Ovulation: Understanding your cycle

Back in high school, I always felt ill during certain days of the month. I would be nauseous and I often vomited, even when I had eaten nothing. In addition, I got terrible headaches. I always thought it was malaria, and so did the school nurse.

So every month, I underwent malaria treatment. At university, it got worse. I started experiencing backache. And when I started working, there were days I never felt like going to work. I felt so weak and thought I would faint. The discomfort was so visible that everyone asked whether I was okay. It was much later that I learnt it was a result of ovulation.

I researched about painful ovulation and discovered that eating healthy like consuming less oils and sugar minimises the effects, although they do not entirely go away. Working out also makes me feel better.

A   little sharp pain in your lower pelvis, but perhaps not to the extent of making you uncomfortable, is normal during ovulation. However, not all women will realise this pain because it does not last more than 48 hours. Usually, the pain is experienced on one side of the lower abdomen, around the hip bone and may alternate between the left and right sides, monthly. This is the time a woman is most fertile.

What is ovulation?
Herbert Turyakira, a general physician at Mulago Hospital, defines ovulation as the process where a mature egg is released from the ovary, moving to the fallopian tube to enable fertilisation take place.  “By then, the uterus has developed a thick lining in preparation for a fertilised egg. When fertilisation does not take place, the thickened lining is shed, hence menstruation,” the physician explains.

Apart from the slight pain, about one in every five women notices the other common signs of ovulation. These include tender breasts, a slight increase in body temperature and increased cervical secretion.

Turyakira says while there are women who barely notice the pain, there are those for whom the pain is as much as menstrual cramps.

“When an egg is released from one of the ovaries during ovulation, it breaks up into tiny bits while in a follicle. It’s this breakage that causes the pain. For some, it may even cause a little bleeding.”

To mitigate the ovulation pain, Turyakira recommends a warm bath, plenty of drinking water and mild pain killers. However, he warns that because ovulation pain is usually not severe and does not last for longer than 48 hours; women who feel severe pain are likely to be experiencing something other than ovulation pain and should consult a doctor.

Normally, one egg is released during ovulation. However, there are cases when multiple ovulation occurs.

“With multiple ovulation, two eggs are released within a day. This, however, does not necessarily mean that if a woman had sexual intercourse, she would get pregnant with twins. Both eggs may not be fertilised, or one may be fertilised, resulting in a single pregnancy,” Abu Busingye, a gynaecologist at Mulago Hospital, adds.

The ability of a woman to undergo multiple ovulations is inherited. What is more, women over 35 are likely to undergo multiple ovulations because of the body’s desire to procreate more offsprings before menopause.

Factors that hinder ovulation
There are factors that may inhibit ovulation from taking place and among them is hormonal imbalance, vitamin or mineral deficiency, obesity and chronic illnesses, among others.

Busingye notes that there is medication to stimulate ovulation, especially when one intends to get pregnant. He adds that scientists have discovered that irregularities of ovulation can cause infertility.

How to keep track of your cycle
Turyakira notes that drawing up an ovulation calendar is useful, particularly for women desiring to get pregnant because the ovulation period is a woman’s most fertile period. Sexual intercourse, therefore, increases the chances of a pregnancy.

 On your calendar, mark the day when your last period started. Usually, ovulation takes place between the 11th and 15th day from the day the last menstrual period started.

He also notes that the other way of tracking ovulation is that it takes place around 14 days before the next period. Usually, a menstrual cycle lasts from 28 to 32 days. For women whose cycle is an average of about 28 days, ovulation takes place between the 13th to 15th days.

However, Turyakira says it is important to note that the ovulation calendar is bound to change when it comes to factors such as sickness, stress, extreme change in physical activity, among others.

Other key facts on ovulation
Some women may experience some light blood spotting during ovulation

 Each woman is born with millions of immature eggs that are awaiting ovulation to begin

 A menstrual period can occur even if ovulation has not occurred

 Ovulation can occur even if a menstrual period has not occurred

 If an egg is not fertilised, it disintegrates and is absorbed into the uterine lining

There will be changes in your cervical mucus. The amount of cervical mucus increases as well as the texture. This indicates the rising levels of oestrogen.

When the cervical mucus resembles raw egg white, a woman is generally considered to be at her most fertile. It is this mucus, resembling raw egg white, which coats the path that the sperm will take on its journey

Your body temperature will rise. When your temperature rises sharply, it means you have ovulated and your body has released the egg. This stimulates the production of the hormone progesterone, which makes your body temperature elevate.

Change in cervical position or firmness. The cervix goes through many changes as a woman ovulates. The cervix will be soft, high, open and wet. For most women it will take some time to study her body to be able to differentiate between what the cervix normally feels like and the changes it goes through during ovulation.

 Light spotting

 Breast tenderness

 Abdominal bloating

 Increased sex drive

 Heightened sense of smell, taste or vision.

Lynn’s cycle is 26 days
She started her period on January 3. Her next period will start on January 29. To calculate her ovulation date for January, Lynn would have to count back about 14 days from the first day of her next period. Her possible date of ovulation, therefore is January 15. However, there is potential for her to ovulate between January 13th and 17th.

To calculate her ovulation date for February, Lynn would have to count back about 14 days from the first day of her next period, which February 24. Her possible date of ovulation, therefore is February 10.

Red
Dates that are coloured red represent the section of the month when you have your period. The first day is labelled with the darkest red because this is usually the day menstrual flow is the heaviest. The slowly subsides.

Green
Dates coloured green represent the section of the month when you are most fertile (ovulation). The darkest green is the ovulation day — the peak of fertility. Several days that are coloured green, meaning there is potential to conceive.

How to use the calendar
You need to enter the first day of your last period, the length of your menstrual cycle and the number of days from the first day of menstruation to the day before the following menstrual period starts. However, sometimes anovulatory cycles happen.

These are menstrual cycles when no egg is released but when a woman does have her period. The ability to ovulate varies from month to month, and can be delayed by a number of factors such as stress, illness, diet, or increased physical activity.