INFORMATION AT YOUR FINGERTIPS
Understanding how your body works, what is healthy and what is not, enables you to participate in decisions regarding your health and wellbeing.
Fertility Aware seeks to bring you up to date with relevant information regarding your fertility health. We encourage you to become familiar with our body literacy pages, while recommending you see a consultant for a more in-depth instruction or to use a fertility awareness method to avoid pregnancy.
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WHAT IS BODY LITERACY?
When we were children, we learnt how to distinguish each letter of the alphabet and to recognise combinations of these as words. We became literate.
But many of us were not adequately taught to be body literate and don’t know how to read the natural signs our body is showing us.
In the area of fertility awareness, body literacy means understanding how everything works together as a complex system to enable reproduction to take place. This includes understanding:
- Women’s and men’s reproductive anatomy
- The art of conception
- What controls the menstrual cycle
- Fertility after birth, during breastfeeding and beyond
- Infertility – causes and treatment
- Common cycle disorders
- Menopause
We hope these pages will inspire and empower you to take charge of your fertility and live the best and healthiest life imaginable.
Know your body
Every woman’s body is unique. The exact size, shape, and location of her organs and the timing of her cycle events are individual to each. We offer the following as a guide only.
Female Reproductive Organs and Cycle Events
The female reproductive system is made up of both internal and external genitalia. The major internal reproductive organs are the ovaries, fallopian tubes, uterus, cervix, and vagina. The external reproductive parts are at the vulva. When a young woman’s menstrual cycle starts to function, it is the beginning of her ability to procreate – to create another human being. Below are some of the key parts of this process. Please also see our Female Cycle page.
Reproductive Parts
Ovaries
The ovaries are almond-shaped organs containing the female sex cells or ova. This is the site of production of the hormones oestrogen and progesterone, which are essential for ovulation and healthy pregnancy. There are two ovaries, one on each side of the uterus.
Follicle
A follicle can be described as an “egg shell.” It encases the egg, and its cells are responsible for secreting the hormones oestrogen and progesterone. Each cycle, one dominant follicle develops per ovary (most often only one ovary per cycle, but sometimes two) and releases an ovum into the fallopian tube.
Fallopian Tubes
The fallopian tubes are trumpet-shaped tubes connecting the ovaries to the uterus. They are approximately 10 cm long and collect the ovum after ovulation through a wide entrance near the ovary and pass it through a narrowing passage into the uterus.
Uterus
The uterus (shaped like an upside-down pear) is a hollow muscular organ, positioned between the bladder and the rectum, in the pelvic region. During pregnancy, this muscular organ stretches significantly to accommodate the growing baby.
Endometrium
This is the nutrient-rich lining of the uterus that builds up during the early phase of the menstrual cycle, under the influence of the ovarian hormone oestrogen. It is made up of blood vessels and tissue.Cervix
The cervix is a firm, narrow muscular tube (about 2-3cm long) leading out of the uterus and into the vagina. It allows sperm to enter the uterus and menstrual fluid to exit. The cervical cells produce different types of mucus essential for transporting and nourishing sperm for conception as well as forming a plug to prevent infection.Vagina
The vagina is a wider muscular tube that connects the bottom of the uterus (cervix) to the vaginal opening.Vulva
The area known as the vulva refers to the many exterior parts of a woman’s reproductive system. This area includes the vaginal opening, clitoris, perineum, hymen, urethra, labia minora (small lips), labia majora (large lips), and mons veneris (mons pubis).Reproductive cycle events
Ovulation is an important event in a woman’s cycle where a fully developed follicle in the ovary ruptures and passes an ovum into the fallopian tube where it begins its journey toward the uterus.Conception
If sperm enters the fallopian tubes while the ovum is present, then fertilization is likely to occur. This process takes place in the outer third of the fallopian tubes. The fertilized egg then travels through the fallopian tube and into the uterus, a journey lasting up to 9 days.Implantation
After traveling through the fallopian tubes, a fertilized embryo burrows into the nutrient-rich lining of the uterus, known as the endometrium. This event is known as implantation.Menstruation
Menstruation is the event in a woman’s cycle when the thickened uterine lining (called the endometrium) breaks down and sheds through the vagina. Lasting 3-7 days, menstruation occurs each cycle that conception and/or implantation does not take place.Know your body
The male reproductive system produces the male sex hormone, testosterone and manufactures and delivers the male sex cells (sperm).Spermatozoa
Spermatozoa, or sperm, are the male sex cells. A single, microscopic sperm has a head – containing DNA and enzymes aiding conception – and a tail, allowing it to travel through a woman’s reproductive system to the egg, and burrow into it.Testosterone
Testosterone is the male sex hormone produced by the testes that causes the growth and maturation of the reproductive system as well as initiating sperm production.Testes
Sperm are produced inside two oval-shaped structures known as testes, or more commonly, testicles. The testicles are located behind the penis inside a sac called the scrotum, which hangs outside the body, providing a natural air conditioning system to ensure sperm stay cool.Epididymis
A tightly coiled tube located behind the testes where sperm reach full maturity before travelling through the vas deferens in preparation for ejaculation.Fun Fact!
The total time it takes for sperm to reach full maturity is around 72 days. Up to 14 days of this is spent in the epididymis where the final ‘finishing touches’ are added.
Vas Deferens
The vas deferens is a tube about 40cm long through which sperm travel from the testes to outside the body.
The Prostate
The prostate is a muscular organ about the size of a walnut that sits close to the bladder. It produces fluid that mixes with sperm to make seminal fluid that is ejected from the penis at ejaculation.
The Penis
The penis is a cylindrical structure that is part of both the urinary and reproductive systems. The sponge-like tissue fills with blood and becomes erect when a man is aroused.
Ejaculation (event)
The autonomic nervous system is responsible for triggering ejaculation at the climax of sexual arousal. During ejaculation millions of sperm are released.
Fun Fact!
About a teaspoon’s worth of seminal fluid is ejaculated per orgasm and typically contains more than 250 million sperm cells
Growing up, girls learn to recognise the menstrual bleed (or period) as the main event in the cycle – but there is much more to it. A woman’s natural fertility signs are the outwardly visible signs of a complex hormonal interplay inside her body. Another very important event, ovulation, happens about two weeks before each period and is vital when it comes to starting a family or avoiding pregnancy naturally. Once you know what to look for, there are reliable and consistent signs that tell you what your hormones are doing. Understanding ovulation and the other important events in the cycle are the basis of fertility awareness methods.
Three Phases of the Fertility Cycle
A woman’s fertility cycle follows the rise and fall of various hormones in her body. Traditionally it was taught that the ‘normal’ cycle will last for 28 days. Now we know there are healthy variations on normal, anything between 21 and up to 45 days (but again, there’s more to it than that).
The cycle can be divided into three main phases:
- Menstruation and pre-ovulatory infertile days
- Follicular Phase – The potentially fertile pre-ovulatory and peri-ovulatory phase
- Luteal Phase – Post-ovulatory phase.
Ready to learn more?
Every woman’s cycle is different and each phase can last for varying lengths of time and present varying signs. Each woman is, after all, unique. The important thing is to be aware. Understanding your own unique pattern can be the start of a healthy future. Get in touch with us to find out more.
1: MENSTRUATION
Menstruation starts when the corpus luteum dies and oestrogen and progesterone levels decrease. With this, the blood supply to the endometrium lining in the uterus is cut off and within 24 hours menstruation begins. The drop in oestrogen and progesterone triggers the production of follicle stimulating hormone (FSH), which stimulates immature eggs (follicles) to start growing and maturing.2: FOLLICULAR PHASE
Oestrogen builds up the uterine lining in preparation for a fertilised egg. Hormonal fluctuation can also result in abnormal bleeding patterns or a little spotting. When oestrogen levels climb high enough, the hypothalamus stops producing FSH and starts releasing luteinising hormone (LH). This release in LH is accompanied with a second rise in FSH, which completes the maturation of one dominant ovum, and triggers ovulation.Ovulation:
A flood of luteinising hormone (LH) causes the follicle to rupture and release the mature ovum. This is ovulation! The ovum enters the fallopian tube and starts travelling from the ovary towards the uterus. It has a lifespan of 12-24 hours before it dies. Sometimes, two mature ova are released and if fertilised, result in non-identical twins.3: LUTEAL PHASE
The ovum travels through the fallopian tube (about 10cm) towards the uterus where the lining has built up to help nourish an embryo. The ruptured follicle left on the ovary undertakes a transformation; it becomes a yellowy-orange gland called the corpus luteum and secretes both oestrogen and progesterone. These hormones ready the body for pregnancy. Progesterone thickens cervical mucus, changes the uterus lining and increases basal body temperature. These two symptoms form an important basis of fertility awareness. Without conception, the corpus luteum only produces oestrogen and progesterone for 9-16 days before it dies, hormone levels fall and menstruation begins again.The male and female bodies are complementary systems that naturally work together to achieve fertility. A healthy man is considered fertile all the time, while a woman’s hormonal changes cause a natural, cyclical pattern of fertility and infertility.
Many things in our daily lives are controlled or monitored by man-made or digital devices, whether it is to monitor our heart rate, measure our daily run or count each step we take. It is easy to assume we can control our fertility too, but the truth is that an element of mystery surrounds conception.
Natural conception happens autonomously, deep inside a woman’s body, at a time unknown to her or her partner. While we participate in the procreative process, we are not ultimately in control at the moment of conception.
Vital Factors for Natural Conception
Timing intercourse to achieve pregnancy involves three vital factors
- Fertile cervical fluid
- 5-7 days sperm survival
- 2-24 hours ovum survival
The ability to recognise and understand these vital factors enables you to do your bit to ensure healthy sperm and egg are given the opportunity to meet.
The rest is for nature to decide!
How can we help?
A Fertility Aware educator will help you create a chart of your unique signs. Knowing your body’s natural fertility signs means you can understand the best time to try for a baby each cycle, or if you aren’t ready to start a family yet, know the times to take a break to avoid pregnancy.
If you experience irregular cycles, very heavy, painful periods or other symptoms that cause you to worry, it is likely that something isn’t quite right.
Did you know that evidence of some reproductive issues may show up in fertility awareness charts?
Cycle charting is the basis for timely and accurate diagnosis and with the right care from trained professionals you can start getting to the bottom of what is going on.
Contact us for more information or to see a consultant.
Common Cycle Disorders
Poly Cystic Ovarian Syndrome (PCOS)
Multiple follicles begin to mature during the early follicular phase but due to hormonal irregularities, none are able to fully mature. Often this means long cycles, with several “attempts” at ovulation, where oestrogen rises but never occurs. This can present as very long or irregular cycles, abnormal bleeding patterns including spotting or extremely light bleeds. PCOS tends to be associated with other symptoms such as overweight or obesity, extra hair growth (eg facial) or acne.
Endometriosis
Endometriosis is a condition of the menstrual lining of the uterus appearing outside the uterus. It can be found throughout the pelvic area including the ovaries, fallopian tubes, bowel and bladder, or in the internal muscle fibres of the uterus. Symptoms are diverse but consist mostly of irregular cycle length, volume of blood loss and extreme pain leading up to, and during the period. Many treatments are available but are tailored to the stage of life and desire to have children. As endometriosis affects all the phases of the cycle, fertility awareness methods can help increase the chance of conception by enabling a couple to understand timing of ovulation with relative accuracy.
Heavy periods
If a woman experiences periods that are considered too heavy, this is Menorrhagia. It is hard to define ‘too heavy’ as women have different expectations, but generally this means exceeding 80mls in volume, lasting more than 7 days and bleeds occurring more frequently than every 21 days. It is recommended that women meeting these criteria consult with their doctor, as anaemia and underlying factors need to be ruled out.
STIs
The number of known sexually transmitted infections and people infected is steadily growing, locally and globally. Not all STIs have a known cure, and some result in infertility, illness, infection and even death. If you think you may be affected with an STI, see your doctor immediately. Common STIs include:
- Gonorrhoea
- Genital Herpes
- Chlamydia
- Hepatitis B and C
- Genital Warts
- HPV and HIV
- Syphilis
During pregnancy and for a period of time after the birth of your baby, the hormones in your body cause a natural period of infertility known as Lactational Amenorrhoea. The Lactational Amenorrhoea Method, or LAM, states that provided you meet three criteria, there is 98% protection from pregnancy. The criteria are:
- Your Baby is less than 6 months old
- You have had no further bleeding after the post-birth (lochia) bleed
- You are fully breastfeeding – see definition below
High levels of pregnancy and breastfeeding hormones prevent ovulation – this is nature’s way of spacing pregnancies!
What defines “Fully Breastfeeding”?
For LAM to be reliably 98% effective for avoiding pregnancy, your baby must be fully breastfeeding. Fully breastfeeding means that the baby must be feeding exclusively on breastmilk, around the clock, without a gap larger than 4 hours. If the following apply to you and your baby, then you successfully meet this criterion:
- My baby is feeding every 4 hours or more often, including overnight.
- My baby has not started solids
- My baby does not “top up” on water or formula feeds
- My baby does not use a dummy
- I am not expressing breast milk.
Please note: It is important to work closely with an accredited consultant. During this time of uncertainty, identifying the signs of returning fertility can be confusing. Changes in baby’s needs, particularly sleeping or breastfeeding patterns will directly influence the hormone levels in her mother’s body. These changes often happen suddenly, so it’s important you are connected with a consultant who can support you and provide you with confident assurance.