Ode to Ovulation

woman holding eggOvulation feels good because it switches on hormones.

As your ovaries get ready to release an egg every month, they pump out estrogen. Estrogen stimulates serotonin, which is why you’re more outgoing and energetic in the few days leading up to ovulation.

What happens just after ovulation is even more interesting. That’s when your ovary (one of them) releases bucket-loads of progesterone—your calming, soothing, anti-inflammatory hormone.  

Your ovary makes progesterone with a unique little gland called the corpus luteum (which forms from the emptied egg-sac). I love the corpus luteum. It is so brave and fabulous—and so fleeting.  It has the lifespan of a butterfly (12-14 days). The gland forms very rapidly, going from nothing to a fully vascularized 4cm structure in less than one day. One researcher said this about the corpus luteum:

..there isn’t anywhere else in the body where you have to develop a tissue from scratch in such a short period of time and get a blood supply in so fast.

The high metabolism of the corpus luteum demands nutrients such as cholesterol, B-vitamins, coQ10, vitamin D, iodine, magnesium, and zinc. The gland has a particularly high requirement for the antioxidant selenium, which is why selenium is the nutrient for progesterone.

Your progesterone should continue through most of the second half of your cycle.  Then when it drops just before your period, you may feel a little agitated (see my PMS post). You may have the odd period when you don’t ovulate, and don’t produce progesterone. That’s called an anovulatory cycle and can cause heavier bleeding or bleeding that goes on for too many days.

estrogen progesterone menstrual cycle

Benefits beyond babies

Ovulation is important for fertility, of course, but it’s SO much more than that. Ovulation is the only way to make estradiol and progesterone: Your sister-steroid, feel-good hormones.

Estradiol and progesterone are powerful players in your health and metabolism. They are both essential for mood, energy, libido, insulin response, thyroid, skin, hair, and so much more. Furthermore, having adequate levels of these hormones when you are young will protect you from osteoporosis, cancer, and cardiovascular disease later in life.

Ovulation saboteurs

Hormonal birth control shuts down ovulation. It is chemical castration, and if you take the Pill, you can wave goodbye to your sister steroids. The Pill’s pseudo-hormones bear no resemblance to your own estrogen and progesterone. To even call them hormones is a cruel joke.

Other ovulation-saboteurs include stress, thyroid disease, inflammation, environmental toxins, sugar, gluten, PCOS, nutritional deficiency, and eating disorder.

Diagnosing ovulation deficiency

Luteal phase deficiency is the medical term for a problem with ovulation and the corpus luteum. If you do not form a corpus luteum, or if it does not survive its full 12-day lifespan, then you have progesterone deficiency. That can cause PMS, premenstrual-spotting, and heavy periods.

With luteal phase deficiency, you will not see a temperature rise on a basal body temperature chart, and your progesterone will be low on a blood test (< 8 ng/mL or 25 nmol/L). To be meaningful, the blood test must be done 5-9 days before the onset of your period. Please read The Right Way to Test Progesterone.

Tip: If you take hormonal birth control there is no point in testing progesterone. You have none.

In the next progesterone post, we will look at ways to improve the health of your corpus luteum and make more progesterone.

39 thoughts on “Ode to Ovulation”

  1. I’ve been experiencing brown spotting on the 21st day of my cycle, so after ovulation… This has been happening since I’ve had a hysteroscopy two months ago… What could be the reason for this?

  2. Doctor Lara, firstly thank you for your extremely informative posts and your book. It has demystified so many things about my period and helped me play detective with what’s going on in my body as you mention in your book.
    I’ve realised I’ve been having a fairly regular anovulatory bleed with one odd ovulatory period. I’ve been tracking this for the last few months and I came off the pill (Diane 35) in February after being on it for 5 months.
    This has also coincided with high free testosterone levels in this phase alone. My free testosterone readings during the follicular phase are always within range. Could inability to make progesterone result in a surge in Free Testosterone? As they are out of range only 5-7 days before my period.
    Thanks!

  3. Since I had my third baby, I’ve noticed a litany of new symptoms 2-4 days before ovulation: achy pelvis for a few days, water retention and just feeling overall “swollen” in my abdomen, and reduced urine flow. Is this normal? I’m also curious about potential causes. Thank you!

  4. Hi Dr Briden,

    I have a random question for you: is it possible to ovulate every month if you only have one functioning ovary?

    During my 1st pregnancy, it was discovered that I had a unicornuate uterus with an asymmetrical rudimentary left horn. I have the normal amount of kidneys, ovaries, and cervixes. The left horn is non-communicating, so they aren’t sure how my left ovary functions. I was able to get pregnant on the 1st try with all three of my kids, so I’m not asking for fertility reasons, just asking out of curiosity. My periods come normally every month, but I only have ovulation pain on my right side, and not every month.

  5. Dear Lara,

    first of all, thanks so much for writing these interesting posts and helping to enlighten us about the mystery of our bodies.

    I was diagnosed with PCOS on a blood test at 16 and refused to take the pill until I was 27, because I had gotten desperate to do something about the hair growing under my chin. The pill didn’t help, so I stopped taking it, and have had regular cycles since. Now I am 31 and had a more recent blood test on day 5 of my cycle that showed that my DHEA-S is 290 ng/ml and my testosterone is 0.67 ng/ml. The glucose tolerance and insulin test last month showed slightly elevated fasting blood sugar but no insulin resistance. I take magnesium and zinc on your advice, and since then I haven’t been getting the terrible cramps I had as a teenager. I had an ultrasound scan of my ovaries on day 14 of my current cycle, which showed a huge follicle, went back for a blood test on day 20 and now my doctor has confirmed that I did ovulate (progesterone = 9.58 ng/ml), but that my estradiol is a bit low (69 pg/ml). Is this something to be concerned about? My doctor has offered me another variety of anti-androgenic pill to deal with the hirsutism, but since reading your work over the past couple of years I have become totally sold on the belief that I should be ovulating and producing my own progesterone every month, not chemically castrating myself. But I am almost giving up on finding a healthy solution to the hair under my chin.

    Sorry for the long post, but any comments would be very much appreciated!
    Christina

  6. Hi, do you promote ‘on time’ ovulation while breastfeeding when prolactin is high? Im 5 months pp ovulating very late day 23/24 of a 29 day cycle. Do you cover breastfeeding and/ or postpartum issues anywhere? Many thanks.

    • Obviously, it’s normal to not ovulate during breastfeeding. I don’t try to override that in my patients.
      re: your case, ovulation on day 24 of a 29 day cycle is unusual. Are you sure you’re ovulating? How do you track it?

      • Using FAM (temp & mucus) to track ovulation have used it for 10 years. This is my 4th baby and fertility always returns by 3 months despite breastfeeding on demand but have not had this issue of ovulating so late/ or very short LP with the previous 3.

  7. Hi Lara,

    I read your book, and think that I have a Lutheal Phase Defect due to pink spotting before my peroid for 1 or 2 days and also a luteal phase of 9 days (in my last cycle, and ovulation confirmed with LH test). As I ovulated, I have a temperature shift and remains pretty stable for those 9 days, but now I read that is the progesterone the hormone responsable for dropping the temperature, so I’m a little bit confused if my problem is progesterone deficiency.
    What would you recomend me to do? trying with Vitex? I have been trying to get pregnant for 4 months and nothing happened. Also I took the pill for around 8 years until march 2016. Thanks!

    • As I explain in my book, ovulation and the health of the corpus luteum is affected by all aspects of health. (That’s why periods are our monthly report cards.)

      If you were my patient, I would be looking at all the usual things to see what might be preventing you from forming a good quality corpus luteum. (for example: thyroid, insulin, zinc deficiency, inflammatory foods… etc)

  8. Is ovulation pain normal? I’ve never been on hormonal birth control, am 30 years old and have had 4 children and sometimes the pain can be very intense. It usually lasts for 24-48 hours and will have several hours of intense pain that may even hurt to walk. It’s not this intense ever cycle. What causes this and is their supplements or diet changes that would help?

  9. By any chance, are you familiar with LUFS (Luteinized Unruptured Follicle Symdrome)? I have been dealing with this for over 2 years now but cannot find anyone who understands the condition and therefore how to help!

    Thank you!

  10. i have no obgyn and no physcian how do i know if i have low progesterone and im trying to get pregnant i have pcos no periods and no ovulation i dont know to start my periods and ovulation though myself and i have high prolactin what do i do to get things going normally

    • Sorry, I just saw your second comment, and the fact that you have high prolactin. You need to ask your doctor about it. The prolactin is why you don’t have periods, and don’t ovulate, and no progesterone. Please see Chapter 7 in my book.

  11. how do i know if i have low progesterone i have obgyn and no physician and im trying to get pregnant i dont ovulate and no periods but i have pcos my old doctor said that when i was 17 but she moved to a differ office and im left without a doctor and ob gyn

    • Hi Lindsey, If you have no periods, then you have no progesterone. You need to find a doctor. I discuss the problem of “no periods” in Chapter 7 of my book. I provide a list of blood tests.

  12. Thank you Lara for explaining this complex process so it’s easy to understand. My doctor put me on progesterone (prometrium) pills 100 mg at bedtime daily, not just from after ovulation until my cycle starts. When I asked him why, he said that it “helps build the pool” of progesterone since I have been deficient for so long. I don’t see much logic in this. Can you clarify this please?

  13. I find this all very fascinating to learn about. Thank you for sharing. I wonder what you would say about when your hormone levels drop off, such as progesterone, then estrogen…so like the article said, to prevent osteoporosis, you need them, which is why a doctor may give you the pill, so you don’t risk other issues/diseases.

    And then if your levels dropped off in the first place…I guess does that mean you weren’t ovulating? Or forming the corpus luteum?

    Hmmm…interesting. Because a doctor told me just because your hormone levels are low, doesn’t mean you can’t get pregnant…so I guess you can still be ovulating and producing the hormones but maybe not enough to get your period…and if not enough…then what’s going on inside?

    And yes, I totally agree that it’s not exercise-caused, but stress/diet are a huge factor and I believe emotional things too can cause the body to react, and by healing, it helps things to get going again! So doctors will prescribe the pill, but I’ve been off of it for 3-4 years, and with a lot of self-healing, am finally starting to normalize so it’s possible! I wonder if you’ve seen this/heard of this. People naturally healing vs. hormonal replacement. I feel there are so many other options people need to know about. Once again, thank you for sharing. I really enjoyed learning more about this topic.

    • Ovulation is how you make hormones. Start by working to identify what is preventing your ovulation (examples: stress, inflammation, gluten, insulin, zinc deficiency). Fix that, and your ovulation will return, and thenyour hormones will rise to normal.

      • Is it possible to never have ovulated in your life due to certain cases of childhood trauma/emotional stress on the mind/body? And does that mean that if it is the case, you can’t get ovulation back? I’m 42.

        • It is possible to have never ovulated, but I would not expect that to happen because of childhood stress. There’s always a physical explanation. Have you never observed signs of ovulation like fertile mucus or change in basal body temperatures

  14. Lara, what do you suggest for women in peri-menopause for whom it is normal to be skipping ovulation sometimes, but who get symptoms from lack of the progesterone? Is it just B6, vitex, and possibly bio-identical progesterone to get over the hump and calm symptoms during the transition?

    Also, why is it called an “annovulatory cycle?” It really isn’t a “cycle” until ovulation has occurred, not matter how long it takes, right? A woman does not know she actually has menses unless she has had a high-temperature phase confirming ovulation, correct? Any other bleeding could be the extended estrogen stimulus combined with hormone shifts.

    Gee, that reminds me of one more question- can the body go through the “motions” and have a thermal shift without actual ovulation?

    I loved the quote about the corpus luteum!! It is truly a fascinating and miraculous aspect of the feminine body! And, thank you for exposing the truth about the Pill- how so many have suffered in the name of “liberation.”

    Thank you!

    • Hi Jill.

      Peri-menopause is a tricky time, precisely because that is when progesterone drops away (due to anovulatory cycles) but estrogen stays high. Yes, I do think that natural bio-identical progesterone can be helpful to navigate these natural changes. I also prescribe treatments to reduce estrogen (like DIM- DiindolyMethane) and to reduce estrogen sensitivity (like iodine).

      Treatments to promote ovulation as-long-as-possible include CoQ10, selenium, thyroid support, B6 and yes, vitex.

      You’re right, ‘cycle’ is probably not an accurate term for some peri-menopausal bleeding. What happens is that the uterine lining builds and builds under the influence of unopposed estrogen until it cannot hold and it sheds. There is no thermal shift observed (because it is progesterone that causes the temperature rise).

  15. Lara what’s the way we can improve our intestinal flora? Which probiotics do you recommend?and another question do you think vitex is a good way to improve ovulation?Thanks a lot!!

    • Diet is how we change our intestinal bacteria. Generally, by eliminating gluten and sometimes dairy. Yes, Vitex can be great. I discuss the herb in both my progesterone and PMS posts. But it should be used with caution with PCOS because it increases the hormone LH.

      • Lara how many months it can take to repair the gut? And to take out of the system the inflammation that cause gluten and dairy?? It’s been over 3 months since I do not eat gluten, and most no dairy except Kefir yogurt. What are your thoughts about Kefir and legumes for pcos?? I really like legumes. ( but, not sure here) I’m trying so hard to bring back my ovulation and stop the hair loss. Not results yet.

  16. Dear Lara what are your thoughts about soy??? And not “obesity” pcos. When pcos came to my life last summer, my weight was 138 (the previous year my weight was around 128-130 I was very active at gym, I was eating low calorie, not the best diet cuz I used to count calories, 1200 a day then being lazy, started yo high carbs, not paying any atention to my food, and pcos triggered on my system. Since December I drop 20 pounds I’m now 118-5’2. Doing paleo, stress for hair loss, pcos etc. my doctor told me to put some weight back, since most of life used to be between 130-140. And estrogens levels drop with you lost weight in a short time. Is that true??? I’m trying to eat plenty of good fats, plenty of seafood, liver, high “good carbs” Do you think consuming soy will help me??? I’ve read some studies that indicate that phytoestrogens ( especially flaxseed) lower serum levels of dhea and testosterone which are high to me. Thank you so much in advance.

    • Good question about soy. Soy can suppress ovulation because it suppresses FSH and LH. Clinically, I have seen many women get their periods back only after they stopped soy. That said, yes, it does increase SHGB (sex hormone binding globulin) thereby reducing available testosterone, so – in theory- it can help with some cases of PCOS. But I prefer other methods of improving SHBG like: healthy intestinal flora, healthy thyroid, healthy insulin response, high vegetable diet, including flax seeds.

  17. Hi Lara. I found this article by researching hair loss and hormones. I notice massive (over 200) hair shedding about 10 days before my cycle day 1 and a noticeable decrease betwen days 5-10, only to have it increase again right after ovulation (day 14+). I’ve talked to two gynecologists to find out what happens hormonally on those days and have 3 different answers! Could you explain the correlation between hormones and hair loss on the days I’ve mentioned above? My hormoned test “normal” but my symptoms of severe PMS, breast tenderness, heavy bleeding, hair loss, and moodiness suggest otherwise. Thanks!

    • Your hair follicles are a time machine. The hair loss that you observe now is the result of something that happened 3-5 months ago. For this reason, it is not meaningful to track hair loss day-by-day in a menstrual cycle.

      In general, for hair, you want to have good ovulations, with strong surges of progesterone in the second half of your cycles. Progesterone is very good for hair because it blocks the testosterone receptor. Anything that interferes with ovulation can result in hair loss a few months later. I discuss this in my Hair Loss post.

I welcome your comment!

Send this to a friend