Ovulation Symptoms (Nursing)

00:01 Now, one of the things that's really important when we talk about the menstrual cycle.

00:04 And one of the reasons it's important for nurses to understand, especially working in reproductive health is because we want to know when someone is ovulating.

00:12 Because if they want to get pregnant, or not pregnant, knowing when ovulation is occurring or not occurring is really important.

00:20 Now, we're not reproductive endocrinologist.

00:22 But there are tools and symptoms that we can use to determine that a patient is actually ovulating.

00:29 So what are those tools? The first one is cycle regularity.

00:33 Someone who is experiencing a normal menstrual cycle.

00:37 And the length of the menstrual cycle can vary anywhere from 21 to 36 days and still be considered normal.

00:44 If the cycle is regular, and every month it's occurring, in terms of time, around the same amount of days, then that's called cycle regularity.

00:52 And that is usually an indication that ovulation is occurring.

00:56 Someone who comes in and has a 21 day cycle, and then a 36 day cycle, and a 37 day cycle, and a 23 day cycle, and they can't really see any pattern to it, they're likely not ovulating.

01:10 There's also some discomfort associated with the stretching of the follicle known as Mittleschmerz.

01:16 Now, Mittelschmerz, we used to think was caused by the rupture of the follicle and that's very dramatic.

01:21 But what we're finding is we actually think it's the stretching of the follicle that creates some discomfort.

01:26 But for some clients, they will feel this every month on one side or the other because we ovulate in one ovary or the other every month.

01:34 So they may tell you about, "I have pain that occurs about halfway through my cycle every month." That's an indicator that they may be ovulating.

01:44 As estrogen levels rise, it actually affects the stretchability of the cervical mucus.

01:51 So what's the purpose of cervical mucus? Cervical mucus actually works like an Uber for sperm.

01:58 So it actually can help the sperm move from the vagina, in through the cervix, in through the uterus, and up to the egg for fertilization.

02:08 So think about the timing of the changes in cervical mucus.

02:12 We need for it to get stretchier, the closer we get to ovulation when the egg is going to be ready.

02:19 So let's look at the change.

02:20 At the beginning of the cycle when we're far away from ovulation, the cervical mucus is pretty dry, so not very stretchy.

02:28 As we move a little bit closer, you'll see that the cervical mucus becomes a little bit more stretchy.

02:33 And we can see this in the graph indicated by the mucus in between the fingers.

02:38 As we get closer to ovulation, we get a little bit more stretchy.

02:42 And finally right before ovulation, we have a really stretchy highway for sperm to be transported.

02:48 Now, let's look at the progesterone.

02:50 So thinking about when progesterone levels go up, they go up after ovulation because of the corpus luteum.

02:57 So in addition to stabilizing the endometrium, the progesterone levels also influence body temperature.

03:04 So this is a body temperature chart.

03:07 So think about the days and the menstrual cycle.

03:10 And what you'll see is at the beginning of the cycle, progesterone levels are low, and so is the body temperature.

03:16 Low meaning normal.

03:18 And then right before ovulation, the temperature drops and then it shoots right back up around the same time progesterone levels increase.

03:27 So imagine if you were trying to figure out when you ovulate, if you were to track your body temperature every day, you could actually figure out when you ovulate, and when your progesterone levels are elevated.

03:40 You have to use a basal body thermometer however, because most temperature readings are not going to be accurate enough.

03:46 And the change is about 0.4 degrees Fahrenheit.

03:50 So my scanner probably won't work for that.

03:53 So we have to use a basal body temperature chart in order to make this work.

03:57 So in the follicular phase temperature levels are normal around ovulation, the temperature drops really quickly.

04:04 And then during the luteal phase, the temperature levels are up about point four degrees.

04:09 If you maintain a pregnancy, you'll find that the body temperature stays elevated because progesterone is still there.