Period positivity is important and inspiring, but if we only focus on the period, we overlook the biggest player in hormonal health and the menstrual cycle: ovulation. Ovulation is the release of an egg from your ovary around the middle of your cycle. It’s important for fertility, but ovulation is not just for making a baby. Ovulation is the main event of a healthy menstrual cycle, and it’s how you make the estrogen and progesterone you need to be healthy.
Men make their hormone testosterone every day, so you might think women would do something similar but we don’t. Instead, we make our hormones during particular times of the month, creating a surge of estrogen just before ovulation and an even bigger surge of progesterone during the two weeks after ovulation. Ultimately, ovulation is how you progress through all the stages of a normal menstrual cycle. If you don’t ovulate, then you technically do not cycle (although you could still bleed) and you miss out on the many benefits of ovulation.
Canadian endocrinology professor Dr. Jerilynn C. Prior says women benefit from 35 to 40 years of ovulatory cycles, not just for fertility, but also to prevent osteoporosis, stroke, dementia, heart disease, and breast cancer.
The benefits come mainly from progesterone, which is a powerful steroid hormone that the body absolutely expects and needs to have. Progesterone reduces inflammation, regulates the immune system, and supports healthy thyroid, brain, bones, and breasts.
Estrogen has many benefits as well. Each monthly dose of estrogen promotes muscle gain, insulin sensitivity, and the long-term health of bones, brain, and the cardiovascular system.
Ovulation is beneficial not only for the hormones it gives you, but also for the insight it provides into your underlying health. For example, when you’re healthy, ýou will ovulate every month. When you are unhealthy in some way, your lack of ovulation can give insight into why. That’s why the American College of Obstetricians and Gynecologists (ACOG) calls the menstrual cycle a “vital sign” of health, and says doctors should always ask patients about ovulation and menstruation.
Do you ovulate every month? If you’re not sure, start by looking at your cycle. A regular cycle is a sign that you probably ovulate but, unfortunately, it’s not a guarantee. You could have an anovulatory cycle, which is a menstrual cycle in which you do not ovulate but could still bleed.
To really know if you ovulate you need a test, and there are several ways to do so including blood tests, urine tests, cervical mucus tests, and taking your basal body temperature (BBT).
Of all of the methods, BBT tracking is the most reliable. To track your BBT, measure your under-the-tongue temperature before you get out of bed each morning. In the first part of your cycle before you ovulate, your temperature will be at a baseline level, between 97.0 °F and 97.7 °F. In the second half of your cycle after you ovulate, your temperature will increase by 0.5 °F and stay high until your period. That small, but significant, increase in temperature during the last two weeks of your cycle is enough to know for certain that you ovulated. Find out more here.
Hormonal birth control works by stopping ovulation, therefore stopping production of your own sex hormones. The pill contains steroid drugs as a kind of “hormone replacement”—not unlike the hormone replacement given to women in menopause. The contraceptive steroid drugs that make up birth control, like levonorgestrel, have different effects on your body compared to your natural progesterone. For example, women on birth control can have altered brain structure compared to women who cycle naturally. There can also be a higher risk of depression, hair loss, and autoimmune disease. Fortunately, there are effective non-hormonal methods of birth control too. Check with your doctor for more information.
It’s common to occasionally stop ovulating due to stress or illness. It just means your body has made the smart decision to pause reproduction until you’re feeling better.
If you are consistently not ovulating, you should check with your doctor. They will likely order tests to rule out various explanations including pregnancy, thyroid disease, and certain medications. They may then diagnose you with one of the two most common reasons for not ovulating:
Before you embark on a calorie or carb-restricted diet for PCOS, take care that your diagnosis was not based solely on an ultrasound. PCOS cannot be diagnosed that way and may have resulted in you being told you have the condition when you do not. Read my blog post Maybe It’s Not PCOS and talk to your doctor.
If you track your periods, please consider tracking your ovulation. It is the most interesting part of the menstrual cycle, and is both a source of health and vitality. Knowing if and when you ovulate is one of the most powerful ways to get to know your body.
photography by onourmoon
illustration by Nick Pons