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The Female Fifth Vital Sign

Our body works in an amazing way. It must coordinate many different functions all the time. How do you know if you are healthy? Well, there are different ways and aspects that we can check to know if you are healthy: normal blood pressure, normal temperature, among other signs. Today, I want to talk to you about a new way, a way that you haven’t heard about it, and it is called the “fifth vital sign”. This is completely true. Women have an extra vital sign and you can recognize it throughout simple changes that you have in your daily routine.


What is our fifth vital sign? It is the menstrual cycle! But it is not only the bleeding itself, but also everything that happens during the cycle. Do you know that the most important event on the menstrual cycle is not menstruation? It´s ovulation! And ovulation is the main goal of the menstrual cycle. All the hormones that we produce are aiming to have a healthy ovulation.


Every month, the brain produces a hormone called FSH which stimulates an egg to grow and mature. While it grows and matures, the egg will produce another vital female hormone called estrogen. This hormone is very important for our body because it will stimulate other parts of our body, like our bones, muscles and cardiovascular system. The egg will continue to mature and when it is ready, another hormone that comes from the brain, LH, will trigger the egg to be released. The egg will be released into the fallopian tubes, and it will only live for 24-36 hours. After ovulation, another important hormone is produced: progesterone. Progesterone is very important too, especially for the neurons in our brain and body.


For ovulation to happen, not only do these 4 hormones need to be in balance, there are many other hormones that have their own impact on the menstrual cycle. Testosterone, Thyroid hormones, prolactin, insulin and cortisol are some examples. Therefore, if you are experiencing a stressful situation, your cycle may change. Also, our bodies are very sensitive to the environment; that is why if you are not sleeping well, working out or eating a healthy diet, you may struggle to ovulate consistently.


In summary, ovulation is a sign of health and in order for it to occur, our hormones need to be in balance. Can I track if ovulation is occurring? All I need to do is track my menstruation? Well, here is the interesting part. Estrogen (produced by the egg) and Progesterone (produced by the corpus luteum) have many effects on our body. For example, estrogen stimulates your cervix, the lower part of your uterus, to produce cervical mucus. Cervical mucus will change within the cycle, depending on which hormone is commanding the moment. When an egg is growing, and estrogen is dominant, the cervical mucus will give you a very characteristic moist and slippery sensation, and you also can see it when you go to the restroom. It will be more stretchy and clear, very similar to the raw egg white. On the other hand, before or after the ovulation phase, when progesterone is dominant, you won´t have cervical mucus and you will feel dry. Learning how to track this is very helpful to know if your ovulation is healthy, if your luteal phase is long enough, if your cervical mucus production is adequate, and if the changes you are making to your lifestyle are working to improve your cycle biomarkers. You can also use cycle charting for family planning, including trying to avoid or to conceive a child. In our clinic at RHM, we use a charting system call FEMM, which also has an app. In addition, we ask patients to chart other symptoms (like cramps, headaches, mood swings) that they may have been experiencing to understand more about their overall health.


In conclusion, women have a powerful tool for tracking our overall health. We invite you to know more about this and to start tracking your cycles with us! Contact the office today to schedule an appointment with one of our medical providers and learn how to chart your menstrual cycle for free with one of our cycle educators!

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