By Shirelle Edghill, FCP
Misunderstanding #1: Your period is your menstrual cycle.
“I’m on my cycle,” or “My cycle is usually 6 days long” are phrases I commonly hear women say when referring to their period. I think women tend to refer to their period as their cycle, because it is such an obvious event, and it is the only event in their fertility cycle that they have to think about and manage. But in actuality, a woman’s cycle is much more than just her period. The period marks the first day of her cycle, which actually ends the day before her NEXT period arrives. The period is of course a really important biomarker of health and fertility, but it is not the ONLY biomarker of health and fertility over the course of the cycle. The total number of days in the entire cycle is also important. The number of days from ovulation to the start of the next period is important. The quality and quantity of the cervical mucus which is produced during the cycle is a great indicator of fertility health, and the presence of any spotting or unusual bleeding between periods, also gives us helpful information about the woman’s fertility.
Misunderstanding #2: Knowing exactly which day you ovulate.
The next misconception I’d like to dispel is for the health conscious women out there that do track their cycle and know something about when they might be ovulating. In a 2012 study at Tufts University researchers had women who were trying to conceive attempt to identify their own time of ovulation over the course of a cycle. What the researchers found was that most women actually do not know when they ovulate, even when they were paying attention to their body’s signs and symptoms. Only 55% of the estimated days of ovulation even fell within the time of fertility, and only 27% of the time did the day the woman's estimate fall within days of peak fertility. I think there is a lot of confusion out there about how to determine the time of ovulation. You actually cannot know, based on any symptom the exact day that you ovulate, but you can get pretty close! There is no symptom or gadget that will tell a woman exactly when she ovulates. There are certain helpful biomarkers which give a very good estimate of ovulation day, but it is always just an estimate. Let’s take cervical mucus, for instance. The presence of good quality cervical mucus and then its subsequent drying up tells us that ovulation probably occurred. But it’s not an automatic shut off switch. Once an egg has been released for possible fertilization it is viable for about 24 hours. The cervical mucus sign tells us usually within a + - 3 day accuracy of when a woman ovulated. The same is true for ovulation predictor kits, and the shift in basal body temperature that we can note after ovulation has passed. All of these things help us estimate ovulation. The only definitive test we have to know for sure that ovulation has occurred is an ultrasound series where a doctor can actually watch the process over a number of days. For purposes of family planning, it’s important to bear this in mind. A couple trying to avoid or achieve pregnancy should understand that the woman is fertile for a number of days before and after her estimated day of ovulation. In the fertility awareness based Creighton method, which I teach, the woman determines a peak day (estimated day of ovulation) based on cervical mucus symptoms, and she is considered fertile for 3 full days past the peak day, even if she has no mucus at all in those three subsequent days.
Misunderstanding #3 You can have a period while using hormonal contraceptives or You can use hormonal contraceptives to ‘regulate’ your cycle.
I wanted to touch on this myth because I hear it so often. Some women use hormonal contraceptives like the birth control pill to try to help regulate their cycle. Doctors will often use this term “regulate the cycle” when trying to treat their patients who are having cycle related issues. When a woman begins taking the pill and sees regular bleeding every 28 days, she thinks she has done just that. But what the birth control pill actually does is suppress the naturally occurring fertility cycle. The bleeding that occurs at the end of a 28 day pill pack is what is called a withdrawal bleed. It is not a period. The final 7 pills in a pack of birth control pills are placebo pills. So instead of receiving the normal dose of hormones that you would get from a regular birth control pill, you get a sugar pill. This causes a bleed due to the abrupt withdrawal of hormones. What’s interesting is that recently more doctors are advocating stopping this practice of inducing a bleed. New research suggests that these days of bleeding are not really believed to be necessary, and may be used for more historical/cultural reasons than anything. The doctors that originally invented the pill wanted to mimic a real cycle. It is unlikely that there is any kind of health benefit with this practice. True periods occur as a result of ovulation, which is suppressed when a woman takes the birth control pill or uses other hormonal contraceptives.
If you are interested in learning how to chart your own fertility cycle for family planning, or to discover information about your own fertility health, please contact me at ShirelleEdghill@gmail.com . I teach in person in the North Texas area and online. Thanks for reading!