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Cervical mucus stages, conditions and how to restore cervical fluid health

Cervical mucus (or fluid) tracking is one of the most powerful tools for increasing awareness of your fertility. In fact, it is estimated that abnormalities in cervical fluid may account for 3-8% of subfertility in women[i]. Fortunately, this is information our bodies are already giving us every day! By practicing body awareness and using your kegg, you are empowered to zone in on your fertile window and gain invaluable insight into your hormonal and reproductive health.
cervical mucus fertlity nectar
Dr. Kalea -min

Dr Kalea Wattles

Serves as clinical coordinator at The Institute for Functional Medicine,
where she works to develop curriculum on gut health, cardiometabolic
health, and hormones. She also cares for patients in her fertility-speciality
practice at Vida Integrated Health in Bellevue, WA. She is one of our kegg testers.

Why is cervical fluid important?

Kegg testing is dependent on the electrolytes present in cervical mucus but if you’re new to kegg this article would be a valuable resource to discover why cervical fluid plays a crucial role in the reproductive process and you’ll understand the importance of a correct cervical mucus tracking better.  Let’s start with a quick review of the functions of cervical fluid – why is this so important and how does it contribute to fertility? Cervical fluid serves a number of very important roles:

1. Protects sperm from an acidic vaginal environment, prolonging the life of sperm in the vaginal canal
2. Filters abnormal sperm
3. Keeps sperm “biochemically nurtured” (AKA: acts as sperm food!)
4. Stores the sperm until an egg is nearby
5. Maintains the opening of the cervical canal

What determines the “quality” of cervical fluid?

If you’ve spent any time on the internet, you know we are aiming for that coveted “egg white” quality cervical fluid (EWCF for short, because we’re all friends here). This fluid is almost clear and VERY stretchy, potentially stretching several inches between your fingers. When you see this type of mucus, you know your fertile window is opening and you are in prime time for achieving a pregnancy.

Women who also use kegg to track their cycles will notice a dip in their results during their fertile window. This downward trend depicts the changes in the electrolytes associated with the hormonal fluctuations when preparing for ovulation, including a surge of estrogen. While kegg indicates the predicted fertile window with highlighted green days, users are also able to see this in realtime with the descending values on their kegg charts.


So, how do we use the presence of EWCF to collect information about our hormones and fertility? Let’s talk about it!

The quality and function of cervical fluid is intimately tied to the phases of your menstrual cycle. In the first half of the cycle, the cervix is under the influence of estrogen. Estrogen causes cervical fluid to be more watery and causes large molecules called mucins to align in an organized fashion that creates the sperm pathway – like when you get bumpers on your aisle at the bowling alley to make sure the ball hits those pins!

Even further, estrogen increases the amount of fluid secreted. Check this out: the cervix secretes 20-60 mg of fluid on a normal day, but might make as much as 700 mg at ovulation time – wow! Because cervical fluid quality is so dependent upon hormonal signaling, it makes sense that conditions associated with hormonal disruption might affect cervical fluid as well.

After ovulation, there is typically a decrease in cervical mucus. The mucus may become thicker or more “creamy” in comparison to the sought-after EWCF. This thickened mucus acts as a barrier to prevent infection after ovulation and occurs in response to the shift in hormones to progesterone production. If conception occurs, women will notice many changes in cervical mucus throughout their pregnancy, and the presence of cervical mucus can vary greatly between women.

Conditions associated with changes to cervical fluid

There are a number of conditions that can affect the quality of cervical mucus, and therefore, fertility status. Both the quantity and sensation of the mucus can be impacted, making it more difficult to track for some women. This is the perfect opportunity to use kegg to help identify when the fertile window is opening! Because kegg detects changes to the electrolyte composition, rather than the quality/quantity of cervical mucus, it can provide incredible information for those who have a hard time depending on their mucus patterns. Here, we will review some of the most common scenarios related to alterations in cervical fluid quality.

PCOS

Polycystic ovarian syndrome, or PCOS, is a very common cause of irregular menses or infertility in women. While a lack of egg maturation and ovulation is most often the culprit, changes to cervical fluid may also contribute to problems getting pregnant. Over the last decade, researchers have discovered that the cervical fluid of women with PCOS may differ from women without PCOS. This effect is greatest in women who do not ovulate regularly. When analyzed under a microscope, the cervical fluid of women with PCOS tends to be denser, therefore more difficult for sperm to swim through. Additionally, fibers within the cervical fluid were arranged in a less organized way, making a less effective pathway to direct sperm towards an egg [ii].

ENDOMETRIOSIS
Endometriosis is an inflammatory gynecologic condition characterized by the presence of uterine-like tissue outside of the uterine cavity, often resulting in debilitating pain and infertility. The gold standard for diagnosis of endometriosis involves laparoscopic surgery, an invasive procedure. This has led researchers to search for less invasive strategies for diagnosis. Emerging research suggests that cervical fluid may suggest the presence of endometriosis based on the composition of proteins present. In a small study published in 2017, cervical fluid samples were collected from 10 women with endometriosis and 10 women without endometriosis who had delivered a baby within the last year. Results indicated that women with endometriosis had more proteins associated with inflammation and less proteins associated with immune function, antioxidant protection, and antimicrobial activity.[iii] It appears that cervical fluid is a powerful signal that can shed some insight into other physiological processes.

BACTERIAL VAGINOSIS
Bacterial vaginosis, a common bacterial infection, may interfere with the production of healthy, fertile-quality cervical fluid. In one study of pregnant women diagnosed with bacterial vaginosis, higher levels of inflammatory chemicals and white blood cells were found in cervical fluid. This fluid also had higher concentrations of endotoxins, which could potentially harm sperm in the reproductive tract.[iv] Even further, pregnant women with bacterial vaginosis may have higher concentrations of prostaglandins in their cervical fluid. These chemicals can stimulate uterine contractions and ripen the cervix, potentially increasing the risk for premature labor[v]. One great benefit of paying close attention to cervical fluid is the ability to notice if something seems “off” – you become the expert on YOU.

What can I do to restore healthy cervical mucus?

If you are concerned about the status of your cervical fluid, here are some suggestions:
1. Use a symptom journal (or even better, your kegg!) to help you track your fluid over a few cycles. There can be a learning curve when getting to know your unique patterns, and the information you can obtain from tracking is invaluable when trying to identify the root cause of any problems that arise.

2. Check out your hormones! Work with a healthcare provider to measure your hormones over the course of your cycle to ensure they are following a normal rhythm.


3. Take good care of yourself! Focus on staying hydrated and eating good quality fats. I know it seems like that’s the answer to everything. But check this out: cervical fluid is 95-98% water. Drink up! The general rule of thumb is to aim for half your body weight in ounces (so someone weighing 150 pounds would need 75 ounces of water daily).


4. Work with your healthcare provider to choose the right supplements. N-acetyl-cysteine is one of my favorites! This supplement acts as a “mucolytic” meaning it thins secretions. It is an excellent support for creating EWCF.


5. Give acupuncture a try! Acupuncture is a lovely way to increase pelvic blood flow (in addition to so many other benefits), encouraging healthy fluid secretion.

[i] Martyn F, McAuliffe FM, Wingfield M. The role of the cervix in fertility: is it time for a reappraisal? Hum Reprod. 2014 Oct 10;29(10):2092-8. doi: 10.1093/humrep/deu195. Epub 2014 Jul 27. 
[ii] Vigil P, Cortés ME, Zúñiga A, Riquelme J, Ceric F. Scanning electron and light microscopy study of the cervical mucus in women with polycystic ovary syndrome. J Electron Microsc (Tokyo). 2009 Jan;58(1):21-7. doi: 10.1093/jmicro/dfn032. Epub 2009 Jan 12.
[iii] Grande G, Vincenzoni F, Milardi D, et al. Cervical mucus proteome in endometriosis. Clin Proteomics. 2017;14:7. Published 2017 Feb 2. doi:10.1186/s12014-017-9142-4
[iv] Platz-Christensen JJ, Mattsby-Baltzer I, Thomsen P, Wiqvist N. Endotoxin and interleukin-1 alpha in the cervical mucus and vaginal fluid of pregnant women with bacterial vaginosis. Am J Obstet Gynecol. 1993 Nov;169(5):1161-6. doi: 10.1016/0002-9378(93)90274-m. 
[v] Platz-Christensen JJ, Brandberg A, Wiqvist N. Increased prostaglandin concentrations in the cervical mucus of pregnant women with bacterial vaginosis. Prostaglandins. 1992 Feb;43(2):133-4. doi: 10.1016/0090-6980(92)90082-5.

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