Ovulation Predictor Kits, Which one should you use?

by Stefanie Miska, Acupuncturist Victoria Infertility Lifestyle Menstrual Cycle Reproductive Health Ritual Medicine

Which ovulation predictor kit should I use?

Many of my patients who come in seeking treatment for fertility, ask my opinion on which ovulation predictor kits (OPK’s) to use, what cycle tracking app is best, what prenatal I recommend, and so on.

I have put together a comparison of three OPK’s in order to provide some insight into which product may be the best one for you. You will also see my clear favourite as well.

The biggest complaint I hear from patients is the cost of these strips. When purchased in a pharmacy, they can range anywhere from $3-8 per strip. With repeated use over time, this cost definitely adds up!

Firstly, what is an ovulation test kit?

Ovulation test kits, or ovulation predictor kits, determine when you are ovulating by measuring the hormone levels in your urine.

Ovulation is controlled by luteinizing hormone (LH). LH levels surge dramatically 24 to 36 hours before ovulation. After ovulation, they return to normal.

You can predict (with fairly good accuracy) when you are about to ovulate by pinpointing your LH surge. This is how OPKs work. They measure LH levels in your urine and compare them with a threshold to tell you if you are likely to ovulate soon.

OPKs work similarly to pregnancy tests in that they have two lines that form after immersing the test stick in urine.

When to test?

If you are unsure when you ovulate, it can be tricky to know when to start using the OPK’s so you’re not testing everyday and using more tests than necessary.

Check out this little info graph from Ovry:

Now, a product comparison:

Ovry

In terms of company and product values, Ovry was my preference. Female founded in Canada, with their products manufactured in North America, those were all ‘checks’ in the positive column for Ovry.

Strips are purchased through the Ovary website but delivered through Amazon.
A medium sized box comes with 24 ovulation strips and 4 pregnancy tests.
Purchase cost $47, which is is approximately $1.68 per strip.
Test strips are recommended to sit for 10 minutes.
Does not come with its own app connection, so if your memory is good then you can easily keep track of the progression of the line getting darker. Alternatively you would need to take pictures of the test results and store them on your phone.
Comes with small cup to collect urine sample, too small if you ask me!

Pearl Fertility

Pearl fertility is the first company I have seen to offer two different test strips to measure both Follicle Stimulating Hormone (FHS) AND Luteinizing Hormone (LH). While this offers more information, it is also more days of testing and more strips to use. This product is also sold in US dollars which is more costly for Canadian consumers (which all of my patients are)

Strips are purchased through the Pearl Fertility website.
Medium kit comes with 15 FSH strips,15 LH strips and 2 pregnancy strip tests.
Cost $40 US, which is approximately $1.60CDN per strip.
Comes with reusable strip holder, which can make collecting sample easier for some. (You pee directly on the stick instead of collecting into a cup)
Pearl Fertility has its own app to track your menstrual cycle and take in-app pictures of your test strip results. It uses the visuals of a flower opening to show when and where you are in your fertile window. This app does not store the images, so you cannot see the progression of the strip line darkening as you get closer to ovulation, I find this less ideal.
This is also the only app that suggested collecting first morning urine samples.
Test strips are recommended to sit for 10-15 minutes.

Easy@Home Premom

Easy@Home is my recommendation for ease of use and cost value. Considering the product and connected app function well, it is impossible to beat the price on this product.

Only available to purchase from Amazon
Best value – kit with 100 OPK’S and 20 pregnancy test strips.
Purchase price $40CDN – approximately $0.33 cents per strip *cheapest
Premom has its own app to track your menstrual cycle and take in-app pictures of your test strip results. This app stores all the pictures you upload, so you can see the progression of the test line getting darker, which I find helpful.
Test strips are recommended to sit for 5 minutes.

If you decide to give any of these products a try, I would love to hear how they work for you. I hope you find this product review and comparison helpful!

Managing stress to balance hormones

by Stefanie Miska, Acupuncturist Victoria Emotional Health and Wellbeing Lifestyle Menstrual Cycle Reproductive Health Ritual Medicine

The bodies response to stress

Human bodies were designed to very effectively address stressful situations. The fight or flight response was a lifesaving mechanism back in the day.

Nowadays the body can feel the stress of a busy work week, a challenging coworker, traffic when you are late, but it cannot differentiate that your life is not on the line. So, not recognizing the distinction, pumps out all the same chemicals and hormones that it would if you were in fact, in a life or death situation.

The hormone cascade during a stress response

The hypothalamus and pituitary gland (both in the brain) are talking to each other and telling each other what to be doing when stress happens. They send signals down to the adrenal glands (sitting on top of the kidneys) to release a specific cascade of stress hormones.

Think adrenaline and cortisol.

Adrenaline boosts blood pressure and heart rate.

Cortisol sends glucose to your muscles so you can outrun danger.

When the body is in a constant state of stress, with elevated or unregulated adrenaline and cortisol levels, the perpetual state of ‘on alert’ can wreak havoc on your hormones.

If you read the previous blog post on blood sugar levels, you will know that mismanaged blood sugar is a stressor that can cause this effect in the body (see how its all related).

Over prolonged periods of time, this may lead to something that is called adrenal fatigue. This I often see in overworked people, CEO’s, single parents, or anyone in a longterm state of stress.

A few ways to manage stress in the body

As you have learned, there are internal stressors in the body, like unregulated blood sugar levels; and there are external stressors on the body, like job stress, traffic, finances etc.

As you would have read in previous blog posts, there are a few simple steps to help manage stress, although they may not always be easy.

Get enough sleep. This is wear your body rests, repairs, and manages inflammation.

Manage blood sugar levels

Exercise regularly – high intensity or low impact will depend on your bodies needs and current symptoms

Meditation or flow state – even 1-2 minutes of meditation per day can be impactful. If meditation doesn’t feel right, find an activity that allows you to be focused, present and playful.

For a more comprehensive program to help your body manage stress, get in touch for a virtual or in person consultation.

Call 1-778-400-6360 to book.

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Balanced hormones- for more than fertility

by Stefanie Miska, Acupuncturist Victoria Infertility Lifestyle Menstrual Cycle Pregnancy Support Reproductive Health Ritual Medicine

The importance of a healthy menstrual cycle

We all know the importance of balanced hormones, but do we really know why? Many of my patients come into my office thinking that the only reason to address hormonal imbalances or menstrual cycle challenges is if they want to get pregnant.

While, if that is a goal of yours, it is essential to address these issues, your menstrual cycle health has so much more to do with your overall health than just your ability to conceive.

Balanced hormones and a healthy menstrual cycle has major roles in

Cardiovascular health
Bone and joint health
Libido (sex drive)
Stress management
Adequate sleep

to name a few!

Hormone balancing basic

There are a few basic tools and steps I invite my patients to incorporate during their treatment plans to help reach their health goals.

The book titled ‘Womancode’ by Alisa Vitti, is one I encourage all my patients to read. It offers a step by step introduction to hormone balancing. It is easy to read and understand.

I will be elaborating on these steps in this blog series. Vitti breaks it down into 5 simple steps:

Regulate blood sugar levels
Address stress and the adrenals
Proper elimination
Understanding your menstrual cycle
Living in alignment with your cycle energy

Simple, but not always easy

While the information I will be sharing with you about balancing hormones may seem simple at first, it is not always an easy adjustment if you are used to eating, acting and living a certain way.

I will be the first to admit, it is not always easy to see the correlation between these actions and our symptoms. With anything cycle related it can takes weeks, or even months, to notice any change. So, often times you will not see the direct benefit from your actions right away.

However, if you stick to these simple hormone balancing tools, with time, you will start to notice a change in your menstrual cycle, energy levels, and more!

As always, get in touch with any questions of concern you may have, or to book an initial consult either virtually or in person.

Call 1-778-400-6360 to book.

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Mittelschmerz – How to tell if you are ovulating

by Stefanie Miska, Acupuncturist Victoria Endometriosis Menstrual Cycle PCOS Reproductive Health

Ovulation Marker #4 – Mittelschmerz

The previous three blog posts have highlighted proven methods of detecting ovulation. The bonus marker for detecting ovulation is mittelschmerz, a German word that means ‘ middle pain’.

While this marker isn’t an accurate (a.k.a official) marker for ovulation, many women experience mittelschmerz around ovulation.

Defining the word

Mittelschmerz: Pain due to ovulation that usually occurs at the midpoint between the menstrual periods. From the German mittel, meaning ‘middle,’ and schmerz, meaning ‘pain.’

Ovulation pain may occur because that follicular growth stretches your ovary before the egg’s release. It might also happen when the cyst actually ruptures, letting loose the egg along with some cystic fluid or blood, which can irritate the lining of your abdomen.

Mittelschmerz pain usually lasts a few minutes to a few hours, but it may continue for as long as a day or two.

How to know if you are experiencing mittelschmerz

While most describe it as a slight pinching sensation, you may experience pain that is:

On one side of your lower abdomen
Dull and cramp-like
Sharp and sudden
Accompanied by mild vaginal bleeding or discharge
Rarely, severe

Mittelschmerz pain occurs on the side of the ovary that’s releasing an egg (ovulating). The pain may switch sides every other month, or you may feel pain on the same side for several months.

Keep track of your menstrual cycle for several months and note when you feel lower abdominal pain. If it occurs midcycle and goes away without treatment, it’s most likely mittelschmerz.

If you have been keeping track of your other signs of ovulation, BBT, cervical mucus, and position of the cervix, and know you are around ovulation, then mittelschmerz is an added tell, or sign, that ovulation is occurring.

I hope you enjoyed this added bonus marker!

Book your consult by calling 1 778 400 6360 or if you are not local, we can connect virtually by booking your 15 minute here.

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Position of cervix – How to tell if you are ovulating

by Stefanie Miska, Acupuncturist Victoria Infertility Menstrual Cycle Pregnancy Support Reproductive Health

Ovulation marker #3 – Position of cervix

Believe it or not, the body has a pretty miraculous way of keeping your informed as to what is going on. One of the ways it does this, is by literally showing you ovulation. This changes the position of the cervix.

During ovulation, the cervix begins to show, by changing position and firmness, almost like a flower softening and opening up for reception.

How do I check the position of my cervix?

The only way to check this yourself, is by using your fingers to feel your cervix. This should be done with clean hands (and short nails), a perfect time to do this is in the shower.

It may sound like something only taught to doctors and nurses, but there’s no reason a woman can’t learn where her cervix is and how to notice changes in cervical position.

For the majority of your cycle, your cervix sits slightly lower in your vagina (meaning its easier to reach with your finger) and is a little but more firm, like touching the tip of your nose.

During ovulation, when the cervix begins to show, she gets softer ,like touching your bottom lip, and sits a bit higher up in the vagina (meaning you must insert your finger deeper).

This is one of the ways your body naturally becomes more receptive for pregnancy, by having a closer, more closed off gateway throughout the cycle, and softening and opening up during ovulation when conception may be desired.

Tips for checking the position of your cervix

Some pro tips:

Don’t expect to understand what you’re feeling the first, second or even tenth time you try—this is a skill that comes from practice and patience. Once you learn what the signs are by experiencing the changes in your cervix throughout a few cycles, you’ll be a pro.

When you’re just learning, try to check your cervical position every so many days, even when you don’t think you’re ovulating. It’s easier to find when you’re not ovulating, and you’ll have a better idea of what you’re feeling.

Book your consult by calling 1 778 400 6360 or if you are not local, we can connect virtually by booking your 15 minute here.

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Cervical Mucus – How to tell if you are ovulating

by Stefanie Miska, Acupuncturist Victoria Infertility Menstrual Cycle Pregnancy Support Reproductive Health

Ovulation key marker #2 – Cervical Mucus

One of the key markers of ovulation is cervical mucus. You have likely noticed it before, whether you knew it was linked to ovulation or not.

But … what is cervical mucus?

The hormones that control your menstrual cycle, they also make your cervix produce mucus. Thats the gooey stuff on your cervix that comes out of your vagina as discharge.

Your cervical mucus changes in colour, texture, and amount during your menstrual cycle, and especially around ovulation.

Cervical Mucous (also known as CM) increases at ovulation due to the increase in estrogen levels. This helps to create a hospitable environment for sperm.

Cervical fluid can be divided into two categories, peak and non-peak mucous. While both are considered fertile mucous, peak mucous is the well known, stretchy, egg white consistency.

Cervical mucous plays an important role in helping sperm survive longer in the vagina and helping them to move upward to connect with the waiting egg for conception.

Sperm can survive in the vagina for up to 5 days. Knowing when you are ovulating, by observing cervical fluid, can be an integral part of achieving or avoiding pregnancy.

You have likely noticed an increase in discharge around mid cycle, which you can tell by the slippery consistency when you wipe after going to the bathroom, some in your underwear or an overall feeling of increased wetness or lubrication.

Cervical mucus is 100% normal

In Toni Weschler’s book ‘Taking Charge of your Fertility’, she highlights a story about a women who was convinced she was having reoccurring infections every month and would continue to visit her doctor asking for antibiotics. What she did not realize, was that the increase in discharge, which happened monthly, is completely normal, and actually a really healthy part of the menstrual cycle.

Some things to look out for, which may require a check in with your doctor, is discharge that is foul smelling, green or thick yellow.

How to check for cervical mucus

There are three ways you can check your cervical mucous

Wipe the opening of your vagina before your pee with toilet paper, check the colour and feel of the mucous
Look at the colour and texture in your underwear
Put clean fingers into you vagina, and then check the colour and texture of the mucous with your fingers

Book your consult by calling 1 778 400 6360 or if you are not local, we can connect virtually by booking your 15 minute here.

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How to tell if you are ovulating – Tracking your temperature BBT

by Stefanie Miska, Acupuncturist Victoria Endometriosis Infertility Lifestyle Menstrual Cycle PCOS Pregnancy Support Reproductive Health

Ovulation Marker #1 – Tracking your BBT

Tracking your basal body temperature, abbreviated as BBT, is one of the main, and most common ways to track ovulation.

Taking your BBT, involves taking your temperature at roughly the same time every morning before getting out of bed. This includes logging your results, either by paper chart, or one of the handy apps you can download on your phone, to keep track of daily measurements and patterns

How to track your BBT

In order to do so, you will need a thermometer that goes to 2 decimal points, for example 36.68C or 97.68F. This makes it easier to notice temperature shifts, which is what you are looking for.

After ovulation, a hormone called progesterone, is released from the same follicle that the egg came from. This release of progesterone creates a slight temperature increase in the body. This is how we know ovulation has occurred, by tracking BBT.

For example, if you are taking your temperature throughout your entire cycle (which is required to get an accurate reading) your temperature will be lower for the first half, and higher for the second half.

Understanding your menstrual cycle

If you are unsure about the different phases of the menstrual cycle, their duration and what’s happening, I encourage you to go back and read the previous posts:

Menstrual cycle simple explained

If a person has, say, a 28 day cycle (let me clarify though, a ‘normal’ cycle is anything between 21-35 days) from day 1 (first day of bleed) to day 14 (ovulation), body temperature would be roughly 2 tenths of a degree cooler than from day 15 to when bleeding starts again.

*If pregnancy occurs, progesterone levels continue to rise (throughout pregnancy) and therefor body temperature continues to rise and will not drop again at day 28.

You can purchase a BBT at any drug store, or easily off amazon. While you can get more fancy versions, it is not necessary, and you can easily get started with a thermometer for $20.

Apps to use when you start tracking your BBT

Some apps to check out are:

Kindara
Daisy
Natural Cycles
Clue
Period Tracker

It is important to remember, that in order to get accurate readings, you must take your temperature after 5 hours of uninterrupted sleep, at roughly the same time every morning, and certain things like drinking alcohol, staying up late, or illness will effect your body temperature.

If you need help with charting your cycle or learning to read your BBT, book your consult by calling 1 778 400 6360 or if you are not local, we can connect virtually by booking your 15 minute here.

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The Importance of Ovulation (and its markers) for Women’s Health

by Stefanie Miska, Acupuncturist Victoria Infertility Menstrual Cycle PCOS Pregnancy Support Reproductive Health

A key marker for overall health

One of the key markers of a healthy menstrual cycle is ovulation, to catch yourself up on exactly what is happening during ovulation, check back to the original blog post here.

In addition to being paramount in conception, ovulation is ALSO important for the health of, your bones, cardiovascular system, and your overall endocrine (hormonal) system.

After reading the blog post ‘The ovulation phase of the menstrual cycle’ , you now know what is happening in your body, the next question is … how can you tell if you have ovulated?

How to tell if you have ovulated

There are three key markers (plus a bonus one) to help you tell if your body is ovulating, and if so, when it is.

The four markers of ovulation are :

The top three are markers, that if use correctly, are very accurate ovulation predictors.

One of the things I always educate my patients on is the importance of presence over prediction. While most often, the cycle tracking apps we have on our phones, or when we are planning ahead as to when we can expect our next period – it is usually based on past cycles and using that old data to predict what will happen and when, during this upcoming cycle.

Your whole menstrual cycle, and especially ovulation and your period, is a report card of the last few weeks, or months, of your life. There are many factors that may change the duration of one or more of the phases of your menstrual cycle, and tuning into that is more important than what date you ovulated last cycle.

Disruptors of healthy ovulation

Things that may disrupt regular cycle patterning are:

Travelling
Changing time zones
Daylight savings
Stress (this includes good stress like planning a wedding or going on vacation)
Lack of nutrition / change in diet
Illness

Observing ovulation during your cycle is important for understanding your body and your overall health.

It is an easy way to keep track of how your hormones, your physical and emotional body are doing.

Book your consult by calling 1 778 400 6360 or if you are not local, we can connect virtually by booking your 15 minute here.

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Your Menstrual Cycle – The luteal Phase

by Stefanie Miska, Acupuncturist Victoria Menstrual Cycle Reproductive Health

What is the luteal phase?

The luteal phase is the phase after ovulation, either until your period starts or pregnancy occurs.

The lining of the uterus releases or secretes chemicals that will either help an early pregnancy attach if an egg was fertilized, or help the lining break down and shed if no egg was fertilized.

Ideally the luteal phase should be closest to 14 days for it to be considered an optimal fertile cycle. This of course isn’t the case for everyone but evidence suggests that a 14 day luteal phase is the ideal for most women.

So… what exactly is happening?

After the egg has travelled down the fallopian tube it gets to the womb. Your body starts to produce a new hormone called progesterone. This hormone will make sure your uterus keeps building up it’s lining.

But If the egg is not fertilized, levels of estrogen and progesterone drop. Your uterus does not need to maintain the nutritious lining it built up so it starts to break it down.

The thick lining and blood that was built up during the menstrual cycle will leave your body. This is your menstruation and it means that a new cycle begins.

Is the luteal phase the same as PMS?

The luteal phase is broken down into two parts, the first, you are riding high from all the feel good hormones from ovulation.

The second half of this phase is notoriously difficult for many women. You might feel PMS symptoms like cravings for carbohydrate-heavy comfort foods, bloating, headaches, anxiety and moodiness. These symptoms are not all in your head but they aren’t something you should suffer through either.

Estrogen drops throughout your premenstrual week 4 and the lower it goes, the more it has the potential to drag down your mood and make you sad, irritable or anxious.

Descending estrogen can trigger cravings for carbohydrate-rich foods, such as sweets, pasta and bread.

The reason? As the level of this hormone drops, it drags down levels of mood-moderating serotonin in the brain—and carbohydrates help replenish it, so your body pushes you to eat more of them.

Progesterone is descending during this week, however, because it’s still at relatively high levels, you’ll likely still feel the urge to eat foods high in fat and calories and have a greater appetite.

What to do during the luteal phase? Or how to help with PMS.

The luteal phase of your menstrual cycle is a great time to deepen your self care practice by taking a few extra steps to do things that you know really nourish your physical, mental and emotional body.

It is still important to continue with moderate exercise as ‘stuck energy’ can manifest as cramps and mood swings leading up to menstruation.

If you know that PMS is something you struggle with, it is important to get your entire menstrual cycle healthy, not just the luteal phase.

Connect with me here to schedule a complimentary consult call to learn how I can help you regulate your hormones for a happy and healthy cycle.

Here’s to happy and healthy cycles!

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Ovulation Phase Of The Menstrual Cycle

by Stefanie Miska, Acupuncturist Victoria Menstrual Cycle Reproductive Health

What is ovulation?

Ovulation (the Ovulatory phase) is the shortest phase and lasts for 2-3 days.

Ovulation is when a mature egg is released from the ovary, pushed down the fallopian tube, and is made available to be fertilized.

Approximately every month an egg will mature within one of your ovaries. As it reaches maturity, the egg is released by the ovary where it enters the fallopian tube to make its way towards waiting for sperm and the uterus.

The lining of the uterus has thickened to prepare for the fertilized egg. If no conception occurs, the uterine lining, as well as blood, will be shed.

The shedding of an unfertilized egg and the uterine wall is the time of menstruation.

The interlude – ovulation

The dominant follicle in the ovary produces more and more estrogen as it grows larger.

The dominant follicle reaches about 2 cm (0.8 in)—but can be up to 3 cm—at its largest right before ovulation (6,7). When estrogen levels are high enough, they signal to the brain causing a dramatic increase in luteinizing hormone (LH).

This spike is what causes ovulation (release of the egg from the ovary) to occur. Ovulation usually happens about 13-15 days before the start of the next period.

During this time, if the egg comes in contact with sperm, it is fertilized. So keep in mind that during these days you are most likely to get pregnant (remember to use contraception).

The egg will survive for 12-24 hours and will either be fertilized or will die. Your cervix becomes soft, moves up higher and opens. It moves up higher to help the egg get the best sperm – the sperm have to swim farther to get to the egg. Your cervical fluid is very clear or viscous egg-white fluid, with lots of elasticity.

Hormones during ovulation

The two main hormones from the previous phase, estrogen and testosterone, continue to ride to their peak levels, enhancing all the benefits you enjoyed during the follicular phase.

You may notice you look, and feel, more attractive, and more confident. Your senses may feel heightened, your vision, smell and taste. You also may notice an increase in libido, or sexual arousal, again – mother nature doing its part to ensure procreation.

What to do when you are ovulating

This is a great time to connect with your sexual energy and put it towards connecting with your own body and energy, or with your partner. Ovulation phase is the optimal time to be putting energy outward, to connect with new friends and relationships, to make future plans, and plan public speaking or networking events.

This is also the best time in your cycle for high impact and intensity workouts.

Book your consults by calling 1 778 400 6360 or if you are not local, we can connect virtually by booking your 15 minute here.

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