Conception Myths: Timing Sex and Your Fertile Window (Episode 366)

Full Transcript: Episode 366

Lisa: Welcome to the Fertility Friday Podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery charting journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health, and I’m so excited that you’re here with us today.

Today I wanted to jump in and share my thoughts on some of the most common conception myths. I wanted to talk to you about how to use fertility awareness cycle charting when you’re trying to conceive. And if you’re not actively trying to conceive right now, I think this episode will be helpful for you if you’re thinking about conceiving in the future. But ultimately, over the past couple of months, I’ve had a number of conversations with clients, I’ve had a number of interviews and just conversations in general that made me really realize just how prevalent some of these myths are.

So a little bit of background about me that some of you already know: when I started charting, I was 18 or 19 years old. So having charted for most of my life, it meant that I never really had the opportunity to develop a lot of these common myths. And so sometimes I don’t even realize how prevalent they are, but it’s been brought to my attention. So we’re going to go ahead and dive in and talk about some of these things today.

Before I jump into the myths themselves, I did want to give some background about how fertility awareness cycle charting can be helpful with fertility. There are two main ways that charting can help you. One is accurate timing. So when you understand how your body works and your menstrual cycle works, then you can time sex accurately so that you can at least rule out the possibility that you’re not hitting the correct days. And then of course the other is when you’re charting your cycles and you’re learning more about your body and the connection between your body and your overall health and your menstrual cycle, there is that potential to identify other issues that you wouldn’t have been able to otherwise know and see.

This is really important because even when I was young, when I first learned fertility awareness as a concept, I remember thinking that timing and the rules only mattered when you’re trying to avoid pregnancy. I remember thinking that because I thought to myself: well, how could you screw it up? The whole thing when you’re trying to avoid pregnancy with fertility awareness is avoiding the fertile window, so you would think it would be kind of impossible to get it wrong. But what I see in today’s day and age is that many women — even though we have this kind of background increasing awareness about the menstrual cycle — we’re still operating from a rhythm method framework. And with that in mind, we’re still operating from: okay, ovulation should be happening on day 14. So regardless of how much you personally might know, the average woman out there who’s trying to conceive is often having sex on day 14 as part of her strategy to conceive. And certainly there’s nothing wrong with having sex on day 14 — have sex whenever you want — but if you’re not charting and you’re not identifying your cervical fluid, you can ovulate earlier or later, and having sex on that day can be birth control depending on when ovulation is happening.

So one thing I want to stress, and kind of start with, is the concept of the recipe for a healthy baby. When you are charting, we can get really focused on the nuts and bolts: the sperm, the egg, and the mucus. And we can really think that that’s all there is to it. But in terms of conception in the broader sense, in order to conceive, we need to have healthy eggs, we need to have healthy sperm. For natural conception, we need to have healthy cervical fluid, and then we also have to have a healthy body. So although cervical fluid is really important for conception, it’s not the only factor. And I’ve seen women with amazing mucus who are hitting all the right days and not conceiving. And I’ve seen women who have no mucus because of an issue — whether it be that she took antihistamines that cycle or whether she just came off the pill and her body is just transitioning — but I’ve seen women that have no mucus but they’re still ovulating and they go on to conceive.

So I think this is a really important point here: the timing is necessary. Obviously, you need to have sex at the right time. But when you are having sex at the right time, cycle after cycle after cycle, and it’s not happening, then there’s something more happening. That’s when we really need to be looking at his sperm quality and her overall health. And especially if you’ve been given a diagnosis of unexplained infertility, it’s time to seek care from a functional practitioner who looks deeper into the actual underlying issues that could be related.

So the basics of charting: the first day of your menstrual cycle is the first day of your period. And once your period is done, we typically have some dry days before you start to see mucus — cervical fluid — so the clear stretchy or the lotiony. Some women will have mucus right off the bat. But either way, you have your period, typically dry days before you start to see mucus, and then you see mucus in a healthy cycle two to seven days before you ovulate, and then once you ovulate, the mucus typically goes away.

So cervical fluid serves a number of really important roles for conception. One is that it tells us when to have sex. Because cervical fluid keeps sperm alive for up to five days, you don’t have to have sex on ovulation day in order to get pregnant — and I would say that’s a pretty big myth as well. So you want to time sex when you have cervical fluid as you approach ovulation. The cervical fluid literally keeps the sperm alive. It draws the sperm into your cervix, which is the base of the uterus, and holds it there for up to five days. So you can have sex on Monday one time and if you ovulate on Friday, you could get pregnant because of the sex you had that one time.

And so I think that’s really, really important just to know. Because what that means is that it’s not about having sex a thousand times. It’s not about trying to have sex on one day of the cycle. From a statistical, scientific standpoint, your fertile window is six days. Because the sperm can survive for five days, you have those five days before ovulation, and then ovulation only happens on one day in the month. And once the egg is released, if it’s not fertilized, it disintegrates within 12 to 24 hours. So for some of you that may seem stressful, because it’s not every single day. We’re all taught that you can get pregnant every day of the cycle, but it’s not. It’s just basically like a week, and that’s it. The other days you can have all the sex you want, but it doesn’t matter from a conception standpoint.

So that can be stressful because you have to time it within that week. But on the other hand, it can be just amazing — the relief that you don’t actually have to be having sex all the time in order to get pregnant. You can just figure out the window and have sex then. And so when you’re charting your cervical fluid, you may see different kinds. I mentioned the lotiony and I mentioned the clear stretchy, which is like the raw egg white. Before ovulation, both of those types are equally fertile. Not all women see a ton of the clear stretchy. I’ve had a number of clients who, as they approach the fertile window, will notice when they go to the bathroom and wipe that for a couple of days it’s really, really slippery — and that’s it. They don’t necessarily have a ton of mucus that they can pick up and stretch. So even knowing that and paying attention to the changes, even if you don’t have a lot of mucus, that is not what is going to determine whether or not you can conceive.

Ultimately, the mucus does two important things. One is timing. Mucus tells us when our follicles are developing. As the follicles develop, they make estrogen; estrogen is what triggers the cervix to make mucus. So it’s timing. And it’s also telling you when the cervix is open. You can have sex throughout your whole cycle, but it’s only during that short fertile window that the cervix is open and receptive to sperm. The rest of the time, the cervix is actually closed and blocked with a mucus plug so the sperm can’t get in at all. I use silly analogies like my bouncer-at-a-nightclub analogy. The majority of our menstrual cycles, the bouncer is out front and no sperm are getting in. But during that short window of time is when the bouncer takes a lunch break and that’s the only time when the sperm can get in.

So regardless of whether you see a little bit or a lot, regardless of whether you see the lotiony or the clear stretchy, or whether you just notice that it’s really slippery and lubricative, or you notice a feeling of wetness in your underwear before ovulation — that is when you want to have sex. And then of course the other aspect of mucus is that healthy cervical fluid plays a really important role in screening out abnormal sperm. So even the healthiest man alive, about half of the sperm is not optimal. And so our cervical fluid actually screens out sperm that is poor morphology — so not properly shaped — or poor motility, meaning that it can’t swim properly. Cervical mucus is key for a number of reasons, but again, it’s not the only factor.

So what this means is that the best advice I can give you when you’re trying to conceive is: once your period is basically done, start checking for cervical fluid. I encourage my clients to wipe when they’re going to the bathroom — before and after they pee — so that they can actually see: does it feel slippery? Are they seeing anything? You can also pay attention to what you’re seeing on your underwear. When is it changing? If you’re cycling normally, you should be able to see cervical fluid. There are certain situations that can be more challenging. If you have uncontrolled PCOS, women with uncontrolled PCOS often have long irregular cycles — 45, 50 days and that kind of thing. And in a cycle of 50 days, you still only have a six-day window. The challenge is identifying which days are fertile. Many women with PCOS will have mucus for weeks in a row, or multiple patches — see it, not see it, see it, not see it. So there are many possible days of fertility, and from the standpoint of fertility awareness, you want to consider all of those mucus days before ovulation to be potentially fertile, because they are.

You can approach that challenge two-fold. One is to understand the role of mucus and to really start paying attention to your patterns so that you can identify those potentially fertile days. And another is to take the opportunity to start making changes to really normalize that menstrual cycle. Once the cycle is normalized and you get it down to 35 days or less, you have way less of a long period of time to try. It becomes easier to identify the fertile window because you don’t have weeks and weeks of mucus or multiple mucus patches. And certainly when the cycle is down to 35 days, you have more opportunities to try per year. So that’s kind of the overview.

And now I want to talk about some of the specific myths. So certainly a lot of women who are trying to conceive, if they go to their doctor, they’re told to have sex basically every other day or have lots of sex. When you don’t understand the biology, that would make sense — have lots of sex. But in our lives, that puts a lot of pressure. There are couples that have sex every single day or multiple times a day, and it’s one thing if you want to and you’re happy to have sex. But for many of us, that’s not the greatest thing to feel pressure to do all the time. And what I’ve seen is that this advice, while seeming to be either neutral or not potentially harmful, can put a lot of pressure on couples to have sex all the time. And it’s also not accurate — because you’re not fertile all the time.

So one of the myths is that you need to have sex every day or every other day for the entire cycle, and that the more sex the better. Where is the evidence that that’s true? From the fertility awareness standpoint, if you’re charting your cycle and you start to understand when that fertile window is — and you understand that from a scientific perspective there are six days of the cycle where sex matters — then at very least what that can do for you is you can focus on those days.

And there’s something else I want to get into, which is another myth: that if you have sex multiple times a day, you’re just going to have multiple amounts of sperm. Have sex five times to get five times as much sperm — that’s a myth. The reason it’s a myth is because men make sperm every day. The fundamental difference between men and women as far as fertility goes is that men are fertile every single day because they continuously make sperm from puberty onward. And as women, we are fertile for — as I’ve said, beating the dead horse — six days per cycle. So the combined fertility is those six days. But men make sperm every day; what that means is that the process of spermatogenesis from beginning to end is approximately 74 days. So essentially about three months is how long it takes. So when your partner is ejaculating today, that is representing a measure of his health essentially three months ago. And there is a finite amount happening here, because if he ejaculates 10 times in a day, eventually the amount of sperm that is coming out is going to be less. There’s no scientific basis to the concept that having sex multiple times is going to increase the amount of sperm he has. It’s an assembly line. A certain amount of sperm is made every single day. And ejaculating multiple times is not going to cause way more sperm to be deposited. So the argument that having sex multiple times in a day when you’re trying to conceive is going to be beneficial is not scientifically sound.

Now let’s move on to another myth. One of the most common questions I get is: should I be having sex every other day, because I’ve heard that having sex every other day will help with the sperm? This actually gets into more of the biological reality. If your partner has ever been sent to have his sperm analyzed, you’ll remember that they asked him to hold off on ejaculation for anywhere from three to five days before he takes the test. The reason the thought process behind that is: since men make sperm every day and it’s an assembly line, there is essentially a finite amount, and so every day he’s making a certain amount. If he holds off on ejaculation for three to five days, you have a bit of a build-up, a higher concentration of sperm. So when he does the test, he’s getting kind of like a better measure of the optimal concentration he would have when you’re having sex. And so it stands to reason that if he ejaculated 10 times in a day, the concentration would be a lot lower the 10th time than the first time.

That is where this idea of having sex every other day comes from — because if you’re waiting a day in between, it gives the opportunity for a little bit more sperm to build up. So when I have clients ask me about this, what I like to remind them is that the whole strategy of having sex every other day is actually intended potentially for when you have a situation where your partner’s sperm quality may not be ideal. It’s a strategy if you kind of know that the sperm count or quality is a bit lower, to give you a better chance of having more in there. So your average 20-year-old man who’s trying to conceive wouldn’t necessarily need to have sex every other day. It doesn’t necessarily hurt, but it’s not something that every single couple has to do. And even that can put pressure on when the fertile window is only five days — if you have sex every other day, that’s only really two, maybe three days you can have sex on. It can become complicated.

So what I suggest for my clients is there are kind of two ways to approach this. One way is if you’ve started charting and you’ve noticed your patterns, you could have your partner hold off on ejaculation for two to three days before you see your mucus, and then have sex. That would allow for some concentration to build up a little bit. You could kind of skip a day here or there if you wanted to, but don’t be so specific about the strategy that you’re making it stressful. Ultimately the best advice is: have sex when you see cervical fluid. Certainly you can alternate a little bit, but I wouldn’t take it too far. Eventually I would just have sex on the days of mucus and call it a day. The bottom line is that it can be helpful to alternate during the fertile window, it can be helpful to wait a couple of days before you start to see your mucus — but it’s not helpful to wait more than four to five days. It is helpful for men to ejaculate fairly regularly because they’re always producing new sperm. So holding off on ejaculation for three to five days before you start to see your cervical fluid is sufficient, and we don’t need to take it further than that.

And for couples who have been trying to conceive for a long period of time, what can happen is that sex is no longer fun. It can become something you have to do even if you don’t feel like it. And especially if you’ve been told that it’s helpful to have sex multiple times — to feel like you have to do that — if you’re having sex on all the right days, you’ve been charting, you know when you’re fertile, you’re having sex in the window, and you know for more than six cycles it’s not happening, having more sex is not necessarily going to make it happen. The reason you’re not conceiving is not because you’re not having enough sex. And so that type of advice can cause couples to focus on the wrong thing, putting all their energy into this thinking it’s going to help, when perhaps what needs to happen is a deeper assessment into his health or her health or something else that’s really the actual problem.

Another myth that I’ve talked about a lot on the podcast is the ovulation predictor kit myth. I’m not anti-tech — I think that ovulation predictor kits are great and I’ve certainly worked with a number of clients where we use the OPK as part of our strategy. But the OPKs are measuring for the luteinizing hormone surge. What happens when you’re approaching ovulation is that the follicles are developing, they’re making estrogen, that estrogen causes you to make mucus, it causes the endometrial lining to thicken, and it also causes ovulation. Once the estrogen reaches a certain point, it sends a feedback message to the pituitary gland, which releases luteinizing hormone — the hormone that actually causes the ovarian follicle to rupture. And that LH surge typically happens 24 to 36 hours before ovulation. But an OPK strip is programmed to give you a result when it detects a certain level of LH. I’ve had clients who ovulated based on the cycle information — temp shift, cervical fluid dries up — but the OPK never turned positive. That means for a certain percentage of women, they’re going to be waiting for this strip to turn positive and it may not actually turn positive each cycle even if they’re ovulating. And there are other women who have elevated LH — they’re going to show a lot of positives, and it may have nothing to do with ovulation.

The other issue with OPKs is that because it turns positive after the LH surge, you may be missing out on several days of perfectly excellent cervical fluid. I’ve worked with a number of women who wait until they get the positive to have sex — so they’re not actually having sex on those mucus days leading up to the LH surge. So ultimately when you’re trying to conceive, my recommendation will always be that your mucus should be the primary sign. Have sex when you see mucus. Start to get to know your cycles. If you’re finding cycle charting to be really stressful, stop taking your temperature — work with an instructor who teaches a mucus-only method if it’s really getting stressful for you. Focus on your cervical fluid and pay attention to your cycle and your patterns and try to identify when you have mucus and let that be the sign. If you’re doing the OPKs, then have that as an additional sign — when it turns positive you know to have more sex — but certainly don’t wait until it turns positive, just in case you’re having several days of wonderful cervical fluid before it turns positive.

So those are kind of the main myths I wanted to talk about. The myth about having sex every other day all the time, or every single day, or multiple times — and that’s all going to make it better. And also the ovulation predictor kit myth that you should wait until it goes positive to have sex. Those are all based on the myth that you need to have sex on ovulation day — like the whole cycle is about timing it on that one day. So those are all myths. Conception is possible from having sex once, four days before ovulation. It’s not about having more sex or trying to have sex directly on ovulation day.

If that is the one thing you take from this episode, I hope that it is. A second point I’ve also alluded to is that if you are timing sex correctly, cycle after cycle after cycle, and it is not happening — pregnancy is not happening — you know, it’s been six cycles of you actually having sex in the window, and I don’t mean any sex, I mean sex in the actual window — then there comes a point where you have to say: it’s not because I’m timing it wrong, it’s not because we’re not having enough sex, it’s not because I’m not lying down long enough. Charting can give you that additional confidence to know that there must be something else going on. So if you’re having sex on the right days, you’re having sex when you see mucus, it’s within five days of ovulation, you’re tracking your temperature and you kind of know when it’s happening — there comes a point where you have to say, it’s time to seek that additional support.

When you’re trying to conceive and it’s not happening, it’s really beneficial to have a team approach. Of course you need your doctor, you need your fertility specialist. But you may also need a functional doctor who looks at root cause medicine. You may also need a naturopath. If you have gut-related issues, the MTHFR gene mutation, thyroid issues, PCOS, or if your partner has health issues — this is the opportunity to actually look deeper to see if there’s something else happening. So the takeaway is: if you’re timing it right and you’re not getting pregnant, it’s not because you’re not having enough sex. Simple as that. There has to be something else going on, and it would be time to seek support to see about improving those underlying factors. And particularly look at his sperm — and even if you were told that it was fine, get a second opinion. Have someone else look at it. Go to a functional doctor who specializes in male fertility and have that doctor look at the sperm as well.

And then the last thing I wanted to talk about is when charting becomes an issue. For many women who are trying to conceive, charting becomes a source of stress and emotional distress — because you have your period, and then you have your fertile window when you have all the sex, and then you have the two-week wait to see if you’re pregnant or not. And certainly taking those temperatures every day and having that repeated cycle of disappointment, if that’s been your experience and you haven’t conceived within a certain period of time, it can become really, really stressful. And so in those types of situations, it really depends on the woman and the situation. So again, it might seem strange for the fertility awareness person to be saying: if it gets too stressful, just stop charting. That’s literally what I’m saying. If it gets too stressful, you can put away the thermometer. You can modify the way you’re charting. You can either stop charting, stop writing it down for a period of time. You can give yourself a specific window of time. You could go to mucus only — stop doing temperatures and just focus on that. If it’s really stressing you out, you may have to just stop for a while. And you can stop while still paying attention to your fertile window in a general sense, because when it comes to trying to conceive, it’s really just about having sex in the window. For many of you it’s not too stressful and you like charting and it’s fine — but there’s a certain percentage of women who it gets really stressful for, and that’s okay. There are no rules here.

So as I bring this episode to a close: what we’ve talked about is a recipe for a healthy baby — to really know the role of fertility awareness in conception, to understand the role of cervical fluid and really understand just when to have sex. To take the pressure off by recognizing that the fertile window is only about six days, and giving yourself permission to enjoy the rest of your cycle with your partner without goal-oriented sex pressure. To recognize that having more sex doesn’t necessarily increase the chance of conception, and to free yourself from that. Hopefully this episode has helped, hopefully it’s encouraged you, taught you something more about the fertile window and how to manage it, taken some of the stress off when it comes to conception — knowing that you could have sex two or three times in the window and that could be fine. But also to help you identify that if you are having sex at the right time, cycle after cycle, and it’s not happening, to really start to look at what actually is the problem. Because in the vast majority of cases, the problem isn’t that you’re not having enough sex or that you need to have sex five times instead of once. Having more sex when you’re not looking at the underlying root problem isn’t necessarily going to result in what you want.

So with that said, I hope that you have a wonderful week — whenever you’re tuning into the show. If you know someone who could really benefit from today’s episode, you can share it and the link to share is fertilityfriday.com/366. And I hope that you enjoy the rest of your day, week, weekend, whenever you’re tuning in. And of course, as always, until next time: be well and happy charting.