Where are you in your cycle right now? How was your last period- was your bleeding heavy or light, dark or pale, clotty or smooth? Any cramping?
If you are a patient of mine and you menstruate, then you are familiar with this conversation. By asking about details from your cycle, I learn about your constitution and how to apply effective acupuncture and herbal strategies that support your overall vitality, help ease discomfort, support healthy periods, and optimize fertility.
Although tracking these signs is crucial for those who are trying to conceive (and also those wanting to avoid pregnancy), it is also helpful for folks experiencing conditions such as PCOS, fibroids, amenorrhea, endometriosis, or perimenopause. By keeping a detailed record of your emotional and physical experiences at different times of your cycle, you can track your responses to treatments along with diet and lifestyle changes.
The list of symptoms you may want to track varies depending on what your health goals are. Here’s a list of the basics and what they tell you:
Cycle length: The most basic aspect of tracking your cycle is simply counting how many days it lasts. “Day 1” is the first day of menstruation, and the count starts over every time you get your period. An average menstrual cycle lasts 28 days, with bleeding for the first 3-5 days and ovulation occurring around day 14. Your cycle may not fit into this template, and tracking the date that you start bleeding every cycle will help to establish a pattern (or lack thereof in the case of irregular menstruation due to PCOS or anovulation).
Premenstrual symptoms: Are you bloated, cranky, tired? Do your breasts feel sore? Having night sweats? How many days before your period do you start experiencing these symptoms? This can help determine what needs to shift in order for you to experience more pleasant cycles with less of the above.
The period: How many days do you bleed? Does it start or end with days of spotting, or turn on and off like a faucet? Is your bleeding heavy, medium, or light? What is the quality of the blood- big clots, small clots, thin and watery, or thick and viscous. Is it bright red, dark red, brownish or purple? Tracking these details can help to illuminate the nature of any imbalances in your cycle.
Basal body temperature (BBT): This is your waking temperature, taken within moments of awakening, before you get out of bed. By measuring this temperature down to a tenth of a degree, you can verify if and when ovulation has occurred. When measured over the course of three or more months, you can use this information to help predict your fertile window- the 6 days of each cycle when your body is able to become pregnant. In addition to fertility support, basal body temperature can be a useful tool if you have especially long or irregular cycles, or if you are perimenopausal and suspect that you may be having anovulatory cycles. The patterns in temperature shifts on your basal body temperature chart can be interpreted to bring to light possible issues with your cycle that can be addressed by acupuncture, herbs, diet, and lifestyle changes.
Cervical fluid: You may have noticed that you have more vaginal discharge on some days than others. If it is relatively odorless and clear or whitish in color, then this is likely healthy cervical fluid that increases in flow around ovulation. By observing the timing, amount, and quality of cervical fluid over a number of cycles you can predict your fertile window, and also the likely date of your next period, since the time between ovulation and menstruation is a set number of days for most people.
Cervix position: If you have yet to feel or look at your cervix, you may want to try it out! During ovulation, the cervix opens slightly, becomes soft, and sits high within the vagina. The rest of the time it is closed, firm, and rests lower within the vagina. By feeling it with you fingers, or viewing it with a speculum and mirror, you can track its position and density and add these to your other signs of ovulation.
Other physical signs of ovulation: Some people experience bloating, back pain, ovarian cramping, and other unique physical symptoms when they ovulate.
Tests: The most common at-home test used to monitor ovulation is an ovulation predictor kit (OPK). OPKs measure the amount of luteinizing hormone (LH) in your urine, which surges right before ovulation. Some OPKs measure the increase in estrogen that happens right before the LH surge, too. Recording the results of your estrogen or LH tests helps to establish a pattern of ovulation, and can be used during the cycles you are actively trying to conceive to plan your timing.
If you haven’t already, I recommend that you start using a cycle tracking app (or devise a handwritten system of record keeping- printable charts can be downloaded here). My favorite app is Clue because of its clean design, gender neutral color scheme and language, and ease of use. Other good ones are Kindara, Ova Graph, and My Flo. The most detailed book on cycle charting is Taking Charge of Your Fertility by Toni Weschler. She expands upon the methods I mention here and explains why and how to track each particular symptom.
If this is all new to you- no worries, we are all learning! Now is a great time to slow down and listen to the messages your body is sending. If you’re not sure what they mean, or you’d like to shift into a place of more ease, call me for a consult: 503-939-1051, or book online!