagina, for five minutes. If this is emotionally uncomfortable, you can take your BMT by mouth or in your armpit. Just know that these locations are not as accurate.The temperature may then be recorded on graph paper or on a website like www.fertilityfriend.com. It has been my experience that digital basal thermometers are not as reliable as mercury-free non-digital thermometers. These ‘old-fashioned’ non-digital devices are a little challenging to find except online.
Over the course of a menstrual cycle, the temperature in a hormonally-balanced woman does a predictable dance. Before ovulation, the temperature will be comparatively lower than after ovulation. After ovulation the temperature will rise and will stay high. When there have been three consecutive high temperatures, ovulation has passed and the non-fertile phase has begun. (See chart below1 for an example of the temperature fluctuations in a normal cycle, as well as accurately charting mucous and other symptoms.) Variations in the temperature can indicate imbalances, including low progesterone and thyroid disorders.
In order for an embryo to implant in the uterine lining, the woman ideally needs to have 12 – 16 consecutive high temperatures after ovulation. The high temperatures are caused by the hormone progesterone, which maintains the pregnancy. Cycles that regularly have less than 10 high temperatures generally do not have enough progesterone to allow the embryo to implant well in the uterine lining, which means even if fertilization happens, pregnancy will not. There are herbs that can help to increase the progesterone and may assist in maintaining a pregnancy in a woman who has lower than optimal progesterone levels.
Cervical Signs. Additionally, the position and firmness of the cervix can help to predict and confirm ovulation. The cervix can be checked by inserting one or two fingers fully into the vagina. Normally, with the pads of the fingers facing toward the front of the body, the cervix will be felt against the pads of the fingers as a fairly firm (like the tip of one’s nose) ring of tissue with a dimple in the middle. As ovulation approaches, the cervix will rise higher in the vagina, and the angle will also shift so as to be felt with the tips of the fingers instead of the pads. It may rise so high that it is difficult to reach. (I’ve fielded a few panicky phone calls of “I can’t find my cervix! Where did it go?”) It will also soften to feel more like one’s lips. The ‘dimple’ will open. When ovulation is over, the cervix will return to its original lower position in the vagina, become firm again, and close.
Low Fertility. Some women have very little vaginal mucous, or the temperature shift is delicate. I have found this to be an indication that the hormones are either low or not properly balanced. Regardless of blood test results from the doctor, if the vaginal mucous is not copious, and/or if the temperature pattern is not obvious, I help my client correct them with herbs and diet. I have seen basal temperature charts that indicated very low fertility correct to become ‘textbook perfect’ within a few months with the proper diet and supplements in place.
Variable or Longer Cycles. Ovulation does not always happen on day 14. In a ‘textbook’ cycle of 28 days it can happen anytime from 12 to 16 days before the next menstrual flow. It is the time before ovulation that is the most variable. If a woman has long cycles, ovulation will happen later in the cycle. A 35-day cycle, for instance, will often show ovulation at day 19 – 23. This is why it is so important for a couple who is trying to conceive to understand vaginal mucous and basal temperature, at the very least.
To recap: vaginal mucous starts before ovulation, is most copious and stretchy at ovulation, and disappears after ovulation. The cervix rises, opens, and gets softer at ovulation then drops, closes, and firms up when ovulation is complete. The first three consecutive high temperatures confirm that ovulation is over and the woman is no longer fertile in this cycle.
Increasing Female Fertility. Here are the top five things (beyond altering the diet – that will be addressed later) that a woman can do to boost her fertility.
- Optimize your weight. Being underweight or overweight can delay the time it takes a woman to conceive. One study found that overweight women took twice as long to get pregnant. Being underweight quadrupled the time it took to conceive.
- Consuming coffee and/or alcohol can reduce fertility. Drinking two alcoholic beverages per day reduces fertility by up to 60%. Most sources recommend keeping caffeine to less than 200 mg per day (although some women are so sensitive that even just ½ cup of coffee [or 50 mg of caffeine] per day reduces their fertility.)
- Stop smoking. Smoking affects how receptive the uterus is to the fertilized egg. It also can mess up the DNA in the egg and increases the risk of miscarriage.
- Choose personal lubricants wisely. While the vast majority of lubricants don’t kill sperm, they may not make it easier for sperm to get into the uterus. Products like Astroglide, KY Jelly, and Touch may inhibit sperm motility by 60 – 100%. Some doctors recommend using vegetable oil or coconut oil if lubrication is needed.
- Avoid harmful chemicals. Both prospective parents need to be aware of, and limit, exposure to chemicals. Farming, yard maintenance, household maintenance/cleaning, printing, dry cleaning, and art materials are just a few things to be aware of as potential places to be exposed to harmful chemicals. Many of these have actions that mimic human hormones and can alter both the female and male hormonal balance.2
If conception is not happening in spite of properly timed intercourse, or if the temperature and mucous are not behaving properly, the hormones are out of balance. Herbs and nutrition can be used to stabilize and enhance the hormones. (I offer private consultations to teach women/men/couples how to use nutrition, herbs and lifestyle to enhance their fertility and overall wellness. See right sidebar for contact information.)
Because some cases of infertility do originate with the man, he should have his sperm checked. It’s an easy test. Slow or poorly formed sperm can often be corrected with nutrition and supplements. Here are the top seven things, in addition to food, that men need to do to enhance and protect their own fertility.
- Stop smoking cigarettes or marijuana. Smoking tobacco has been linked to low sperm counts and sluggish motility. Long-term use of marijuana can result in low sperm count and abnormally developed sperm.
- Decrease your drinking. Alcohol can reduce the production of the normally-formed sperm needed for a successful pregnancy.3
- Watch your weight. Both overweight and underweight men can have fertility problems. With too much weight, there can be hormonal disturbances, and when a man is too lean, he can have decreased sperm count and functionality.
- Exercise in moderation. Excessive exercise could lower your sperm count indirectly by lowering the amount of testosterone in your body. And as you might have guessed, stay off the steroids — they can cause testicular shrinkage, resulting in infertility.
- Value your vitamins. Low levels of vitamin C and zinc can cause sperm to clump together. Vitamin E can counteract excess free-oxygen radicals, which can also affect sperm quality.
- Eliminate coffee/caffeine consumption. Long ago I read a study that showed caffeine can make sperm hyperactive in some men (and you know how a hyperactive child behaves), and in others it impairs overall sperm health.
- Don’t delay sex to try to ‘save up’ the sperm. Going more than a week without sex allows the sperm count to increase but slows down their motility. A few studies show the best success rates with daily intercourse, but that may create its own unique stress as well. Intimacy every 24 – 48 hours during the woman’s fertile days tends to be a good balance for most couples.
Diet and Lifestyle
Diet is crucial when trying to conceive! The better the parents’ diet and lifestyle are, the more likely they will enjoy a healthy conception and a healthy baby. Generous amounts of veggies every day are definitely in order. (Interestingly, green peas have been found to reduce fertility. Other legumes seem to be fine.) Whole grains are definitely in. Proteins are good (a little bit of animal source and a lot of vegetarian source, mostly organic). Be sure to limit alcohol4,5, coffee/caffeine6, refined sugars, artificial sweeteners, and white flour.
And a final note – hot tubs/steam rooms/saunas7, and excessive exercise are definitely out for both men and women. “In some epidemiological studies, more than seven hours per week of aerobic exercise has been associated with ovulatory infertility. In women undergoing in vitro fertilization, four or more hours of strenuous exercise weekly over a period of years has been associated with poorer outcomes.”8 Men need to be sure to keep the temperature of their testicles in check. Studies show that even as little as one-third of a degree Fahrenheit, regardless of the source of the heat, can harm the sperm count.9
Although getting pregnant may just be a matter of timing, it is always also a matter of hormones. Regardless of what the problem is, there are holistic approaches that may be helpful.
If you are having fertility challenges or just don’t know where to begin and would like some help, please contact me, Judith Cobb, to book an appointment. Skype, phone, webinar, and face-to-face appointments are available.
- Olek, Michael J., Gibbons, William E. “Optimizing natural fertility in couples planning pregnancy.” UpToDate. Accessed: September 2009.
Copyright © 2015 by Judith Cobb, Cobblestone Health Ltd. All rights reserved. Please respect the time it takes to write and publish articles. If you will link to this article and give proper attribution, you are encouraged to quote sections (though not the entire article).