Balance your hormones, starting now >>

PERIMENOPAUSE PROGRAM
HORMONE BALANCE PROGRAM
BOOK AN APPOINTMENT
BOOK AN APPOINTMENT

Balance your hormones, starting now >>

PERIMENOPAUSE PROGRAM
HORMONE BALANCE PROGRAM

Articles

BBT Tracking and Your Hormone Health

BBT Tracking and Your Hormone Health

Basal Body Temperature (BBT) charting may sound like an old-school method of tracking your menstrual cycle, but it’s making a comeback. Did you know that when you ovulate, your temperature increases by about 0.5ºC or more? This may not seem like much, but when you are monitoring your temperature on a graph daily, you can see the distinct shift in temperature, and therefore know what day you ovulated on.


This method has been a game changer for not only many of my patients, but for me too! Once you develop the habit of checking your temperature every morning, it is SO informative and empowering to become attuned to the subtle shifts that are occurring in your body. Here are a few comments from my patients who have started temperature tracking regularly:


“I feel relieved knowing that I’m actually ovulating, because we want to try to get pregnant soon – now I know exactly what days of the month we should try.”


“I assumed that everyone ovulates on day 14! But actually I ovulate closer to day 17 or 18.”


“I was following my period tracker app, which tells me when I should be ovulating… but now I’ve learned with tracking my temperature that actually I ovulate around day 11. So my period tracking app is wrong.”


“I didn’t think I’d like tracking my temperature, but it’s a habit, just like taking my birth control pill was a habit. So it’s actually very easy. I really like using this natural method, and it’s cool to watch the temperature shift occur. I feel so much better now that I’m finally off the pill.”


I’ve also had women who have had regular monthly periods, but when we monitored their temperature, we realized that she wasn’t actually ovulating every month. This simple tracking tool helped us identify a hormone imbalance that we then treated using natural medicine.


So, what’s so great about BBT charting?


Tracking your temperature is an excellent, accurate, cheap, easy way to get to know your menstrual cycle and ovulation. You should consider tracking your temperature if you:


  • Have recently come off hormonal contraception in the last few months and want to become re-acquainted with your own natural hormone cycle.
  • You’re not sure if you are actually ovulating or not, and you want to know (because you want to start trying to get pregnant soon, or just for health and hormone balance reasons).
  • Want to become an even better expert of your own body.
  • Are trying to get pregnant.
  • Are trying to NOT get pregnant (more on this later in the article).
  • Suspect that you might have a hormone imbalance, and want to collect more data so you can work with their Naturopathic Doctor or health care provider to figure out what is going on.


How does it work?


Your “basal body temperature” (BBT) is the lowest temperature your core gets to while you sleep overnight. This is why you take your temperature first thing in the morning, before you move or get out of bed.


Your BBT shifts depending on where you are in your menstrual cycle and if you have indeed ovulated. In the first half of your menstrual cycle, called the follicular phase, a woman’s average waking temperature is approximately 36.1-36.5ºC. After you ovulate, you enter the second phase of your cycle, called the luteal phase. During this phase, if you have ovulated, progesterone causes your waking temperature to rise by about 0.5ºC to an average temperature of around 36.7-37.1ºC. While this may seem like only a subtle shift, it is very clear when you view it on a chart.


It is important to highlight that the increase in temperature signifies that ovulation has ALREADY occurred within the last 24 hours or so. It means that your peak fertile day has already passed. If you’re interested in BBT in order to conceive, you’ll also want to track the changes in your cervical mucus, which is a better predictor of the peak fertile day (more on this later!)


Tracking the shift in temperature helps:


  • To identify you have indeed ovulated,
  • That your luteal phase length (from ovulation to period onset) is a healthy length. It should be at least 9 days long, ideally 11 or more days long. 8 days or less may not be enough time for a fertilized egg to implant in the uterus and may contribute to a luteal phase defect.
  • To identify if you have conceived that cycle,
  • To predict future ovulation dates to better time (or avoid) intercourse for conception, using a validated contraceptive app.


What do you need to track your BBT?


You need a thermometer (with 2 decimal points), and an app such as Kindara or Clue. These options are free. If you’d like to use BBT as your contraceptive method of choice, I strongly recommend Natural Cycles, which is the only approved contraceptive app in the world. Otherwise, all you need is a little time to build the habit of taking your temperature!


How do you do it?


Tracking your BBT is very easy. Here is what you do:


  1. Leave your thermometer beside your bed.
  2. The very first thing you do when you open your eyes in the morning is take your temperature. Do this before you get up or move around.
  3. Take your temperature by placing the thermometer underneath your tongue.
  4. Add your temperature to your app. (Or you can take your temperature then roll over and go back to sleep. Then when you wake up properly, turn on your thermometer again - it will display your most recent reading, and you can record it!)


It is important to take your temperature before you get out of bed. This is because when your body is resting overnight, your core body temperature will decrease. This is your “basal body temperature”. As soon as you wake up and get out of bed, your temperature will increase. We want to measure your basal temperature for the purposes of identifying the natural increase in temperature after ovulation.

Tip: I recommend putting your thermometer right on top of your cell phone or right beside your alarm clock. This will help to remind you to use it immediately upon waking.


What are the benefits of BBT charting?


It’s informative and empowering. It is a beautiful thing for women to become more attuned to the shifts and changes in their hormones. While you observe your temperature shift mid-month, you may also notice other ovulation signs, too. Cervical discharge changes throughout the month, as does your energy, libido, and mood. Becoming attuned to these shifts can help you see the beauty, nuance and power of your hormone cycle.


Helps you with trying to conceive. Learning about your cycle and fertility window will educate and support you for future family planning, if that is of interest to you. You will learn the specific days of the month that you are most fertile and have the best chance of getting pregnant.


It’s cheap and easy. All you need is a basic $20 thermometer that has 2 decimal points, and an app. Many apps are free. If you are trying to conceive, it’s cheaper to monitor your temperature than it is to use Ovulation Predictor Kits (OPKs), which can certainly add up if you’re using them for a week each month to identify when you’re ovulating.


YOU have the control. You don’t need to rely on doctors for prescriptions or procedures. You don’t need to rely on chance, wondering if you’ve ovulated or not, or if you might get pregnant.


It’s natural, non-prescription, and no gynecologist needed. Some women really don’t tolerate the pill or IUD’s. For those women who want a trustworthy form of contraception, BBT is helpful. Similarly, for women who ARE trying to conceive, you can save money on Ovulation Predictor Kits (OPK’s) and just monitor your temperature.


“There’s an app for that!” There are some excellent apps that use machine learning and algorithms to learn about your cycle using the data you input, and thereafter more accurately predict when you will ovulate in future months. This is important for women trying to conceive, and very important for women using this as their contraceptive method of choice. As mentioned previously, the app Natural Cycles is the only app in the world that has been approved as a form of contraception. It uses your daily temperature readings with its algorithm to accurately predict your fertile days.


No side effects. Unlike other forms of birth control, like the pill, patch or IUD, there are no side effects of tracking your temperature.


You may discover hormone imbalances before your doctor even does. Unusual BBT patterns can indicate a hormone imbalance, like PCOS or anovulation. When you are tracking your own cycle, you can be the first to notice and bring this data to your ND or doctor to review.


BBT to help you get pregnant


Do you know what days of the month a woman is most likely to conceive? This is known as the “fertile window.”


What is the fertile window?


This is the specific number of days of the cycle that you can get pregnant, based on how long an egg and sperm can survive for. Sperm are resilient and can live in the female reproductive tract for about 5 days. On the contrary, an egg is only viable for fertilization for about 24 hours before it deteriorates. Therefore, your fertile window is about 6 days long. This includes the 5 days BEFORE ovulation, since sperm can hang around and wait and still be viable, and the 24 hours AFTER ovulation occurs.


Figuring out your fertile window


The trick to planning to conceive (or, to AVOID conceiving) is understanding when your fertile window occurs with as much as accurately as possible. Since 5 of those 6 days occurs BEFORE you even ovulate, you need to use information from previous menstrual cycles to better “predict” when your ovulation occurs, and therefore when your fertile window will occur in any given month.


The most rudimentary way to try to predict your fertile window is using the “Rhythm Method” or “Calendar Method.” This is when you track your periods for 6-12 months, figure out your longest and shortest cycles (for example, if you had one 32 day cycle and one 26 day cycle) and do some math to figure out when you’re “likely” having your fertile window.


Here’s the math, if you’re curious:


  1. Record the length of 6 to 12 of your menstrual cycles. Using a calendar, write down the number of days in each menstrual cycle — counting from the first day of your period to the first day of your next period.
  2. Determine the length of your shortest menstrual cycle. Subtract 18 from the total number of days in your shortest cycle. This number represents the first fertile day of your cycle. For example, if your shortest cycle is 26 days long, subtract 18 from 26 — which equals 8. In this example, the first day of your cycle is the first day of menstrual bleeding and the eighth day of your cycle is the first fertile day.
  3. Determine the length of your longest menstrual cycle. Subtract 11 from the total number of days in your longest cycle. This number represents the last fertile day of your cycle. For example, if your longest cycle is 32 days long, subtract 11 from 32 — which equals 21. In this example, the first day of your cycle is the first day of menstrual bleeding and the 21st day of your cycle is the last fertile day.


The problem with this method is that it assumes that you have a regular, mid-month ovulation, which not all women have! Therefore, this is not the method I recommend.


More accurately predicting your fertile window: Ovulation Signs


The most accurate way to understand your fertile window is to track your BBT and the changes in your cervical fluid. Tracking these signs comprises the “Fertility Awareness Method” (FAM). Tracking your BBT as been outlined already, so let’s talk about cervical fluid briefly.


Cervical fluid changes


Did you know that the consistency of cervical fluid (i.e. vaginal discharge) that is produced changes depending on where you are in your menstrual cycle? You may notice slight changes in vaginal discharge depending on the time of the month. This is a very useful sign to understand when ovulation is approaching.


As estrogen increases during the follicular phase, the cervical fluid becomes more conducive to sperm as ovulation approaches. The cervical fluid is important for providing a nourishing alkaline medium through which the sperm can swim to get to the egg. As ovulation approaches, cervical fluid changes in consistency from dry, to sticky, to creamy, to the fertile “egg white” consistency. The egg white fluid is an excellent and reliable sign of ovulation.


“Egg white” fluid looks just like it sounds - like the clear, stretchy consistency of raw egg white. You may notice a sensation of “increased watery discharge” mid-month. That’s the sign that you are approaching or on your most fertile day of the month.

This is useful for women to observe because the egg white mucus will show up just before or during ovulation, on your peak fertile day, whereas the shift in temperature on your BBT indicates that ovulation ALREADY happened and you may have missed the most fertile day.


Used together, your BBT and cervical fluid changes are highly accurate ways of charting YOUR OWN UNIQUE FERTILE WINDOW. It doesn't rely on the “average” woman’s cycle - it is unique to you, because you’re tracking YOUR ovulation signs.


Timing intercourse to conceive


When trying to conceive, you should aim to have intercourse at least every other day throughout your fertile window, and particularly on the days where you have the egg white fluid discharge, as these are your most fertile days (typically 1-2 days).

Is this good for all women who want to try to get pregnant?

Yes, this is an excellent first step for couples to take to help maximize their chances of conception, and to help identify if there are any hormone irregularities that might impede conception.


When to do additional fertility testing


If you are age 34 or younger and have been actively trying to conceive for over a year, then it’s time to get some extra testing done. If you are age 35 or older, than time frame is 6 months.


For more information on planning for your pregnancy, check out this article.


BBT as a form of Contraception


On the opposed end of the scale, some women choose to use the Fertility Awareness Method (tracking temperature and cervical fluid changes) for the complete opposite reason - to prevent pregnancy. You may be surprised to learn just how effective this form of contraception can actually be.


How effective is FAM as a form of contraception?


This is always the first question you want to ask about any form of contraception. With perfect use, and following the rules strictly (i.e. monitoring daily), the FAM is up to 99% effective. The Society of Obstetricians and Gynecologists states it is 91-99% effective with “perfect use.”


The app Natural Cycles is the only approved contraceptive app in the world. It utilizes your temperature and its algorithm to identify your fertile window and educate you when you need to use additional protection. According to their studies, it is up to 98% effective with perfect use.


It is important to look at the effectiveness of these methods using the “typical” use (we are humans and we make mistakes, after all!) FAM is 80% effective in preventing pregnancies with “typical use”, and up to 93% effective if you use an app such as Natural Cycles. For comparison, the birth control pill is 92% effective use typical use, and condoms are 85% effective with typical use. So in fact, FAM is a safe and reliable option for contraception.


Effectiveness of Various Forms of Contraception:


Sympto-thermal method (tracking cycle and temperature only) (1):

  • Perfect use:  91-99% effective in preventing pregnancies
  • Typical use:  80%


Fertility Awareness Method (tracking cycle, temperature and cervical mucus) (2,3,5)

  • Perfect use: 98%
  • Typical use: 85-94%


Natural Cycles app (4):

  • Perfect use: 98%
  • Typical use: 93%


Birth Control Pill (1):

  1. Perfect use: 99.7%
  2. Typical use: 92%


Condoms (1):

  • Perfect use: 98%
  • Typical use: 85%


Who is this form of contraception good for?


BBT, in addition to tracking other fertility signs like cervical fluid, is appropriate for women who have the discipline to monitor closely. It is more accurate and reliable if you have predictable and regular cycles. You also need to use barrier protection (ex. condoms) during your fertile window, and a partner who is supportive of this method. Additionally, if you have more than one sexual partner, additional barrier protection is recommended to help reduce the risk of STI’s.


Otherwise, BBT tracking is highly beneficial for all cycling women who simply want to educate themselves about their own bodies.


Do I have to abstain from sex during my fertile period?


No (unless you want to), but you do need to use additional barrier protection (ex. a condom) during your fertile period to prevent pregnancy. Of course, abstaining from sex during your fertile window is obviously more reliable than using condoms, which as outlined above, which have a 18% typical use failure rate.


In summary…


If you’ve made it this far, congratulations! I promise that tracking your temperature is easier than getting through this whole article. 


For more information about fertility or contraceptive options, join my mailing list for updates!


Yours in health,

Dr. Kathleen Mahannah, ND

References:


(1) Ku CW, Allen JC Jr, Lek SM, Chia ML, Tan NS, Tan TC. Serum progesterone distribution in normal pregnancies compared to pregnancies complicated by threatened miscarriage from 5 to 13 weeks gestation: a prospective cohort study. BMC Pregnancy Childbirth.

2018;18(1):360. Published 2018 Sep 5. doi:10.1186/s12884-018-2002-z



(2) Mesen TB, Young SL. Progesterone and the luteal phase: a requisite to reproduction. Obstet Gynecol Clin North Am. 2015;42(1):135-151. doi:10.1016/j.ogc.2014.10.003


(3) Thurston L, Abbara A, Dhillo WS. Investigation and management of subfertility. J Clin Pathol. 2019;72(9):579-587. doi:10.1136/jclinpath-2018-205579


(4) Schliep KC, Mumford SL, Vladutiu CJ, et al. Perceived stress, reproductive hormones, and ovulatory function: a prospective cohort study. Epidemiology. 2015;26(2):177-184.

doi:10.1097/EDE.0000000000000238


(5) Prior JC. Progesterone for Symptomatic Perimenopause Treatment – Progesterone politics, physiology and potential for perimenopause. Facts Views Vis Obgyn. 2011;3(2):109-120.


(6) Schüssler P, Kluge M, Yassouridis A, et al. Progesterone reduces wakefulness in sleep EEG and has no effect on cognition in healthy postmenopausal women. Psychoneuroendocrinology. 2008;33(8):1124-1131. doi:10.1016/j.psyneuen.2008.05.013


(7) Roomruangwong C, Carvalho AF, Comhaire F, Maes M. Lowered Plasma Steady-State Levels of Progesterone Combined With Declining Progesterone Levels During the Luteal Phase Predict Peri-Menstrual Syndrome and Its Major Subdomains. Front Psychol. 2019;10:2446. Published 2019 Oct 30. doi:10.3389/fpsyg.2019.02446


(8) Dennerstein L, Spencer-Gardner C, Gotts G, Brown JB, Smith MA, Burrows GD. Progesterone and the premenstrual syndrome: a double blind crossover trial. Br Med J (Clin Res Ed). 1985;290(6482):1617-1621. doi:10.1136/bmj.290.6482.1617


(9) Nillni YI, Toufexis DJ, Rohan KJ. Anxiety sensitivity, the menstrual cycle, and panic disorder: a putative neuroendocrine and psychological interaction. Clin Psychol Rev. 2011;31(7):1183-1191. doi:10.1016/j.cpr.2011.07.006


(10) Baker FC, Colrain IM, Trinder J. Reduced parasympathetic activity during sleep in the symptomatic phase of severe premenstrual syndrome. J Psychosom Res. 2008;65(1):13-22. doi:10.1016/j.jpsychores.2008.04.008


(11) Arafa A, Mostafa A, Khamis Y. The association of acne and menstrual symptoms among young women (18-25 years) in Egypt: a population-based cross-sectional study [published online ahead of print, 2020 Jun 10]. Int J Adolesc Med Health. 2020;/j/ijamh.ahead-of-print/ijamh-2019-0220/ijamh-2019-0220.xml. doi:10.1515/ijamh-2019-0220


(12) Lucky AW. Quantitative documentation of a premenstrual flare of facial acne in adult women. Arch Dermatol. 2004;140(4):423-424. doi:10.1001/archderm.140.4.423


(13) Stoll S, Shalita AR, Webster GF, Kaplan R, Danesh S, Penstein A. The effect of the menstrual cycle on acne. J Am Acad Dermatol. 2001;45(6):957-960. doi:10.1067/mjd.2001.117382


(14) Ziomkiewicz A, Pawlowski B, Ellison PT, Lipson SF, Thune I, Jasienska G. Higher luteal progesterone is associated with low levels of premenstrual aggressive behavior and fatigue. Biol Psychol. 2012;91(3):376-382. doi:10.1016/j.biopsycho.2012.08.001


(15) Brotfain E, Gruenbaum SE, Boyko M, Kutz R, Zlotnik A, Klein M. Neuroprotection by Estrogen and Progesterone in Traumatic Brain Injury and Spinal Cord Injury. Curr Neuropharmacol. 2016;14(6):641-653. doi:10.2174/1570159×14666160309123554

All content found on this website was created for informational and general educational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your primary care provider or other qualified health professional with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Your cart is empty Continue
Shopping Cart
Subtotal:
Discount 
Discount 
View Details
- +
Sold Out