Self-Examination of the Cervix
A woman can detect changes in the cervix by feeling gently with the fingertip. A delicate touch is all that is required to distinguish the subtle day-to-day changes.
The cervix should be examined at the same time each day, for example while washing in the morning, after emptying the bladder. The same position should be used, either standing with one leg raised (e.g. on the side of bath), or squatting. If the position is varied then the cervix will appear to be at a different level.
? The hands should be washed and dried (the fingernails should be short).
? The right index finger is gently inserted into the vagina until the cervix can be touched.
It will feel like a smooth indented ball.
The vaginal walls feel soft, moist and ridged in comparison.
? If the cervix is difficult to reach, the uterus may be pushed down by pressing on the abdomen with the left hand, just above the pubic bone.
With experience this examination should only take a few seconds.
Some women find it easier to use two fingers, the index and middle fingers to examine the very subtle changes in the cervix.
Other women find that their partner is more in tune with these changes and is so is able to be actively involved and share the responsibility. It is important that cervical observations are made in the same way, by the same person. It generally takes two or three cycles for cervical changes to be interpreted accurately.
Detection of mucus at the cervix
While checking the cervix, some cervical mucus may come away on the examining finger.
Women who have difficulty distinguishing mucus changes externally or have a very short mucus build up may find it useful to take mucus directly from the cervix in this way.
This avoids the delay in transit time from cervix to vulva and gives an earlier warning of approaching fertility.
An interval of a day or two may occur before thick, sticky mucus noted at the cervix is visible externally.
The more liquid, fertile mucus appears at the vulva within hours.
Some women find that mucus becomes trapped in the ridged vaginal walls, and it appears as a long thread on the finger.
RECOGNISING THE CHANGES IN CERVICAL MUCUS
During the menstrual cycle changes take place in the mucus produced by the cells lining the cervical canal. Cervical mucus can be recognised by sensation, by appearance and by testing with the finger-tip.
Sensation
Sensation is very important and often the most difficult to learn. Throughout the day the presence or absence of mucus will be recognised by the sensation at the vulva (the vaginal lips), the way the beginning of a period is noticed. The sensation may be a distinct feeling of dryness, of dampness or moistness, stickiness, wetness, slipperiness or lubrication.
Appearance
Soft white toilet tissue should be used to blot or wipe the vulva. There may be dampness only on the tissue resulting from vaginal moistness. This moistness soaks into the tissue and any cervical mucus will appear raised as a blob on the tissue. The colour should be noted. It may be white, creamy, opaque, or transparent (clear).
Mucus is often noticed on underclothing, where it will have dried slightly causing some alteration in its characteristics.
CHANGES IN CERVICAL MUCUS DURING THE FERTILITY CYCLE
Pre-ovulatory relatively infertile phase
Following the menstrual period there may be several dry days.
These days may be absent in short cycles and numerous in long cycles.
A feeling of dryness or a positive sensation of nothingness at the vulva will be experienced. There will be no visible mucus.
The fertile phase
As the oestrogen levels rise, cervical mucus will be felt at the vulva.
At first it will give a sensation of moistness or stickiness and will appear in scant amounts - white or creamy-coloured.
On finger testing the mucus will hold its shape and break easily.
The mucus goes through a transitional phase where increasing amounts of cloudy mucus secretion may be observed.
It may be slightly stretchy on finger testing producing a wetter sensation at the vulva.
As the oestrogen levels continue to rise with approaching ovulation, the mucus will become more profuse, and there may be up to a tenfold increase in volume.
It will give a sensation of lubrication or slipperiness at the vulva.
The appearance will be similar to that of raw egg white, thin, watery and transparent.
On finger-testing this highly fertile mucus may stretch for several inches before it breaks.
Fertile mucus maintains the life of sperm, nourishes it and allows it to pass freely through the cervix.
In fertile mucus, sperm may live for up to three days, in rare circumstances for five days or even longer.
Peak day
Peak day denotes the LAST day on which this highly fertile-type slippery, transparent, stretchy mucus is either seen or felt.
Post-ovulatory completely infertile phase
During the post-ovulatory phase, following peak day the slippery sensation is lost and there will be a relatively abrupt return to stickiness or dryness again.
This subjective symptom reflects the presence of progesterone, which thickens the mucus again forming a plug at the cervix acting as an impenetrable barrier to sperm.
The amount and quality of mucus will vary from woman to woman and also from one cycle to the next.
A woman should be alert to any changes in sensation and to even relatively small amounts of mucus.
If a woman is finding difficulty detecting mucus externally, it is often recognised more easily after exercise or a bowel movement.
It may also help to use the Kegel exercise or a slight bearing down action to expel any mucus.
GENERAL OVULATION DAYS
28 Day cycle ovulate day 12 - 15
29 Day cycle ovulate day 13 - 16
30 Day cycle ovulate day 14 ? 17
Ovulation generally occurs 14 days before the start of a new cycle
Finger Testing
A finger-tip can be lightly applied to the mucus on the tissue and then pulled gently away to test its capacity to stretch. It may feel sticky and break easily, or it may feel smoother and slippery like raw egg white and stretch between the thumb and first finger, from a little up to several inches before it breaks. This stretchiness is described as the Spinnbarkeit or Spinn effect, and shows that the mucus is highly fertile.
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