Thursday, September 23, 2010

8.29 Ovulation Prediction & Detection -Be Superwoman

Physician's Notebooks 8 - - See Homepage

Note: This is a chapter a young woman should read. But also the surrounding chapters are important. Update 28 Jan. 2019
29. Predict and Detect Ovulation
In the US, an ovulation urine test kit may be available in a drugstore. It detects the rising LH (brain hormone that pops an ovum from ovary each month between menses) in successive urine sample starting just before mid-cycle a few days before ovulation.
   But you do not need the kit to detect ovulation. In detecting ovulation the day-1 is the date you see first menstrual blood. If you get up as late as 5 AM Sunday and see first blood, you count Saturday as day-1, but if you see blood at 6:01 AM or later, then Sunday becomes day-1. Thereafter each successive day is counted serially (day-1,-2,-3,-4 ...) until next menstrual blood seen. Most cycles go 25 to 30 days. Using the calendar method of the previous chapter to guide whether sexual intercourse is safe against pregnancy is practical only when menstruation is regular. If menstruation is regular, you can be assured there will be no ovulation from day-1 to and including day-3; then, a gradually rising from a zero risk of ovulation from day-4 to day-11, a 95% risk of ovulation between day-12 to day-16, and a remaining 5% risk on day-17 or later. So, considering a 3 days lifetime of the spermatozoa in the tubes, and then an extra day for uncertainty, the days when you cannot get pregnant with unprotected sex with regular menstruation start after 4 full days (96 hours) after you detect ovulation and they last until the end of the next menstrual cycle day-3.
   Estimating ovulation by menstruation-start date and by signs is good for learning to accurately detect it because it teaches you not to waste time looking for the signs during a day when it is unlikely. In the usual case, you should not waste time testing before day-11.
   A good sign of ovulation comes from Basal Body Temperature (BBT) recording. The BBT is your first morning-in-bed body temperature (3-minute oral or rectal, or 5-minute underarm but should be consistently one or other and also consistent digital electronic or mercury column shakedown thermometer one or the other) Again, do it consistently and follow the written instructions just before you get up to start your day. (Should be or so each morning)
   With a usual 28-day menstrual cycle, the BBT rises sharply (There is often a sharp drop below the normal on the day of ovulation but it is not always seen) after day-12, day-13 or day-14, and by day-16, a higher level is seen in a typical graph at mid-cycle. Ovulation is c.2 hours before the 1st recorded temperature rise but this is clear only in retrospect after the high post-ovulation temperature. Thus BBT is not much more useful than the calendar alone in predicting ovulation but it is very useful to indicate sharply that ovulation has occurred and to tell you when it occurred. As soon as one is sure ovulation has occurred, one knows that coitus sex starting from 4 full days after is safe from getting pregnant till next cycle. (You are free to have unprotected sex without fear of pregnancy but you still might get an STD like HIV if you choose the wrong partner and no condom) So if a woman has practiced good contraception with a condom and/or (most safely “and”) diaphragm or just saying "No" up to the day the temperature elevation pattern is clear, then there will be no need to take basal body temperature for the rest of month.
   By detecting the BBT rise, one gives one's self 2 to 3 weeks of not worrying about getting pregnant. And it is not necessary to take BBT every day of the month. The ovulation-educated woman knows that no ovulation will occur before day-8, and it will occur only rarely before day-11 so she starts taking her BBT on the morning of day-12. If she finds an elevated BBT (oral higher than 36.8C, or>98.2F), she assumes ovulation has happened but waits another 2 days at least for confirmatory elevated daily temperatures before acting on that knowledge and before she is becoming less strict about not using a condom and/or diaphragm. (Or if she is relying completely on BBT, ending the fertile period avoidance of sex relations and allowing sex for rest of monthly cycle including the early days of next menstruation)
   From a sharply dropping BBT day-25 or later, you can predict menstruation in the next day or two. A continuing high BBT by day-30 and after, with no menstruation, means pregnancy.
   Note that if one is taking birth control pill or another hormone, aspirin or NSAID, or adrenal cortex steroid, or with illness, the BBT may not be accurate to predict or detect ovulation.

The vaginal cervical mucus method is good for the woman who does self-examination. On day-12 or day-13 of the menstrual cycle, as ovulation becomes imminent, the cervical mucus, which one catches on finger inserted deeply in the vagina, is copious and slimy and sometimes drips out looking like clear thick mineral oil; and, on the day the egg pops out, it may be streaked with blood. Once ovulation occurs, the cervical mucus or secretion becomes sparse. Combined with BBT it ups the accuracy of ovulation prediction. (Cervical mucus method is not accurate if you take birth control pill or other hormones, or have an IUD or  a vaginal infection)

How to use the above knowledge? You, a young woman, should spend time concentrating on the day or so preceding your BBT-evidenced monthly ovulation and the day of ovulation observing your changes in vaginal secretion, mood, sexual desire, appetite, abdominal bloating and pain, and breast and nipple feeling or any other change. These all have a specific pattern of change for an individual woman pre-ovulation and post-ovulation. A woman by this method may become so attuned to body change that she can start to predict her monthly ovulation from how she feels and thinks on the morning of the day it happens. Once a woman can predict ovulation accurately she becomes master of her childbearing fate and sexuality gets freed from baby-making fear.
END OF CHAPTER. To read next now, click 8.30 How To Get a Baby Despite Infertility & Have...

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