If you're like many women, you're probably still a little mystified by your cycle, and you probably haven't had to think twice about it until you decided to start a family. Once you throw conception into the mix, things can get even trickier to understand. So we asked two top doctors to answer some of the most common questions women have about their reproductive health.
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How do I know if my cycle is normal?
This is one of the most common questions that Pamela Berens, M.D., professor of obstetrics, gynecology and reproductive medicine at The University of Texas Health Science Center at Houston gets asked in her practice. Although the average cycle occurs every 28 to 32 days, some variation each month is common, says Dr. Berens. "Many women are concerned that they're not regular if their cycle is off by a few days, but most cycles will not be perfect every month," she says. In fact, it would be unusual to have a period every 28 days on the dot with no deviation. "When your doctor asks if your cycle is regular, she's really just making sure it isn't occurring every two weeks or that you're not skipping months between cycles."
Can I get pregnant even if I don't have a regular period?
"Absolutely; it's just harder," says Michele Hakakha, M.D., an ob-gyn in private practice in Beverly Hills, California. A woman who has a period every 28 days will ovulate on day 14 of her cycle every month; a woman with a 35- to 42- day cycle will ovulate less frequently because her periods are less frequent. If you have irregular periods and you're trying to get pregnant, Dr. Hakakha suggests booking a preconception visit with your doctor to discuss your cycle and when you'll most likely be ovulating.
Can I get pregnant during my period?
"Although it is possible to get pregnant during your period, it's not very common," says Dr. Hakakha. The only time this can happen is when a woman has a shorter than average cycle. For example, a woman who has a 21-day cycle will ovulate around day seven. If she has intercourse on the fifth day of bleeding, it's possible she could get pregnant because sperm can live for up to five days and would be present in her fallopian tubes when she's ovulating, says Dr. Hakakha.
I've been on birth control pills for several years. Will this affect my chances at getting pregnant?
Long-term hormonal birth control won't affect your fertility. In fact, most women begin ovulating within three months of stopping birth control. "I usually have patients stop their birth control a few months prior to attempting to conceive and tell them to use condoms for contraception in the meantime," says Dr. Berens. "This way, a woman will know if her cycle is regular and she'll be able to tell her doctor when her last period started in order to calculate her due date once she becomes pregnant." If you're itching to get pregnant right away, finish your current pack of pills to avoid any irregular bleeding.
I'm dying to know if I'm pregnant. How soon can I use a pregnancy test?
When you're trying to get pregnant, it's tough to resist testing early (and often) but there's no point in forking over cash for expensive pregnancy tests until you're sure you'll get an accurate reading. Over-the-counter tests are very sensitive and can detect the pregnancy hormone (hCG) in urine by the day of your missed period --and sometimes a day or two before your expected period, says Dr. Hakakha. If you test any sooner than that, you'll probably get a negative result even if you are pregnant. If you get a negative result on the day of your expected period but your cycle hasn't started, try repeating the test in 48 hours. Most urine tests are accurate a week after your expected period. For the best chances of getting an accurate result, test using your first morning urine, as it contains the highest level of hCG.
Is there a chance I could be pregnant even if I get my period?
No. You can't be pregnant and have a period, but it is possible to mistake implantation bleeding for a menstrual cycle, says Dr. Berens. About seven days after conception, the embryo imbeds itself in the wall of the uterus and can cause spotting. Implantation bleeding is lighter and shorter in duration than a menstrual period but it can still be difficult to tell which you're experiencing. If you're unsure, take a pregnancy test in a week for a definitive result. If you experience profuse bleeding at any point in your cycle, call your doctor immediately.
Is there a certain time of month to have intercourse for the best chance at getting pregnant?
Absolutely. "Because sperm lives for three to five days, conception is more likely to occur when intercourse happens a few days before ovulation," says Dr. Hakakha. Most women ovulate at midpoint in their cycle. So, if you have a typical 28-day cycle, you'll ovulate 14 days after your last period began. If your cycle is longer, say 34 days, you'll ovulate around the 20-day mark. Every woman is unique, so it's helpful to track the length of your cycles to better anticipate ovulation. To take the guesswork out of predicting your fertile window, some doctors recommend having intercourse every other day. "If this seems difficult for you, and believe me it is for a lot of women, you can always purchase an ovulation predictor kit and have intercourse only when indicated on the test," says Dr. Hakakha.
How can I tell if I'm ovulating?
There are a few ways. You may notice that your cervical mucus changes during ovulation, becoming clear, thin, and stretchy (similar to the consistency of raw egg whites). Some women can actually feel a twinge or even pain on one side of their lower abdomen during ovulation. If you're having a tough time deciphering your body's clues (or lack thereof), think about investing in an over-the-counter ovulation kit, advises Dr. Hakakha. These kits detect a surge in the production of luteinizing hormone (LH), which occurs roughly 36 hours before ovulation. That doesn't mean you should wait a day to have intercourse. Having sex when the test is positive gives sperm time to travel to the fallopian tubes to meet your egg. Ovulation predictor kits run from $15 to $50, depending on the brand and how many tests are included.
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