Ovulation symptoms: what are they and how to recognise them?

The menstrual cycle, with an average duration of 28 days, is divided into four main phases: 

Menstruation (lasting 3 to 7 days) marks the start of the cycle. If no fertilisation has taken place, the endometrium, which had thickened to receive an embryo, breaks down and is expelled in the form of bleeding — known as a period. 

The follicular phase (from menstruation to ovulation): Under the influence of follicle-stimulating hormone (FSH), several follicles in the ovaries begin to develop, but generally only one reaches maturity. The oestrogen produced by these follicles stimulates the thickening of the endometrium to prepare the uterus for possible implantation.

Ovulation, at mid-cycle (day 14 in a 28-day cycle). A sudden surge in luteinising hormone (LH) triggers the release of a mature oocyte by the dominant follicle. This oocyte is then captured by the fallopian tubes, where it may be fertilised.

The luteal phase: After ovulation, the empty follicle transforms into the corpus luteum, which secretes progesterone, stabilising the endometrium to support implantation. If no fertilisation takes place, the corpus luteum degrades, progesterone levels drop, and a new cycle begins with menstruation.

To find out more, read our article on how to calculate your ovulation. 

These phases, regulated by a precise hormonal balance, influence not only fertility but also various aspects of physical and emotional health. 

The first sign of ovulation is the LH level, which the body secretes in greater quantities to help release the egg from the ovary. This phenomenon is known as the LH surge, and ovulation occurs approximately 16 to 36 hours later. LH induces a marked reduction in oestrogen production approximately 12 hours before ovulation and, at the same time, triggers a 2 to 3-fold increase in progesterone production relative to baseline levels [1].

You are most fertile when your LH level rises.

A reliable method: 

Detection of the LH surge, whether in serum or urine, is highly sensitive and specific for ovulation and offers great accuracy in determining the likelihood of conception [2].

But do take care if you have luteinised unruptured follicle syndrome: 

This method may not be suitable in this situation, which occurs in 10% of menstrual cycles in normally fertile individuals. In those affected, hormonally, everything functions as in a successful ovulation. However, in reality, the follicle fails to rupture and release its egg. This is therefore not detectable because all indicators appear normal, yet no egg is captured by the fallopian tube and can therefore not be fertilised [3].

LH levels may not be reliable in cases of PCOS: 

Another situation where the LH test can be misleading: in the case of polycystic ovary syndrome (PCOS), LH is often persistently elevated, and may therefore trigger a positive ovulation test even when ovulation is not imminent.

Your reproductive hormones have a measurable impact on your body temperature. As a baseline, it is slightly lower during the follicular phase (the first half of the cycle), it rises after ovulation and remains elevated throughout the luteal phase (the second half of the cycle)[4].

A small, measurable variation

An increase is produced in response to progesterone, which is released after ovulation. It prepares the uterus for the implantation of a fertilised egg. The change after ovulation is small — it rises by only 0.3ºC to 0.6°C (but this remains measurable with a basal thermometer) — and can be easily affected by factors such as illness, alcohol and changes in sleep patterns[5].

A reliable technique when not used alone

When comparing these changes to ultrasonographic diagnosis, it is noted that the measurements give a correlation of only 30% with the diagnosis of ovulation[6]. Methods have been developed using basal body temperature in combination with other ovulation indicators, such as cervical mucus, and the synthesis of both menstrual cycle parameters indicates clinical ovulation, which corresponds to within less than one day of ovulation as determined by these factors in 89% of cycles[7].

The conditions for it to be reliable.

It must be taken in the morning upon waking, before getting out of bed, always at the same time within a window of no more than 1 hour, and ideally vaginally or rectally (or orally if needed).

This is a retrospective indicator of ovulation, although sometimes it can begin to rise beforehand, when the follicle starts to be luteinised under the effect of LH, before releasing its oocyte.

Stepwise rises can therefore be observed.

Since the 1980s, it has been widely accepted that the mucus peak is closely correlated with ovulation[8].

Advanced quantification using a scoring system for this peak indicated that it is at its highest on the day of the LH surge, and that ovulation begins on average 0.9 days after the peak, with a range of 3 days after to 2 days before[9].

Changes in appearance 

When ovulation is imminent, cervical mucus becomes very fluid, stretchy, and transparent (like raw egg white or even oil), giving a very slippery and lubricated sensation. This should not be confused with white discharge, which is normal discharge and is not a sign of ovulation.

The cervical mucus after fertilisation is distinctive. Ovulation is confirmed by its sudden drying up from one day to the next.

These changes are a reliable indicator 

Data from one study show that 78% of LH surges occur within ± 1 day of the peak, and 91% within ± 2 days. A comparison with a urinary LH detection monitor revealed that the average day of the fertility peak as identified by the monitor and by self-observation of cervical mucus were very similar (i.e. day 16)[10].

During your period, the cervix sits low and can generally be felt quite easily; it is also fairly firm. As the menstrual cycle progresses, it rises higher. Around the time of ovulation, it reaches its highest position, and at that point it may even be too high for you to reach. It also becomes softer.

By taking this ovulation symptom into account, it is possible to determine when ovulation is likely to occur for you. These changes tend to happen a day or two before ovulation, and can therefore be used alongside other signs to help you accurately plan intercourse during your fertile window.

Once ovulation has occurred, it becomes firmer again, drops lower in the vagina and the opening closes. This can happen anywhere from a few hours to a few days after ovulation and varies from person to person. It is therefore worth tracking it over a few months to understand what is normal for you and to observe it as an ovulation symptom.

Some women experience an ovulation symptom known as Mittelschmerz. This is a one-sided pain in the lower abdomen associated with ovulation.

It can be felt as a sharp or dull cramp in the body, generally on the side of the abdomen where the ovary is releasing an egg. This is due to the strong tension exerted by the follicle against the wall before it manages to rupture and release the oocyte [11]. It typically occurs 10 to 16 days before the onset of a period, is not dangerous and is usually benign. It generally lasts a few hours, though for some people it can last a few days.

Research using ultrasound to determine the timing of ovulation has revealed that ovulation pain is generally felt at the time of the LH surge, approximately 24 to 48 hours before ovulation [12].

As LH peaks 16 to 36 hours before ovulation, your chances of conception are high if you have sex during this window. Women are more sexually active in the days leading up to and including the pre-ovulatory surge, characterised by the LH peak. This period of heightened sexual activity is more pronounced with regular sexual partners, although the increase in sexual desire is just as significant for those without a partner[13].

A rise in testosterone

The rise in testosterone that precedes ovulation largely explains this variation in libido. Furthermore, this fluctuation in testosterone throughout the menstrual cycle may influence women's preferences for masculinity in men's faces, voices and behaviours — particularly around ovulation[14]!

A rise in oestrogen

Another study found that sexual desire peaks when oestrogen levels are higher. The rise in oestrogen levels generally begins earlier than that of LH, but typically peaks at the same time[15].

Observation of salivary characteristics has shown that in 88% of cycles, there is a direct correlation between salivary crystallisation and the fertile window, as well as a connection between the onset of crystallisation and the cervical mucus peak [16].

Although this peak has proven to be a reliable indicator of ovulation symptoms, the relationship between saliva and the peak is that the onset of crystallisation occurs, on average, 6 days before the peak. This suggests that saliva is useful for identifying the beginning of the fertile window, but not for the direct detection of ovulation according to available studies [17].

Other ovulation symptoms

Here is a non-exhaustive list of ovulation symptoms:  

Light bleeding or spotting, during the release of the oocyte by the follicle.

Breast tenderness.

Headaches and mood changes. 

Abdominal pain (bloated stomach, cramps, gas, bloating or abdominal cramps).

A general sense of fatigue may accompany ovulation.

Lower back pain

When successful ovulation leads to fertilisation, followed by pregnancy, certain signs of successful ovulation may appear, although these vary from woman to woman. Here are the main indicators to look out for:

Missed period: A missed period is often the first obvious sign, especially if your cycles are usually regular.
Changes in basal body temperature: After ovulation, basal body temperature remains elevated due to progesterone production. If this elevation persists for more than 14 days, it may be an indicator of pregnancy.
Breast tenderness, sore breasts: Breasts may become more sensitive, heavy, or painful due to early hormonal changes.
Light bleeding or implantation bleeding: A small amount of blood may be observed a few days after ovulation, when the embryo implants in the uterine wall. This bleeding is generally lighter than a period.
Unusual fatigue : Rising progesterone levels can lead to increased fatigue, even very early in pregnancy.
Increased vaginal discharge: A change in the consistency or quantity of vaginal discharge may be observed, often thicker and more whitish in appearance.
Heightened sensitivity to smells and mild nausea: Although more common after a few weeks, some women notice these symptoms from the very beginning.
Mild abdominal cramps : they may occur as a result of the embryo implanting.
Cravings: you may notice an increase in appetite. 

A positive pregnancy test will confirm the presence of a pregnancy. If in doubt or if you experience unusual symptoms, it is advisable to consult your doctor or gynaecologist.

Conclusion

There are several factors that can help you determine whether or not you are ovulating, and combining the observation of these different factors will allow you to know with even greater precision when you are ovulating.

Not all factors will be noticeable for everyone. Abdominal pain does not occur for everyone, nor does breast tenderness or nausea and headaches, for example. The absence of symptoms does not mean you have not ovulated, but it can be an indicator. If you are trying for a baby, there are also certain factors or signs of successful ovulation that you can look out for. 

Do not hesitate to consult your healthcare professional (gynaecologist, midwife, or GP) for support and guidance. 

Our pregnancy food supplement Baby Bump multivitamins will help you stock up on nutrients that support ovulation and increase your chances of pregnancy.