7 Signs And Symptoms Of Ovulation

Ovulation occurs when an egg is released from the ovary. In a regular menstrual cycle, this typically happens two weeks before your period starts.

Ovulation signals the end of the follicular phase—which is characterized by the shedding of the uterus lining and menstrual bleeding. It occurs right before the luteal phase, in which the uterus lining thickens again.

“The menstrual cycle is centered around the ovulation of an egg into the fallopian tube, which connects the ovary to the uterus,” says Lucky Sekhon, M.D., a medical expert for the period tracking app Flo and a reproductive endocrinologist at RMA of New York. “If an egg is fertilized by sperm, it may slowly develop into an embryo over the course of a week, making its way toward the uterus where it can then implant and grow into a pregnancy.”

“If the ovulated egg doesn’t result in a pregnancy, the estrogen and progesterone [types of steroid hormones responsible for regulating reproduction] coming from the ovary where the egg was released plummet, and the lining of the uterus breaks down and sheds, leading to a period,” she says.

Though ovulation occurs in the middle of a menstrual cycle, pinpointing the exact day can be a challenge, especially if a woman has an irregular menstrual cycle. Data suggest that up to 35% of women have irregular cycles not lasting the typical average of 28 to 30 days^[1]Kwak Y, Kim Y, Baek KA. Prevalence of irregular menstruation according to socioeconomic status: A population-based nationwide cross-sectional study. PLoS One. 2019;14(3):e0214071. (although other experts note a normal cycle can range between 21 to 35 days).

Even if you don’t have a regular cycle, you can still determine when ovulation occurs by tracking backward from the day your period begins, says Serena H. Chen, M.D., chief of reproductive endocrinology at Saint Barnabas Medical Center in Livingston, New Jersey, and medical advisor for Oova, a fertility diagnostic company.

“Theoretically in a 28-day cycle, ovulation occurs around the middle of the cycle,” says Dr. Chen. “For people who don’t have 28-day cycles, we can estimate the ovulation date in retrospect because we know the luteal phase—the phase after ovulation—is about 10 to 14 days. So, if you have a 35-day cycle, we can estimate you ovulated around day 20 to 25, but this is all done retrospectively.”

This isn’t very helpful for women who may be trying to conceive and have menstrual cycles that vary each month. Dr. Sekhon acknowledges in these cases, it can make it impossible to anticipate when ovulation is happening. However, “aside from relying on your menstrual pattern to project when ovulation will take place, there are also physical signs and symptoms that can help determine when you are ovulating,” she says.

The following physical signs suggest you’re ovulating, experts and research suggest.

Changes in Cervical Mucus

Some women experience an increase in cervical mucus, a watery discharge causing dampness, during ovulation. Increased cervical mucus is a sign of estrogen going up prior to ovulation, says Dr. Chen.

Indeed, reports of a rise in cervical fluid and ovulation have been confirmed via ultrasound^[2]Owen M. Physiological signs of ovulation and fertility readily observable by women. Linacre Q. 2013;80(1):17-23. . Cervical mucus varies throughout the cycle, but at its peak is often noticed as dampness or wetness in your underwear, with discharge appearing thick, creamy or even like a raw egg white.

Rise in Basal Body Temperature

Basal body temperature is defined as your “lowest resting body temperature.” Your basal body temperature rises during ovulation, though only by half a degree or less. If that higher temperature stays steady for three days or more, it could signal ovulation. You can track daily changes to determine ovulation using a special basal body thermometer that measures your temperature in tiny increments.

Pelvic Cramping (Mittelschmerz)

Some women may experience pelvic cramping, especially on the side of the ovary where ovulation is occurring. “When the egg bursts from the fluid-filled follicle, this is ovulation,” says Dr. Sekhon. “This may be felt as an intense cramp on one side of the lower abdomen or pelvis called mittelschmerz [German for middle pain].”

One small study of about 50 women found that reported mittelschmerz occurred on the same side as verified follicular rupture, which is when the ovary has released the egg, in 86% of participants, meaning this pain may be an indication that ovulation is or has recently occurred^[3]Marinho AO, Sallam HN, Goessens L, Collins WP, Campbell S. Ovulation side and occurrence of mittelschmerz in spontaneous and induced ovarian cycles. Br Med J (Clin Res Ed). 1982;284(6316):632. .

Breast Tenderness

Breast tenderness has been noted as a possible sign of ovulation. This is due to the rise in progesterone that occurs after ovulation, says Dr. Sekhon.

Vulval Swelling

Another reported side effect—again, due to progesterone—is vulval swelling, which occurs on the outside of the genitals. It may be useful as a secondary measure of ovulation, in concurrence with tracking cervical mucus and basal body temperature, research suggests.

Backache

The increase in progesterone after ovulation can have a relaxing effect on the body, according to Dr. Sekhon. Because of this, some people may experience ligament laxity—back pain due to shifting in the spine—which is why a backache is an associated symptom of ovulation.

Perception of Facial Features

Research has found a peculiar body change—the perception of facial attractiveness after ovulation. One study used pictures of 48 women’s faces, some taken during the follicular phase (before ovulation) and others in the luteal phase (after ovulation), and asked 130 males and 131 females to select which photos they found more attractive. Over 50% of respondents noted those taken soon after ovulation were more attractive, and while unable to determine exactly which “visible cues” occurred in conjunction with ovulation, researchers did confirm their existence^[4]Roberts S.C., Havlicek J, Flegr J, Hruskova M, Little A.C., Jones B.C., Perrett D.I., Petrie M. Female Facial Attractiveness Increases during the Fertile Phase of the Menstrual Cycle. Proceedings: Biological Sciences. 2004:S270-272. .

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There are several reliable predictors you can use at home to help you learn how to tell when you’ll ovulate.

• Basal body temperature monitoring: As mentioned above, you can track daily changes in your basal body temperature to determine whether you’re ovulating by using a special basal body thermometer that measures temperature in tiny increments. By tracking your basal body temperature at the same time daily over several months, you can observe patterns in your temperature fluctuations and determine when you’re usually ovulating.
• Menstrual charting: Simply record the days your period begins and ends for several consecutive months. If you have normal menstrual cycles, you can place an estimated time of ovulation at approximately 14 days after each period ends.
• An ovulation predictor kit: Available in most pharmacies, over-the-counter ovulation predictor kits measure levels of luteinizing hormone (LH) via a urine sample. Ovulation typically occurs within 12 hours of LH peaking around the 14th day of your menstrual cycle (if you have a 28-day menstrual cycle). As you chart your cycle, use this kit around day 14 to measure your LH level. LH concentrations usually remain elevated for 14 to 27 hours.
• A fertility monitor: While more expensive than ovulation predictor kits, a fertility monitor can help you identify your high and peak fertility days within your menstrual cycle by measuring changes in both LH and estrogen levels. Some monitors store previous cycle information as well to provide more sophisticated fertility readings.

Ovulation Tests

Ovulation tests are the part of ovulation predictor kits that closely resemble at-home pregnancy tests. They feature either a stick or a test strip that is activated by urine. When taking an ovulation test, two lines appear on the stick or strip. A positive result, which indicates that ovulation is imminent, occurs when the test line looks darker than the control line.

While a popular at-home method for predicting ovulation, ovulation tests have their advantages and disadvantages.

Pros

• Require the least work of most at-home ovulation prediction methods
• Easy to access online and most pharmacies
• Accurate detection of LH levels

Cons

• Not always easy to interpret test line darkness
• Can be expensive if used over a longer period of time
• A positive result doesn’t guarantee ovulation will occur

Without ovulation, you cannot get pregnant, and if you ovulate irregularly, you will likely experience additional challenges in trying to conceive. Not sure if you’re experiencing anovulation (the medical term for not ovulating) or oligoovulation (the medical term for irregular ovulation)? The most common signs of not ovulating regularly include:

• Irregular or missed periods
• No noticeable rise in basal body temperature with a basal body thermometer
• Inconsistent or multiple positive ovulation test results
• A polycystic ovary syndrome (PCOS) diagnosis

Fertility Treatments

If you’ve been trying to get pregnant for at least six months to a year and are struggling with fertility issues relating to irregular ovulation, consider speaking to your doctor about fertility treatments that may be a good fit for you. Options abound, and not all of them are prohibitively expensive.

For instance, Clomid, the brand name for clomiphene citrate, is a popular oral medication known to aid ovulation. It’s also one of the least expensive and least invasive fertility treatments available, and most women experience minimal side effects. Clomid can be prescribed by a gynecologist or a reproductive endocrinologist.