Cycle Monitoring with Your Naturopathic Doctor

Cycle monitoring can be done in various ways. This article will discuss cycle monitoring in the context of working with a naturopathic doctor. You will find there are many ways to do it, varying in price and convenience. When working with conventional Fertility Clinics, you may find cycle monitoring requires repeated visits to the clinic, and may be costly. It's nice to know there are options when doing this important assessment. One important caveat is some methods aren't as reliable as others. We will discuss below.

The objective of cycle monitoring is to determine when ovulation occurs. The ultimate goal with this information is to determine the best time for conception (through insemination or sexual intercourse). In other words, if we know WHEN a woman ovulates, we will know when she is at her most fertile. This is useful for timing conception. Certain hormonal changes as well as bodily changes may signal ovulation is happening; the following discussion will elaborate.

Basal Body Temperature (BBT)

What is BBT?

BBT is the temperature of your body is fully at rest. Ovulation may cause a slight increase in basal body temperature. The first high point in temperature occurs around 8 hours after ovulation. The temperature continues to rise in relation to progesterone and 17-hydroxyprogesterone with 24-36 hours’ delay [1].

How Do We Track Basal Body Temperature?

Tracking your basal body temperature doesn’t require any special preparation. You take your basal body temperature every morning before getting out of bed. Oral temperature or axillary temperature is sufficient. Next, you plot your temperature readings on graph paper. We look for a pattern to emerge. When you ovulate you may see a very slight increase in temperature, a modest 0.3°C or 0.5°F. You may assume you ovulate if your slightly higher temperature remains steady for three days or more.

Figure 1: An ordinary thermometer, available at a drug store, will be sufficeint to track daily temperatures.
Figure 1: An ordinary thermometer, available at a drug store, will be sufficeint to track daily temperatures.

How Do We Interpret BBT?

To interpret this, we say: ovulation occurred 2-3 days prior to the increase in temperature. This makes BBT somewhat less useful, because for the purpose of fertility treatments, we need to know BEFORE ovulation occurs.

A significant limitation of BBT is its accuracy in detecting ovulation. A lot of research shows BBT is only marginally accurate in about 45% of healthy women and even less in infertile women; about 25% [1]. In other words, if you’re undergoing fertility treatment, BBT is not a suitable way to track ovulation.

 

Figure 2: Ovulation typically occurs a few days before the increase in body temperature.
Figure 2: Ovulation typically occurs a few days before the increase in body temperature.

DUTCH Cycle Mapping (Urine Hormone Testing)

Testing reproductive hormones are very helpful. When cycle mapping through a fertility clinic, they usually assess blood levels of hormones. The Dutch Cycle Mapping test helps outline month-long patterns, through dried urine. Click here for an info sheet from the lab.

Figure 3: Precision is an American Laboratory, and Ontario Naturopaths have access to these tests.
Figure 3: Precision is an American Laboratory, and Ontario Naturopaths have access to these tests.

Which Hormones are tested on the DUTCH Cycle Mapping Test?

The monthly pattern of estrogen and progesterone metabolites. Click here for a sample report.

What’s the Difference between This Test and Blood Tests?

There are various metabolites of each hormone, notably estrogen and progesterone. It’s important to capture all types of these hormones rather than just one. Performing Urine Testing shows us a comprehensive view of these important hormones, whereas blood testing is limited to only showing one measurement.

Who can benefit from the DUTCH Cycle Mapping Test?

They’re not only helpful for women struggling with infertility; this test is often used for menstrual irregularity, those on the Mirena IUD, partial hysterectomy (ovaries intact, no uterus), PCOS, luteal phase shifts from month-to-month and perimenopause.

How is the test performed?

You purchase at testing kit from your Naturopath, and take the kit home. Each day you take a urine sample and at the end of the month, you mail the kit back to the laboratory. Results usually take 2 weeks to get back.

Figure 4: This is the test collection kit. Once samples are collected, mail the whole kit back for analysis.
Figure 4: This is the test collection kit. Once samples are collected, mail the whole kit back for analysis.

RMA Month-Long Hormone Assessment (Salivary Testing)

Testing reproductive hormones are very helpful. As mentioned above, the goal of cycle monitoring is to assess hormones throughout the month. The Rocky Mountain Analytical (RMA) Month-Long Hormone Assessment helps outline month-long patterns, through urine. Click here for an info sheet from the lab.

Figure 5: RMA is a Canadian lab, offering Naturopaths many functional tests for our patients.
Figure 5: RMA is a Canadian lab, offering Naturopaths many functional tests for our patients.

Which Hormones are tested on the RMA Month-Long Hormone Assessment

The monthly pattern of estradiol, progesterone, testosterone, DHEA-S and Cortisol. Click here for a sample report.

What’s the Difference between This Test and Blood or Urine Tests?

This test looks at more than just estrogen and progesterone. It looks at cortisol, testosterone and DHEA-S; all of which are important in certain cases. The DUTCH test mentioned above looks at estrogen and progesterone and their metabolites, whereas this done does not look at metabolites. Each is indicated in different cases. Discuss more with your naturopath to determine, if either of these tests is indicated for you.

Who can benefit from the RMA Month-Long Hormone Test?

They’re not only helpful for women struggling with infertility; this test is often used for menstrual irregularity, abnormal bleeding, lack of menses and mood swings.

How is the test performed?

You purchase at testing kit from your Naturopath, and take the kit home. Every third day you spit into a provided test tube, and by the end of the month, you will have 11 tubes. You then mail the kit back to Rocky Mountain Analytical and the doctor will be mailed the results. Results usually take 7-10 days to be reported.

Figure 6: The collection kit includes all the saliva tubes required for the month long assessment. When done, the kit can be mailed back for analysis.
Figure 6: The collection kit includes all the saliva tubes required for the month long assessment. When done, the kit can be mailed back for analysis.

References