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Module 3: Cycle Charting, Fertility Awareness, Birth Control Options > The Basics of Fertility Awareness Charting > Flashcards

The Basics of Fertility Awareness Charting Flashcards

1
Q

What is the first step in cycle charting?

A

Identify the fertile window

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2
Q

When does the fertile window phase begin?

A

The first time a woman starts to observe cervical mucus and then completes after ovulation is successfully confirmed.

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3
Q

When are women technically the most fertile?

A

The day before ovulation, the day of ovulation, and the day after ovulation, but are considered fertile for 6 days total due to the presence of cervical mucus.

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4
Q

For how many days are women considered fertile and why?

A

6 days due to the presence of cervical mucus.

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5
Q

How long can the female egg survive and how long can sperm survive?

A

24 hours; up to 5 days in fertile-quality cervical mucus, thus elongating the fertile window.

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6
Q

Are any days of cervical mucus considered potentially fertile?

A

Yes, because we can’t determine the exact date of ovulation.

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7
Q

Different types of cervical mucus are produced by the cervix in response to BLANK or BLANK production in the ovaries.

A

estrogen or progesterone

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8
Q

How does estrogen produce different types of fertile-quality cervical mucus?

A

By stimulating the cervical crypts.

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9
Q

What are cervical crypts?

A

They can be found within the lining of the cervix, and serve as both a place for mucus production and shelter for sperm.

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10
Q

During the fertile window, in presence of estrogen, the cervix will produce 3 different types of mucus. What are the 3?

A
  • S-Mucus
  • P-Mucus
  • L-Mucus
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11
Q

What is S-Mucus?

A

Stands for String-Mucus.

Type of fertile-quality mucus that will shuttle sperm into the cervical crypts, nourishing and protecting them in an alkaline environment until ovulation occurs.

At which point it acts as a safe medium for the sperm to travel tup toward the egg, like speed lanes in a highway.

S= shuttle

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12
Q

What is P-Mucus?

A

P = Peak/Push-mucus

Type of cervical mucus that helps disintegrate the mucus plug from the previous cycle and helps the sperm to move out of the cervical crypts and into the uterine cavity.

Responsible for the lubcricative sensation of peak cervical mucus.

P = push sperm out of the crypts and into the cavity.

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13
Q

What is L-Mucus?

A

L = Loaf Mucus

Acts as a filtration system, kicking out the “bad” or “deformed” sperm, and selecting only the fittest, healthiest sperm to survive

This mucus also “locks” sperm into the S-crypts while they wait for ovulation

L = locks, loaf of bread must not have mold on it or “bad” qualities

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14
Q

During the luteal phase the cervix will produce what type of mucus?

A

G-Mucus
G= gestogenic, also refered to as the “G Mucus Plug”

A thick development of mucus at the cervix in response to rising progesterone levels within the luteal phase

This mucus plug has anti-microbial properties that protect the uterine environment from bacteria, and other pathogenic invasions, as well as sperm from entering into the uterine environment post ovulation

This thick mucus plug is also what continues to protect a growing fetus during pregnancy until it passes in early labor - known as the “bloody show”

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15
Q

What are the ways you can identify the fertile window?

A
  • Cervical mucus
  • Cervical position
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16
Q

What is the cervical os?

A

It is the cervical opening at the bottom of the cervix

It’s circular shaped, with a hole in the middle

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17
Q

Does the cervix moves & changes throughout the course of the menstrual cycle?

A

Yes

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18
Q

In the fertile window, the cervix should feel BLANK?

A

Soft to texture, sort of like how your lips feel; it will feel generally wet or slippery.

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19
Q

In the fertile window, the cervix should rest BLANK in the vaginal canal and the opening will be BLANK?

A

Rest higher in the vaginal canal and the cervical opening will be open

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20
Q

After ovulation occurs, the cervix returns to its BLANK place, where it feels BLANK and sits BLANK in your vaginal canal?

A

To its resting place, where it feels firm like the tip of your nose, it sits lower in your vaginal canal, the cervical opening feels closed, and in general it feels drier inside, and not as wet or slippery, thanks to the mucus plug due to progesterone.

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21
Q

T or F: For those who have had a vaginal birth in the past, their cervix may always remain slightly open, and the opening may feel more like a slit rather than a circular hole.

A

True

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22
Q

T or F: the cervix is not open during menstrual

A

False, it is usually slightly open during menstruation to allow for blood to pass through.

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23
Q

Is cervical height (vaginal fornix length) the most variable characteristic?

A

Yes, so for a woman who chooses to observe this sign, it’s recommended that she observe her cervix once daily, in the evening, for a full cycle. This will allow her to see what her individual pattern is

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24
Q

What is the acronym to remember signs of fertility?

A

SHOW (Soft, High, Open, Wet)

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25
Q

What is the acronym to remember not being fertile?

A

(Firm, Low, Closed, Dry)

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26
Q

True or False: Cervical mucus typically shows in the fertile window in a specific pattern. However, this pattern will be unique to each woman

A

True. Observing mucus patterns throughout the course of multiple cycles will allow you great insight into this area of your client’s reproductive health.

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27
Q

What is a Basic Infertile Pattern of Discharge (BIP)?

A

Some women never have any dry days after their menstruation ends.

Instead, they experience a continuous, unchanging discharge that does not reveal the typical developing, changing pattern of mucus associated with ovulation and potential fertility.

The sensation and appearance of this dischrage can vary greatly from person to person.

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28
Q

In cycles less than 35, the BIP mucus is made up of what?

A

Small fragments of the G mucus plug in the cervix flaking off.

Usually, at this point, the cervix is still closed, estrogen levels are low, and the woman is not considered fertile

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29
Q

In regular cycles, a woman only has two options for a BIP, which are?

A

Dry or unchanging discharge

If she has even one completely dry day after her period ends, any mucus she might see after that is potentially fertile.

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30
Q

What does dryness mean?

A

No mucus felt or seen

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31
Q

If a woman with a regular cycle has even one completely dry day after her period ends, any mucus she might see after that is BLANK?

A

Potentially fertile

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32
Q

In cycles longer than 35 days, an unchanging dischrage is caused by BLANK?

A

A slightly raised level of estrogen that is stimulating the vaginal walls, causing the epithelial cells to grow and shed.

In this case, estrogen is just high enough to cause a vaginal response, but not high enough to trigger a cervical response and ovulation. This is common in cycles influenced by stress, breastfeeding, and perimenopause.

33
Q

Which method is helpful for women with patterns of continuous discharge and why?

A

The Billings Ovulation Method can be very helpful for women with patterns of continuous discharge because there are specific protocols for identifying when fertility begins and ends

34
Q

In healthy cycles, any mucus that is observed before BLANK is confirmed should be considered fertile quality.

A

Ovulation

35
Q

In the first part of the fertile window, when the cervical mucus is thicker and less abundant, is considered by most FABMs to be BLANK.

A

Non-peak mucus.

Although, it is still considered fertile and can potentially keep sperm alive for up to 5 days.

36
Q

What is peak mucus?

A

has more water concentration (up to 90-95% water) and may appear like raw egg whites, or very watery, and usually occurs right before ovulation, and sometimes on the same day as ovulation.

37
Q

What does peak mucus look and feel like and what is the most important quality of Peak mucus?

A

It is usually very stretchy and will stretch to at least 1 inch. It may also appear very clear, and very lubricative when wiping. This sensation (observed either via sensation
at the vulva or by wiping toilet paper across the perineum) is correlated very closely with ovulation.

38
Q

What is the reason why they call it peak mucus?

A

Because this mucus is very sperm friendly, as we talked about earlier, indicating you are nearing your peak fertile days.

39
Q

Peak mucus helps to provide a BLANK environment that will protect and nourish the sperm to live in until ovulation occurs.

A

alkaline, normally the vaginal environment is rather acidic to keep pathogens and bacteria out of the reproductive system.

40
Q

If your clients experience cervical mucus-like discharge after ovulation has been confirmed, it technically isn’t considered fertile-quality mucus. It’s refered to as BLANK.

A

Vaginal discrhage

41
Q

What is cell slough?

A

ischarge can be normal, as the vagina is a self-cleaning machine and will shed cells of the vaginal wall daily, which can result in “creamy” or “sticky” discharge on occasion. This is known as cell slough.

42
Q

If a woman experiences what may appear as egg white cervical mucus in the luteal phase, typically right before menstruation, what is that a sign of typically?

A

Hormone imbalances, such as estrogen excess, and/or low progesterone, as estrogen stimulates the cervical crypts and progesterone creates the mucus plus.

If a woman experiences a wet sensation a few days before menstruation, this means that progesterone is falling faster than estrogen at the end of the cycle. This de-activates the Pockets of Shaw, which regulate the amount of moisture in discharges leaving the vagina.

43
Q

What are the Pockets of Shaw?

A

The structures at the base of the vagina that remove moisture from all discharges leaving the vagina when progesterone is the dominant hormone. Their response to progesterone around the time of ovulation is what causes the abrupt drying of mucus after peak day. This drying-up process can begin prior to ovulation since progesterone rises during luteinization of the follicle to assist in ovulation.

44
Q

Taking BLANK can impact the Pockets of Shaw, so some women experience wetness throughout the cycle, even outside the ovulatory phase.

A

The Pill and even if they are recently coming off of hormonal contraception.

45
Q

What cause cause abnormal mucus patterns in the luteal phase?

A

Hormonal disruptions

46
Q

What is vaginal sensation determined by?

A

What you feel when you wipe or what is felt at the vaginal opening, depending on the method being used. It is indicated by the feelings of smoothness, slipperiness, or dryness when wiping.

47
Q

What is walking sensation?

A

Sensationat the vulva.

Indicated by how your vulva/ vaginal opening feels throughout the day when performing daily activities

a microscopic amount of mucus can be felt, even if it can’t be seen. Just like when a woman can feel her period starting.

48
Q

Tuning into BLANK or BLANK sensation allows women to identify the beginning and end of their fertile windows more precisely.

A

Wiping and walking sensation

Some FABMs require this observation to reach studied efficacy in avoiding pregnancy.

49
Q

BLANK is the backbone to the fertility awareness process

A

Charting

50
Q
A
51
Q

When used perfectly, fertility awareness methods can be up to BLANK % effective

A

98-99%

52
Q

How should you bring charting your cervical mucus?

A

Checking your cervical mucus throughout the day, every day each time you wipe after going to the bathroom.

Checking both before and after you go pee or poop. If you are in your fertile window and you experience peak mucus, it’s possible it can “slip” out without you noticing.

53
Q

What is the point of change?

A

Signifies that a follicle has begun developing on the ovary.

54
Q

When may there be multiple points of change?

A

In cycles during certain points of life (such as breastfeeding), as FSH attemps to launh follicles.

If they don’t proceed to ovulation, they will die, and FSH will continue to recruit follicles and try again.

55
Q

In a normal, healthy ovulatory cycle, the point of change occurs and is followed by BLANK?

A

A dynamic and changing pattern of mucus that ends in a slippery sensation.

The slippery sensation is followed by an abrupt change to no longer slippery and wet.

Ovulation can still occur in the absence of this pattern, but that typically means there was something faulty about the ovulatory process, and may or may not be a fully fertile cycle.

56
Q

It can be challenging to determine the difference between different types of cervical mucus that you observe. When you’re starting to get to know your patterns, what can you try first?

A

Feeling with your fingers how CM feels, without looking at it. Then, look at your CM to confirm what you felt, then chart accordingly.

57
Q

Can you check your cervical mucus internally, which can be done by inserting a clean and dry finger and seeing what comes out and/or how your cervix feels?

A

You can, but this method of checking may be a bit trickier to discern the difference between true cervical mucus, cellular slough, and general vaginal moisture.

FABMs that allow internal cervix checks typically have a specific protocol for checking mucus to limit the influence of normal vaginal fluids.

58
Q

What are the reasons to consider avoiding internal mucus checks?

A
  • It can create unnecessary confusion. The inside of the vagina is always moist and has a mucus membrane, so a woman will always have something on her fingers when she checks internally.
  • It can introduce harmful bacteria
  • Internal checks are unnecessary for assessing health and fertility (mucus has nowhere to go but out, so if she is checking diligently, she will sense or see mucus if it’s present)
  • Bypassing the Pockets of Shaw may make the ovulatory phase seem artificially long (She may find mucus at the cervix that appears to be peak type, but if she waited for it to come out naturally, the Pockets of Shaw could absorb moisture and it may present as non-peak instead)
59
Q

What is the Peak Day?

A

Your peak day refers to the last day you experienced peak type cervical mucus, or, the last day that you experience lubricative vaginal sensation.

60
Q

What is a basal thermometer?

A

A thermometer that reads to the hundredth degree

61
Q

When charting you will record in either Fahrenheit or Celsius, depending upon your preference, and round your temperature to BLANK.

A

The nearest tenth degree.

For example, if your temperature is 97.34, you would record it as 97.3 in your charts. Celsius temperatures are rounded to the nearest 0.05 degree (36.63 → 36.65).

62
Q

What do you need to do to ensure an accurate temperature reading?

A

Make sure you are taking your temperature at the same time every morning, immediately upon rising & before getting out of bed or moving.

You’ll also want to make sure you avoid any other disturbances such as drinking water, looking at your phone, or engaging in conversation or sexual activity.

Make sure to take your temperature in the exact same place every single time. If you temp orally, make sure to always take your temperature on the same side of your mouth, or in the same position each time

63
Q

Can you take your temperature vaginally or under your armpit?

A

You can, but axillary temperatures may be less accurate, so use caution if trying to avoid pregnancy.

Whichever method you choose, just stay consistent and avoid switching around different temping modalities throughout a single cycle.

64
Q

Can sleep quality affect basal body temperature?

A

Yes, to get an accurate basal body temperature reading, you must be asleep for at least 3 straight hours, without disturbances.

If you do happen to wake up in the middle of the night, it is possible the disturbance may interfere with your reading, so note that on your charts.

Keep in mind that this is not the same for everyone. Some people do not see a difference whether they get out of bed in the middle of the night to pee or not. It’s specific to your body and your patterns.

65
Q

What is the Tempdrop termometer and when should someone consider investing in it?

A

This is a wearable thermometer that selects one temperature from the many readings it takes overnight while you sleep and works upon an algorithm to determine your basal body temperature. This device IS based upon an algorithm, so you may want to consider that before deciding, but know that it is one of the most precise & user-friendly devices with an algorithm on the market.

If you tend to have trouble waking up at the same time every morning, or you frequently get disturbed in the middle of the night.

66
Q

Progesterone is BLANK, meaning it elevates your body temperature by stimulating BLANK activity.

A

Thermogenic; thyroid hormone activity

67
Q

How can you see in your charts approximately when you ovulated?

A

By observing a sustained thermal shift in your temperatures.

68
Q

To confirm ovulation using the sympto-thermal method, you will need to observe what?

A

Several days of high temperatures in a row, alongside observing your cervical mucus drying up.

The temperatures have to rise a certain amount above the previous 6 low temperatures, but the specific nuances vary by method.

69
Q

To confirm ovulation using the sympto-thermal method, what do you need to notice about your temperature shift?

A

When you notice 3-4 temperatures in a row that are at least 1/10th of a degree (in Fahrenheit) higher than the previous six.

In Celsius, they should be at least 0.05 degrees higher. This usually happens a day or two after your peak day, but it can sometimes happen on the peak day itself. However, if you see a temp rise before your peak day, do not record it as a thermal shift.

70
Q

If you happen to experience variations in your temperature, you don’t observe a precise thermal shift, or you are having a difficult time interpreting what’s going on, what can you do?

A
  • First, make sure you are taking your temperature at the same time every single morning.
  • if you happened to drink alcohol the night before, or if you are sick with a fever.
  • Mouth breathing can cause artificially low oral temperatures
71
Q

If you are concerned about mouth breathing causing artifically low oral temperatures, what can you do?

A
  • Mouth taping with a medical-grade, skin-safe tape
  • Before temping, close your mouth for about 30 seconds and swallow a few times
  • Pre-warm the thermometer in your mouth for 5 minutes before turning it on. Make sure to set a timer, so you always pre-warm for the same amount of time.
72
Q

Why might some people have trouble detecting thermal shifts?.

A
  • If you don’t ovulate consistently
  • If you have a hormone imbalance like low progesterone
73
Q

What are ovulation predictor kits or OPKs?

A

They don’t predict ovulation despite their name.

They test for the LH surge; which is only an indicator that ovulation might occur within 16-48 hours (usually 24-36), but it does not guarantee that it will happen.

Although you may be able to more easily determine your most fertile days with OPKs, here are more processes & hormones needed to be in place for ovulation to occur, and LH is just one piece to that puzzle.

74
Q

Some cases of BLANK might show false OPK positives due to LH being elevated throughout the entire cycle

A

PCOS

This is one of the reasons why people often have ovulatory issues with PCOS, as LH stays elevated, and rarely gets high enough to trigger ovulation.

75
Q

What is Mittelschmerz?

A

Some women experience pain around ovulation which is translated as “middle pain” in German.

This may or may not be accompanied by light spotting around ovulation.

76
Q

Why does Mittelschmerz usually occur?

A

Because ovulation is an inflammatory event, and in some cases, that can lead to mild pain or discomfort usually located o whichever side of the ovaries ovulation is occurring.

77
Q

Why can spotting be common during ovulation?

A

Aittle bit of blood may come from the ruptured follicle that facilitated ovulation, and/or it could be due to estrogen lowering right around ovulation before progesterone is produced, which can result in slight shedding of the uterine lining.

78
Q

If your client tends to experience a lot of pain around ovulation or at other times throughout their cycle outside of menstruation, what could this be due to?

A

Elevated inflammation and/or a more serious condition like endometriosis

Module 3: Cycle Charting, Fertility Awareness, Birth Control Options (4 decks)

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