Charting
Charting your body basal temperature (our body temperature upon waking after 5 hours of undisturbed sleep) and cervical mucus whilst trying to conceive for some can be off putting, time-consuming and stressful. I have lost count how many people have said: “but isn’t it just best to wait until it happens naturally”. I guess this a fair point but I’m of the mindset that it is so so important in a lot of circumstances (even if it’s only for a few months).
This information for your clients is crucial in detecting any cycle issues and gives you important details so you can adapt your treatment or signpost your clients with ways to help.
It is so important for your client to become in tune with their bodies. So many of us now have very busy, stressful jobs and just as hectic social lives. We just lose sight of our bodies and what they are trying to tell us and actually what they are telling us is a huge amount.
Charting our basal body temperature and cervical mucus can tell us so much about our hormonal health, particularly making sure the luteal phase (the phase after ovulation) is long enough for an egg to implant to sustain a pregnancy. A luteal phase of shorter than 10 days means the lining of the uterus starts coming away (what is recognised as a period) before the egg has travelled out of the fallopian tube into the uterine cavity to implant.
I only get my clients to chart for three months and then throw the thermometer and the charts away. 3 months should be enough time to really understand your natural cycle and pinpoint your fertile window and the best time to conceive.
The sympto-thermal method of charting teaches a client how to identify their own unique fertile time in each cycle, therefore enhances chances of conception.
In this chapter we explain how you can teach your client to chart her cycle using the sympto-thermal method of Natural Family Planning, using the 2 main indicators: –
- Checking the Basal Body Temperature
- Observing changes in Cervical Mucus
Basal Body Temperature Method
Picture: An example of a basal body temperature chart
The basal body temperature is the main element to chart. The temperature gives no warning of impending ovulation; however, it does confirm that ovulation has definitely occurred as the temperature rises sharply after ovulation.
THE MAIN RULE TO REMEMBER TO DETERMINE OVULATION
After recording three readings which are at least 0.2 degrees Celsius higher than the six lower temperatures preceding them, we can confirm ovulation has definitely occurred.
How to take your temperature
- Take orally using a digital basal body thermometer. It must record to two decimal places.
- Keep the thermometer clean and ready for use by the side of the bed.
- Take it at the same time every morning in bed before any movement.
- Place the tip of the thermometer under the tongue, well back in the soft flesh at the base of the tongue, close the mouth tightly and wait for the beep before taking it out of your mouth.
- Record the reading on the chart.
How to keep a chart
- The first day of your clients’ period is day 1 on the chart (must be red blood).
- Mark the date across the top of the chart and circle the weekend dates (this is where most disturbances may occur).
- Record the reading for each day with a large dot in the centre of the square opposite the appropriate temperature on the scale.
- Join the dots up to make a chart at the end of each cycle.
Disturbances that can affect temperature
There are several things that the waking temperature is affected by, like illness, travelling, alcohol the night before, a heavy meal the night before and a bad night’s sleep. It is imperative when recording the temperature that your client notes down any disturbances so that the chart is accurate.
- Read the list and mark at the bottom of the temperature chart any disturbances which can alter a reading, using the given letter code.
- Circle the affected readings to highlight them so that they can be discounted when interpreting the chart
List of codes for the disturbances
NT = new thermometer
A = Alcohol
L = Late
E = Early
D = Disturbed Night
U = Unwell
T = Travel
H = Holidays
C = Cystitis
T = Thrush
M = Medicine
S = Stress
How to observe Cervical Mucus
Unlike the temperature indicator, the mucus symptom appears for several days before ovulation occurs so that sperm is kept alive until the egg is released. Cervical mucus gives an advance warning of approaching ovulation and so all mucus before ovulation is potentially fertile.
Encourage your client to check cervical mucus. It is a quick, efficient and most importantly a free way to understand when to have sexual intercourse to try to conceive.
From the time of menstruation up until about a few days before ovulation, cervical mucus is thick, tacky and fairly inhospitable to sperm. This type of mucus makes it difficult for sperm to make the journey through the reproductive tract. In this type of environment, sperm can live for a very short time (approximately 4 hours).
Around ovulation and during ovulation cervical mucus changes to a clear and watery consistency that is very similar to egg whites. This type of cervical mucus provides an easy environment for sperm to reach the matured egg and helps it survive in the reproductive tract up to 5 days.
How to observe
- Look for mucus at the vulva every time you go to the toilet.
- Observe before and after passing urine, by wiping from front to back across the vaginal opening with toilet tissue.
- The tissue will pick up any mucus, which can then be quickly observed on the paper before it is absorbed.
- Mucus will usually be shiny and needs to be stretched between the fingers, to recognise its changing qualities.
Please note
- Some medications can interrupt the natural secretion of cervical mucus such as antihistamines and the fertility drug Clomid, creating less of it just before ovulation.
- Women with illnesses such as Polycystic Ovary Syndrome (PCOS) find that they produce a heavy level of fertile-like cervical mucus at different times during their monthly cycle. If this is the case for you using cervical mucus as a way to predict ovulation may not be the right method for you.
Describing cervical mucus
the typical pattern of mucus throughout a cycle, goes from DRY after the period, to a scant white sticky type, developing into a more profuse wet, slippery secretion which disappears at ovulation.
Get your clients to note the type of cervical mucus seen at the end of the day (observing what type is seen most throughout the day) , use the code SCAT which stands for Sensation, Colour, Amount, and Type.
How to chart the Mucus Symptom
Menstruation
Day one of a period is day one on the chart. Put an X in the period/spotting line for each day the period continues.
Dry Days
If there are any dry days after the period with no mucus seen or felt, the client must mark D in the sensation line and nothing else.
Mucus Days
The client must mark either M for moist or W for wet in the sensation line. Then add a description below in the ‘appearance’ block (following the SCAT pattern as discussed previously).
Peak Day
When the cycle progresses the mucus develops into stretchy, slippery, raw egg white fertile mucus. This is the highly fertile mucus and it means that ovulation is very close. When this mucus disappears, the last day of its presence is marked as PEAK DAY ‘P’. Ovulation occurs very close to peak day.