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funciona",{"_315":316,"_298":1028,"_318":1029},"fD6-tMFMTP-TgfTjjpZUfQ","/es/how-does-natural-cycles-work",{"_298":1031,"_311":1032,"_313":1033,"_320":42,"_321":42,"_322":369},"bQgzQdJSQPGXBWznb9VqHQ","Lo que incluye",{"_315":328,"_298":1034,"_330":1035},"UfO_RiKsSH6OC5r3Nd3Qqg",{"_315":332,"_298":1036,"_311":1032,"_335":1037},"Lo8YJKUIQbWnLikb6OaN1Q",[1038,1043,1048,1053],{"_298":1039,"_318":1040,"_311":252,"_340":1041,"_342":1042},"dyrPiv0XRQCBeIKlbc02fw","/es/is-natural-cycles-right-for-me","Prevén el embarazo de forma natural",{"_41":344,"_345":346},{"_298":1044,"_318":1045,"_311":230,"_340":1046,"_342":1047},"LNZRVpudR0Wk_vUUgEFMmg","/es/plan-pregnancy","Identifica tu pico de fertilidad",{"_41":352,"_345":353},{"_298":1049,"_318":1050,"_311":357,"_340":1051,"_342":1052},"dr5QFEsfReO4O-fyiP1NLQ","/es/follow-pregnancy","Monitorea tu embarazo",{"_41":360,"_345":361},{"_298":1054,"_318":1055,"_311":232,"_340":1056,"_342":1057},"MuRXJxqhTk6IbvPEK9Y_9Q","/es/postpartum","Optimiza tu 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artículos","/es/cyclematters",[1087,1130,1145,1184],{"_298":1088,"_408":1089,"_410":1090,"_412":413,"_414":1091},"DQeY2ZEDQ6GwPppfihNWNw","Métodos anticonceptivos","Explorar más",[1092,1106,1116],{"_298":1093,"_401":1094,"_318":1095,"_420":1096,"_410":42,"_412":42},"UCiIUeJfSeWRiVl0a3uB0w","Siete métodos anticonceptivos sin estrógeno","/es/cyclematters/metodos-anticonceptivos-sin-estrogeno",{"_345":1097,"_422":1098},"illustration showing: the calendar method, condoms, mini pills, IUds, implant, injection and natural cycles",{"_424":1099,"_426":1100,"_428":1101,"_430":1102,"_432":1103,"_434":1104,"_436":1105,"_345":1097,"_438":-5},"https://www.datocms-assets.com/21281/1631280383-blogpostimage7-types-bc-without-estrogen-01-1.jpg?dpr=0.25 1323w,https://www.datocms-assets.com/21281/1631280383-blogpostimage7-types-bc-without-estrogen-01-1.jpg?dpr=0.5 2646w,https://www.datocms-assets.com/21281/1631280383-blogpostimage7-types-bc-without-estrogen-01-1.jpg?dpr=0.75 3969w,https://www.datocms-assets.com/21281/1631280383-blogpostimage7-types-bc-without-estrogen-01-1.jpg 5292w","https://www.datocms-assets.com/21281/1631280383-blogpostimage7-types-bc-without-estrogen-01-1.jpg?dpr=0.25&fm=webp 1323w,https://www.datocms-assets.com/21281/1631280383-blogpostimage7-types-bc-without-estrogen-01-1.jpg?dpr=0.5&fm=webp 2646w,https://www.datocms-assets.com/21281/1631280383-blogpostimage7-types-bc-without-estrogen-01-1.jpg?dpr=0.75&fm=webp 3969w,https://www.datocms-assets.com/21281/1631280383-blogpostimage7-types-bc-without-estrogen-01-1.jpg?fm=webp 5292w","(max-width: 5292px) 100vw, 5292px","https://www.datocms-assets.com/21281/1631280383-blogpostimage7-types-bc-without-estrogen-01-1.jpg",5292,3000,1.764,{"_298":1107,"_401":1108,"_318":1109,"_420":1110,"_410":42,"_412":42},"OCS9s_asSoiDVDHluZVE3g","¿Puedo quedar embarazada por el líquido preseminal?","/es/es/cyclematters/puedo-quedar-embarazada-por-el-liquido-preseminal",{"_345":1111,"_422":1112},"Illustration of pre-cum",{"_424":1113,"_426":1114,"_428":429,"_430":1115,"_432":433,"_434":482,"_436":483,"_345":1111,"_438":-5},"https://www.datocms-assets.com/21281/1726587370-cyclematters-what-is-pre-cum.jpg?dpr=0.25 320w,https://www.datocms-assets.com/21281/1726587370-cyclematters-what-is-pre-cum.jpg?dpr=0.5 640w,https://www.datocms-assets.com/21281/1726587370-cyclematters-what-is-pre-cum.jpg?dpr=0.75 960w,https://www.datocms-assets.com/21281/1726587370-cyclematters-what-is-pre-cum.jpg 1280w","https://www.datocms-assets.com/21281/1726587370-cyclematters-what-is-pre-cum.jpg?dpr=0.25&fm=webp 320w,https://www.datocms-assets.com/21281/1726587370-cyclematters-what-is-pre-cum.jpg?dpr=0.5&fm=webp 640w,https://www.datocms-assets.com/21281/1726587370-cyclematters-what-is-pre-cum.jpg?dpr=0.75&fm=webp 960w,https://www.datocms-assets.com/21281/1726587370-cyclematters-what-is-pre-cum.jpg?fm=webp 1280w","https://www.datocms-assets.com/21281/1726587370-cyclematters-what-is-pre-cum.jpg",{"_298":1117,"_401":1118,"_318":1119,"_420":1120,"_410":1090,"_412":1129},"KyraB6c5QCqAZAcdqLlmBw","¿Qué tan efectivo es el método de coito interrumpido?","/es/cyclematters/que-tan-efectivo-es-el-metodo-de-coito-interrumpido",{"_345":1121,"_422":1122},"'Does the pull out method work?' written next to an illustration of the crossed fingers of a woman.",{"_424":1123,"_426":1124,"_428":1125,"_430":1126,"_432":1127,"_434":1128,"_436":458,"_345":1121,"_438":-5},"https://www.datocms-assets.com/21281/1610617239-pull-out-method-effectiveness.png?dpr=0.25 480w,https://www.datocms-assets.com/21281/1610617239-pull-out-method-effectiveness.png?dpr=0.5 960w,https://www.datocms-assets.com/21281/1610617239-pull-out-method-effectiveness.png?dpr=0.75 1440w,https://www.datocms-assets.com/21281/1610617239-pull-out-method-effectiveness.png 1920w","https://www.datocms-assets.com/21281/1610617239-pull-out-method-effectiveness.png?dpr=0.25&fm=webp 480w,https://www.datocms-assets.com/21281/1610617239-pull-out-method-effectiveness.png?dpr=0.5&fm=webp 960w,https://www.datocms-assets.com/21281/1610617239-pull-out-method-effectiveness.png?dpr=0.75&fm=webp 1440w,https://www.datocms-assets.com/21281/1610617239-pull-out-method-effectiveness.png?fm=webp 1920w","(max-width: 1920px) 100vw, 1920px","https://www.datocms-assets.com/21281/1610617239-pull-out-method-effectiveness.png",1920,1080,"/es/cyclematters/birth-control",{"_298":1131,"_408":1132,"_410":1090,"_412":462,"_414":1133},"QvbSHcVkSGilGbahCGqKeA","Planifica el Embarazo",[1134],{"_298":1135,"_401":1136,"_318":1137,"_420":1138,"_410":1090,"_412":1144},"Hlr7-rcGRnW6vTP3ruESTA","Cómo concebir un niño o una niña: ¿es posible elegir el sexo de tu bebé?","/es/cyclematters/como-concebir-un-nino-o-una-nina",{"_345":1139,"_422":1140},"illustration of hand with two different coloured sperm hovering above it",{"_424":1141,"_426":1142,"_428":429,"_430":1143,"_432":433,"_434":457,"_436":458,"_345":1139,"_438":-5},"https://www.datocms-assets.com/21281/1644418674-blogpost_image-shettles_method.png?dpr=0.25 320w,https://www.datocms-assets.com/21281/1644418674-blogpost_image-shettles_method.png?dpr=0.5 640w,https://www.datocms-assets.com/21281/1644418674-blogpost_image-shettles_method.png?dpr=0.75 960w,https://www.datocms-assets.com/21281/1644418674-blogpost_image-shettles_method.png 1280w","https://www.datocms-assets.com/21281/1644418674-blogpost_image-shettles_method.png?dpr=0.25&fm=webp 320w,https://www.datocms-assets.com/21281/1644418674-blogpost_image-shettles_method.png?dpr=0.5&fm=webp 640w,https://www.datocms-assets.com/21281/1644418674-blogpost_image-shettles_method.png?dpr=0.75&fm=webp 960w,https://www.datocms-assets.com/21281/1644418674-blogpost_image-shettles_method.png?fm=webp 1280w","https://www.datocms-assets.com/21281/1644418674-blogpost_image-shettles_method.png","/es/cyclematters/planifica-el-embarazo",{"_298":1146,"_408":1147,"_410":1090,"_412":1148,"_414":1149},"dJXrzr2DT_KFV99EHsaYag","Período y Sangrado","/es/cyclematters/periodo-sangrado",[1150,1164,1174],{"_298":1151,"_401":1152,"_318":1153,"_420":1154,"_410":42,"_412":42},"TC_tHTWxRNyXlpp305RD-A","¿Qué es el sangrado por deprivación?","/es/cyclematters/que-es-el-sangrado-por-deprivacion",{"_345":1155,"_422":1156},"Withdrawal bleeding illustration",{"_424":1157,"_426":1158,"_428":1159,"_430":1160,"_432":1161,"_434":1162,"_436":1163,"_345":1155,"_438":-5},"https://www.datocms-assets.com/21281/1597395319-blogpostimagewithdrawalbleeding.png?dpr=0.25 350w,https://www.datocms-assets.com/21281/1597395319-blogpostimagewithdrawalbleeding.png?dpr=0.5 700w,https://www.datocms-assets.com/21281/1597395319-blogpostimagewithdrawalbleeding.png?dpr=0.75 1050w,https://www.datocms-assets.com/21281/1597395319-blogpostimagewithdrawalbleeding.png 1400w","https://www.datocms-assets.com/21281/1597395319-blogpostimagewithdrawalbleeding.png?dpr=0.25&fm=webp 350w,https://www.datocms-assets.com/21281/1597395319-blogpostimagewithdrawalbleeding.png?dpr=0.5&fm=webp 700w,https://www.datocms-assets.com/21281/1597395319-blogpostimagewithdrawalbleeding.png?dpr=0.75&fm=webp 1050w,https://www.datocms-assets.com/21281/1597395319-blogpostimagewithdrawalbleeding.png?fm=webp 1400w","(max-width: 1400px) 100vw, 1400px","https://www.datocms-assets.com/21281/1597395319-blogpostimagewithdrawalbleeding.png",1400,914,1.5317286652078774,{"_298":1165,"_401":1166,"_318":1167,"_420":1168,"_410":42,"_412":42},"VRCbTg9eSWaqkQrbPmNkig","¿Qué significan los colores de la sangre de mi periodo?","/es/cyclematters/que-significan-los-colores-de-la-sangre-de-mi-periodo",{"_345":1169,"_422":1170},"Menstrual cup in a white sink with blood",{"_424":1171,"_426":1172,"_428":429,"_430":1173,"_432":433,"_434":482,"_436":483,"_345":1169,"_438":-5},"https://www.datocms-assets.com/21281/1707390971-period-color-1.jpg?dpr=0.25 320w,https://www.datocms-assets.com/21281/1707390971-period-color-1.jpg?dpr=0.5 640w,https://www.datocms-assets.com/21281/1707390971-period-color-1.jpg?dpr=0.75 960w,https://www.datocms-assets.com/21281/1707390971-period-color-1.jpg 1280w","https://www.datocms-assets.com/21281/1707390971-period-color-1.jpg?dpr=0.25&fm=webp 320w,https://www.datocms-assets.com/21281/1707390971-period-color-1.jpg?dpr=0.5&fm=webp 640w,https://www.datocms-assets.com/21281/1707390971-period-color-1.jpg?dpr=0.75&fm=webp 960w,https://www.datocms-assets.com/21281/1707390971-period-color-1.jpg?fm=webp 1280w","https://www.datocms-assets.com/21281/1707390971-period-color-1.jpg",{"_298":1175,"_401":1176,"_318":1177,"_420":1178,"_410":1090,"_412":1148},"T6QXTWDPSU-JY5iwKKZmoQ","11 indicios de que falta poco para tu 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640w,https://www.datocms-assets.com/21281/1726657575-cyclematters-signs-your-period-is-coming.png?dpr=0.75&fm=webp 960w,https://www.datocms-assets.com/21281/1726657575-cyclematters-signs-your-period-is-coming.png?fm=webp 1280w","https://www.datocms-assets.com/21281/1726657575-cyclematters-signs-your-period-is-coming.png",{"_298":1185,"_408":1186,"_410":1090,"_412":1187,"_414":1188},"Phz0UyVbTimqaR74Qutnnw","Salud Reproductiva","/es/cyclematters/salud-reproductiva",[1189,1195,1205],{"_298":1190,"_401":1191,"_318":1192,"_420":1193,"_410":42,"_412":42},"W4c7FX_rQVeuqcDMmpCiJw","Los 5 datos que deberías saber acerca de los labios vaginales","/es/cyclematters/que-son-los-labios-vaginales",{"_345":920,"_422":1194},{"_424":922,"_426":923,"_428":429,"_430":924,"_432":433,"_434":457,"_436":458,"_345":920,"_438":-5},{"_298":1196,"_401":1197,"_318":1198,"_420":1199,"_410":42,"_412":42},"b4onghwYQVCy_4DF3S35YQ","5 datos que deberías saber sobre el clítoris","/es/cyclematters/5-datos-que-deberias-saber-sobre-el-clitoris",{"_345":1200,"_422":1201},"Clitoris illustration showing both the internal and external parts sparkling",{"_424":1202,"_426":1203,"_428":1159,"_430":1204,"_432":1161,"_434":1162,"_436":1163,"_345":1200,"_438":-5},"https://www.datocms-assets.com/21281/1614169017-clitoris.jpg?dpr=0.25 350w,https://www.datocms-assets.com/21281/1614169017-clitoris.jpg?dpr=0.5 700w,https://www.datocms-assets.com/21281/1614169017-clitoris.jpg?dpr=0.75 1050w,https://www.datocms-assets.com/21281/1614169017-clitoris.jpg 1400w","https://www.datocms-assets.com/21281/1614169017-clitoris.jpg?dpr=0.25&fm=webp 350w,https://www.datocms-assets.com/21281/1614169017-clitoris.jpg?dpr=0.5&fm=webp 700w,https://www.datocms-assets.com/21281/1614169017-clitoris.jpg?dpr=0.75&fm=webp 1050w,https://www.datocms-assets.com/21281/1614169017-clitoris.jpg?fm=webp 1400w","https://www.datocms-assets.com/21281/1614169017-clitoris.jpg",{"_298":1206,"_401":1207,"_318":1208,"_420":1209,"_410":1090,"_412":1187},"En28Ja-aQt-lx6YXDec7fA","5 datos sobre el óvulo femenino","/es/cyclematters/5-datos-sobre-el-ovulo-femenino",{"_345":1210,"_422":1211},"Red female egg cell on a pink background with the text 'the egg cell survives up to 24h'",{"_424":1212,"_426":1213,"_428":1159,"_430":1214,"_432":1161,"_434":1162,"_436":1163,"_345":1210,"_438":-5},"https://www.datocms-assets.com/21281/1583245433-bea3dd15-blogpostegg24hour.jpg?dpr=0.25 350w,https://www.datocms-assets.com/21281/1583245433-bea3dd15-blogpostegg24hour.jpg?dpr=0.5 700w,https://www.datocms-assets.com/21281/1583245433-bea3dd15-blogpostegg24hour.jpg?dpr=0.75 1050w,https://www.datocms-assets.com/21281/1583245433-bea3dd15-blogpostegg24hour.jpg 1400w","https://www.datocms-assets.com/21281/1583245433-bea3dd15-blogpostegg24hour.jpg?dpr=0.25&fm=webp 350w,https://www.datocms-assets.com/21281/1583245433-bea3dd15-blogpostegg24hour.jpg?dpr=0.5&fm=webp 700w,https://www.datocms-assets.com/21281/1583245433-bea3dd15-blogpostegg24hour.jpg?dpr=0.75&fm=webp 1050w,https://www.datocms-assets.com/21281/1583245433-bea3dd15-blogpostegg24hour.jpg?fm=webp 1400w","https://www.datocms-assets.com/21281/1583245433-bea3dd15-blogpostegg24hour.jpg","Nuestro blog de salud femenina",{"_401":1084,"_41":1085},{"_298":1218,"_311":1219,"_313":1220,"_320":42,"_321":42,"_322":605},"Ul24I2rDS_2oIzguRcoTuw","Gestiona tu cuenta",{"_315":602,"_298":1221,"_318":1222},"NfysGA2VTRKirc2mME8RbA","https://signup.naturalcycles.com/es-US/account/login",{"_298":1224,"_311":250,"_313":1225,"_320":42,"_321":611,"_322":612},"Rzee-Xm9S2efkEpWQaRARw",{"_315":602,"_298":1226,"_318":610},"Xo5I4C06RWm1V_qWhnWIrg",{"_43":1228,"_304":1229},"fr_FR",[],{"_43":1231,"_304":1232},"it_IT",[],{"_43":1234,"_304":1235},"pt_BR",[1236,1242,1270,1276,1282,1288,1367,1373],{"_298":1237,"_311":1238,"_313":1239,"_320":42,"_321":42,"_322":323},"V32bkvaxTdaB1nzz4SAxJA","Como funciona",{"_315":316,"_298":1240,"_318":1241},"Mm7eW14dRdyIxKbHlLGYPw","/pt-br/how-does-natural-cycles-work",{"_298":1243,"_311":1244,"_313":1245,"_320":42,"_321":42,"_322":369},"MW-nkfZ7QRelFiFBtCvXxQ","O que está 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960w,https://www.datocms-assets.com/21281/1726657524-cyclematters-pregnant-on-your-period.jpg?fm=webp 1280w","https://www.datocms-assets.com/21281/1726657524-cyclematters-pregnant-on-your-period.jpg",{"_298":1493,"_408":1494,"_410":1445,"_412":1495,"_414":1496},"HLAOgCvcTP-0rpUIYqvp-g","Reproduktiv hälsa","/sv/cyclematters/reproductive-health",[1497,1504,1514],{"_298":1498,"_401":1499,"_318":1500,"_420":1501,"_410":42,"_412":42},"ONR6T49cQhSnL_DJH59ikg","Klitoris: Var sitter den, diagram & anatomi förklarad","/sv/cyclematters/var-ar-klitoris",{"_345":1502,"_422":1503},"Clitoris",{"_424":1202,"_426":1203,"_428":1159,"_430":1204,"_432":1161,"_434":1162,"_436":1163,"_345":1502,"_438":-5},{"_298":1505,"_401":1506,"_318":1507,"_420":1508,"_410":42,"_412":42},"EtFwWqAfQ6K_IaULcGaR9Q","Ägglossning och temperatur: hitta din fertilitet","/sv/cyclematters/agglossning-och-temperatur-hitta-din-fertilitet",{"_345":1509,"_422":1510},"Illustration of person holding thermometer against a temperature 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Weeks pregnant: Baby development, symptoms and signs","slug","4-weeks-pregnant","noIndex",false,"date","2025-07-22","createdAt","2025-07-22T15:58:59+01:00","excerpt","

At 4 weeks pregnant, you’ve just discovered you’re expecting! Whether your pregnancy was long-awaited or came as a surprise, you’re processing life-changing news and gearing up for a profound journey ahead. This moment can be thrilling, surreal, and a little overwhelming — but remember that everything you’re feeling is normal. This is the very start of your first trimester, and even though your pregnancy is still in its earliest stages, your body is already working hard behind the scenes to support new life.

","summary","

Key takeaways:

At 4 weeks pregnant, you’ve likely just received a positive pregnancy test.
At this stage, your little one is transforming from a ball of cells to an embryo, and other key structures of your pregnancy are beginning to form
Thanks to a cascade of hormonal shifts, you may start experiencing early pregnancy symptoms — though it’s possible you don’t feel any symptoms at all (yet)
It’s a good time to calculate your due date, schedule a prenatal appointment, and make any necessary lifestyle changes to support early pregnancy
At 4 weeks pregnant, focus on rest, nutrition, and emotional self-care as you ease into this exciting new chapter

","content","

Your body at week 4

Now that you’ve received a positive pregnancy test, it means that implantation has occurred: your fertilized egg has successfully attached itself to the lining of your uterus, where it will grow and develop for the next eight months. This microscopic chain of events marks the official start of your pregnancy, and sets off a cascade of hormonal shifts.

Among these is the production of human chorionic gonadotropin (hCG), which is the hormone at-home pregnancy tests detect. These rising hCG levels are responsible for the early pregnancy symptoms you may be feeling. However, it’s normal not to experience any symptoms just yet [1,2, 3].

Understanding the timing of pregnancy

When you hear “4 weeks pregnant,” you may be confused — which is totally normal. This is because the timing of your pregnancy is measured according to your menstrual cycle, rather than the date of conception.

Specifically, your pregnancy is calculated from the first day of your last menstrual period (LMP) [4]. This means by the time you receive a positive pregnancy test, you're already considered about 4 weeks pregnant, even though the fertilized egg likely implanted in your uterus just a few days ago.

In other words, your pregnancy is just beginning on a biological level, but medically, you're already one month in. Consider it two “bonus” weeks on the journey ahead: 4 down, 36 to go!

Pregnancy symptoms at week 4

At week 4, a wave of hormonal changes can bring on early pregnancy symptoms. However, it’s also perfectly normal if you're not experiencing any symptoms at all.

Fatigue
Feeling unusually tired, sluggish, or drained? You’re not alone — growing a human is nothing short of exhausting. Fatigue is one of the most common symptoms of early pregnancy, and at 4 weeks, you might feel like you can’t get through the day without a nap (or two). This heavy, worn-down feeling is a result of shifts in your hormones, including a rise in progesterone levels.

In addition, your body is producing more blood to support your pregnancy, which can lead to lower blood pressure and decreased energy. If you’re feeling wiped out, listen to your body and give yourself the rest you need [5, 6].

Nausea or vomiting
An upset stomach is a hallmark symptom of the first trimester — 70% of pregnant people experience it!— and for some, that first wave of nausea is what makes their pregnancy feel “real” [7]. Nausea and vomiting during pregnancy are referred to as morning sickness, though the term is a misnomer, and these symptoms can occur at any time of day.

At 4 weeks pregnant, you may find yourself feeling queasy, nauseated, and sick to your stomach, which may lead to vomiting. However, if these symptoms become more severe (i.e. you cannot keep food down), it’s important to speak to your doctor. This could indicate a rare condition called hyperemesis gravidarum (HG) [6, 8].

Mood swings
If you’re feeling more emotional than usual — teary one moment, frustrated the next, or just not quite yourself — it’s because mood swings are common in early pregnancy. Part of this emotional whirlwind stems from the fact that you’re processing such a massive life change, but your brain chemistry is at play here, too. Remember those shifting hormones? These fluctuations have an effect on the neurotransmitters in your brain, which are responsible for regulating your mood.

It’s completely normal to experience emotional highs, lows, and everything in between. Remember to be gentle with yourself, and lean on loved ones or professionals for support [9, 10].

Cramping and light bleeding
Even though you’ve said goodbye to your period for the next nine months, you may get a visit from a common PMS symptom.This pain is typically mild or moderate, and some describe a tingling, prickling, and pulling sensation that’s different from the dull pain of menstrual cramps. Implantation cramping may be accompanied by light bleeding, referred to as implantation bleeding [11]. It's important to note that there is currently no strong scientific evidence for this phenomenon. Implantation bleeding is thought to be caused by the fertilized egg cell coming into contact with blood cells in the uterus lining as it implants into the uterine wall. [12].

If you are experiencing bleeding, it’s important to speak with your doctor or midwife to eliminate causes for concern. Learn more about early pregnancy bleeding.

Your baby’s development at week 4

At week 4 of pregnancy, you may not feel much — but incredible changes are already happening within. From your recently developed embryo to the start of a totally new organ, incredible things are happening inside your uterus.

Your baby’s size at week 4

At this point in your pregnancy, the embryo is roughly the size of a poppy seed (0.078 inches, or 1-1.98 mm, long) and doesn’t weigh anything yet. But don’t be fooled by its tininess. It’s growing and developing at high speed [13].

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Important terminology at week 4 of pregnancy

There’s so much going on inside your body, and you may feel like you’ve encountered a whole new world of language at the same time. We’ve broken down some of the common terms that are important to understand at this point in the journey, and how they relate to your pregnancy.

Implantation
At 4 weeks pregnant, your body has completed the process of implantation. This means the fertilized egg has successfully made its way through the fallopian tube and attached to the lining of your uterus [3]. Technical terms aside, this is an important hurdle in the conception journey and a crucial first step to growing your little one.

Blastocyst
This is a monumental week in your baby’s early development. However, the more accurate description of your little one would not be a baby, but a ball of cells, called a blastocyst [14]. At this stage of pregnancy, the cells of the blastocyst divide, develop, and transform into the building blocks of new life [15].

Embryo
From the inner cells of the blastocyst, the embryo is formed. This is the tiny structure that will eventually be your baby. By week 9 of pregnancy, the embryo becomes a fetus [15], but for now, your embryo is made up of three cell layers that form the beginnings of your baby’s body [16]. The innermost layer develops into their lungs and stomach, while the middle layer becomes their heart, muscles, and bones. The outer layer is what forms the brain and the structures in their eyes, teeth, skin, and nails [16].

Placenta & amniotic sac
In addition to the embryo itself, your body is developing key structures to protect and nourish it.

Remember that ball of cells, known as a blastocyst? The outer cells of the blastocyst begin forming what will become the placenta. This is responsible for nourishing your baby throughout pregnancy [16]. This organ — yes, your body grows a whole new organ — will supply your baby with the oxygen, nutrients, and hormones it needs to thrive [3].

Another key structure in your pregnancy is the amniotic sac, which forms around the embryo during this time. Filled with liquid (known as amniotic fluid), this structure protects your baby and helps regulate their temperature. In other words, it keeps your little one safe and warm [17].

4 weeks pregnant checklist

Calculate your due date: “When is my baby due?” is often the first question people ask after receiving a positive pregnancy test. At four weeks pregnant, you can calculate your due date by counting 40 weeks from the first day of your last menstrual period [4]. If you’re unsure of that date or have irregular cycles, don’t worry. Your provider will likely use an early ultrasound to confirm the timeline.

Keep in mind that this date is only an estimate, and very few babies arrive exactly on their estimated due date. If you’ve been using Natural Cycles to plan your pregnancy, the app will automatically calculate your due date (along with many other features in NC° Follow Pregnancy). Keep in mind, this might look a little different than the due date provided by a healthcare professional, as this is based on the ovulation date.

Schedule your prenatal appointment: Now is the perfect time to call and schedule your first appointment with your preferred OB-GYN or midwife. This will take place around 8 weeks of pregnancy, though the timing of your first visit may vary based on your medical history or your medical condition [18]. This first appointment is often longer and more in-depth (as compared to routine visits later in pregnancy), and may include a physical exam and a review of your medical history, any medications you're taking, and lab work. It’s also a great opportunity to ask questions, talk about your lifestyle or symptoms, and get clear on what to expect in the weeks ahead.

Follow pregnancy-safe guidelines
Now that you’re officially expecting, it’s important to create a healthy environment for your early pregnancy. This means avoiding foods and substances that are considered pregnancy-unsafe (such as unpasteurized cheese and high-mercury fish, or pesticides and fertilizer); and making lifestyle changes as necessary (such as cutting out alcohol and smoking). It’s also best to speak with your doctor about any over-the-counter and prescription medications you’re taking. Adhering to these best practices helps support both your health and your baby’s development. [19].

Tips for 4 weeks pregnant

At 4 weeks pregnant, you’re stepping into a brand-new chapter—and your body is rising to the occasion. This week is all about grounding yourself, taking care of your body, and learning more about the changes to come. Here are some small but meaningful ways to support your health and well-being:

Eat nutritious foods — and smaller meals if necessary: Now that you’re officially expecting, nourishing your body becomes even more important. Prioritize nutrient-dense foods like whole grains and lean proteins, along with foods that are high in vitamins like folate and iron (such as leafy greens) [20, 21]. If you’re feeling nauseous, try eating smaller, more frequent meals made up of simple, starchy foods — such as bread, rice, or crackers — which can be easier on your stomach [22]. Learn more about what to eat when pregnant.
Continue taking your prenatal vitamins. It’s recommended that you begin taking prenatal vitamins before you start trying for a baby. Continue taking your vitamins as directed by your doctor, and if you haven’t started, now is the time to start. Learn how to choose the right prenatal vitamin for you [20].
Prioritize rest & relaxation: Your body is working overtime, so it’s important to give yourself permission to slow down. This could mean going to bed earlier, carving out time for an afternoon nap, or simply saying no to commitments that drain you. Mental rest is important, too. Finding ways to calm your mind (whether journaling, meditation, or prenatal yoga) can help ease anxious thoughts and create space for emotional grounding.

Following your pregnancy with Natural Cycles

Natural Cycles is the first app of its kind to be FDA Cleared for use as contraception but did you know you can also use the app for more than just birth control?Natural Cycles can be used throughout pregnancy and postpartum, too. NC° Follow Pregnancy provides prenatal guidance, comprehensive tracking, and seamless support for your pregnancy. You can access weekly guides like this one, monitor your symptoms, your baby’s movement, and more. Wherever you are in your journey, find out how Natural Cycles can work for you.

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As a new mom herself, she is passionate about empowering women with knowledge as they navigate this life transition. \n\n","avatar",{"_41":1900,"_422":1901,"_345":1907},"https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg",{"_424":1902,"_426":1903,"_428":1904,"_430":1905,"_432":1906,"_434":1906,"_436":1759,"_345":1907,"_438":-5},"https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=0.5&h=100&w=100 50w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=0.75&h=100&w=100 75w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?h=100&w=100 100w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=1.5&h=100&w=100 150w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=2&h=100&w=100 200w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=3&h=100&w=100 300w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=4&h=100&w=100 400w","https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=0.5&fm=webp&h=100&w=100 50w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=0.75&fm=webp&h=100&w=100 75w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?fm=webp&h=100&w=100 100w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=1.5&fm=webp&h=100&w=100 150w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=2&fm=webp&h=100&w=100 200w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=3&fm=webp&h=100&w=100 300w,https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?dpr=4&fm=webp&h=100&w=100 400w","(max-width: 100px) 100vw, 100px","https://www.datocms-assets.com/21281/1746198437-vbw-headshot-2.jpg?h=100&w=100",100,"Blair West headshot","factChecked","Fact checked by","reviewer",{"_39":1912,"_1896":1913,"_1898":1914},"Dr. Erica Brondolin PhD","Dr. Erica Brondolin obtained her PhD in particle physics from the Technical University of Vienna. Following a decade-long tenure at CERN, she transitioned to her current position as a Data Scientist at Natural Cycles. Dedicated to women's health, Erica specializes in women’s reproductive health research within her role at Natural Cycles.",{"_41":1915,"_422":1916,"_345":1922},"https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png",{"_424":1917,"_426":1918,"_428":1904,"_430":1919,"_432":1906,"_434":1920,"_436":1921,"_345":1922,"_438":-5},"https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=0.5&h=100&w=100 50w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=0.75&h=100&w=100 75w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?h=100&w=100 100w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=1.5&h=100&w=100 150w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=2&h=100&w=100 200w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=3&h=100&w=100 300w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=4&h=100&w=100 400w","https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=0.5&fm=webp&h=100&w=100 50w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=0.75&fm=webp&h=100&w=100 75w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?fm=webp&h=100&w=100 100w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=1.5&fm=webp&h=100&w=100 150w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=2&fm=webp&h=100&w=100 200w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=3&fm=webp&h=100&w=100 300w,https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?dpr=4&fm=webp&h=100&w=100 400w","https://www.datocms-assets.com/21281/1713776033-screenshot-2024-04-22-at-09-53-43.png?h=100&w=100",98,1.016,"Dr. Erica Brandolin headshot","positionOfReviewer","Scientist at Natural Cycles","editorialProtocols",{"_438":1927,"_1707":1928}," Follows NC° Editorial Policy","

At Natural Cycles, our mission is to empower you with the knowledge you need to take charge of your health. At Cycle Matters, we create fact-checked, expert-written content that tackles these topics in a compassionate and accessible way. Read more...

","references",{"_438":1931,"_1707":1932},"References","

Knowing if you are pregnant | Office on Women’s Health [Internet]. 2025 [cited 2025 Jun 21]. Available from: https://womenshealth.gov/pregnancy/you-get-pregnant/knowing-if-you-are-pregnant
Villines Z. Early pregnancy symptoms by days past ovulation (DPO) [Internet]. 2025. [cited 2025 Jun 21]. Available from: https://www.medicalnewstoday.com/articles/322723#7-10-dpo
How your fetus grows during pregnancy [Internet]. ACOG. 2025 [cited 2025 Jun 21]. Available from: https://www.acog.org/womens-health/faqs/how-your-fetus-grows-during-pregnancy
Calculating a due date [Internet]. Johns Hopkins Medicine. 2024 [cited 2025 Jun 21]. Available from: https://www.hopkinsmedicine.org/health/wellness-and-prevention/calculating-a-due-date
Sanghavi M, and Rutherford JD. Cardiovascular physiology of pregnancy. Circulation. 2014. Available from: https://doi.org/10.1161/circulationaha.114.009029
Signs and symptoms of pregnancy [Internet]. nhs.uk. 2024 [cited 2025 Jun 21]. Available from: https://www.nhs.uk/pregnancy/trying-for-a-baby/signs-and-symptoms-of-pregnancy/
Einarson TR, Piwko C, and Koren G. Quantifying the global rates of nausea and vomiting of pregnancy: a meta analysis. Journal of Population Therapeutics and Clinical Pharmacology = Journal de la Therapeutique des Populations et de la Pharmacologie Clinique. 2013;20(2):e171-83. Available from: https://europepmc.org/article/med/23863575
Severe vomiting in pregnancy [Internet]. nhs.uk. 2024 [cited 2025 Jun 21]. Available from: https://www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting/
Early signs of pregnancy[Internet]. American Pregnancy Association. 2025 [cited 2025 Jun 21]. Available from: https://americanpregnancy.org/pregnancy-symptoms/early-signs-of-pregnancy/
Mood swings during pregnancy [Internet]. American Pregnancy Association. 2021 [cited 2025 Jun 21]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/mood-swings-during-pregnancy/
Stomach pain in pregnancy [Internet]. nhs.uk. 2024 [cited 2025 Jun 21]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/stomach-pain/
Hasan R, Baird DD, Herring AH, Olshan AF, Funk MLJ, Hartmann KE. Patterns and predictors of vaginal bleeding in the first trimester of pregnancy. Annals of Epidemiology . 2010 Jun 9;20(7):524–31. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2884141/
4 Weeks Pregnant [Internet]. American Pregnancy Association. 2023 [cited 2025 Jun 21]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/4-weeks-pregnant/
How does pregnancy happen? | Pregnancy symptoms & signs [Internet]. Planned Parenthood. 2025 [cited 2025 Jun 21]. Available from: https://www.plannedparenthood.org/learn/pregnancy/how-pregnancy-happens
Brogaard K. The stages of embryo development [Internet]. Path Fertility. 2024. Available from: https://pathfertility.com/the-stages-of-embryo-development/
0 to 8 weeks pregnant [Internet]. HSE.ie. 2022 [cited 2025 Jun 21]. Available from: https://www2.hse.ie/pregnancy-birth/baby-development-pregnancy-stages/stages/0-8-weeks/
Jessian L. Muñoz. Stages of Fetal Development [Internet]. 2024 [cited Jun 2025]. Available from: https://www.msdmanuals.com/home/women-s-health-issues/normal-pregnancy/stages-of-fetal-development
What happens during prenatal visits? [Internet] NIH. 2017. Available from: https://www.nichd.nih.gov/health/topics/preconceptioncare/conditioninfo/prenatal-visits
Medicines in pregnancy [Internet]. nhs.uk. 2025 [cited 2025 Jun 21]. Available from: https://www.nhs.uk/pregnancy/keeping-well/medicines/
Vitamins, supplements and nutrition in pregnancy [Internet]. nhs.uk. 2025 [cited 2025 Jun 21]. Available from: https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/
Have a healthy diet in pregnancy [Internet]. nhs.uk. 2024 [cited 2025 Jun 21]. Available from: https://www.nhs.uk/pregnancy/keeping-well/have-a-healthy-diet/
Vomiting and morning sickness [Internet]. nhs.uk. 2025 [cited 2025 Jun 21]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vomiting-and-morning-sickness/

",{"_298":1934,"_438":1935,"_1695":1936,"_1697":1698,"_1699":1937,"_1701":1938,"_1703":1939,"_1705":1940,"_1707":1941,"_1709":-5,"_1710":1942,"_408":1976,"_410":1978,"_1810":1979,"_1880":2022,"_342":2023,"_1891":1892,"_1893":2029,"_1908":1909,"_1910":2039,"_1923":1924,"_1925":2051,"_1929":2052},"3367778","Non hormonal birth control methods: Effectiveness rates & how to choose","non-hormonal-birth-control-methods","2025-07-16","2020-03-03T15:23:21+00:00","

Are you considering your contraceptive options? If so, non-hormonal birth control is worth exploring. In this article, we’ve compiled a list of 11 non-hormonal contraception options, including natural birth control methods, to help you see all of your options in one place. You’ll find details about how each non-hormonal birth control works, their effectiveness, and the pros and cons so that you can have an informed conversation with your healthcare provider about what’s best for you.

","

Key takeaways

Non-hormonal birth control is a good option for those who want to avoid hormonal birth control methods (whether that’s due to side effects, risks, or any other reason)
Non-hormonal methods include natural birth control, barrier methods, long-term birth control procedures, and more
Consider factors like cost, side effects, protection against STIs, and future family plans when making your contraceptive choice with your healthcare professional

","

Hormonal vs non-hormonal birth control

When it comes to choosing contraception, there’s no “one-size-fits-all” option. The birth control method that you decide on will depend on many factors and circumstances, like current lifestyle, future goals, relationship status, and more. These may change over time as well.

Some people opt for hormonal birth control if they’re looking for certain benefits like lighter periods, acne control, and less intense period cramps. But not everyone responds to hormonal birth control in this way, and there are some less desirable side effects of hormonal birth control as well, such as increased risk of blood clots and high blood pressure. Some types of hormonal contraception also may not work for you based on your habits and schedule. For example, if you don’t want to remember to take the pill every day, or if you need protection against sexually transmitted infections (STIs), hormonal birth control may not be suited to your lifestyle [1].

If you’d like to factor in these preferences and work with the natural hormonal cycle of your body, a non-hormonal birth control method might be a better option for you.

“Perfect” vs. “typical” birth control use

Before we dive into the details of the list, let’s go over one key difference to consider when looking at non-hormonal birth control: effectiveness with “perfect” and “typical” use. No birth control is 100% effective at preventing pregnancy (except abstinence), but some methods are more effective than others [2].

For example, the birth control pill is 93% effective at preventing pregnancy with typical use, and 99% effective with perfect use. “Typical use” reflects how the method is used in real life, e.g. forgetting to take the pill occasionally or taking it at the wrong time.. “Perfect use” means that the contraception is used as intended every single time. Back to our example, this means that 7 out of 100 women will experience an unintended pregnancy within one year of using the pill as contraception with typical use. This is an important factor to know while exploring your birth control choices [2].

$\"comparison$

Non-hormonal birth control options

Below, we’ve curated a list of 11 common non-hormonal birth control options and their uses and effectiveness, along with some pros and cons. We’ll start with natural birth control methods, move on to barrier birth control, explore long-term non-hormonal contraceptives, and end with a few alternative contraceptive methods. We hope this can help you have informed discussions with your healthcare professional..

Natural birth control methods

1. Natural Cycles

Natural Cycles is the first FDA Cleared birth control app in the United States. NC° Birth Control uses your basal body temperature, menstrual cycle data, and optional ovulation tests to predict your fertile window, similar to some fertility awareness methods (FAMs). You can choose to measure temperature with a basal thermometer or opt for one of our integrated wearables — Oura Ring or Apple Watch.

Unlike traditional FAMs and other tracking apps, Natural Cycles uses an algorithm that learns the pattern of your cycle and does the calculations for you. The algorithm will show you your daily fertility status in the form of either a “Red Day” or a “Green Day.” On green days, you’re not fertile and can have sex without protection. On red days, there’s a risk that you’re fertile and you’ll need to either use condoms or abstain from penetrative sex to prevent pregnancy. Since this method works with the natural processes of your body, it means that this birth control method is 100% hormone-free.

Natural Cycles is available online with an annual or monthly subscription. You can order it online or buy NC° Birth Control in select pharmacies.

Pros of Natural Cycles:

Order online
Non-invasive
No side effects
Less daily work than traditional FAMs

Cons of Natural Cycles:

Doesn’t protect against STIs
Must be 18+ to use

Perfect use: 98% effective [3]

Typical use: 93% effective [3]

2. Calendar methods

Calendar methods are a broad category that includes a range of natural family planning techniques, including Standard Days, the rhythm method, cervical mucus method, and body temperature measurement methods. All calendar methods rely on getting to know your fertility indicators, or by counting days to determine your own fertile window when you’re likely to conceive [4].

One of the main reasons people choose to use these methods is because they offer a natural way to prevent pregnancy. They don’t involve invasive procedures, using barrier methods, creams, or putting anything else in or on your body. However, they do require daily dedication and knowledge, and they require you to practice the method for at least three months before it can be relied on as natural birth control [4].

Pros of fertility awareness methods:

No prescription needed
Non-invasive
No side effects
Typically low or no cost

Cons of fertility awareness methods:

3-6 month monitoring period before it can be used for contraception
Requires dedication and daily work
Is subject to human error (e.g. counting cycle days incorrectly)
Does not protect against STIs

Perfect use: 95% effective (Standard Days) [5]

Typical use: 88% effective (Standard Days) [5]

Barrier methods

3. Male condom

The most common type of condom is the male condom, also known as the external condom. It’s worn on the penis during sex and works to prevent pregnancy by collecting semen and acting as a barrier between the penis and the vagina. This stops sperm cells from meeting an egg cell, thus preventing conception and pregnancy. This method also helps stop the spread of certain STIs by preventing sexual skin-to-skin contact and swapping of fluids. Condoms can be used on their own or with another birth control method to add another layer of protection [6].

This male birth control option is pretty easy to obtain — you don’t need a prescription, and you can buy condoms in most supermarkets, drug stores, pharmacies, and more. Prefer not to leave the house to buy your contraception? No stress. You can also buy condoms online. If you have an allergic reaction to latex, it’s also possible to buy latex-free condoms [6].

Pros of male condom:

No prescription needed
Offers protection from STIs
Affordable, easy to obtain and sometimes free in certain clinics

Cons of male condom:

Needs to be used every time you have sex
May take time and practice to learn how to use correctly
Costs are involved

Perfect use: 98% effective [5]

Typical use: 87% effective [5]

4. Female condom

The female/internal condom, also known as the internal condom, is another barrier non-hormonal birth control method. It’s similar to the external condom in terms of how it works to prevent pregnancy and STIs, but it’s worn inside the vagina and also covers part of the vulva.

Some people prefer to use the internal condom as it puts the user in control. It’s important to note that an internal and external condom should not be worn at the same time during sex, as this increases the chances of friction and tearing [7].

Although you don’t need a prescription to access this method, female condoms are a bit harder to obtain. You can buy them online, or over the counter in some pharmacies. If you have a latex allergy, internal condoms are a good option because they’re latex-free, hypoallergenic, and made of nitrile (a soft plastic material) [7].

Pros of female condom:

No prescription needed
Protects against STIs

Cons of female condom:

Needs to be used every time you have sex
May take time and practice to learn how to use effectively
Not as easy to buy as the male condom
Costs are involved

Perfect use: 95% effective [5]

Typical use: 79% effective [5]

5. Contraceptive gels and creams

Non-hormonal contraceptive gels and creams work as chemical barriers to prevent pregnancy. There are two main kinds: spermicide and Phexxi. Both can be inserted into the vagina immediately or up to one hour before sex, but they work in slightly different ways. [8].

Spermicide contains a chemical that disables sperm so that they cannot swim, and also blocks the entrance to the cervix so that sperm cannot reach your fallopian tubes to fertilize the egg. Phexxi stops sperm from reaching the egg by lowering the pH in the vagina, creating an environment where sperm can’t move well or survive [8].

There are a few side effects of contraceptive gel, including vaginal burning and discomfort, increased chance of yeast infections, and bacterial vaginosis. Phexxi is also not recommended for those who are prone to urinary tract infections (UTIs). You can find spermicide at most drug stores and pharmacies over-the-counter, but you’ll need a prescription to use Phexxi. They also do not protect against STIs, notably [8].

Pros of contraceptive gel:

Insert it up to an hour before sex
Works with other types of contraception, such as a diaphragm

Cons of contraceptive gel:

Prescription required (for Phexxi)
Costs may be involved
Some people may experience side effects

Perfect use: 84% effective (for spermicides) [5]

Typical use: 79% effective (for spermicides) [5]

6. Diaphragms and cervical caps

Diaphragms and cervical caps are also barrier birth control methods, but neither protects against STIs. They’re small objects made of silicone that sit inside the vagina and cover the cervix. This means that sperm cells cannot reach the egg cell during or after sex. For maximum effectiveness as birth control, they should be used with a spermicide [9, 10].

The main difference between the two is the shape — diaphragms are disc-shaped, while cervical caps look more like sailor hats. Another key difference is that diaphragms need to be left in place for at least six hours after sex, while cervical caps can be left inside the vagina for longer (up to two days after sex). Both of them can be inserted any time before sex [9, 10].

These non-hormonal birth control methods may not be right for you if you regularly get UTIs. You also need a prescription in order to buy them at a pharmacy, drugstore, or the like. For diaphragms specifically, a healthcare professional will need to fit you for one and show you how to use it before you can get started. Diaphragms and cervical caps are typically covered by insurance and are available for free in the UK on the NHS [9, 10].

Pros of diaphragms and cervical caps:

Insert it any time before you have sex (more spermicide should be used if it’s more than three hours prior)
You can use the same one for a year before it needs to be replaced

Cons of diaphragms and cervical caps:

Requires fitting
Requires a prescription
Does not protect against STIs

Perfect use: 84% effective (for diaphragms) [5]

Typical use: 83% effective (for diaphragms) [5]

Long-term/permanent non-hormonal birth control methods

7. Copper intrauterine device (IUD)

If you’re looking for a long-term, non-hormonal contraception, the copper IUD might be a good fit for you. Also known as the copper coil, this t-shaped piece must be inserted by a healthcare professional and can sit in the uterus for up to ten years. It primarily prevents pregnancy by creating a hostile environment in the female reproductive tract, which inhibits sperm motility and survival and thus prevents fertilization. If used as emergency contraception within five days after unprotected sex, it can also prevent implantation [11].

The copper IUD is highly effective at preventing pregnancy. In fact, it’s more than 99% effective with both typical and perfect use. One of the reasons it’s so effective is that it requires little work from the user after it’s inserted — it can just sit there and effectively prevent pregnancy for years without you having to think about or maintain it. It doesn’t protect against STIs though, so if that’s a concern, you may still want to use condoms in conjunction with a copper IUD [12].

One of the great things about this method is that it can also be used as emergency contraception if fitted for up to five days after having unprotected sex. It’s also usually covered by insurance and available in the UK from the NHS. But some people who use this method of birth control may get unpleasant side effects such as longer or heavier periods, spotting between periods, or worse period pain. It’s also common to experience some pain or cramping during the fitting and in the following days [12].

Pros of copper IUD:

Highly effective for years
Doesn’t require any work once fitted
Can be used as emergency contraception

Cons of copper IUD:

Invasive
Requires a professional to fit and remove
Can have side effects, such as heavier or longer periods and pain
Doesn’t protect against STIs

Perfect use: More than 99% effective [5]

Typical use: More than 99% effective [5]

8. Vasectomy (male sterilization)

Another long-term, non-hormonal birth control method is a vasectomy procedure. This is a surgery that involves cutting or sealing the tubes that carry sperm. It is intended to, and should be considered, permanent birth control, although it is possible to successfully reverse a vasectomy in some rare circumstances [13].

The procedure itself is quick, and although the individual may experience some mild discomfort, most people will be able to return to work after a day or two. After the procedure, you’ll need to use another method of contraception for several months to make sure there’s no residual sperm left. You’ll be asked to provide a sample after a few weeks to check that the procedure was successful. Physiologically, there are no changes to sex drive or hormone levels post-vasectomy, but it’s important to note that the procedure does not protect against STIs [13, 14].

Pros of vasectomy:

Highly effective
Long-term option
Quick procedure with low down time

Cons of vasectomy:

Permanent
Invasive
Costs can be involved depending on your country
Does not protect against STIs

Perfect use: More than 99% effective [5]

Typical use: More than 99% effective [5]

9. Female sterilization (tubal ligation)

As with a vasectomy, female sterilization is more than 99% effective as a long-term non-hormonal birth control option. The procedure is called a tubal ligation and it works by permanently blocking or sealing the fallopian tubes. This surgery is a bit more complicated than male sterilization, and may require a general anesthetic and more recovery time [15].

Sterilization works right away, so it’s a “get-it-and-forget-it” birth control, but consult with your healthcare professional about when it’s safe to have sex again. It’s also worth noting that you’ll still get your period after having your tubes tied, and it also does not protect against STIs [15].

Pros of tubal ligation:

Highly effective
Long-term option

Cons of tubal ligation:

Permanent
Invasive
Depending on country costs may be involved
The procedure is not as quick and easy as with male sterilization and may require more recovery time
Does not protect against STIs

Perfect use: More than 99% effective [5]

Typical use: More than99% effective [5]

Other methods

10. Pull out method

When it comes to preventing pregnancy, the pull out method (also known as the withdrawal method) has been around for a very long time. However, just because it’s tried and tested doesn’t mean it’s the best way to prevent pregnancy (far from it!). When it comes to failure rates, this method is only 80% effective with typical use. This means that 20 out of 100 people using the pull out method will get pregnant within a year [16].

The pull out method works by removing the penis from the vagina before ejaculation. This can be tricky to time, and even if it is done perfectly, there is still a risk of pregnancy. Sperm may present in pre-ejaculate, and there’s a risk of pregnancy if even only a small amount of sperm gets into the vagina. It also does not protect against STIs [16].

Pros of the pull-out method:

Free
Easily available
Can be used with another form of contraception

Cons of the pull-out method:

Hard to time
Much less effective than other methods
Does not protect against STIs

Perfect use: 96% effective [5]

Typical use: 80% effective [5]

11. Breastfeeding as birth control (lactational amenorrhea or LAM)

Lactational amenorrhea (or LAM for short) is another non-hormonal birth control method that is suitable for people who have just given birth and are breastfeeding full time This means you’re only feeding your baby breast milk directly (no pumping), and the gaps between feeds are no longer than four hours during the day and six hours at night [17]. During this time, your body naturally stops ovulating. When ovulation stops, you’re not fertile and cannot get pregnant. You can use breastfeeding as contraception for up to six months, or until your period naturally returns.

Keep in mind that this is only a temporary option, and you’ll need to find another birth control method after six months or as soon as your period has returned. Due to the way the menstrual cycle works, you’ll ovulate before you get your first period after pregnancy again, which means that you may be fertile before you know you are. It’s important to follow the guidelines of LAM to use it effectively [17].

Pros of breastfeeding as birth control:

Free
Convenient if you’re already planning to breastfeed full time

Cons of breastfeeding as birth control:

Requires daily dedication
Only works for a short period of time
Does not protect against STIs

Perfect use: More than 99% effective (during the first six months after delivery) [18]

Typical use: 98% effective [18]

How to choose a non-hormonal birth control option

With all of that information about the non-hormonal birth control options available to you, you may be wondering how to make the right choice that will fit your unique needs. Some questions you may want to consider when choosing a non-hormonal birth control include:

Do I want a permanent or short-term solution?
What side effects can I handle? Which ones do I want to avoid?
Am I comfortable with an invasive procedure?
Do I need protection against STIs?
How much does it cost?

Answering these questions for yourself can help narrow down the list above before speaking with your healthcare provider about your choice [19]. Here’s a handy table to use for reference with some of the most common considerations:

$\"Non-hormonal$

Ready to go hormone-free?

Thanks for checking out our roundup of non-hormonal birth control. We hope you’ve learned a bit more non-hormonal birth control and the options available to you. If you’re thinking about switching contraception methods, it’s always a good idea to talk to your reproductive healthcare professional about your options. They’ll be able to provide counseling and patient education to help you make an informed choice.

Natural Cycles is the first FDA Cleared birth control app, putting the power of your cycle in your hands. Hormone-free and non-invasive, find out if Natural Cycles could work for you today.

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Planned Parenthood. Fertility Awareness (multiple pages) [Internet]. [cited 2025 July 3]. Available from: https://www.plannedparenthood.org/learn/birth-control/fertility-awareness
Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception and the percentage continuing use at the end of the first year. [Internet]. [cited 2025 July 3]. Available from: https://www.datocms-assets.com/21281/1662539230-contraceptive-technologies_failure-rates-table-2018.pdf
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Planned Parenthood. Spermicide & Contraceptive Gel (multiple pages) [Internet]. [cited 2025 July 3]. Available from: https://www.plannedparenthood.org/learn/birth-control/spermicide
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Howard SA, Benhabbour SR. Non-Hormonal Contraception [Internet]. 2023 [cited 2025 July 8]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10381146/
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National Health Service (NHS). Vasectomy (multiple pages) [Internet]. 2024 [cited 2025 July 14]. Available from: https://www.nhs.uk/contraception/methods-of-contraception/vasectomy-male-sterilisation
Engl T, Hallmen S, Beecken WD, Rubenwolf P, Gerharz EW, Vallo S. Impact of vasectomy on the sexual satisfaction of couples: experience from a specialized clinic [Internet]. 2017 [cited 2025 July 8]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5656365/
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National Health Service (NHS). Choosing a method of contraception (multiple pages) [Internet]. 2024 [cited 2025 July 8]. Available from: https://www.nhs.uk/contraception/choosing-contraception/

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While many of us have probably heard of the G-spot, we might not all know where the G-spot is. Despite being a small erogenous zone in our bodies, it is one of the most well-known areas. Yet even researchers are not quite sure whether it truly exists or not. If you're curious to learn more about the G-spot orgasm and how to stimulate this area for pleasure, read on.

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Key takeaways:

The G-spot is an area located on the anterior wall of the vagina that triggers sexual arousal and, for some people, an orgasm when stimulated
It might be that the G-spot is not an independent spot but a part of the internal clitoral structure
Some people might experience pleasure when their G-spot is stimulated, and some might not — every body is unique

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What is the G-spot?

The G-spot is a zone or an area inside the vagina located on the anterior wall [1]. When this area is stimulated, it triggers sexual arousal. In the 1950s, German gynecologist Dr. Ernst Gräfenberg was the first medical professional to identify this area in a scientific article. This led to later authors referring to the anatomical area as the “Gräfenberg spot,” which became shortened to what we call today the “G-spot.” While the G-spot is famous for G-spot orgasms and squirting, it's a pretty controversial pleasure spot.

The G-spot has been studied from many angles by the scientific community, from medical imagery, anatomical explorations, cadaver dissections, and self-awareness surveys, but the data brings conflicting conclusions [4]. The researchers who believe in its existence argue that the G-spot is a sac with erectile-like tissue on the anterior wall of the vagina [2]. However, a more recent study found no anatomic evidence of such a structure [3], while yet another identified it in approximately half the bodies it investigated [4].

Finally, a 2021 systematic review on the G-spot notes that the G-spot might not be a separate pleasure spot but rather an area close to the internal part of the clitoris structure if it does indeed exist for a woman [5]. While scientists debate on the location, size, function, or even existence of the G-spot [5], no one can argue that vulvas and vaginas are full of sensitive pleasure areas that feel amazing when stimulated.

Where is your G-spot?

So, the G-spot indicates an area located about 2-3 inches or 5-8 centimeters inside the vagina [5]. However, the exact location might vary from person to person, as everyone's anatomy is slightly different.

It's important to note that not everyone experiences pleasure when stimulating their G-spot area. If you have little to no sensations when that area is stimulated or haven't experienced a G-spot orgasm, there's really no cause for concern. Our bodies are unique, and the erogenous zones that bring us pleasure can vary a lot!

How to hit the G-spot

Want to explore your pleasure zone and hit all the right spots? Whether solo or with a partner, we've got some hot tips to help you elevate your experience when stimulating your G-spot.

How to stimulate the G-Spot by yourself

When you're ready to dive into solo self-pleasure exploration and discover what feels good when you stimulate the G-spot, try:

Warm up first: To have the most pleasurable experience stimulating the G-spot, it's important to dedicate time to foreplay before attempting penetration of any sort. So, spend some time warming up and building arousal. Play with the breasts and nipples, if that's something you enjoy, the clitoris and your vulva, and explore other erogenous zones on your body before diving inside.
Add lubrication: When it comes to penetrative sex, it can be a good idea to add some lube, even if you have plenty of natural lubrication. It'll make things glide smoother and enhance the sensations, which will make the experience much more pleasurable. Some of the best lubes are water-based. There are advantages to using a water-based lube, such as how easily it cleans up and that it doesn’t stain clothes or sheets. They're also great if you have sensitive skin since they won't cause irritation. To use, apply a bit to your fingers, the sex toy, or directly on the vulva. You can re-apply more lube later if you feel like you need it.
Find the right type of stimulation: As we already discussed, the G-spot is located a few inches inside the vagina, on the anterior wall. Slide one or two fingers inside and make the \"come here\" motion to explore how it feels when you touch that area. Be patient with yourself and open to experimentation. It might take some time to find the most pleasurable stimulation. You might want to play around with the speed — go slower and faster, or alternate between the two speeds. It might feel better to draw circles around the area or go side to side rather than gesturing \"come here\" with your fingers. Experiment and have fun!
Play with pressure: Pressure might be the key to getting the most out of G-spot stimulation. As you stimulate the area, start by applying a little pressure and then increase it as you go.

How to stimulate your partner's G-spot

Want to blow your partner's mind with a G-spot orgasm? Take note of these suggestions:

Explore their body first: Our bodies are full of erogenous zones that feel amazing when stimulated. Before you even attempt to stimulate the G-spot, spend time showering your partner's body with gentle touches, caresses, and kisses to turn them on. Once they're aroused and fully in the zone, dive into the G-spot stimulation.
Use your words: Did you know that our brains are our biggest sex organs? Use this fact to your advantage when playing with your partner! As you explore their body, tell them how aroused you are by their presence, how good they taste or smell, and how much you want to please them. A simple \"I love to hear you moan\" can make a huge impact on your partner's arousal.
Check-in with them: Not sure if the type of stimulation is working? Have trouble reading your partner's body cues? Ask them! You'll have the best experience if you communicate during exploration. As you try different types of touch, gently ask your partner, \"Does that feel good, baby?\"
Take your time: G-spot orgasms may take longer than clitoral orgasms for some people. Generally, female orgasms tend to become elusive when there are expectations involved. So, help your partner feel as relaxed as possible by taking your time exploring their body. Get comfortable, and go slow.
Consistency is key: For many people, the key to achieving orgasm is erogenous stimulation, finding what feels good, and staying with it until you climax. Once you know what type of touch and stimulation feels the best for your partner, stick with it until they reach an orgasm.
Communicate: Whether you choose to stimulate your G-spot with a partner present, or if they are the ones doing the stimulation, having clear and open communication is so important. Be very clear to your partner about what sort of stimulation feels the best, and ask them to continue what they're doing if it feels great, so they don’t end up switching up the stimulation types at the worst moment.

The best sex positions to stimulate the G-spot

Some sex positions might work better than others for direct G-spot stimulation. The best positions will be those that give you the most control over the hip movements and access to the clitoris and offer an angle where the anterior wall of the vagina receives the most stimulation. Here are four that combine all four elements you might want to try.

1. Spooning

The spooning position is great because of the angle — when in the position, the penetrating partner hits the anterior wall over and over again, right where the G-spot area should be. In this position, the receiving partner has the freedom to move their hips to add more stimulation. Both partners have easy access to the clitoris, which can greatly enhance pleasure.

To get into this sex position, both partners lie down on their sides, just like they would when they're cuddling. The penetrating partner is behind the receiving partner, and they enter from behind.

2. Speed Bump

The speed bump sex position offers a great penetration angle where the penetrating partner hits the anterior wall repeatedly, exactly where your G-spot should be. It's also a position with easy clitoris access for extra stimulation. You might place a pillow under the hips to lift them higher if you desire a deeper penetration angle.

To get into this position, the receiving partner lies down on their stomach, and the penetrating partner settles on top of them and penetrates from behind. The receiving partner might keep their legs spread wide or keep them together. Both partners can slip a hand around the receiving partner to stimulate their clitoris to enhance the pleasure.

3. Doggy

Doggy style is very versatile and works wonders for G-spot stimulation. It gives both partners plenty of control over the depth and angles, and it has many variations. Also, it gives easy access to the clitoris to help make sex more pleasurable for the receiving partner.

To get into this sex position, the receiving partner gets on all fours. The penetrating partner kneels (or stands) behind them and enters. If the receiving partner arches their back in this position, it might offer more direct anterior wall stimulation. If the receiving partner gets on their forearms instead of their hands, it deepens the angle of penetration. It's a good idea to play around with different variations to find one that works best for you.

4. Cowgirl

The cowgirl sex position gives a lot of control to the receiving (or top) partner over the movements, depth of penetration, and speed. To get the most out of this sex position for G-spot stimulation, instead of moving up and down, the top partner wants to focus on moving back and forth.

To get into this position, the penetrating partner lies down on their back. The receiving partner straddles their hips, facing them. The bottom partner might lie still and allow the top partner to do all the work, or they might thrust their hips up. Both partners have access to the clitoris in this position for more pleasure.

Are G-spot orgasms more powerful?

It's difficult to say whether G-spot orgasms are more powerful than clitoral orgasms because of the conflicting evidence about G-spot existence and nature. Some individuals report that vaginal orgasms do feel different — they last longer, feel more intense and deeper, and give a whole-body experience [6].

However, if the G-spot is an internal stimulation of the clitoris, as some scientists suspect, the orgasms it causes would be clitoral instead of vaginal. As long as you’re having a good time, it doesn’t really matter if one orgasm is more powerful than another. Just do what feels right for you.

Can stimulating your G-spot help you squirt?

Squirting is a release of a clear fluid caused by stimulation of the female genitals [7]. It might or might not induce or accompany an orgasm, and not all people experience it — a study in the United States found that around 40% of women reported having ever squirted [8].

It's a common belief that G-spot stimulation is the way to achieve squirting, but it's not as simple as that. In the same survey in the United States, different techniques were mentioned to help experience squirting, including pressure inside the vaginal wall and clitoral stimulation on its own [8].

Reasons some people can’t orgasm from G-spot stimulation

While stimulating the G-spot can be a source of great pleasure for some, others may not feel much at all in that area. First of all, know that if you don't experience many sensations from G-spot stimulation, it's completely normal. There's nothing wrong with you or your body.

Sexual pleasure is highly individual, and there are a few different reasons why some people may not be into G-spot stimulation, such as:

Anatomic differences: Because our bodies are unique, anatomical variations such as the thickness of the anterior vaginal wall, the distance between the clitoris, vaginal opening, and urethra, and even erectile tissue differences can influence whether or not you feel sensitivity in the area.
Different stimulation preferences: Not all types of stimulation are effective for every person. You may notice that solo G-spot stimulation is easier than with a partner, which may influence whether or not you enjoy G-spot orgasms during penetration.
Hormonal fluctuations: The hormonal swings we experience over the course of our cycles may affect how sensitive and responsive we are to certain types of stimulation.
Psychological factors: For some people, an orgasm is much more than manual stimulation. Factors such as stress, anxiety, relationships, and feeling connected to their partner can have a great impact on their sexual arousal and orgasmic abilities [9].

Before you decide G-spot orgasms are something you can’t achieve, you may want to change your perspective. It may be that G-spot orgasms are elusive for you because you focus too much on stimulating one small specific spot. In reality, the G-spot may be a complex, dynamic structure that looks and feels different for you than for someone else. To enjoy the full potential of G-spot pleasure, you may need a wider type of stimulation that includes internal areas around it, and even adding in a clitoris.

Other erogenous zones worth stimulating

G-spot is not the only area in our bodies that feels good when stimulated! We're lucky to have quite a few erogenous zones (genitals and not) that can bring a ton of pleasure for us.

Aside from the G-spot, here's a list of other potential erogenous zones to explore [10, 11]:

Lips
Nipples
Breasts
Clitoris
Anus
Perineum
Nape of the neck
Ears
Toes
Inner thighs
Lower back
Stomach
Shoulders
Head

Everyone's bodies are different, so what may feel good for one person may not have give any pleasure to another. So, as you pleasure map your body, keep an open mind!

Learn more about your body with Natural Cycles

Increasing awareness about female health is key to our mission here at Natural Cycles. Our FDA Cleared app can help you plan or prevent pregnancy and learn more about your body and pleasure. Try it to discover if Natural Cycles is right for you!

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Pfister, R. (2017). Ernest Gräfenberg 1950 The role of urethra in female orgasm. in: The International Journal of Sexology vol. III, no. 3: 145-148. www.academia.edu. https://www.academia.edu/1743428/Ernest_Gr%C3%A4fenberg_1950_The_role_of_urethra_in_female_orgasm_in_The_International_Journal_of_Sexology_vol_III_no_3_145_148
Ostrzenski, A. (2012). G‐Spot Anatomy: a new discovery. The Journal of Sexual Medicine, 9(5), 1355–1359. https://doi.org/10.1111/j.1743-6109.2012.02668.x
Hoag, N., Keast, J. R., & O'Connell, H. E. (2017). The \"G-Spot\" Is Not a Structure Evident on Macroscopic Anatomic Dissection of the Vaginal Wall. The Journal of Sexual Medicine, 14(12), 1524–1532. https://doi.org/10.1016/j.jsxm.2017.10.071
Thabet SM. Reality of the G-spot and its relation to female circumcision and vaginal surgery. J Obstet Gynaecol Res. 2009;35:967–973.
Vieira-Baptista, P., Lima-Silva, J., Preti, M., Xavier, J., Vendeira, P., & Stockdale, C. K. (2021). G-Spot: fact or fiction?: A systematic review. Sexual Medicine, 9(5), 1. https://doi.org/10.1016/j.esxm.2021.100435
Pfaus, J. G., Quintana, G. R., Mac Cionnaith, C., & Parada, M. (2016). The whole versus the sum of some of the parts: toward resolving the apparent controversy of clitoral versus vaginal orgasms. Socioaffective Neuroscience & Psychology, 6(1), 32578. https://doi.org/10.3402/snp.v6.32578
Rodriguez, F. D., Camacho, A., Bordes, S. J., Gardner, B., Levin, R. J., & Tubbs, R. S. (2020). Female ejaculation: An update on anatomy, history, and controversies. Clinical Anatomy, 34(1), 103–107. https://doi.org/10.1002/ca.23654
Hensel, D. J., Von Hippel, C. D., Lapage, C. C., & Perkins, R. H. (2023). Vaginal Squirting: Experiences, discoveries, and strategies in a U.S. probability sample of women ages 18-93. The Journal of Sex Research, 61(4), 529–539. https://doi.org/10.1080/00224499.2023.2243939
Mollaioli, D., Sansone, A., Colonnello, E., Limoncin, E., Ciocca, G., Vignozzi, L., & Jannini, E. A. (2021). Do we still believe there is a G-Spot? Current Sexual Health Reports, 13(3), 97–105. https://doi.org/10.1007/s11930-021-00311-w
Erogenous zones - Centre for Sexuality. (2021, July 10). Centre for Sexuality. https://www.centreforsexuality.ca/learning-centre/erogenous-zones/
Maister, L., Fotopoulou, A., Turnbull, O., & Tsakiris, M. (2020). The Erogenous Mirror: Intersubjective and multisensory maps of sexual arousal in men and women. Archives of Sexual Behavior, 49(8), 2919–2933. https://doi.org/10.1007/s10508-020-01756-1

",{"_298":2179,"_438":2180,"_1695":2181,"_1697":1698,"_1699":2182,"_1701":2183,"_1703":2184,"_1705":2185,"_1707":2186,"_1709":-5,"_1710":2187,"_408":2220,"_410":2221,"_1810":2222,"_1880":2265,"_342":2266,"_1891":1892,"_1893":2272,"_1908":1909,"_1910":2282,"_1923":2295,"_1925":2296,"_1929":2297},"Vc5ETPaHSmupD4kNSRta1g","3 Weeks pregnant: Pregnancy symptoms & tips","3-weeks-pregnant","2025-07-14","2025-07-14T15:59:24+01:00","

Welcome to week three of your pregnancy! As a reminder, pregnancy is calculated from the first day of your last period [1] — so at three weeks pregnant, you have attempted to conceive and may be eagerly awaiting the right time to take a pregnancy test. Mixed emotions are common during this time, ranging from excitement to anxious anticipation. In the meantime, if conception is successful, you may notice some early pregnancy symptoms, and the embryo that will become your baby is already starting to grow!

","

Key takeaways:

After attempting to get pregnant, you are now in the “two-week wait” until you can take a pregnancy test
You may experience early pregnancy symptoms, such as breast sensitivity, spotting, and a heightened sense of smell.
Your baby’s sex is already determined, and it is starting to grow

","

Note: Throughout these early pregnancy articles, we will often refer to your baby as an embryo. Pregnancy is divided into four stages of fetal development, and your baby is technically an embryo until week eight. Read our full article on the difference between an embryo and a fetus to learn more.

Your body at 3 weeks pregnant

Implantation

If your egg is fertilized by a sperm cell (known as conception), that fertilized egg will now be traveling down your fallopian tube toward the uterus, ready for implantation. Implantation occurs when the fertilized egg attaches itself to the lining of the uterus, marking the beginning of pregnancy. You likely won’t notice any symptoms with implantation, though some women may experience implantation bleeding or mild cramps (more on this below).

Two-week wait

While you wait for confirmation of successful conception and implantation, you are in a phase known as the “two-week wait” (TWW). This term describes the time between an attempt to get pregnant and confirmation of pregnancy. This attempt to get pregnant may be through unprotected intercourse timed with ovulation, or fertility treatment such as IUI or IVF.

The TWW begins at ovulation when an egg is released into the fallopian tube. After TWW, you will be able to confirm where conception and implantation have occurred or not, through either a positive pregnancy test or the arrival of your period in the case that you are not pregnant.

Mixed emotions are common during the TWW. You may feel excited about the potential pregnancy or anxious about the upcoming pregnancy test. It is also important to remember that the term “two-week wait” is a broad colloquial term. The average time between ovulation and period ranges, on average, between seven and nineteen days. This duration may be longer or shorter for individuals with irregular cycles [2].

Early pregnancy hormones

From the moment of conception, your hormone levels will start to change. You will begin to produce human chorionic gonadotropin (hCG), also known as the pregnancy hormone, which signals your body to increase levels of progesterone and estrogen [3]. hCG is the hormone tested by home pregnancy tests to confirm pregnancy, though levels will not be high enough to detect until around the end of week four.

Symptoms at 3 weeks pregnant

Though most of us who are expecting will not show any obvious symptoms at week three, early pregnancy symptoms can begin within a week of conception [4]. Note that many of the early symptoms are similar to those of illness or PMS. As pregnancy symptoms occur in the luteal phase, around the same time in your cycle as PMS symptoms would, it can be difficult to differentiate between PMS and pregnancy symptoms.

Missed period

For many, week three will be too early to track a missed period, but it is worth noting that this is the most indicative pregnancy symptom. It is also a very individual experience. Those on an irregular or short cycle may have already noticed a missed period. If you are tracking your period and symptoms, it can be easier to spot when a missed period occurs.

Basal Body Temperature

If you are tracking your basal body temperature (BBT), you likely already know that your BBT varies depending on what stage of your cycle you are in. Typically, your temperature will be higher in the second half of your cycle (the luteal phase) and drop again when your period arrives. If your period is late or lighter than usual, and your BBT remains high after the time of ovulation, this could be an early indicator of pregnancy [5].

Implantation Bleeding

As week three of pregnancy is in the luteal phase of your cycle, it can be hard to pinpoint whether spotting is due to an oncoming period or another cause, such as implantation bleeding. Implantation bleeding is a type of spotting that may occur when the fertilized egg attaches itself to the uterine lining, shedding some blood cells. However, the research surrounding implantation bleeding is not conclusive. There are several reasons bleeding may occur in early pregnancy. In fact, it is thought that up to a quarter of women may experience bleeding in the first trimester [6].

If implantation bleeding does occur, it may be light in flow and last a short length of time. If your bleed is heavier and lasts more than two days, it may be your period instead. Speak to your healthcare practitioner if you are concerned about any spotting or bleeding.

Breast sensitivity

Tender breasts, or breast changes, are a common pregnancy symptom. You may notice that your breasts are more tender, swollen, or heavy than usual. Your nipples may feel particularly sensitive, or you may experience a tingling sensation [7]. Breast pain and sensitivity in pregnancy are thought to be linked to hormonal changes.[4]

Heightened sense of smell

Since as early as the 1800s, pregnant women have reported an increase in their sense of smell sensitivity. More research is needed into the phenomenon, but one proposed evolutionary reason for this increased sensitivity is that it helps mothers protect the embryo from food or environmental toxins [8]. Note that this change in sensitivity to smells applies to both pleasant and unpleasant smells. You may find potent odors, such as fish or garbage, to be even stronger than usual, or notice a change in your perfume preference. Even the scent of your partner can smell different!

Fatigue

Tiredness is a common symptom of early pregnancy, particularly during the first 12 weeks. Although you can’t feel much, at three weeks pregnant, your body is already allocating extra resources and energy to grow the embryo. Increased urination, breast pain, and nausea may interrupt sleep, while hormonal changes and emotions may add to overall fatigue [7].

Your baby’s development at 3 weeks

After fertilization, the fertilized egg begins to duplicate cells and is referred to as a zygote. At week three, about five to six days after fertilization, the zygote transforms into a blastocyst — a group of rapidly dividing cells that eventually become the embryo [9]. This week, your baby is the size of a pinhead. Its weight is 0oz (0 grams), but it is already growing, reaching a length of 0.0019 inches (0.048mm).

Though it is small at this stage, whether your baby will be a boy or a girl has already been decided! Sex is determined at fertilization, though most parents will find out the sex around week 20 through an ultrasound.

Tips at 3 weeks pregnant

Practice self-care during the two-week wait

As mentioned above, you may experience a wide range of emotions during the two-week wait. Take this time to look after your mental health. Practicing yoga or meditation can reduce stress and anxiety. Socializing with friends and family may help brighten your mood. Your favorite TV show may provide comfort, and a walk in nature can help clear your mind.

Avoid alcohol

While you are waiting to find out if you are pregnant, it is a good time to avoid any substances that can cause harm during pregnancy or reduce the potential to get pregnant. You should cut out alcohol altogether, as it can increase the risk of miscarriage, premature birth, and other problems. However, do not be concerned if you have enjoyed a couple of drinks before you knew you were pregnant — the risk is very low as long as alcohol consumption is discontinued [10]. If you need help quitting alcohol, speak to your healthcare provider.

Quit smoking

If you are a smoker, now is the time to look into quitting. Not only is smoking bad for your health, but it also has a huge impact on your growing embryo’s health. Toxins from cigarettes pass onto the embryo, and they experience extra pressure on their heart from a decreased oxygen supply [11]. Stopping smoking will reduce the risk of stillbirth, pregnancy complications, and your baby’s likelihood of developing breathing ailments such as asthma.

Increase folic acid consumption

Eating well is recommended for everyone, especially when trying to conceive or in the early stages of pregnancy. A healthy, balanced diet will help you get all the nutrients your body and baby need. Folic acid, also known as vitamin B9, is recommended in early pregnancy and while trying to conceive. Folic acid is essential in the development of the embryo’s neural tubes, which happens in the first few weeks of pregnancy [12]. Increase your folic acid intake through foods such as legumes, eggs, and cruciferous vegetables like broccoli. Other vitamins that can support pregnancy include vitamin D, iron, and vitamin C. It is essential to consult with your healthcare advisor before you consider taking any supplements.

Keep hydrated

You are drinking for two now! Adequate hydration aids the body’s absorption of nutrients and minerals [13] and can help fight fatigue [14]. Drink plenty of water throughout the day to meet the hydration needs of both you and the embryo. Water should be the go-to, but you can also include decaffeinated teas, sparkling water, or juice. Be cautious of herbal teas, as some are not recommended for consumption during pregnancy.

Following your pregnancy with Natural Cycles

Did you know that you can track your pregnancy and baby development with Natural Cycles? As the first FDA-approved cycle tracking app, NC Follow Pregnancy in the Natural Cycles app gives you week-by-week updates on your growing baby, lets you track your symptoms each day, and will help you take care of your emotional, physical, and mental well-being by offering insights into your body changes throughout your pregnancy.

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Department of Health & Human Services. Pregnancy - week by week [Internet]. Better Health Channel. Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/pregnancy-week-by-week
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Early signs of pregnancy | American Pregnancy Association [Internet]. American Pregnancy Association. 2025. Available from: https://americanpregnancy.org/pregnancy-symptoms/early-signs-of-pregnancy/
Steward K, Raja A. Physiology, ovulation and basal body temperature [Internet]. StatPearls - NCBI Bookshelf. 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546686/
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Signs and symptoms of pregnancy [Internet]. nhs.uk. 2024. Available from: https://www.nhs.uk/pregnancy/trying-for-a-baby/signs-and-symptoms-of-pregnancy/
Cameron EL. Pregnancy and olfaction: a review. Frontiers in Psychology [Internet]. 2014 Jan 1;5. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3915141/
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Drinking alcohol while pregnant [Internet]. nhs.uk. 2024. Available from: https://www.nhs.uk/pregnancy/keeping-well/drinking-alcohol-while-pregnant/
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",{"_298":2300,"_438":2301,"_1695":2302,"_1697":1698,"_1699":2303,"_1701":2304,"_1703":2305,"_1705":2306,"_1707":2307,"_1709":-5,"_1710":2308,"_408":2341,"_410":2343,"_1810":2344,"_1880":2387,"_342":2388,"_1891":1892,"_1893":2394,"_1908":1909,"_1910":2397,"_1923":1924,"_1925":2400,"_1929":2401},"OsajnGM0RRKY0x_VjfjO6w","Vulval and vaginal itching: Itchy with no discharge & how to treat","vaginal-itching-no-discharge","2025-07-09","2025-07-09T10:10:31+01:00","

Itchy vagina, no discharge? Vulvar and vaginal itching can be uncomfortable, confusing, and even concerning sometimes. If you’ve ever experienced this symptom, you know how frustrating and distracting it can become. In this article, we’re going to explore the topic of vaginal discharge with no discharge — a symptom that’s relatively common. While this can be caused by something as simple as an allergic reaction, it can also be a sign of an underlying condition like a hormonal shift or an infection. In this article, we’ll explore some of the most common causes of vaginal itching, along with what you can do to find relief.

","

Key takeaways

Vaginal itching can be an uncomfortable experience, whether or not it’s accompanied by discharge
Itching around the vulva and in the vagina isn’t always a cause for concern — it can be caused by allergies, irritants, hormonal changes, skin conditions, or treatable infections
There are plenty of ways to find relief from vaginal itching, including some lifestyle adjustments and medications that you can discuss with your doctor depending on the root cause of the itching

","

What is vaginal irritation and what does it feel like?

Vaginal irritation can feel like an itching or burning sensation on the skin of your genital area. These sensations may be accompanied by redness or swelling, and you may also notice unusual discharge, normal discharge, or no discharge at all, depending on your circumstances and the underlying cause. Sometimes, the itching is accompanied by pain during sex as well [1, 2].

Let’s do a quick refresher on the difference between the vagina and the vulva, as the location of the itchiness may help to determine the root cause and the right treatment method. The vulva is the outer part of the area that you can see. Itching here usually indicates an allergy to external irritants or a skin condition. The vagina is the internal canal inside your body that leads up to the cervix. Itching inside the vagina may indicate an infection or a reaction to hormonal changes [3].

Is vulvar and vaginal itching without discharge a concern?

Itching and irritation around the vulva and vagina is fairly common, but it’s usually not an isolated symptom (even if there is no discharge) [1]. It’s typically an indication that something deeper is going on in your body, like an allergy, infection, or other condition. But the most common underlying causes are usually treatable, especially if they’re caught early.

Causes of vulvar and vaginal itching without discharge

There are a number of causes of vulvar and vaginal itching, and it’s best to consult your healthcare provider whenever you feel any sort of irritation so that they can help address it quickly. Here are some of the most common conditions that cause vaginal itching:

Bacteria overgrowth

Your vagina (the internal canal) has a sensitive, balanced ecosystem of bacteria that keeps the area healthy and protected. Sometimes, certain types of bacteria can overgrow and throw off that natural balance, causing infections like bacterial vaginosis or yeast infections. Both types of infections can cause itching inside and around the vagina, and both can be treated with either prescription or over-the-counter medication [1,3].

Contact dermatitis/allergies

Externally on the vulva, you can experience itching if your skin comes into contact with something you’re allergic to or can be caused by irritants. This is called contact dermatitis. The most common culprits here include scented pads or tampons, certain types of synthetic fabrics, or products like soaps, creams, or gels that have an irritating ingredient. Remember that the vagina is self-cleaning, and the vulva often just needs a daily wash with warm water and a gentle, fragrance-free soap to stay healthy and clean [4]. Learn more about the best ways to clean your vagina and vulva here.

The contact dermatitis reaction that causes itching can be immediate, or it may take a few hours to a few days of exposure to arise. Figuring out which new product caused the irritation and avoiding it in the future usually clears up the itching, although you may need a special moisturizer or topical steroid from your doctor if the itching persists or covers a large area of the skin [1, 4].

Hair removal irritation

Another common cause of itching and irritation on the vulva is hair removal. Whatever way you choose to groom — whether you wax, shave, trim, or anything else — there’s a chance that the hair removal process can cause skin irritation. Razors and wax in particular can be harsh on sensitive skin, and certain shaving products can have irritating ingredients like added fragrance. Ingrown hairs are also common with hair removal in the pubic area, and these can be quite itchy as well. Using gentle, unscented products and exfoliating the skin beforehand can prevent irritation and itching from hair removal [3,5].

Hormonal changes

We go through many hormonal shifts throughout our lives, including starting hormonal birth control, pregnancy, breastfeeding, and perimenopause. These hormonal transitions may be the underlying cause of vulvar and vaginal itching. Bacterial infections and vaginal dryness are both more common during these times, which can cause that persistent itching [3, 6].

Sexually transmitted infections and conditions

Itching is a common symptom of some sexually transmitted infections (STIs) such as genital herpes. Pubic lice can also cause itching, and although it’s usually transmitted via sexual contact, it's not considered an STI. You can also get pubic lice from sharing clothes, towels, or bedding with someone who has them. While these conditions can be worrying, they are treatable and should be addressed with a healthcare provider as soon as possible [7, 8].

The best way to avoid STIs is to use condoms when having unprotected sex with a new sexual partner. Keep in mind that some people may be allergic to latex, which can cause skin irritation, and condoms themselves may cause dermatitis in some individuals [1].

Skin conditions

Aside from the one-off irritants and allergies associated with contact dermatitis, certain chronic skin conditions may be causing vulvar itching as well. Psoriasis and eczema are common conditions that can cause chronic skin itching, along with lichen sclerosus or lichen simplex chronicus (prolonged contact dermatitis). All of these can make the skin appear rashy, irritated, or leathery, although symptoms vary from person to person. They’re usually manageable with specialized steroid creams [4, 9, 10].

Sweating/heat rash

Sweating more than you normally do and/or prolonged exposure to heat can cause something called heat rash, also known as prickly heat. This condition may cause itching on any part of your body, including the vulva. It’s usually accompanied by small raised bumps, mild swelling, and/or a prickly or tingly feeling in addition to an itch. It generally goes away on its own as long as you keep the skin cool and drink plenty of fluid to avoid dehydration [11].

How can I prevent vaginal itching?

In general, practicing good hygiene and safe sex can prevent many of the causes of vaginal itching. In practice, this can look like changing out of wet or sweaty clothes promptly, wearing breathable cotton underwear, showering each day, staying away from scented feminine hygiene products, and having honest conversations about sexual health with your partner(s). But sometimes, this itchiness symptom can still pop up despite our best efforts.

How to treat vaginal itching without discharge

If itching arises, it’s best to get to the root cause with a doctor and treat that condition for the most relief. They’ll ask about your symptoms, medical history, and exposure to certain products or situations that may be causing the itching. They’ll likely do a physical exam to assess the conditions, and do testing for the potential causes listed above. Once the root cause has been identified, they’ll go over treatment options with you. Medication recommendations may include antihistamines for allergic reactions, antibiotics or antifungals for infections, or medicated creams for skin conditions [1, 2].

While you’re waiting for appointments or prescriptions, there are some at-home methods you can try to relieve vulvar and vaginal itching temporarily. Sitting on a cold ice pack or placing one on the area can reduce soreness, swelling, redness, and itching. Rinsing the area with warm water may also provide relief. Be mindful of overexposure to heat or cold as this may cause injury [1].

Here’s a quick reference summary to help you get started on treating vaginal itching and prevent it from happening in the future:

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n

\n Do’s \n	\n Don’ts \n
\n Wash the vulva daily with warm water and/or gentle, fragrance-free soap and dry thoroughly \n	\n Don’t use douching methods or clean inside the vaginal canal (it’s self-cleaning) \n
\n Wear cotton underwear \n	\n Don’t wear tight-fitting, synthetic fabric underwear and clothing \n
\n Opt for pads during your period \n	\n Don’t use tampons (or limiit their use), as they may exacerbate internal vaginal itching \n
\n Use condoms and lubrication during sex \n	\n Don’t use scented hygiene products in the vagina or around the vulva \n
\n Sit on a cold ice pack or place one on the area for a few minutes to get quick itch relief \n	\n Avoid very hot baths and showers, as this might irritate the area more \n

[2]

Learn more about your symptoms with Natural Cycles

Vaginal or vulvar itching without discharge can have a variety of causes from bacterial imbalances and allergic reactions to hormonal changes and more. The good news is that many of these issues are treatable, but getting an accurate diagnosis is key to finding relief.

At Natural Cycles, we're passionate about empowering women with the knowledge they need to take charge of their health. If you'd like to explore more useful reproductive health content, give Natural Cycles a try. The app has tailored insights specific to your cycle, helping you learn more about your body. Plus, the Natural Cycles app is the first of its kind to be FDA Cleared for use as contraception. Find out if it could work for you today.

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National Health Service. Psoriasis [Internet]. 2022 (cited 30 June 2025). Available from: https://www.nhs.uk/conditions/psoriasis/
National Health Service. Heat rash [Internet]. 2024 (cited 30 June 2025). Available from: https://www.nhs.uk/conditions/heat-rash-prickly-heat/

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In this article, we’ll take a look at stress and the menstrual cycle, and explore how stress can affect your period, ovulation, and more. We’ll also go over some effective stress management techniques to help you cope with stress in a healthy way.

","

Key takeaways

Stress can affect your menstrual cycle by delaying or stopping your period, and/or by stopping ovulation
Many of the hormones involved in regulating your cycle can be affected by excess stress levels
A bit of stress here and there is a normal part of life, but there are certain coping techniques we can all employ to deal with stress and stay healthy in mind and body

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You might think of your menstrual cycle as a physical part of your health, but it can be influenced by mental and emotional conditions like stress as well. Stress is unfortunately very prevalent in our society, and women have been found to have higher instances of mental health conditions like anxiety and depression, particularly during stressful times like the COVID-19 pandemic [1].

Can stress affect your period?

If you’re noticing a change in your menstruation or your period is later than usual and you’ve been experiencing a lot of stress lately, the two may be related. Stress can affect your period by delaying the start date, stopping it from coming entirely, or by preventing ovulation. This happens because stress has a direct effect on the hormones that regulate the menstrual cycle.

Although the menstrual cycle has a series of phases, it's often changes to our period that let us know when something unusual is happening. Late or missed ovulation often goes unnoticed, as it's not as obvious as changes to your period. However, ovulating earlier or later than usual can have a knock-on effect on when your period arrives. Knowing if and when you ovulate can help you understand what's going on in your body and prepare you for any upcoming changes to your period.

How does stress affect the hormones that drive the menstrual cycle?

Mental and emotional stress is known to impact the menstrual cycle by affecting something called the hypothalamic-pituitary-gonadal axis (HPG). This hormonal mechanism allows your body to produce and regulate hormones. Any sort of interruption or dysfunction to this axis (including stress) can cause menstrual irregularities [1].

Bodily stress can also cause a delay in your period, or cause you to skip a period entirely. This type of stress usually comes from your body not having enough energy to produce and regulate the hormones related to your menstrual cycle, particularly gonadotropin-releasing hormone (GnRH), luteinizing hormone, follicle stimulating hormone (FSH), and estrogen. If you’re not getting enough food or doing excessive amounts of exercising, this can deplete your body’s energy resources and increase the level of cortisol (the stress hormone). Increased cortisol and low energy can cause a delay or stop to your period. This condition is called “functional hypothalamic amenorrhea (FHA)” and accounts for up to 35% of all instances of one or more missed periods after the age of 15. It’s more common in female athletes like runners, dancers, gymnasts, and figure skaters who have high energy expenditure, or in marginalized communities [2, 3].

There are other factors that can delay your period aside from stress, though. Irregular periods have a variety of causes, and as many as one in four women can experience menstrual irregularity at some point during their reproductive years [4]. Keeping track of your cycle over time can help you identify any irregularities.

What sort of menstrual changes can be caused by stress?

Ovulation changes

When stress affects the hormones that control the menstrual cycle, it can also cause early or late ovulation, or it may prevent ovulation entirely. A menstrual cycle without ovulation is called an anovulatory cycle [1]. You might not even be aware that you’re experiencing an anovulatory cycle unless you track your ovulation with the support of Natural Cycles — it can help pinpoint the timing of ovulation based on your body temperature and help you identify other signs of ovulation so that you can tell whether or not you’ve ovulated that month.

Just like a late period, anovulation can be a reaction to emotional or physical changes, like shifts in diet, exercise, and stress levels. As we mentioned earlier, chronic stress can lead to FHA by causing anovulation (if you don’t ovulate, you may not get a period later in that cycle) [1].

PMS amplifies

Another way that stress can affect the menstrual cycle is by amplifying premenstrual syndrome (PMS) symptoms. The same study that found that women tend to have higher instances of mental health conditions, particularly during stressful times like the COVID-19 pandemic, also found that 53% of women described worsening premenstrual symptoms, particularly painful cramps, during the pandemic. In times of high stress, women reported more and even brand new instances of PMS [1].

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Does the Natural Cycles algorithm take stress into account?

If you’re using or thinking about using Natural Cycles, the first FDA Cleared birth control app, you might be wondering how this hormone-free method incorporates stress into fertility predictions. While the algorithm can’t specifically detect stress, it does process objective fertility metrics such as basal body temperature, period data, and ovulation tests. It is designed to be tailored to your unique cycle and can detect irregularities and flag if cycles are longer or shorter than usual.

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Natural Cycles fertility algorithm always provides a buffer of extra Red Days (when you should use protection). This is designed to protect you from unintended pregnancy if your predicted ovulation day should move.

How do you know if stress is affecting your period?

The best way to know if your menstrual cycle is being affected by stress is to see your healthcare professional. FHA in particular, is known as a “diagnosis of exclusion,” meaning that other underlying conditions need to be ruled out first before settling on stress as the cause of a missed or delayed period [2]. Together with your doctor, you can figure out what’s happening in your body and how to treat it.

What should I do if my period is late from stress?

It’s best to consult with a healthcare professional if your period is late so that they can help figure out and address the root cause. While stress may be the reason, it’s best to consider all possibilities like early pregnancy, PCOS, or endometriosis that may be causing the late period. Your healthcare provider can do a full assessment and provide next steps for any of these conditions (including stress).

It may be worth doing an at-home pregnancy test if your period is late and you’ve had unprotected sex. You may experience a late period and get a negative result on a pregnancy test, which may give you another clue that stress is the underlying issue. Again, it’s best to consult with a healthcare provider for a comprehensive health evaluation.

What kinds of stress can affect my period?

“Stress” is an umbrella term for your body's physical and emotional response to new or challenging situations [5]. We’ve mentioned the common mental/emotional stress, along with bodily energy stress in this article so far. However, there are a few specific excess stress categories that healthcare professionals may use to get a better understanding of your situation. These include:

Acute stress: Short-term stress that results from immediate stressors or stressful situations. This is where your “fight-or-flight” response usually comes in, leading to temporary physical changes like increased heart rate and adrenaline.
Chronic stress: This occurs when stressors persist over a long period of time. Prolonged stress can lead to an increased risk of health complications such as cardiovascular disease, anxiety, and depression.
Episodic acute stress: This type of stress happens when someone experiences frequent episodes of acute stress, like constantly facing deadlines or sporadic interpersonal conflicts. It can lead to impaired daily functioning.
Environmental stress: Living in challenging conditions like noisy neighborhoods, pollution, overcrowding, or unsafe conditions can contribute to an overall sense of discomfort or unease, and have negative effects on both physical and mental health.
Psychological stress: Cognitive or emotional challenges, such as perceived threats, worries, or negative thoughts, can increase stress and lead to mental health conditions like anxiety or rumination.
Physiological stress: Physiological stress is the body's reaction to internal or external stressors like illness, injury, sleep deprivation, or nutritional deficiencies.
Traumatic stress: When someone experiences a traumatic event(s) such as a natural disaster, an accident, or violence, the trauma may become overwhelming. This can lead to symptoms of posttraumatic stress disorder (PTSD) [3].

How does stress affect my body otherwise?

Chronic stress, particularly, can increase the chances of certain health risks other than irregular cycles, including:

Body aches pains
Changes in appetite and energy
Headaches
Increased use of alcohol, drugs, and other substances
Skin rashes
Sleep troubles
Stomach problems
Trouble concentrating and making decisions
Worsening of chronic physical and mental health conditions [5]

However, in small doses, stress can be a good thing, too! It helps us learn and adapt to new situations, solve problems effectively, and even increase our energy in certain circumstances. This positive stress is called “eustress,” and it can replenish energy stores, boost heart health, sharpen mental function, and increase motivation [3].

Ways to manage stress effectively

A bit of stress here and there is a normal part of life, and we can only control so much in our environments. But we can control how we react to and cope with everyday negative stressors when they arise. Here are a few tips for effectively combating stress and staying healthy in mind and body:

Mental mindfulness

There are quite a few ways to take care of your mental health on a regular basis so that you’re prepared when stressors come around (plus, you’ll probably feel better in your day-to-day, even without stressors). A few of our favorites include:

Less screen time: Taking breaks from the news and social media can significantly improve your mental health. It’s great to be informed and connected, but the constant stream of information available at our fingertips can become overwhelming [5].
Regular relaxation: Making time in your schedule to unwind — however that looks for you — can give your brain some much-deserved downtime. If you’re looking for ideas, try meditation, breathing exercises, spending time outdoors, or other activities you find enjoyable [5].
Write it out: Keeping a journal can help with self-expression, reflection, emotional processing, and keeping a log of memories [5].
Gratitude: Reminding yourself of specific things in your life that you’re grateful for each day can help rewire your brain to look for the good throughout life [5].
Cognitive behavioral therapy (CBT): This form of therapy can specifically target stressful events and help create a healthy response to them [2].

Take care of your body

Caring for your physical health can also help you prepare for (and combat) stress. Speak with your healthcare provider about what’s needed for your body, but a few general recommendations include:

Getting enough sleep: Going to bed and waking up at around the same time each day, sleeping for at least seven hours, and keeping a dark, cool room can vastly improve sleep quality, ensuring that you’re rested and ready to take on anything the day throws at you [5].
More movement: Exercise, or even just regular movement throughout your day, can greatly improve mental and emotional health. About 20-30 minutes of movement per day is recommended for positive health outcomes [5].
Healthy eating habits: Again, speak with your doctor about your specific dietary recommendations, but eating lots of fruits and vegetables, lean protein, and whole foods can help you feel your best [5].
Limit alcohol, smoking, and drugs: These substances can make it much more difficult to deal with stress. We know that they can be a big part of both socializing and relaxing for some people, which can lead to some scenarios where they’re hard to avoid. If you do partake, remember that moderation is key, and there’s nothing wrong with abstaining for a while if you’re going through something difficult [5]. (For support with addiction and recovery, check out https://drughelpline.org/ or call the U.S. National Drug Helpline at (844) 289-0879. For the UK, find NHS resources here.

Connect with others

Human beings are social creatures, so try to carve out time to connect with your loved ones and community. Whether it’s friends, family, neighbors, faith-based communities, or any other person or people you trust, talking with them about how you’re feeling can provide lots of stress relief [5].

Keep your routine

Humans are also creatures of habit. Whether it’s visiting your favorite coffee shop at lunch regularly, going for a walk after work, cooking your favorite meal once a week, or watching your favorite show each night or binging on the weekends, there are a few habitual comforts we can adopt and work into our lives so that we have something to look forward to, even if we’re stressed otherwise.

Set realistic goals

If you’re currently experiencing stressful times, it may seem impossible to integrate all of these stress management techniques into your life at once (especially if you’re dealing with the added stress of a late or missed period). Know that you don’t need to do all of these things in order to cope with stress in a healthy way. Just one may be enough to help you feel (and deal) better. Stay in tune with how you’re feeling, set realistic goals, go easy on yourself, and focus on what works best for you. Stress affects all of us differently, and simply showing up for yourself to try to address it is half the battle. Recognizing your efforts and achievements, no matter how small, can set you on a course for healthy stress management long-term.

When to seek care about period changes

To echo our earlier notes, it’s a good idea to see your healthcare provider any time you notice menstrual cycle irregularities so that they can help identify and address the root cause, whether that’s stress or another condition. They can also provide recommendations for dealing with stress effectively based on your unique health history and circumstances.

Get to know your body better with Natural Cycles

Thanks for reading up on whether stress can delay your period. If you think stress might be affecting your cycle and you’d like to track the changes happening in your body over time, Natural Cycles can help you detect irregularities, and provides a downloadable Cycle Report, making it easy to discuss with your doctor when things don’t seem quite right. See how Natural Cycles can support you today.

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Vigil P, Meléndez J, Soto H, Petkovic G, Bernal YA, Molina S. Chronic Stress and Ovulatory Dysfunction: Implications in Times of COVID-19 [Internet]. 2022 [cited 19 June 2025]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9168655/
Huhmann K. Menses Requires Energy: A Review of How Disordered Eating, Excessive Exercise, and High Stress Lead to Menstrual Irregularities [Internet]. 2020 [cited 19 June 2025]. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0149291820300527
NIH. What are menstrual irregularities? [Internet]. 2017 [cited 19 June 2025]. Available from: https://www.nichd.nih.gov/health/topics/menstruation/conditioninfo/irregularities
Chu B, Marwaha K, Sanvictores T, et al. Physiology, Stress Reaction [Internet]. 2024 [cited 19 June 2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541120/
CDC. Managing Stress [Internet]. 2025 [cited 24 June 2025]. Available from: https://www.cdc.gov/mental-health/living-with/index.html

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Are you thinking of coming off birth control but worried about acne breakouts? We get it. Most people are aware of the potential side effects when starting hormonal birth control, but it’s perhaps less known that there might also be symptoms, like acne, when you come off them. In this article, we’ll talk about what post-birth control acne is, why it happens, what hormones have to do with it, and how to treat it. Let’s dive in!

","

Key takeaways

Post-birth control acne, or “post-pill acne”, refers to acne breakouts after coming off hormonal birth control, and it can happen regardless of which method was used
These breakouts are likely caused by hormonal shifts as the body adjusts back to its natural levels, and if you used birth control to treat acne, it may reappear when you come off it
Post-birth control acne will often go away on its own in time, but it can also be treated similarly to other acne, using medications like topical retinoids, antibiotics, or spironolactone, or managed with natural options such as gentle skincare, tea tree oil, or reducing stress

","

What is post-birth control acne?

Some estimate that acne affects up to 80% of people at some point in their lives [1], and many of us have experience with it in some shape or form. Women are also more likely to seek treatment for acne than men [2].

So, what is post-birth control acne? It refers specifically to acne that occurs after you stop using hormonal birth control, such as the pill, implant, or hormonal IUD. This is also known as post-pill acne, though it can happen when coming off any type of hormonal contraceptive.

While there are records of post-birth control acne as far back as the 1970s [3], and it’s well-known by now that stopping birth control can result in acne breakouts [4], there hasn’t been a lot of research into the specifics of it, like how common it is or how long it lasts. However, one study that looked at the pill found that 63% of the study participants experienced skin blemishes after they stopped using it [5].

How do hormones affect acne?

Before we jump into the nitty-gritty of acne after birth control, it’s important to know that acne and hormones often go hand-in-hand. With that in mind, it’s no surprise that acne breakouts are so common during times in our lives when hormones go a bit haywire — like during puberty, pregnancy, or even perimenopause [2]. Breakouts can also be triggered by the hormonal shifts within the menstrual cycle, which is why you might experience acne during ovulation or right before your period [2].

Acne is complex, and many different hormones and other factors are involved, but to keep things simple, we’ll talk about the most important ones. These are a group of hormones called androgens (testosterone being the most well-known example) [6]. High androgen levels have been linked with acne outbreaks because androgens are in charge of controlling glands in our skin that produce an oily substance called sebum. This is important for keeping our skin healthy, both by maintaining moisture and protecting it from infection [1], but if there’s too much sebum, the pores can get clogged. In turn, this allows bacteria to grow and can result in acne and inflammation [6].

Other hormones also play a role in acne breakouts. The two main female sex hormones, estrogen and progesterone, as well as insulin, which helps regulate our blood sugar, are also involved. Progesterone and insulin trigger sebum production, while estrogen can decrease it and counteract the effect of androgens [6].

How hormonal birth control works

There are two main types of hormonal birth control: those containing estrogen and synthetic progesterone (like the combination pill or vaginal ring) and progestin-only methods that only contain synthetic progesterone (like the hormonal IUD or mini pill). While you’re using these methods, your hormone levels will remain stable and you won’t have the cyclical fluctuations that come with the menstrual cycle, since they work by suppressing ovulation or making it less frequent [7].

Can birth control help acne?

Yes, it can! Hormonal birth control, and especially the birth control pill, is commonly prescribed as treatment for acne since it stabilizes your hormone levels and stops the menstrual cycle. Methods that contain estrogen, like the combination pill, also have anti-androgenic effects — meaning that the estrogen suppresses the androgens that trigger excess sebum production and oily skin [8].

However, acne can also be a side effect of hormonal birth control. It’s most common with progestin-only options, like the hormonal IUD or implant, but can happen with any method [9]. It’s also good to know that certain types of progestins are more likely to trigger acne [6, 9], so if you know you’re prone to outbreaks, it’s a good idea to discuss your options with your healthcare provider. And remember, you can always switch methods if needed.

Why do you get acne outbreaks when stopping birth control?

If you had acne before you started birth control or you were prescribed birth control to treat acne, there’s a chance it will come back after you stop using it. However, some people get acne after stopping birth control even if they haven’t had problems with it before. So, why does it happen?

Androgens on the rise

If you were using a method that contains estrogen, like the pill, it may have to do with increasing androgen levels. As we mentioned earlier, estrogen suppresses the androgens that trigger our skin’s production of oil [6]. So, when you’re no longer adding a steady level of estrogen via your birth control, estrogen levels drop and androgen levels can become higher again — resulting in acne.

Fluctuating hormone levels

Another aspect of stopping hormonal birth control, regardless of which type you were on, is that your body will start adjusting back to its natural hormone production, meaning that your menstrual cycle will return. It’s common that it takes a while for your cycle to get back to its natural rhythm, and in the meantime, hormones may fluctuate a bit more than usual. This can lead to acne breakouts while your body is working to get back to normal. In general, hormonal shifts are notorious for causing symptoms like acne, which is why we can also get acne around ovulation or around the time we get our period [2].

Do you get post-birth control acne after all hormonal birth control?

Well, the short answer is that you might — but you also might not. Even though post-birth control acne might be better known under the name “post-pill acne”, it doesn’t just happen when you come off the pill. You may see acne breakouts when you stop any type of hormonal birth control, since your body will still need to adjust to your natural hormone levels.

To complicate things further, not everyone will experience acne flare-ups at all after stopping birth control. It can depend on which method you were on and the type and doses of hormones it contained, how sensitive your body is to hormonal shifts, and (perhaps more importantly) whether or not you had acne before you started birth control in the first place.

How long does post-birth control acne last?

Again, it depends. Some see their skin clear up after a few weeks, while others may have acne for several months after stopping birth control. We’re all different, and it’s individual how long it takes for the body to get back to its natural rhythm.

Given enough time, post-birth control acne often goes away on its own. However, if your acne bothers you a lot, or if you had acne before going on birth control and it comes back, there are treatments available. Make sure you speak with your healthcare provider or dermatologist if you’re concerned or have questions — they can help you find a treatment plan that works for you.

How can you treat post-birth control acne?

Post-birth control acne can be treated similarly to other acne. One thing to note is that hormonal birth control itself is often used to treat acne. So, if you’ve recently stopped using it — and you don’t want to start again — that might affect your treatment options. Still, there are several others available. With that in mind, it’s always a good idea to speak with a healthcare provider before starting any treatment on your own.

Medications to treat acne

There are several medications available to treat acne, both over-the-counter options and some that require a prescription. Let’s take a look at a few common ones.

Topical retinoids: A class of chemical compounds derived from vitamin A, retinoids come in the form of over-the-counter creams, gels, or serums that you put on your skin. Some topical retinoids need to be prescribed by a doctor. Retinoids can be effective in treating acne and preventing new outbreaks, mainly by reducing inflammation and normalizing the skin's ability to shed dead skin cells so that the pores don’t become clogged, and can also help with acne scars. Keep in mind that retinoids can make the skin more sensitive to sunburn, so make sure to use sunscreen and avoid tanning while using it [10].

Benzoyl peroxide: An over-the-counter treatment for acne that you put on your skin, and often combined with other methods like retinoids or antibiotics. Benzoyl peroxide is antibacterial and works by killing bacteria that can cause acne, and it also reduces inflammation. For some people, it can cause skin irritation in the form of redness, itching and/or skin peeling [10, 11].

Antibiotics: Both topical antibiotics (in the form of creams you put on your skin) and oral antibiotics can be used to treat acne. They work by killing bacteria that causes acne and also have anti-inflammatory properties, and they are usually combined with other treatments like benzoyl peroxide or retinoids. Oral antibiotics are typically only used for severe acne [10].

Spironolactone: A type of steroid that works by blocking androgens, which in turn reduces the production of sebum that leads to acne. Spironolactone needs to be prescribed by a doctor, but it’s worth knowing that you’ll need to use some form of contraception at the same time, as you shouldn’t use it while pregnant since it can harm the fetus. It’s often prescribed together with birth control pills to prevent pregnancy, so make sure you discuss your options with your doctor [12].

Isotretinoin: Perhaps more known under the brand name Accutane, isotretinoin is an acne treatment that works primarily by reducing the production of oil in the skin (sebum). Because it can have some potentially serious side effects, it’s not typically used as a first treatment, but isotretinoin has been found to be effective for severe acne, as well as acne that doesn’t respond to other treatments. Similar to spironolactone, you need to use an effective birth control method while on isotretinoin, as it can’t be used during pregnancy [10].

Keep in mind that most acne treatments take time to work — often up to 12 weeks — before you see any results, so patience is also key.

Other treatments for acne

Aside from the medicines, there are also some natural options that may help with acne or can complement the medications listed above. However, research is more limited here, so it’s still a good idea to speak with your doctor if you’re thinking of trying some of these out.

Skincare routine: It’s a myth that all acne is caused by bad hygiene, but there are some things you can think about when it comes to your skincare routine that may help reduce acne breakouts. Wash your face with gentle cleansers (but not too often; try to keep it to once or twice per day), and use gentle skincare products that don’t irritate your skin. Try not to touch your face too often or pick at your acne. And lastly, remember you can always ask your dermatologist or pharmacist if you need help finding good skincare products.

Tea tree oil: An essential oil that has anti-inflammatory and antibacterial properties. It may help mild acne and has been shown to reduce outbreaks, but research is still limited when it comes to its effectiveness and safety [13].

Alpha-hydroxy acids (AHAs): AHAs are a group of acids that are commonly used in different types of skincare products. They work by exfoliating the skin so that pores don’t get clogged, and reduce redness and inflammation. AHAs are often used together with other acne treatments like salicylic acid [14].

Niacinamide: A type of vitamin B3 that comes in the form of topical creams that you put on your skin or as supplements. Niacinamide is said to have anti-inflammatory properties and to reduce the build-up of oil in the skin, which is why it could potentially help in treating acne [15]. However, there hasn’t been much research done on its effectiveness, so it’s not possible to say how well it works [10].

Diet changes: While the relationship between diet and acne isn’t entirely understood, some studies suggest that certain diet changes can be helpful for some people when it comes to managing acne. For example, a low-GI diet — limiting refined carbs and sugar, and focusing on whole grains, healthy fats, fruits, and vegetables — and consuming less dairy has shown some promise when it comes to managing acne [16].

Managing stress: There’s research indicating stress can make acne worse, so managing stress levels may help reduce outbreaks [17]. We know that’s easier said than done, and acne can have a negative impact on our mental health on its own, but try to find ways to reduce your stress levels — whether it’s through mindfulness or medication, by going on walks in nature, taking breaks throughout the day, or just taking a moment to breathe.

We know acne can be challenging to deal with. Post-birth control acne will often go away on its own if given enough time, but don’t hesitate to speak to a doctor if you feel that your acne negatively impacts your life or mental health — there is help available.

Keep track of skin changes with Natural Cycles

Here at Natural Cycles, we believe that information is key to making informed decisions about your health. Knowing what to expect when coming off hormonal birth control can help you feel in control and manage symptoms as they come. The NC° app isn’t just an FDA Cleared and CE marked digital birth control method and fertility app — you can also use it to keep track of changes to your skin, including acne, along with other symptoms you may experience during your menstrual cycle. Curious to learn more about your body? See if Natural Cycles could be right for you today.

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Wienand PE, Wilhelm M. Expectations versus reality: two cross-sectional studies on expected and experienced discontinuation symptoms in current and former contraceptive pill users. Women’s Health (Lond). 2025;21. Available from: https://doi.org/10.1177/17455057251338401
Elsaie ML. Hormonal treatment of acne vulgaris: an update. Clin Cosmet Investig Dermatol. 2016;9:241–8. Available from: https://doi.org/10.2147/CCID.S114830
American Society for Reproductive Medicine. Hormonal Contraception [Internet]. 2023 [cited 2025 Jul 3]. Available from: https://www.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/hormonal-contraception/
Del Rosso JQ, Kircik L. The cutaneous effects of androgens and androgen-mediated sebum production and their pathophysiologic and therapeutic importance in acne vulgaris. J Dermatolog Treat. 2024;35(1). Available from: https://doi.org/10.1080/09546634.2023.2298878
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Welcome to week 27 and the final week of your second trimester! In this week’s article, we will discuss some body and pregnancy symptoms from the thickening of hair on your head to restless leg syndrome causing tingling in your toes. We will also check in on your baby, who is busy punching and kicking to help develop their muscular strength. Finally, we will discuss birth plans and offer some tips for feeling calm and confident going into your third trimester.

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Key takeaways:

Increased hair growth might prompt you to find new hairs in unexpected places, like your face, back, or stomach
Keeping track of your baby’s movements is important, keeping in mind that they tend to move mostly when they are awake
A birth plan that prepares for the expected, and unexpected, can help you feel calm and supported by those who will care for you and your baby during labor and delivery

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Your body at week 27

Changes to your hair

Increased levels of the hormones estrogen, progesterone, prolactin, and growth factors during pregnancy have been linked to increases in hair growth and hair diameter [1]. The growth and shedding cycle of hair occurs in roughly four stages: growth (anagen), regression (catagen), rest (telogen), and shedding (exogen) [2]. Studies have shown that during pregnancy, the rest phase, telogen, gets delayed, which results in less shedding. This can promote both new hair growth as well as thicker hair (since shedding is delayed) for some women. But remember, these changes are not limited to the hair on your head! It’s common to experience new hair growth on the abdomen, lower back, thighs, and face as well.

Hair loss connected to pregnancy is usually experienced 1-5 months after delivery. This type of postpartum hair loss is called telogen effluvium and refers to the delay of the telogen phase that happens during pregnancy [3]. During telogen effluvium, excessive shedding and thinning of the hair can occur and it is estimated that between 40-50% of women can experience this type of hair loss after giving birth [3]. Like many changes during pregnancy and postpartum, telogen effluvium is temporary.

Restless leg syndrome

Have you noticed a tingling, crawling, or creeping sensation in your feet, calves, or thighs that prompts you to want to move your legs suddenly? It’s possible you are experiencing restless legs syndrome (RLS) brought on by your pregnancy. Studies have shown that up to 34% of pregnant women experience RLS, and it is particularly common during the third trimester [4]. For most, the condition resolves after delivery. Different hormonal, dietary, and genetic factors have all been linked to pregnancy-related RLS [4].

RLS can be particularly disruptive to your sleep, coinciding with increases in leg cramps in the night as well as daytime fatigue. If you are experiencing RLS, talk to your nurse or doctor about what treatments might be right for you. The most common recommendations include stretching, iron supplements, and compression socks, but in some cases, medication can also be prescribed [4,5].

Heat rash

Heat rash, also known as prickly heat, is commonly experienced by pregnant women particularly in the warm weather months. During pregnancy, hormonal changes and increased blood flow to your skin can make you feel warmer than usual, increasing perspiration or sweat [6]. When sweat glands on the skin get blocked and sweat is not able to evaporate, a heat rash can develop. It usually appears as small pink or red bumps that can itch or feel sensitive.

During pregnancy, heat rash can commonly appear anywhere where sweat can accumulate and the skin might not be able to ventilate, like in the skin between and beneath the breasts, between your pregnant belly and upper pubic area, the inner thighs, and the armpits.

To prevent heat rash, try to stay in cooler and ventilated environments and avoid spending too long outside, particularly when the weather gets warm. Wearing light, breathable, loose-fitting clothes, fans, and air conditioning can also help. To treat inflammation, you can apply a cold, damp cloth or a covered ice pack to the area. Speak with your nurse, doctor, or pharmacist about other topical treatments like creams, lotions, or antihistamine medications.

Your baby’s development at 27 weeks

At 27 weeks, you are likely feeling your baby move throughout the day. These movements are important for strengthening their little muscles. Your nurse, midwife, or doctor can recommend different tools you can use for counting or monitoring your baby’s movements [7]. Remember that your baby has sleeping and waking cycles just like you do, and will likely be more active when they are awake than while they are asleep.

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At week 27, your baby is now as big as a head of lettuce, weighing around 1.9 to 2.2 pounds (880g to 1 kilogram) and measuring 13.8 to 14.6 inches (35 to 37 centimeters) [8].

What is a birth plan?

A birth plan is a prepared outline, list, or record of your wishes for your and your baby’s care through labor, delivery, and just after birth. It is not required, but it can be a useful tool for helping you learn about and understand the different parts of labor and delivery, and for communicating your wishes to those who will be caring for you and your baby before, during, and after the birth.

Building your birth plan with input from your medical team is important as your medical history, circumstances of your pregnancy, and what is available where you plan to give birth all affect your birth plan. Discussing your birth plan with your healthcare team also helps establish good lines of communication. While there are many resources available for creating a birth plan, it is recommended to start with outlines or templates available from your midwife, doctor, hospital, or national healthcare service [9,10]. Making sure your birthing partner(s) (those who will be in the delivery room with you) are familiar with your birth plan also helps them advocate on your behalf throughout labor and delivery.

Finally, birth plans can be as broad or as specific as you wish. Whatever type of birth plan you choose to create, if you decide to make one, being flexible is crucial. While you might have strong wishes regarding your labor and delivery, birth can proceed in unexpected ways. Being prepared ahead of time to do things differently from your birth plan is also an important way to plan for welcoming your new baby into the world.

Tips in week 27

Prepare for more frequent prenatal appointments: For many women, the frequency of visits to your nurse, midwife, or doctor can increase in the third trimester. These visits are important to continue to monitor your and your baby’s health and provide support, resources, and education to you and your partner as you get closer to giving birth and welcoming your baby into the world.
Plan your hospital bag: If you know you will be giving birth in a hospital or maternity center, it’s not too early to start thinking about what you want to pack. While there are plenty of resources online, it’s recommended to start with guidelines provided by the facility where you will give birth. Keep in mind that even if you plan to give birth at home, birth can be unpredictable, and having a bag packed just in case can be helpful if the need arises.
Keep an eye on your heart rate: Throughout the duration of your pregnancy, it’s considered normal and expected for your heart rate to increase by around 10 to 20 beats per minute [11]. The extra work of your cardiovascular system, your body’s natural weight gain, and the pressure of your growing uterus on your internal organs can all contribute to increased shortness of breath and fatigue. Whether you are exercising or going about your day-to-day activities, maintaining a safe pulse can help prevent undue stress on your heart and help ensure good blood flow to your baby. A talk test – if you can converse comfortably during activity – is a practical way to monitor your intensity and ensure that you are not overexerting yourself [12].
Flying during pregnancy: If you’re considering a last minute vacation before your baby’s arrival, it’s advised to check with your health team and your airline before booking tickets. While most travel is considered safe into the third trimester for low-risk pregnancies, many airlines will require a note from your doctor before allowing you to fly. It’s also a good idea to check what healthcare facilities are available where you are thinking of going, bring relevant maternity medical records, and check that your insurance covers your care abroad [13].

Prenatal guidance with Natural Cycles

If you enjoyed reading this article, did you know that you can access guides just like this weekly, alongside symptom and baby movement trackers, all in an easy-to-use app? NC° Follow Pregnancy from Natural Cycles offers prenatal guidance designed to you to support you on your pregnancy journey. Why not see if Natural Cycles is right for you today?

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Grymowicz, M., Rudnicka, E., Podfigurna, A., Napierala, P., Smolarczyk, R., Smolarczyk, K., & Meczekalski, B. (2020). Hormonal Effects on Hair Follicles. International Journal of Molecular Sciences, 21(15), 5342. https://doi.org/10.3390/ijms21155342
Natarelli, N., Gahoonia, N., & Sivamani, R. K. (2023). Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss. Journal of Clinical Medicine, 12(3), 893. https://doi.org/10.3390/jcm12030893
Pregnancy and hair loss [Internet]. American Pregnancy Association. 2021 [Cited 2025 Jun 23]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/hair-loss-during-pregnancy/
Gupta, R., Dhyani, M., Kendzerska, T., Pandi-Perumal, S. R., BaHammam, A. S., Srivanitchapoom, P., Pandey, S., & Hallett, M. (2015). Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta Neurologica Scandinavica, 133(5), 320–329. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5562408/
Djokanovic N, Garcia-Bournissen F, Koren G. Medications for restless legs syndrome in pregnancy. J Obstet Gynaecol Can. 2008 Jun;30(6):505-507. doi: 10.1016/S1701-2163(16)32866-3. PMID: 18611302. Available from: https://www.jogc.com/article/S1701-2163(16)32866-3/pdf
Common health problems in pregnancy [Internet]. nhs.uk. 2024 [Cited 2025 Jun 23]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/common-health-problems/
Your baby’s movements [Internet]. nhs.uk. 2024 [Cited 2025 Jun 23]. Available from: https://www.nhs.uk/pregnancy/keeping-well/your-babys-movements/
27 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 Jun 23]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/27-weeks-pregnant/
Sample birth plan [Internet]. ACOG. [Cited 2025 Jun 23]. Available from: https://www.acog.org/womens-health/health-tools/sample-birth-plan
How to make a birth plan [Internet]. nhs.uk. 2024 [Cited 2025 Jun 23]. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/preparing-for-the-birth/how-to-make-a-birth-plan/
Sanghavi, M., & Rutherford, J. D. (2014). Cardiovascular Physiology of Pregnancy. Circulation, 130(12), 1003–1008. https://doi.org/10.1161/circulationaha.114.009029
Cooper DB, Yang L. Pregnancy And Exercise. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430821/
Travelling in pregnancy [Internet]. nhs.uk. 2025 [Cited 2025 Jun 23]. Available from: https://www.nhs.uk/pregnancy/keeping-well/travelling/

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Welcome to week 26 and the final weeks of the second trimester. In this week’s article, we will talk all things headaches, coordination, balance, and leg cramps. We will also check in on your baby, who is working on their eye and lung development this week. Finally, we will discuss what gestational diabetes is and finish up with some tips for caring for your mind and body this week.

","

Key takeaways:

While most headaches during pregnancy are normal, it’s important to be mindful that severe headaches and headaches that do not go away could be a sign a preeclampsia
Your baby is starting to open their eyes this week as their eyes continue to mature and develop
Gestational diabetes can develop in anyone, most often without symptoms, which is why a glucose tolerance screening test between weeks 24 and 28 is important for early detection

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Your body at week 26

Headaches

Though most commonly a pregnancy symptom in the first and third trimesters, headaches can happen throughout your pregnancy and are linked to a number of factors, from hormone changes to lack of sleep, stress, dehydration, low blood sugar, and caffeine withdrawal [1]. You can try treating your headache at home with rest, a warm bath or shower, or a massage to relieve tension. Drinking enough water and making sure you eat small, regular meals throughout the day can also help.

Paracetamol and acetaminophen are considered safe to take during pregnancy as over-the-counter painkillers [2]. Be mindful that some acetaminophen tablets have caffeine, and it is generally advised not to exceed 200mg of caffeine (from all sources) per day.

In some cases, a bad headache can be a sign of preeclampsia. Preeclampsia is a high blood pressure disorder that requires medical monitoring for the safety of both the mother and the baby. While the causes of preeclampsia are not well understood, scientists believe it is linked to blood flow issues with the placenta [3]. The most common symptoms of preeclampsia are a severe headache, or a headache that does not go away, swelling of the face and hands, vision changes, pain in the upper abdomen or shoulder, and nausea or vomiting. If you experience any of these symptoms, contact your healthcare provider immediately.

Coordination and balance

Have you been having difficulty balancing while getting dressed or feeling particularly clumsy? Weight gain during pregnancy on account of the baby, placenta, amniotic fluid, and increased blood and fluid volume generally concentrates in the front and center of your body, which directly affects your center of gravity [4]. A shifting center of gravity combined with relaxation of your muscles and joints on account of pregnancy hormones can disturb your ability to balance and your motor coordination. Additionally, if you are suffering from pelvic girdle pain (which we discussed in the 25 weeks pregnant guide), it can worsen coordination and balance further [5].

While balance and mobility will recover during the postpartum period, you should exercise caution while engaging in tasks that could put you at increased risk of falling. This includes, for example, day-to-day activities that require balancing on one leg, exercise that requires coordination or balance, carrying other children, and riding public transportation standing. Physical activity continues to be important, so straight line or stationary activities like walking, jogging, swimming, and cycling (if safe to do so in your pregnancy) are ideal if you are dealing with balance and coordination issues.

Leg cramps

Cramps and muscle spasms in the legs are common in the second and third trimesters of pregnancy, resulting from changes in blood circulation and tiredness in your leg muscles [6]. In addition to being shocking and painful, they can disrupt your sleep and continue to ache for up to a day. To ease the pain of leg cramps, massaging the muscle vigorously can help increase blood flow to the affected area. If you experience a muscle spasm, try to gently pull your toes upwards with knees straight to stretch the calf muscle (pointing the toes down contracts the calf muscle).

You can try to prevent leg cramps by staying hydrated, stretching your leg muscles regularly, and making sure your diet includes the recommended amounts of calcium and magnesium. Light, regular exercise can also help with circulation. If your leg cramps are severe or persistent, contact your healthcare provider to see if they have recommendations regarding supplements or exercises to improve flexibility and circulation. You should also contact them if you experience swelling or redness, as this might be a sign of a more serious condition.

Your baby’s development at 26 weeks

About the size of a scallion, your baby is measuring around 13.4 to 14 inches (34-36 centimeters) and weighing 1.7 to 1.9 pounds (760 to 850 grams) [7].

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At 26 weeks, your baby is just beginning to partially open its eyes [8]. Their first eye movements are mostly reflexive, as their eyes continue to open and develop all the way until birth. You might also periodically feel rhythmic pulsing or movements in your belly. These are not a heartbeat, but likely hiccups — the result of your baby swallowing amniotic fluid. While scientists are not sure why babies get the hiccups in utero, some studies have suggested that hiccups can play a role in lung development [7].

Managing gestational diabetes

Between weeks 24 and 28, you will likely have an oral glucose tolerance test to screen for a type of diabetes called gestational diabetes. Gestational diabetes is a condition that develops in pregnancy when your body cannot produce enough insulin to control your blood sugar levels [9]. Because it can cause problems for both you and your baby, early detection is key to managing the condition throughout pregnancy.

Anyone can develop gestational diabetes, but there is an increased risk if you are overweight, have given birth to a baby who weighed over 9 pounds (4 kilograms), have had gestational diabetes in a previous pregnancy, or have a family history of type 2 diabetes [10]. Gestational diabetes often does not have any symptoms, but can lead to issues in your pregnancy, like your baby growing larger than usual, having too much amniotic fluid, premature birth, and preeclampsia, which is why early detection is important [9].

If you are diagnosed with gestational diabetes, you will likely be given a blood sugar testing kit so that you can monitor your blood sugar. You will also be given recommendations and advice on changing your diet, and likely be encouraged to stay active in order to lower your blood sugar and make your body more receptive to insulin [10]. In some cases, medicine might be prescribed.

While gestational diabetes typically goes away after birth, it’s important to know that having gestational diabetes in one pregnancy increases the likelihood it will develop in subsequent pregnancies. About half of women who get gestational diabetes when pregnant will develop type 2 diabetes later in life, so it is important to talk to your doctor about managing your risk after you’ve given birth [10].

Tips in week 26

Avoid drinking too much at night: While it’s important to stay hydrated during the day, your growing baby will likely place more and more pressure on your bladder in the weeks and months to come. Try to moderate how much you drink in the evenings to avoid having to get up in the night to use the bathroom.
Remember your posture: The way you hold your posture can make a difference. Slouching, overarching, or sitting in the same position for too long may add pressure to your neck, back, and pelvis, which can worsen existing pelvic or hip discomfort and contribute to headaches. Try to stay aware of your posture when sitting and standing — small adjustments can help. Aim to gently tuck your pelvis to avoid arching your lower back, keep hips and knees at 90-degree angles, and align your ears over your shoulders and your shoulders over your hips.
It’s ok to be anxious about childbirth: As you head into your third trimester, you will likely begin thinking about childbirth. It is completely normal and expected to have questions or concerns. While there is no shortage of reliable sources online, it’s easy to inadvertently land on a page that can trigger or worsen uncertainty. Speak with your nurse, midwife, or doctor, and remember, there are no dumb questions. Your healthcare team can recommend sources, classes, and additional counseling to help support you through this time.
Familiarize yourself with the difference between Braxton Hicks and labor contractions: In the third trimester, or sometimes earlier, you might begin to feel cramps or pressure periodically in your lower abdomen and wonder if you are going into labor. Knowing the difference between Braxton Hicks contractions and labor contractions can help you stay calm in the moment. While labor contractions will continue, without stopping, at regular but decreasing intervals and get stronger over time, Braxton Hicks contractions will come and go irregularly and can even stop if you change positions or get a drink of water.

Using Natural Cycles during your pregnancy

Natural Cycles is best recognized as the first FDA Cleared birth control app. But did you know you can use Natural Cycles throughout your pregnancy as well as postpartum? NC° Follow Pregnancy was designed to support you by providing weekly guides, symptom trackers, and informative articles throughout the duration of your pregnancy. After giving birth, NC° Postpartum will help you during your recovery and can be used to prevent pregnancy when ovulation returns.

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Headaches in pregnancy [Internet]. HSE.ie. [Cited 2025 Jun 16]. Available from: https://www2.hse.ie/conditions/headaches-pregnancy/
Headaches and pregnancy [Internet]. ACOG. [Cited 2025 Jun 16]. Available from: https://www.acog.org/womens-health/faqs/headaches-and-pregnancy
Karrar SA, Martingano DJ, Hong PL. Preeclampsia. [Updated 2024 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570611/
Lewis, E. Exercise in pregnancy [Internet]. Australian Family Physician. 2014 [Cited 2025 Jun 17]. Available from: https://www.racgp.org.au/afp/2014/august/exercise-in-pregnancy
Wu, W.H., Meijer, O.G., Bruijn, S.M. et al. Gait in Pregnancy-related Pelvic girdle Pain: amplitudes, timing, and coordination of horizontal trunk rotations. Eur Spine J 17, 1160-1169 (2008). https://doi.org/10.1007/s00586-008-0703-0
Leg cramps in pregnancy [Internet]. HSE.ie. [Cited 2025 Jun 17]. Available from: https://www2.hse.ie/conditions/leg-cramps-pregnancy/
26 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 Jun 17]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/26-weeks-pregnant/
Donovan, T., Dunn, K., Penman, A., Young, R. J., & Reid, V. M. (2020). Fetal eye movements in response to a visual stimulus. Brain and Behavior, 10(8). https://doi.org/10.1002/brb3.1676
Website N. Gestational diabetes [Internet]. nhs.uk. 2025 [Cited 2025 Jun 17]. Available from: https://www.nhs.uk/conditions/gestational-diabetes/
Gestational diabetes [Internet]. Diabetes. 2024 [Cited 2025 Jun 17]. Available from: https://www.cdc.gov/diabetes/about/gestational-diabetes.html

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More and more people have children later in life, but at the same time, we know that our fertility decreases as we get older. With that, it’s no surprise that treatments to prolong the fertile years have also become increasingly common — including egg freezing. In this article, we’ll cover what you need to know if you’re considering freezing your eggs, including the best time to do it, what the egg freezing process looks like, things to consider before freezing your eggs, success rates, and more.

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Key takeaways

Egg freezing is a way of preserving fertility and prolonging the fertile years by extracting your eggs and freezing them to use at a later time
The highest success rates for having a baby from IVF with frozen eggs are seen if you freeze your eggs before the age of 35
Egg freezing can’t guarantee a pregnancy later in life — many factors can affect our chances of getting pregnant, such as the age when the eggs were frozen, how many eggs were extracted, and the quality of the eggs

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What is egg freezing?

Egg freezing, also known as oocyte cryopreservation, is a type of fertility preservation treatment. In short, you’re given hormone injections to stimulate the ovaries so more eggs mature compared to a normal menstrual cycle, and the eggs are then extracted, frozen, and stored. When you’re ready to use them, the eggs are fertilized in a lab, and the embryos are later implanted into the uterus (in the same way as during conventional IVF).

Egg freezing can be done for medical reasons, for example, before undergoing a treatment that can impact fertility. However, it’s also become an increasingly popular procedure in recent years to prolong our fertile years so that we can potentially have children later in life [1]. This is sometimes referred to as “social” or “elective” egg freezing.

When should you freeze your eggs?

As always, we all have our different fertility journeys. Because egg freezing is a personal choice, it’s hard to give a one-size-fits-all answer to the question of when it’s best to do it. However, one very simplified way of answering it is: if you know you want to freeze your eggs, it’s best to do it sooner rather than later.

At this time, there hasn’t been enough research done to give specific guidelines on exactly at what age you should freeze your eggs. That being said, it’s important to know that age does impact fertility, and studies into egg freezing have shown that outcomes are better if eggs are frozen at a younger age [2]. Even with that in mind, there’s no guarantee that the outcome will be successful — and that’s important to understand too.

Our mid-thirties seem to be a point of reference, though — this is generally when the age-related fertility decline picks up speed. One study looking at outcomes after egg freezing cycles found the chances of giving birth were better if the eggs were frozen before the age of 35 [3]. Another study found a sort of “threshold” with markedly better outcomes for eggs that were frozen at a younger age when comparing eggs frozen before and after the age of 38 [4].

When it comes to freezing your eggs, timing matters. According to Dr. Natalie Crawford, a fertility expert and member of the Natural Cycles Medical Advisory Board, earlier is generally better.

“The take-home message as it relates to your eggs: the sooner the better,” she says. Dr. Crawford explains that “for most, the ideal age to freeze your eggs is around age 32 to 33 years if you are not ready to conceive. At this time, egg quality and egg quantity are still relatively high, which can lead to better outcomes.\"

But the decision is highly individual. As Dr. Crawford notes, “your own individual goals — how many kids you want and when you might be ready to start trying to conceive — will impact what age will be the best for you.”

Her final word of advice? “If you know having a family is a life goal, consider freezing your eggs when you are young in order to keep as many options open as possible.”

Why does age impact fertility?

Most people are probably aware that fertility is linked to age, and that it becomes more difficult to get pregnant as we get older. But it’s probably less known why that is, and when these changes happen. You may have guessed it — it has to do with our eggs.

We’re born with all the eggs we’re ever going to have, and this collection of eggs is called our ovarian reserve. Common estimates are that we’re born with around 1–2 million eggs, and our ovarian reserve will shrink starting from the moment we’re born until we reach menopause [5]. Broken out, it looks roughly like this:

Birth: 1–2 million eggs
Puberty starts: 3–500,000 eggs left
Age 37: 25,000 eggs left
Menopause: 1000 eggs left [6]

Aside from the number of eggs in our ovarian reserve, the quality of the eggs is another aspect. Some eggs will naturally have genetic changes that mean they either can’t be fertilized or won’t result in a healthy pregnancy, and as we get older, we’ll have fewer of the high-quality eggs left in our ovarian reserve [7].

We’re generally the most fertile in our twenties and early thirties, so if egg freezing is something you’re thinking about — and you have the option — this may be a good time to consider it. It’s also a good idea to discuss it with your healthcare provider — they can help you understand what timing would be best for you.

Other circumstances that can impact the decision to freeze your eggs

Age isn’t the only factor to take into account when it comes to freezing your eggs — there are several other reasons you might consider this option.

Illness: If you have a medical condition or need to undergo a treatment that can affect your fertility, you may consider freezing your eggs to preserve your fertility. This can be the case for certain cancer treatments, like chemotherapy. Make sure to check with your doctor about what options are available for you.
Partner: We all know that finding the right partner isn’t always the easiest, and research has found that this is a common reason for choosing to freeze eggs [8]. Egg freezing can offer some extra time to find the one to spend your life with, so there’s less stress to jump into a relationship.
Career: Another common reason for egg freezing cited in research is wanting more time to build one’s career before having children [8]. Since women still take on much of the burden at home, along with the physical experience of pregnancy and postpartum recovery, this is something that can impact the timing of when you want to have kids. Again, egg freezing offers the possibility of delaying starting a family until you’re ready in your career.
Economy: Other socioeconomic factors also come into play when it comes to our decision to start a family. Being financially stable is an important factor for many before starting a family, and this can also impact the decision to freeze your eggs [8]. On the other hand, egg freezing itself can be expensive, so it’s not a possibility for everyone.

Everyone has their own fertility journey, and that includes decisions around fertility preservation treatments like egg freezing. It’s also worth considering that you’ll need to go through IVF if you decide to use the eggs later, and that can be a challenging process itself. That’s why it’s always a good idea to discuss with your doctor if you’re thinking about freezing your eggs — they can help you figure out if this is the right option for you.

How does the egg freezing process work?

The egg freezing process usually takes around two to three weeks to complete [1], and there are a few different steps involved. Let’s go through what you can expect.

1. Taking medication to stimulate the ovaries

You’ll be given hormone injections that you can take yourself at home (or with help from someone you trust), and you’ll also go to regular scans at your clinic to check on the progress. In most cases, you’ll take the injections for around two weeks [9]. They contain a hormone called follicle stimulation hormone (FSH), which works by stimulating your ovaries so that more eggs mature than in a typical menstrual cycle [10].

In some egg freezing protocols, you’ll need to take medications to stop the ovaries from releasing eggs for a couple of weeks before you start the stimulation [10]. Make sure you discuss with your doctor which protocol would work best for you.

2. Extracting the eggs

When the eggs are mature, it’s time to extract them. This is done by your doctor at a clinic. You’ll be put under general anesthesia or sedation for the procedure, which takes about 30-60 minutes. Your doctor will insert a small tube into your vagina which contains a needle, and that’s used to extract the mature eggs from the follicles [11].

So, how many eggs are collected? Usually, it’s somewhere around 7-14 eggs per egg retrieval if you’re under the age of 38 [1], but this number will ultimately depend on how many eggs there are. Your doctor will let you know after the procedure how many eggs were extracted.

3. Freezing the eggs

Once the eggs are extracted, they are frozen using a technique called vitrification. Essentially, this means that the eggs are cooled really quickly to freezing temperatures, and that’s done to ensure that as many as possible are preserved when thawing [9]. The eggs are then stored until you’re ready to use them.

Are there any side effects from egg freezing?

Because you’re given hormones to stimulate your ovaries during the egg freezing cycle, it’s possible you’ll experience some side effects. For most people, these are mild and they should go away once you stop the injections. You might notice:

Breast tenderness
Bloating
Feeling nauseous
Headaches
Mood swings [10, 12]

There’s also a small risk of ovarian hyperstimulation syndrome, which is quite rare but can lead to more serious symptoms that require treatment, like blood clots, stomach pain, shortness of breath, or dehydration [12]. If you experience any symptoms or feel unwell after the procedure, always reach out to your doctor to be sure.

How long do the frozen eggs last?

The eggs are stored in liquid nitrogen tanks at extremely low temperatures. There isn’t really any time limit for how long they will last, so in theory, they can be stored indefinitely. However, you should check with your clinic how long they will store your eggs for, since this can vary depending on where you live and what your contract says.

Things to consider before freezing your eggs

So, is there anything you should keep in mind before starting the egg freezing process? First off, it’s always best to get in touch with a healthcare professional who can give you personalized advice. However, here are some things you can consider doing:

Check your ovarian reserve: There are some tests that you can do to get a better understanding of how many eggs you have in your ovarian reserve, which can be helpful if you’re thinking about freezing your eggs. An AMH-test (which measures the levels of Anti-Müllerian hormone in your blood) is often used as an estimate of how many eggs you have left, as well as how you would respond to fertility treatment [13].

Stop hormonal birth control: Because hormonal birth control generally works by inhibiting ovulation, you can’t use it during the egg freezing process. You may even need to come off your birth control some time before starting the egg freezing protocol, so make sure to check with your doctor so you can plan ahead. Keep in mind that you’ll still need to use protection, such as condoms, to prevent pregnancy.

Maintain healthy habits: Age is the main factor that will impact our eggs, but it’s always good to maintain healthy habits, too. Research into this area is fairly limited, but maintaining a healthy weight and diet, exercising regularly, not smoking, limiting alcohol, and managing stress levels can all be beneficial for fertility [14].

Consider the cost: Egg freezing can be expensive, and unfortunately, it’s not an option for everyone. The cost of the treatment can vary depending on where you live and what type of insurance you have, so it’s good to do some research ahead of time to understand how much you’d need to pay. If you have a medical condition, you may be able to get the treatment covered, so make sure to check with your provider.

What happens when you want to use the eggs?

If you decide to use your frozen eggs, you’ll go through IVF. The process will look very similar to “regular” IVF — the main difference is that you’ll use your frozen eggs instead of extracting new ones during the IVF cycle.

The frozen eggs will be thawed and fertilized with sperm in a lab using a process called intracytoplasmic sperm injection (ICSI), which means that one sperm is injected into each egg [1]. The resulting embryo or embryos will then be inserted into your uterus.

What are the chances of getting pregnant using frozen eggs?

It’s important to know that egg freezing isn’t a guarantee that you’ll become pregnant if you do decide to use your eggs. Estimates of the chances of success for IVF treatment with frozen eggs will vary depending on several factors, mainly your age, when and how the eggs were frozen, and how many eggs were extracted during the egg freezing process.

Success rates can be measured in different ways, but let’s look at a successful treatment as one resulting in the live birth of a baby. An estimate supported by research is that the success rate for those who come back to use their frozen eggs is around 30%. This means that roughly a third of embryos from frozen eggs result in a baby after they are inserted into the uterus [15]. Research also shows that the birth rate increases a bit if 15 or more eggs are frozen [16].

Broken down further, here are some stats for egg freezing based on a small study of 27 women who returned to use their frozen eggs:

74% of eggs survive the thawing after having been frozen
67% of those eggs become fertilized on average
48% of embryo transfers result in pregnancy
35% of embryo transfers result in birth [16]

It’s also worth keeping in mind that egg freezing is still relatively new, and techniques are still advancing, which means that success rates vary for different people and clinics. More research is also needed in this area, as studies that look at the success of these treatments are often based on a relatively small number of women, and that makes it more difficult to make general statements. If you’re looking into freezing your eggs, make sure to check what the success rates look like for your age group at your clinic.

Take control of your fertility journey with Natural Cycles

Everyone has their own unique fertility journey, and here at Natural Cycles, we believe that understanding your body and fertility empowers you to make informed decisions about your reproductive health. The NC° app isn’t just a hormone-free and FDA Cleared birth control method and fertility tracker that uses your body temperature to pinpoint ovulation — it also allows you to better understand your body through personalized insights about your menstrual cycle. Why not see if Natural Cycles could be right for you today?

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HFEA (Human Fertilisation & Embryology Authority). Egg freezing [Internet]. n.d. [cited 2025 June 12]. Available from: https://www.hfea.gov.uk/treatments/fertility-preservation/egg-freezing/
American Society for Reproductive Medicine. Evidence-based outcomes after oocyte cryopreservation for donor oocyte in vitro fertilization and planned oocyte cryopreservation: a guideline (2021) [Internet]. 2021 [cited 2025 June 12]. Available from: https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-outcomes-after-oocyte-cryopreservation-for-donor-oocyte-in-vitro-fertilization-and-planned-oocyte-cryopreservation-a-guideline-2021/
Nagy ZP, Anderson RE, Feinberg EC, Hayward B, Mahony MC. The Human Oocyte Preservation Experience (HOPE) Registry: evaluation of cryopreservation techniques and oocyte source on outcomes. Reprod Biol Endocrinol 2017;15:10. Available from: https://doi.org/10.1186/s12958-017-0228-7
Doyle JO, Richter KS, Lim J, Stillman RJ, Graham JR, Tucker MJ. Successful elective and medically indicated oocyte vitriﬁcation and warming for autologous in vitro fertilization, with predicted birth probabilities for fertility preservation according to number of cryopreserved oocytes and age at retrieval. Fertil Steril 2016;105:459–66.e2. Available from: https://doi.org/10.1016/j.fertnstert.2015.10.026
Cox E, Takov V. Embryology, ovarian follicle development [Internet]. StatPearls - NCBI Bookshelf. 2023 [cited 2025 June 12]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532300/
American College of Obstetricians and Gynecologists Committee on Gynecologic Practice, The Practice Committee of the American Society for Reproductive Medicine. Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril. 2014;101(3):633-634. Available from: https://doi.org/10.1016/j.fertnstert.2013.12.032
ACOG. Having a Baby After Age 35: How Aging Affects Fertility and Pregnancy. [Internet]. 2023 [cited 2025 June 12]. Available from: https://www.acog.org/womens-health/faqs/having-a-baby-after-age-35-how-aging-affects-fertility-and-pregnancy
Katsani D, Paraschou N, Panagouli E, Tsarna E, Sergentanis TN, Vlahos N, Tsitsika A. Social Egg Freezing—A Trend or Modern Reality? J Clin Med. 2024;13(2):390. Available from: https://doi.org/10.3390/jcm13020390
Guy's and St Thomas' NHS Foundation Trust. Freezing eggs or embryos [Internet]. July 2024 [cited 2025 June 13]. Available from: https://www.guysandstthomas.nhs.uk/health-information/fertility-preservation-for-women/freezing-eggs-or-embryos
Guy's and St Thomas' NHS Foundation Trust. Step 1: Medicines to produce eggs [Internet]. July 2023 [cited 2025 June 13]. Available from: https://www.guysandstthomas.nhs.uk/health-information/ivf-treatment/step-1-medicines-produce-eggs
Guy's and St Thomas' NHS Foundation Trust. Step 2: Egg collection [Internet]. July 2023 [cited 2025 June 13]. Available from: https://www.guysandstthomas.nhs.uk/health-information/ivf-treatment/step-2-egg-collection
Petropanagos A, Cattapan A, Baylis F, Leader A. Social egg freezing: risk, benefits and other considerations. CMAJ. 2015 Jun 16;187(9):666–9. Available from: https://doi.org/10.1503/cmaj.141605
National Library of Medicine. Anti-Müllerian Hormone Test [Internet]. March 2023 [cited 2025 June 16]. Available from: https://medlineplus.gov/lab-tests/anti-mullerian-hormone-test/
Sharma R, Biedenharn KR, Fedor JM, Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reprod Biol Endocrinol. 2013;11:66. Available from: https://doi.org/10.1186/1477-7827-11-66
Kirubarajan A, Patel P, Thangavelu N, Salim S, Sadeghi Y, Yeretsian T, Sierra S. Return rates and pregnancy outcomes after oocyte preservation for planned fertility delay: a systematic review and meta-analysis. Fertil Steril. 2024;122(5):902–17. Available from: https://doi.org/10.1016/j.fertnstert.2024.06.025
Kakkar P, Geary J, Stockburger T, Kaffel A, Kopeika J, El-Toukhy T. Outcomes of social egg freezing: a cohort study and a comprehensive literature review. J Clin Med. 2023;12(13):4182. Available from: https://doi.org/10.3390/jcm12134182

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Cervical mucus plays a key role in our reproductive health. Also called cervical fluid, cervical mucus is a substance that forms in the cervix and is secreted through the vagina. It can provide all kinds of indications about your health, fertility, and more. In this article, we’ll go over the different types and stages of cervical mucus you can expect during your cycle, what the Cervical Mucus Method is in relation to natural family planning, plus how cervical mucus symptom tracking can help you learn more about your body.

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Key takeaways

Cervical mucus is a natural fluid that forms in the cervix and gets secreted out via the vagina throughout the menstrual cycle
Depending on what phase of the cycle you’re in, your cervical mucus will vary in consistency, color, texture, and more
Tracking these changes over time can help you identify patterns and figure out the timing of your cycle phases, including your fertile window

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What is cervical mucus?

Cervical mucus is a bodily fluid that is formed and secreted by the cervix. Its production is stimulated by increasing levels of estrogen in the body during each menstrual cycle. Since estrogen levels vary throughout the cycle, the amount, consistency, and even color of your body’s cervical mucus will also change throughout your cycle. Observing these changes over time with Natural Cycles can help you identify your unique cycle patterns [1].

What can cervical mucus tell you about your health?

Cervical mucus can give you clues about your fertility, particularly the timeframe when you’re most fertile. It’s a good indicator of your most fertile days when you’re most likely to conceive. During this time, your cervical mucus will have a unique consistency and color.

The mucus can also be an indicator of your libido (sex drive), which may change throughout your cycle depending on which phase you’re in. Major, unusual changes in your cervical mucus, like foul smells or a green color, can signal a more serious underlying condition like an infection. See a healthcare professional if you notice these unusual shifts [2].

How does cervical mucus change throughout my menstrual cycle?

Let’s go over the most common ways cervical mucus changes over the course of a menstrual cycle:

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n

\n Cycle phase \n	\n Cervical mucus characteristics \n
\n After your period \n	\n This is when your body will produce the least amount of cervical mucus, and you may feel “dry.” If you do have any discharge, it will likely feel “sticky.” \n
\n Approaching ovulation \n	\n As you approach and enter your most fertile days, you’ll notice an increase in the quantity and moistness of your cervical mucus. It will likely look and feel a bit “creamy,” and may also be cream-colored. \n
\n Around ovulation \n	\n During ovulation, your body will produce the highest amount of cervical mucus. It will feel quite “wet” or slippery, and it will be thin and stretchy. It’ll resemble egg whites in color and consistency. \n
\n After ovulation \n	\n At this time, your body will produce less cervical mucus. It will also become slightly thicker in consistency until your period. You may also have a few “dry” days right before your period. \n

[1, 3]

What does your discharge look like when you are ovulating?

Your cervical mucus will appear similar to egg whites in both color and quality in the days around ovulation. It will be almost clear, thin, stretchy, and slippery — very similar to egg whites. This happens because estrogen is surging, causing these changes in the mucus to create an environment that is more welcoming to sperm cells in terms of both texture and pH [1].

How many days before ovulation do you get egg white mucus?

You’ll start to see egg white discharge a couple of days before ovulation. While this will likely be the ~6 days around ovulation, this timeframe can vary from person to person [4]. The best way to predict when egg white mucus will happen each cycle is to check and track the quality of your cervical mucus over time to identify your unique cyclical pattern.

Checking cervical mucus

Now that we know what changes to be looking out for, you may be wondering how to tell that these changes are happening. It’s very common to find cervical mucus discharge in your underwear, or when you wipe using the toilet, so you may notice these changes in your cervical mucus in those ways.

If you really want to be sure you’re getting an accurate picture of your cervical mucus, the most accurate way to identify these changes is to collect and observe a sample of the mucus on a daily basis with your fingers. To do this, first you’ll wash and dry your hands thoroughly. Then, you’ll insert your middle and/or index finger into your vagina, getting up and as close to the cervix as possible. When you remove your fingers, you’ll have a sample of the mucus. To assess the quality, you can roll it in between your fingers, or press your fingers together and slowly move them apart [1].

What’s the Cervical Mucus Method?

The Cervical Mucus Method is a way to naturally identify your most fertile days each month. You’ll use all the information outlined above — collecting a sample of your cervical mucus each day and noticing the quality, consistency, and color. Then, you’ll log these qualities on a calendar to identify the patterns over time, particularly your fertile window. To simplify the logging process, you can label the days as “dry,” “wet,” or “sticky.” “Wet” days will probably be when you’re most fertile, and when conception is most likely [3].

If you’re using Natural Cycles to track your fertility, you’ll have the option each day to add the amount and consistency of your cervical mucus. You can then compare this easily from day-to-day and cycle-to-cycle to learn more about your body.

What are some limitations of the Cervical Mucus Method?

The Cervical Mucus Method can give you a good idea of your patterns and fertility, but it’s not perfectly reliable. The qualities of cervical mucus can be hard to identify and distinguish without practice, and may require dedicated training [5]. It’s also possible to misinterpret cervical fluid as sexual secretion (the body’s natural lubricant), or even residual semen from sex [3].

Furthermore, women who are breastfeeding, taking hormonal birth control, have vaginitis or sexually transmitted infections, or who have had cervical surgery shouldn’t rely on this method, as all of these conditions may affect the characteristics of cervical mucus [3, 4].

This is why Natural Cycles uses more objective measurements — basal body temperature readings, period dates, and optional luteinizing hormone tests — to identify your fertile window.

Signs of pregnancy in cervical mucus

You may be wondering if there are any noticeable changes in your discharge after ovulation if you’re pregnant. While it’s normal to have more discharge than you normally do during pregnancy, this increase typically doesn’t start immediately.

Cervical mucus in early pregnancy

You’ll still have cervical mucus and discharge in early pregnancy, but any changes here are typically not a great indication of early pregnancy [6]. The only surefire way to tell if you are pregnant is with a pregnancy test.

Cervical mucus later in pregnancy

As the pregnancy progresses, you will start to notice more cervical mucus than you’re used to. The reason why we have higher amounts of discharge during pregnancy is to help prevent infections from traveling up the vagina to the womb to protect the pregnancy. This increase happens gradually during the pregnancy until the last week or so. At this point, you may notice discharge that contains streaks of sticky, jelly-like pink mucus. This is often referred to as a “show,” “bloody show,” or “mucus plug” and indicates that you’re near the end of the pregnancy journey [6].

Does hormonal birth control affect cervical mucus?

More research is needed in this area, but we do know that cervical mucus is affected by the hormone levels in your body, particularly estrogen. Taking hormonal birth control will affect the natural hormones already present in your body, so it’s likely that hormonal birth control does affect cervical mucus as well. We just don’t know exactly how, although researchers are currently investigating this [4]. An analysis including the results of three different sub-studies found that people who used hormonal birth control had a less predictable cervical mucus pattern overall [7].

What can cause changes to my cervical mucus?

As we mentioned earlier, breastfeeding, having vaginitis or sexually transmitted infections, or a history of cervical surgery can all affect the characteristics of cervical mucus.

Outside of these conditions, other factors like diet, stress level, or taking certain prescription medications like Clomid can also affect your cervical mucus, particularly in terms of the amount your body produces each cycle [1].

Track your cycle symptoms effectively with Natural Cycles

Cervical mucus is just one indicator of your fertility and cycle patterns. Using Natural Cycles, you can harness the power of these symptomatic changes along with your basal body temperature to get the full picture of your reproductive health. See if Natural Cycles can help you learn more about your body today.

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American Pregnancy Association. Cervical Mucus and Early Pregnancy [Internet}. [cited 11 June 2025]. Available from: https://americanpregnancy.org/getting-pregnant/cervical-mucus/
National Health Service. Vaginal discharge [Internet]. 2024 [cited 18 June 2025]. Available from: https://www.nhs.uk/symptoms/vaginal-discharge/
Planned Parenthood. What's the cervical mucus method of FAMs? [Internet]. [cited 11 June 2025]. Available from: https://www.plannedparenthood.org/learn/birth-control/fertility-awareness/whats-cervical-mucus-method-fams
Najmabadi S, Schliep KC, Simonsen SE, Porucznik CA, Egger MJ, Stanford JB. Cervical mucus patterns and the fertile window in women without known subfertility: a pooled analysis of three cohorts [Internet]. 2021 [cited 18 June 2025]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8487651/
Stanford JB, Schliep KC, Chang CP, O'Sullivan JP, Porucznik CA. Comparison of woman-picked, expert-picked, and computer-picked Peak Day of cervical mucus with blinded urine luteinising hormone surge for concurrent identification of ovulation [Internet]. 2021 [cited 18 June 2025]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8495767/
National Health Service. Vaginal discharge in pregnancy [Internet]. 2024 [cited 11 June 2025]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vaginal-discharge/
Han L, Taub R, Jensen JT. Cervical mucus and contraception: what we know and what we don't [Internet]. 2017 [cited 11 June 2025]. Available from: https://pubmed.ncbi.nlm.nih.gov/28801053/

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Welcome to week 25 of your pregnancy! As you head into your third trimester in a couple of weeks, you might experience both new and returning pregnancy symptoms as your body continues to grow and change. In this week’s article, we will discuss some physical symptoms like pelvic pain and gas, alongside a common mental health symptom – mood swings. We will also check on your baby and discuss strategies for coping with unsolicited questions and advice on pregnancy and childrearing. Finally, we’ll offer practical tips for things you can do this week to support your health and prepare for your baby’s arrival.

","

Key takeaways:

Your mental health is as important as your physical health during pregnancy, and it is important to seek professional support for relief if you feel you need it
Your baby is starting to be able to respond to both physical touch and sound this week, which means you might be able to feel them jump at a loud noise or move when you stroke your stomach
However well-intentioned, it is completely up to you whether to answer questions or accept advice from others about your pregnancy or postpartum plans

","

Your body at week 25

Hip and pelvic discomfort

As you approach your third trimester, your baby has grown large enough that you might begin to experience new twinges, aches, pains, or discomforts in your hips, pelvis, and thighs. As your ligaments continue to relax and stretch to support your growing uterus (and baby), this can affect both your mobility and your ability to move around comfortably day-to-day.

Pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD) are both used to describe symptoms that arise from stiffness or uneven movement of the joints in the pelvis [1]. PGP and SPD are not harmful to your baby and do not normally affect your ability to give birth vaginally, but they can make everyday activities more difficult [2].

If you are experiencing pain in your pelvis, lower back, or thighs, try to rest when possible, wear supportive footwear, keep aware of your posture, and avoid sitting or standing for too long. While certain exercises, even walking, might become more difficult, it is important to try your best to stay active. Incorporating pelvic floor strengthening exercises can help. If you are having difficulty getting relief, talk to your healthcare provider about other treatment options like physiotherapy.

Gas and bloating

The effects of pregnancy on your digestive system can result in constantly changing symptoms throughout the duration of your pregnancy. Gas is one of the most common and refers to the buildup of air and other gases in your digestive tract that are released either by burping or flatulence. During pregnancy, it is believed that rising levels of progesterone relax muscles and lead to the slowing down of your digestive tract. This can increase the time it takes to digest food by up to 30% [3]! This slowdown, combined with the pressure of your growing uterus on your abdominal cavity, can lead to feeling bloated. Your relaxing muscles might also make it more difficult to control the release of gas, leading to flatulence in less-than-ideal times and places.

While preventing gas during pregnancy is nearly impossible, avoiding certain foods and exercising (if recommended during your pregnancy) can help minimize gas buildup. Different foods affect people in different ways, so try to keep track of your diet to investigate whether certain foods are giving you issues. In general, chewing your food well and staying hydrated can both be a big help to your already hard-working digestive system.

Mood swings

As your body undergoes huge physical and emotional changes, it is normal to experience rapid swings in your mood or general feeling throughout the day. Fluctuations in mood can be linked to physical, emotional, and mental stress, as well as fatigue, shifts to your metabolism, and in your hormones levels [4]. While mood swings are most common in the first trimester of pregnancy, they can continue through the second and third trimesters as well as after the baby is born postpartum.

It is important to try and remember that if you are having mood swings, you are not alone, and what you are experiencing is extremely common. Caring for your physical and mental health by eating well, trying to get enough rest, and staying physically active can all help you manage stress and might help. However, if you find that your mood swings are lasting more than two weeks or do not seem to get better, speak with your healthcare provider. During pregnancy, caring for your mental health is as important as caring for your physical health, for both you and your baby.

Your baby’s development at 25 weeks

Important developments to your baby’s neurological and auditory system mean that they can now respond to touch and sound [5]. You might notice that a loud sound or certain music actually makes them jump or kick, which is known as the ‘startle’ response. You might also sometimes feel rhythmic movements in your belly – don’t worry, these are just hiccups!

This week, your baby weighs around 1.5 to 1.7 pounds (660 to 750 grams and measures around 13 to 13.8 inches (33 to 35 centimeters) [6]. This is around the size of a turnip, or rutabaga.

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Managing unsolicited advice

Your bump might become more noticeable to those around you, and there are pros and cons to others realizing you are pregnant. On the plus side, you might be offered that last seat on public transport during rush hour! On the other hand, you might be surprised at how many people – sometimes perfect strangers – are willing to ask you personal questions or offer unsolicited advice.

In the 22 weeks pregnant guide, we talked about how to deal with those invading your physical space, also known as uninvited tummy touchers. But what about your mental or emotional space? You might be surprised to find out that some around you are unashamed to ask you personal questions about your fertility journey or birth plans, and are eager to offer unsolicited advice on everything from breastfeeding to raising your unborn baby.

When it comes to questions, you are entitled to answer or not answer with as much or as little detail as you want. Even if these questions are coming from a close family member or friend. If you feel comfortable, you have questions, or you are genuinely interested in another person’s opinion, questions can lead to conversations that can be nurturing and helpful. But it is also OK to feel uncomfortable, or to want to avoid discussing these topics. A simple “I don’t know right now” or “I don’t really feel comfortable talking about it” are firm but respectful ways of signaling your boundaries to others.

Unsolicited advice is sometimes harder to avoid, but it is up to you (and your partner) to decide where and from whom to take advice. You can, and should, ignore any advice that you aren’t interested in receiving or which you disagree with based on your own knowledge or what you have been advised by your medical team. However well-intentioned, it is not rude to respond quickly and briefly with “thanks for the tip” or “I appreciate the advice” and leave it there, no further explanation or expounding needed. If listening to the advice or experiences of others, particularly concerning childbirth or breastfeeding, make you stressed or anxious, you are allowed to remove yourself from those situations as quickly as possible.

Finally, you can find support from those around you. If certain topics make you stressed or you just don’t want to talk about them, let those around you, like your partner or trusted friends, know. They can help have your back in social or public situations. Venting to trusted friends and family can also help you relieve stress and anxiety while strengthening the support of those around you.

Tips in week 25

Continuing exercise during pregnancy: It is normal that during your pregnancy, you might find that certain exercise or types of exercise are no longer possible or comfortable because of your changing body. If you find you are getting exhausted, out of breath, or experiencing pain or discomfort of any kind, it might be time to modify your routine or find a new physical activity. Talk to your nurse, midwife, or doctor for advice on continuing exercise safely.
Think about where your baby will sleep: Current guidelines suggest sharing a room with your baby for the first 6 months of their life [7]. This means the baby is in the same room as you, but in their own separate and safe sleeping space. Room sharing makes feeding, comforting, and monitoring your baby easier [8]. Depending on your living situation, this might mean reconfiguring furniture and talking with a partner on how you plan to tackle nights. By six months, some babies may be able to sleep for 8 hours or longer at night, but every baby is different, and it can take up to a year or more before they will consistently sleep through the night [9].
Keep up-to-date with vaccines: Check to make sure you’re up to date with flu, Tdap (tetanus-diphtheria-acellular pertussis), RSV, and COVID-19 vaccines. If you have any questions about your vaccine status, contact your nurse, midwife, or doctor. Getting vaccinated while pregnant helps create antibodies that you can pass to your baby to help protect them from disease in their first few months of life, and most vaccines are considered safe for use during pregnancy [10].
Antenatal classes: There are a variety of classes you can take during pregnancy that can help you prepare for your baby’s birth and give you information that can help you feel more confident caring for your newborn. Depending on where you live, many are free to attend. You can find antenatal classes by contacting your nurse or midwife or the children’s or family health center in your area.

Supporting your health with Natural Cycles

Finding support for your mental and physical health during pregnancy is important. NC° Follow Pregnancy is there to equip you with the information you need from conception through postpartum. Track your symptoms in the app and access weekly guides detailing the progress of your pregnancy. Interested in learning more – why not check out Natural Cycles today?

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She currently works as a Data Scientist for Natural Cycles in the field of women’s reproductive health. 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Pelvic pain in pregnancy [Internet]. nhs.uk. 2024 [Cited 2025 Jun 16]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/pelvic-pain/
Pelvic girdle pain and pregnancy | RCOG [Internet]. RCOG. [Cited 2025 Jun 16]. Available from: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-girdle-pain-and-pregnancy/
Pregnancy gas [Internet]. American Pregnancy Association. 2021 [Cited 2025 Jun 16]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/gas-during-pregnancy/
Mood swings during pregnancy [Internet]. American Pregnancy Association. 2021 [Cited 2025 Jun 16]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/mood-swings-during-pregnancy/
Stages of pregnancy: 25 to 28 weeks [Internet]. HSE.ie. [Cited 2025 Jun 13]. Available from: https://www2.hse.ie/pregnancy-birth/baby-development-pregnancy-stages/stages/25-28-weeks/
25 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 Jun 13]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/25-weeks-pregnant/
Beijers, R., Cassidy, J., Lustermans, H., & de Weerth, C. (2018). Parent–Infant Room Sharing During the First Months of Life: Longitudinal Links With Behavior During Middle Childhood. Child Development, 90(4), 1350–1367. https://doi.org/10.1111/cdev.13146
Safe Sleep Environment | Safe to Sleep® [Internet]. [Cited 2025 Jun 16]. http://safetosleep.nichd.nih.gov/. Available from: https://safetosleep.nichd.nih.gov/reduce-risk/safe-sleep-environment
Your baby’s sleep patterns - Start for Life [Internet]. nhs.uk. [Cited 2025 Jun 16]. Available from: https://www.nhs.uk/start-for-life/baby/baby-basics/newborn-and-baby-sleeping-advice-for-parents/your-babys-sleep-patterns/
About vaccines and pregnancy [Internet]. Pregnancy and Vaccination. 2024 [Cited 2025 Jun 16]. Available from: https://www.cdc.gov/vaccines-pregnancy/about/index.html

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If you’ve been pregnant before or know someone who is, you may have heard of preeclampsia. The relatively common pregnancy complication can be serious if left untreated, but what exactly is it, what causes it, and how is it treated?

","

Key takeaways

Preeclampsia is a serious complication that can happen during or after pregnancy
Symptoms include swelling of the face and hands, high blood pressure and severe headaches
Talk to your doctor immediately if you have any symptoms or suspect you may be experiencing preeclampsia

","

What is preeclampsia?

Preeclampsia is a complication that occurs either during pregnancy, most commonly throughout the second half (after 20 weeks), or soon after delivery. Whilst we don’t know exactly what causes it, it is believed that issues with the development and function of the placenta play a significant role. Preeclampsia affects 5 to 8 in 100 pregnant women in the US [1]. Though preeclampsia is usually mild, it can develop into a very serious illness, and can cause harm to you and the baby if left untreated [2].

How is preeclampsia diagnosed?

Typical preeclampsia symptoms include persistent high blood pressure and high levels of protein in your urine, but there are some other symptoms to watch out for that we’ll go over below.

Blood pressure

Throughout pregnancy, at your regular health checks with your doctor or midwife, your blood pressure will routinely be monitored to check for signs of high blood pressure [3]. A blood pressure test generates two numbers, systolic pressure and diastolic pressure. Blood pressure tests measure the pressure of circulating blood against the artery walls. Systolic pressure is measured during the heartbeat, whereas diastolic is measured between two heartbeats. A blood pressure reading is measured in mmHg, or millimetres of mercury [4].

A typical healthy range for blood pressure is around 120/80mmHg or below–high blood pressure during pregnancy is when your blood pressure reading measures at 140/90mmHg or above in two readings that are 4 or more hours apart [5]. If you typically have a blood pressure reading within a ‘normal’ range and then suddenly develop high blood pressure, you should consult with your doctor right away.

Urine tests

During your routine visits, your care team will also check whether you have high protein levels in your urine with a simple urine test. If the test shows protein in your urine, you may be asked to do another urine sample, which will be sent off to a lab for further testing [3].

Blood tests

If your doctors suspect you may have preeclampsia, they may offer you a blood test to rule it out. The blood test will measure levels of a protein called placental growth factor (PIGF), which is produced by the placenta. PIGF contributes to the growth of new blood vessels. If you have high levels of PIGF, it's likely that you do not have preeclampsia. However, low levels of PIGF may indicate that the placenta is not functioning as it should, which could be an indication that you have the condition. At this point, your care team would refer you for further tests or monitoring [6].

Signs and symptoms of preeclampsia

Preeclampsia symptoms can begin to develop without you noticing. Whilst routine checkups are an effective way to identify early warning signs for this condition, if you do notice any of the symptoms below, particularly after 20 weeks along, it's important to contact your care team right away. Symptoms can include [7]:

High blood pressure
Swelling of the face or hands
A headache that will not go away, even after taking painkillers
Changes in your vision
Nausea or vomiting
Difficulty breathing
Sudden weight gain

Can you have preeclampsia without high blood pressure?

Preeclampsia is often defined by protein in your pee and high blood pressure. However, in a very few rare cases, women have had preeclampsia without the high blood pressure feature [8,9]. This would be considered atypical though, and more research is needed to understand how and why this happens.

What can cause preeclampsia?

As mentioned above, the exact cause of preeclampsia is not well understood. However, issues with placental development are thought to underlie the condition. During a typical pregnancy, the placenta develops to link the mom’s blood supply with the fetus’, delivering food and oxygen to the developing baby.

To ensure that the baby gets enough food and oxygen from the mom, the placenta requires a constant supply of blood. If you have preeclampsia, the placenta doesn’t get enough blood, which means that the energy supply between mom and baby doesn’t work as it should [10]. It is possible that during the first half of the pregnancy the placenta didn’t develop properly, which may contribute to issues with the placenta in later pregnancy.

Are there any known risk factors for preeclampsia?

There are many factors that may increase the risk of developing preeclampsia. If you have any of the major risk factors below and are trying to conceive or thinking about starting a family soon, we recommend speaking with your healthcare provider.

Major risk factors of preeclampsia

Preeclampsia in a previous pregnancy: If you have had preeclampsia in a previous pregnancy, then you are eight times more likely to develop the condition in another pregnancy [11].

Chronic hypertension: If you experience hypertension, or high blood pressure, outside of pregnancy, you have a higher chance of experiencing preeclampsia during a pregnancy [11].

Chronic kidney disease: Kidneys are the body’s filtration system – they filter your blood to remove any waste and help to maintain electrolyte balance and regulate blood pressure [12]. Having chronic kidney disease can reduce kidney functioning, which when added to the extra strain placed on the kidneys during pregnancy, increases the risk of having protein in the urine or high blood pressure.

Autoimmune conditions: Having certain autoimmune conditions, like Lupus or Antiphospholipid syndrome (APS), may increase the risk of developing preeclampsia during pregnancy [10]. Lupus can increase the risk of developing preeclampsia due to its impact on the functioning of the kidneys. Having APS increases the risk of developing blood clots and other pregnancy complications like preeclampsia. If conditions like lupus and APS are appropriately managed, the risk of developing preeclampsia is reduced. However, if you have one of these conditions, you should speak with your healthcare provider as part of your preconception care.

Other risk factors of preeclampsia

Though not as significant a risk factor for developing preeclampsia as those listed above, women who haven’t previously been pregnant are two times more likely to experience preeclampsia [10]. This is thought to be because the maternal blood system is not yet adapted to the physical demands that a pregnancy places on the body. Women who have a multiple pregnancy (e.g. twins or triplets) are also more likely to experience preeclampsia.

Complications arising from preeclampsia

Having preeclampsia increases the risk of pregnancy complications, which can have serious effects on both you and your baby. However, knowing more about preeclampsia and being able to identify any symptoms of the complication in yourself or others, can help you to recognise when to seek extra care. We’ve outlined some of the complications that are more likely if you have preeclampsia.

Fetal growth restriction: Since preeclampsia affects blood flow to the placenta, if not enough blood is able to reach the baby through the placenta, it is possible that the baby will receive less blood and nutrition than is required for sustained fetal growth.

Preterm birth: Depending on the severity of preeclampsia and how far along in the pregnancy you are, you may have a preterm birth, and give birth before 37 weeks. A preterm birth can come with its own set of complications for both the mom and baby. This, in some cases, will be planned in advance to ensure your baby is delivered as safely as possible. If you need to have a planned preterm birth, you may still be able to develop a birth plan and share your wishes for birth, such as who is present, with your care team and partner [13].

Hemolysis elevated liver enzymes and low platelet count (HELLP): HELLP is a severe case of preeclampsia which can affect several organ systems, and be life-threatening for both you and your baby. Signs and symptoms of HELLP include headache, upper right belly pain, vomiting and nausea [14].

Eclampsia: Eclampsia is a rare but life-threatening condition that occurs in pregnant women with preeclampsia – it results in convulsive seizures or a coma without other causes. Researchers don’t fully know what causes eclampsia, though it may be due to similar risk factors as preeclampsia, issues with blood flow to the placenta, genetic factors or inflammation in the brain [15].

How to prevent preeclampsia

In general, if you’re considered to be at low risk for preeclampsia, one of the best ways to reduce the likelihood of developing the condition is to maintain a healthy lifestyle throughout pregnancy. This can include regular exercise, maintaining a balanced pregnancy diet and other activities which may reduce your blood pressure [16].

If you’re considered to be at a higher risk for developing preeclampsia, your doctor may recommend taking low-dose aspirin from week 12 of pregnancy until you deliver to help reduce your risk. It is thought that aspirin reduces inflammation and increases blood flow to key organs like the kidneys, and the placenta [17].

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Help us further the field of female health

We are currently supporting a research project being run by Cambridge University – researchers are investigating risk factors for heart disease and diabetes in women actively trying to conceive. The goal of this research is to understand whether placental complications, like high blood pressure and kidney problems, make a difference to heart health, and how best to reduce these risk factors. If you’re based in the UK and are planning to conceive in the next year, consider taking part.

How is preeclampsia treated?

If you’ve been diagnosed with preeclampsia, it is important to know that in most cases, the only way to cure the condition is by giving birth. However, if you’ve been diagnosed before you’re at full term, your care team will help to manage symptoms and continuously monitor your condition to ensure that your symptoms and blood pressure remain stable. If they have concerns about either yours or your baby’s health and safety, you may be required to stay in hospital, or to deliver the baby early. Below, we've outlined some steps your care team may take to support you and your baby during this time.

Preeclampsia without severe features

If you’ve been diagnosed with preeclampsia without severe features, like seizures, you will be closely monitored by your care team after your diagnosis until you deliver. According to the National Institute of Health and Care Excellence (NICE), if you are experiencing preeclampsia and hypertension, your blood pressure may be monitored every two days, you may have more regular blood tests, and anti-hypertensive medications will be offered [18]. If it is safe to do so, your care team will try to manage symptoms until delivery at 37-38 weeks gestation [19].

Severe preeclampsia

In severe cases of preeclampsia, you may have to be admitted to the hospital for regular monitoring. With severe preeclampsia, you are more likely to develop eclampsia. To prevent eclampsia seizures, you will be given a medication called magnesium sulphate. Depending on the severity of preeclampsia, and whether the preeclampsia has been well managed or not, you may have to be induced earlier than expected [18]. This may seem scary, but your care team will only take this route if medically necessary for you and the baby.

As things may move quickly, we encourage you and, if you have one, your birthing partner, to speak with your care team and ask any questions you may have about the plan for delivery and next steps.

What is postpartum preeclampsia?

With most cases of preeclampsia, symptoms will resolve soon after delivery. However, it is possible to have preeclampsia after delivery, most typically within the first 7 days – though the risk remains until about 6 weeks postpartum [20]. If you’ve not had preeclampsia during pregnancy, it is still possible to have postpartum preeclampsia. If you experience any of the following symptoms after birth, it is important that you consult a healthcare provider right away”

Warning signs you may have postpartum preeclampsia [21]

Blood pressure over 140/90mmHg
Headache that won’t go away
Vision changes
Stomach pain
Swelling in your hands or feet
Feeling nauseous or throwing up

If you experience any of the following, you should go to the emergency department to be seen by a healthcare professional right away [21]

Blood pressure over 160/110mmHg
Shortness of breath or trouble breathing
Seeing spots
Seizure

When to see a doctor

As part of standard antenatal care, you should make sure you go to all of your antenatal appointments. During these visits, your care team will monitor your blood pressure and other potential symptoms or risk factors for developing pregnancy complications like preeclampsia.

Preeclampsia can be a very serious and, in rare cases, fatal condition if left untreated. It is important that if you have any of the symptoms listed above, you consult with a doctor right away.

If you are experiencing symptoms of preeclampsia throughout pregnancy or after giving birth – Speak with your doctor right away. If you’re experiencing any of the symptoms listed above, or if you’re experiencing any of the following, you should go to the hospital immediately:

Blood pressure over 160/110mmHg
Shortness of breath or trouble breathing
Seeing spots
Seizure

Learn more with Natural Cycles

Thanks for reading! We hope you found this article helpful. Whether you’re trying to conceive, are currently pregnant, or have just given birth, Natural Cycles is the FDA Cleared app that can help you navigate all stages of the journey. Packed full of tailored content on reproductive health, and with science-backed insights that are tailored to you, find out how Natural Cycles can support you today!

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Have you ever heard about a CNC kink or consensual non-consent? Maybe the term is not familiar to you, but you sometimes fantasize about being forced to have sex. Or, maybe you noticed that when you read steamy romance novels where the hero rips the heroine's clothes off and takes her against her will until she submits to him, you get hot and bothered?

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Key Takeaways

Consensual non-consent is a pre-agreed sexual scenario where participants act out a non-consensual situation, such as forced sex or being force-fed
Sexual fantasies are common amongst all genders and are completely normal
Having CNC sexual fantasies is not an indication of a mental health disorder or problems — fantasies are a healthy part of our sexuality
Your safety is important: having a safe word and practicing aftercare can help you and your partner ensure this type of sex stays enjoyable and doesn't put either of you at risk

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If you have ever fantasized about having any type of non-consensual sex, you are definitely not alone — it's a very popular sexual fantasy people have. Yet, despite its popularity, CNC kinks are greatly misunderstood. In our article, we'll discuss everything there is to know about consensual non-consent, which will hopefully help you gain a deeper understanding of this kink.

What is consensual non-consent (CNC)?

CNC stands for 'consensual non-consent,' and it involves a plethora of sexual and non-sexual activities that are enacted as if they are 'forced' on a consenting person. This sexual kink falls under the BDSM umbrella (Bondage and Discipline, Dominance and Submission, Sadism, and Masochism) and requires extensive communication and trust between the individuals who choose to engage in CNC activities.

It's essential to note that consensual non-consent is pre-agreed between those taking part. Any party can withdraw their consent at any time as the scene unfolds. You should never be made to do anything you don't want to do — then it stops being consensual sex and becomes a sexual assault or rape, which are serious crimes.

Are CNC kinks normal?

Yes, absolutely! CNC kinks (just like any other kink) are normal. It's a healthy part of our sexuality and nothing to be ashamed of or worried about in most cases. However, whatever form your sex life takes, if you find it is stopping you from enjoying your everyday life, then it might be a good idea to talk to a medical professional. They may be able to offer advice or treatment like talking therapy.

What does CNC look like during sex?

When most people hear the term 'CNC,' they think of being forced to have sexual intercourse against their will. However, consensual non-consent can be so much more than that. CNC kinks can include rape fantasies, interrogation, force-feeding, or any act that's pre-agreed to be played out as non-consensual.

CNC kinks can be seen as controversial for a number of reasons. The very idea of enacting forced sex or power play can be triggering for those who are survivors of sexual assault. It's important for those taking part in CNC or other BDSM activities to prioritize safety and communication due to the potentially dangerous nature of enacting these types of fantasies.

While CNC is by its very nature about pushing and exploring boundaries and may verge into uncomfortable places, it's essential your sexual play always remains safe and legal.

What sort of acts someone chooses to engage in when they explore a CNC kink can look very different from person to person. For some, CNC kink exploration might involve non-sexual activities like being forced to eat foods they dislike against their will. The beauty of any kink is that we have the power to personalize it to fit our needs, wants, and desires.

CNC vs. Free use

Free use is another kink under the BDSM umbrella that's essentially an agreement between two consenting adults when one partner receives the right to initiate sex whenever they desire, and the other partner has to oblige without protesting whether they're sleeping, eating, or doing laundry.

Free use may sound the same as CNC, but these two arrangements differ in a couple of ways. Here's how:

CNC is a broader term that may include sexual activities, but it may also include non-sexual activities, while free use always refers to sexual activities
CNC play often means that sex (or other activities) is being forced onto someone, while free play doesn't revolve around force and is more about relinquishing your autonomy to your partner so you don't have to make decisions
CNC play can be contained within one 'BDSM scene,' or it could be a continuing agreement, while free play is often an ongoing agreement in a relationship

How common are CNC fantasies?

If you ever feel like you're the only person to have forced sex fantasies, know that you're far from alone – these fantasies are more common than you think.

Social psychologist and researcher Dr. Justin Lehmiller surveyed over 4,000 Americans on their sexual fantasy habits. 98% of people have sexual fantasies and have them often. And the second most popular sexual fantasy was various BDSM activities [1].

BDSM activities include things like power, control, and rough sex, including consensual non-consent. When asked specifically about sexual fantasies involving sex, 61% of people who identify as women, 54% of people who identify as men, and 68% of non-binary people said they fantasize about being forced to have sex [1].

When it comes to fantasies of forcing sex on someone, the numbers are different. 20% of people who identify as women enjoy these types of fantasies, compared to 38% of people who identify as men and non-binary [1]. As you can see, a huge number of people have CNC fantasies.

Why are these fantasies so common?

A common misconception about CNC fantasies is that people who have these fantasies must have some mental health problems. This isn't true — sexual behaviors like spanking, CNC, dominance, or aggression have no link to emotional disturbance, pathology, or childhood trauma [2,3].

Lehmiller found that people have forced sex fantasies for a few reasons. People with an overly active imagination or those who like to fantasize more often tend to have CNC fantasies more. People who have sensation-seeking personalities are also more likely to have forced sex fantasies [4].

A small number of people with a history of sexual victimization also fantasized about forced sex more. Lehmiller believes that the reason why sexual assault victims have these fantasies is because it's a way for them to take back control over what happened to them — in their rape fantasies, they have control over the situation that they lacked when the assault happened [4].

Interestingly, women tend to fantasize about being forced into sex due to the desire to feel wanted [5]. The idea that someone is so turned on by them and finds them irresistibly attractive is a huge turn-on for many people.

What people like about CNC

Sexuality and what turns us on in the bedroom are highly individual, so the reasons why people enjoy CNC play vary greatly. However, there are some common themes that arise whenever people share why they enjoy CNC play:

Complete surrender: CNC play involves a strong power play dynamic between the person who plays “the attacker” role and “the victim” role. Some people love completely relinquishing their power and feeling helpless with a partner they trust. It’s relaxing and liberating for them
Taking charge is thrilling: On the opposite side of the spectrum, some people love the idea of taking charge and being in control of their partner and their pleasure during CNC play.
Control over oneself: Others love to master the control over their urges and desires as the CNC fantasy plays out. They enjoy the sense of being aggressive and intense during play, but still remain aware of their partner’s needs and are able to stop at any moment.

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How to safely practice consensual non-consent

Exploring a CNC kink can be a great way to bring sexual novelty into our long-term relationships or simply understand our sexuality better. If you're curious to try any of the consensual non-consent activities with your partner, we have a few tips to help you do it safely:

Set your boundaries

Before engaging in any CNC activities, it's very important to set boundaries. That includes all the partners involved in the activity discussing what acts they are excited to engage in, what ‘okay’ activities are, and what 'hard no' activities are.

For example, you might be comfortable being forced to engage in oral or penetrative vaginal sex. However, being forced into anal sex or having your hair pulled during the act is not something you consent to.

Both parties (or more if you have more people participating in the act) want to be clear about their boundaries. Even partners who are the 'enforcers' or 'Dominants' might not feel comfortable engaging in certain acts, so it's important that everyone's boundaries are heard and respected.

Consider creating a BDSM contract

There is a lot to remember and many things to consider when you're exploring CNC. That's why some people choose to create a BDSM contract before they try to bring their CNC fantasies to life.

Essentially, this BDSM contract is between the people involved, and it outlines all the important information you discuss before anything happens. It includes things like boundaries, what responsibilities each role has, what the safewords are, and even what sort of activities you want to engage in during aftercare.

Use safewords

Many CNC activities revolve around ignoring the protests and words like 'no,' 'stop and 'I don't want this.' Because of that, it's crucial to establish safe words beforehand that will allow all parties involved to communicate their desire to slow down or stop the activities.

Choosing a safeword is pretty straightforward. You want to pick a word that's easy to remember and say in the heat of the moment but which wouldn't normally come out during sex. For example, Bora Bora, pineapple, or avocado. You and your partner can decide on what word works best for you.

There are instances when you might not want the action to stop completely, but you might want to slow down. Or, you might want an effective way to communicate without breaking the scene. In this case, using a Traffic Light System might be a great choice.

The Traffic Light System involves using colors to communicate during a BDSM scene:

Green: All is good, let's keep going.
Yellow: I don't want to stop, but please, let's slow down.
Red: I want to stop all the activities immediately.

Sometimes, a CNC activity might involve the submissive partner being forcefully silenced by covering their mouth. In this case, you might need a nonverbal safeword, which will indicate to the dominant partner that it's time to pause or stop.

Nonverbal safewords can be a series of taps on a surface (like the wall or bed) or may involve placing your hand on your partner's body part in a certain way. What sort of nonverbal communication you choose is between you and your partner.

Don't hesitate to speak out

All parties involved in consensual non-consent activities have to be on board at all times for it to be pleasurable and fun. Your voice matters, no matter what role you take on. So, don't hesitate to speak out in the middle of the action if any unpleasant emotions, sensations, or feelings come up. Your partner should appreciate this, and honest communication will make the experience better for everyone.

Consider roleplay

If you are feeling shy or uncomfortable engaging in forced sexual activities as yourself, it's totally fine. That's where roleplay comes in handy. By taking on the role of someone else, you can create a distance that can help you feel more confident and bold.

So, consider exploring CNC through roleplay scenarios. Some of the most popular roleplay scenarios kinksters love to play out that are great for CNC play are:

Master/slave fantasy play
Job/occupation play (ex, boss/assistant)
Age regression play (ex, guardian/child)
Religious play (ex, priest/nun) [6]

If any of these feel too realistic or taboo, you may want to explore fantasy roleplay, too. For example, play out an alien abduction fantasy where your partner dresses up as an alien and abducts you.

Always practice aftercare

Aftercare includes all the activities we engage in with our partners after sex. That might vary from person to person but can involve things like cuddling, kissing, pillow talk, or having a shower together. It's an essential part of sex, and it's definitely something you want to engage in after a CNC exploration.

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What does aftercare look like following a CNC scene?

Aftercare is something very intimate and personal. You and your partner can decide what sort of activities you want to engage in during aftercare. For some people, it might be an opportunity to share emotions and talk or journal about the experience. Others might want to cuddle or be held by their partner. Taking a shower together, getting a snack, or a drink together are also great aftercare activities.

How to bring up the idea of trying CNC with your partner

Communicating your sexual desires and wants can be challenging–we get it. It can be even more challenging to communicate certain sexual desires and fantasies, like consensual non-consent. So, how do you do it in a safe and healthy way?

Well, that will depend on your relationship. If you and your partner have very honest and straightforward communication about sex, you may say to them: 'I always wanted to explore consensual non-consent, and I was wondering if that's something you'd like to explore with me?'

If you feel a bit more shy, or you're not certain how your partner would react to the suggestion to explore CNC kink, you might want to consider a slower and softer approach. Start by opening up the conversation about sexual wants, desires, and fantasies. Be curious about what your partner shares, and share your honest desires, too.

Once you are more comfortable and open to communicating about your desires and wants, you can bring up your desire to try consensual non-consent. Instead of approaching it as 'I want to try it with you now,' consider finding out what your partner thinks and feels about such a fantasy first. After you get a feel for what your partner is open to, you can then move forward and suggest exploring it together.

Is CNC Roleplay Unethical?

If practiced the right way with the consent established prior to engaging in CNC play and safewords in place, then CNC is ethical. However, it's important to acknowledge that even if it's ethical play, not everyone will be into it. And that's okay.

If someone forces you into CNC play without establishing consent, boundaries, and safewords or completely disregards your use of a safeword during play, it's not CNC play – it's sexual assault.

CNC play examples

If you're curious to explore CNC play with your partner but are not sure how to go about it, here are different CNC fantasy roleplays from which you can draw inspiration:

Blackmail: One partner blackmails the other in exchange for sexual favors (or house chores and similar things if no sexual activity is involved).
Rape fantasy: One partner acts out forcing the other into sexual activity.
Kidnapping: One partner ties, blindfolds, and kidnaps the other. Sexual activity may be forced, or it may not be.
Forced feeding: One partner restrains the other and forces them to eat against their will.
Forced orgasm: One partner restrains the other and uses various stimulation methods to bring them to an orgasm, over and over again.
Sleep sex: One partner initiates sex with the other while they're asleep.

You and your partner are the architects of your own CNC play experience, so feel free to combine different parts of CNC roleplays to find something that works for you.

Pros & cons of consensual non-consent

It's one thing to indulge in sexual fantasies involving CNC, but engaging in these activities in real life is another matter. You might fantasize about something, but it doesn't mean that you need to bring those fantasies to life. However, if you do want to try consensual non-consent activities with a partner, here are some pros and cons you might want to consider:

Pros

Feel closer to your partner: Exploring consensual non-consent with a long-term partner can bring you closer and improve your relationship satisfaction. When couples in long-term relationships engage in novel-arousing activities together, they report higher relationship satisfaction and quality [7].
It allows you to explore your sexuality: Exploring a kink, whether it's consensual non-consent or something less bold like bondage, can be a great way to understand your sexuality better. Through exploration of different things, you can find out what you enjoy most, what might not be your favorite thing, and how your body and mind respond to various activities. All of that will help you have better sex and feel more empowered in your body and with your sexuality.
Reclaim your sexuality: Exploring CNC play in a safe environment with someone you trust can help those with past trauma reclaim their sense of bodily autonomy and control over what happened [4]. That, combined with therapy, can be healing.

Cons

Risk of injury: Consensual non-consent involves using physical force, which can sometimes end with an injury. While you may feel okay about the occasional bruise or scratch, there are also risks of more serious physical injury, so always keep that in mind when you are about to engage in CNC sex and be prepared.
With the wrong person, it could be dangerous: As with all types of sex, choosing the right person to engage in consensual, non-consent sex is very important. If you're exploring it with someone new or someone you don't know well, there is always a risk that they might not respect the boundaries you agreed on. So, always be cautious about choosing the right partner for CNC exploration.
Damaged relationships: If partners don't respect boundaries set beforehand or fail to communicate well during the CNC play, it could damage trust between partners and cause emotional distress in a relationship.

When to see a professional

If your CNC fantasies are causing excessive stress and discomfort and interfere with your day-to-day life or have the potential to harm you and those around you, it might be a good idea to seek out professional help. Consider speaking with a therapist, or if you're in a relationship, you might want to look for a couples therapist.

It's important to remember that consensual non-consent is not the same as rape. All parties involved in the activity have to consent. You are free to withdraw consent at any time. If you express the desire to stop the activity at any point and your partner doesn't stop, it's not CNC but sexual assault.

Sexual assault is a crime, and it's important to take it seriously, talk to the authorities, and consider how you can look after yourself. Some people may find it useful to talk to a therapist, a friend, or a family member. You do not need to go through it alone.

Practice safer sex with Natural Cycles

At Natural Cycles, we're passionate about helping you create a healthy, safe, and satisfying sex life. We are the first app of our kind to be FDA Cleared as birth control in the US, and our features help you understand your sexual and reproductive health better. By tracking your fertile window with the app, you can schedule sex around it depending on whether you want to get pregnant or not.

Take control of your fertility, sex life, and more with Natural Cycles. Try the app yourself today.

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Justin Lehmiller Science of Fantasy — Sexual Health Alliance. (n.d.). Sexual Health Alliance. https://sexualhealthalliance.com/justin-lehmiller-science-of-fantasy
Dolan, E. W. (2021, April 1). Studies provide new insights into possible psychological mechanisms underlying interest in BDSM. PsyPost - Psychology News. https://www.psypost.org/studies-provide-new-insights-into-possible-psychological-mechanisms-underlying-interest/
Brown, A., Barker, E. D., & Rahman, Q. (2019). A Systematic Scoping Review of the Prevalence, Etiological, Psychological, and Interpersonal Factors Associated with BDSM. The Journal of Sex Research, 57(6), 781–811. https://doi.org/10.1080/00224499.2019.1665619
Lehmiller, J. J., PhD. (2022, March 21). New research sheds light on the psychology behind fantasies about forced sex. Psychology Today. https://www.psychologytoday.com/us/blog/the-myths-sex/202003/why-are-rape-fantasies-so-common
Norén, L. (2023, November 23). What triggers sexual desire in women. Leigh Norén. https://leighnoren.com/human-sexuality-blog/what-triggers-sexual-desire-in-women/
Aron, A., Norman, C. C., Aron, E. N., McKenna, C., & Heyman, R. E. (2000). Couples’ shared participation in novel and arousing activities and experienced relationship quality. Journal of Personality and Social Psychology, 78(2), 273–284. https://doi.org/10.1037/0022-3514.78.2.273

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Whether you’re trying to become pregnant or just exploring the possibility, you’ve probably come across the term “DPO” in conversations with doctors or online communities. It stands for “days past ovulation,” that nerve-wracking time when you’re wondering if you’re pregnant or not [1]. The 12 DPO, or 12 days past ovulation, can come with a rollercoaster of emotions — from excitement to confusion and maybe even a little frustration — as you’re trying to figure out if your body is dropping hints that you’re pregnant.

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Key Takeaways:

“DPO” is an acronym used by the medical and trying to conceive (TTC) communities that stands for “days past ovulation” or “days post ovulation”
DPO is the time span between ovulation and your missed period, when some early pregnancy symptoms may start to emerge
It can be difficult to distinguish these early pregnancy symptoms from PMS symptoms, but there are a few notable differences that may help you navigate your fertility journey with more clarity

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In this article, we’ll dive into everything that might be happening in your body during this time, from hormone patterns to physical symptoms, and what those signals might mean for you. It’s important to remember that the only definitive way to tell if you’re pregnant is with a pregnancy test, which usually isn’t accurate until around 14 DPO (ideally, on the first day of a missed period). However, things may start to get interesting during the 12 DPO if conception has occurred.

Quick spoiler alert: everyone’s experience is unique. This article is meant to provide generalized guidance for what to expect during 12 DPO, and should not be a substitute for personal advice from a doctor.

What is days past ovulation (DPO)?

First things first: DPO is an acronym referring to “days past ovulation.” It can also be read as “days post ovulation” or “day past ovulation.” While we’re at it, here are a few more acronyms you might come across as you’re doing research and interacting with TTC communities during your fertility journey:

BBT: basal body temperature (the body’s lowest resting temperature. Its patterns are used to detect ovulation) [1]
DPO: days past/post ovulation [1]
EPT: early pregnancy test [1]
hCG: human chorionic gonadotropin (the pregnancy hormone) [1]
IVF: in-vitro fertilization [1]
IUI: intrauterine insemination [1]
POAS: pee on a stick (the most common type of at-home pregnancy test) [1]
TTC: trying to conceive [1]
TWW: two week wait

The 12 DPO are a popular topic of conversation because these are the days when signs of an early pregnancy may start to emerge. In a confusing coincidence, many of these early pregnancy symptoms are very similar, if not identical, to common symptoms associated with the luteal phase of the menstrual cycle that comes each month after ovulation (whether you’re pregnant or not) [2]. This means that the DPO can be a nail-biting period of uncertainty, waiting, hope, or disappointment.

1 to 12 DPO pregnancy symptoms to expect

We know this time can be overwhelming in many ways, so we’re here to break down exactly what happens during the 12 DPO to help you feel more confident in your fertility journey. Again, while some people will experience some or all of these symptoms, others may experience none of them and still be pregnant. On the other hand, you may experience some of these things and not be pregnant, since they’re quite similar to luteal phase symptoms [2].

With that in mind, symptoms alone are not a definitive marker of whether or not you’ve conceived a baby — only a pregnancy test can provide that answer — and we encourage you to try not to rush to conclusions. However, if you’re curious about what might be happening in your body during the DPO, there are some common biological processes and patterns we can explore.

1 to 3 DPO symptoms: progesterone rises

In the first 48 hours after conception, the symptoms post-ovulation will most likely be linked to the luteal phase of your menstrual cycle, as these symptoms are associated with a rise in the progesterone hormone. It’s just too early in the process for you to experience any distinct pregnancy symptoms just yet. Symptoms of rising progesterone include:

Bloating
Breast tenderness/nipple sensitivity
Cravings
Fatigue
Headaches
Muscle aches [2]

These symptoms can happen every cycle after ovulation, regardless of whether or not pregnancy occurs. Let’s remember that in order for pregnancy to happen, sperm needs to fertilize the egg cell released during ovulation. This usually happens in the fallopian tubes. Then, the fertilized egg cell (also called a zygote) needs to travel through the rest of the tube to the uterus and attach to the uterine lining (a process called implantation). It’s only once all of that has happened that conception has occurred and early pregnancy has begun [3].

All of this happens over the course of the 12 DPO, so during 1-3 DPO, it’s likely you’re at the beginning of that process when sperm is trying to fertilize (or has already fertilized) the egg released during ovulation in your fallopian tubes. Progesterone is rising as it is still being produced by your ovaries, the same way it is produced every cycle (regardless of whether or not an egg cell is fertilized). And it’s this rise in progesterone levels that can cause some of the symptoms listed above [3].

4 DPO symptoms: making moves

If sperm fertilize the egg cell during those initial days DPO, at 4 DPO, the fertilized egg is now moving through your fallopian tubes toward your uterus. Symptoms would be similar to those listed above, whether you’re pregnant or not, as this day is still characterized by the gradual rise of progesterone levels, which are also associated with the luteal phase [2].

5 DPO symptoms: blastocyst development

The fertilized egg is on the move in your fallopian tubes during 5 DPO — it takes time to make its way through your body! By the time of 5 DPO, the zygote is approaching your uterus and has expanded and divided into multiple cells until it becomes a blastocyst (a cluster of 100-200 cells) [3]. Again, symptoms will be similar to those listed above, associated with the luteal phase, not early pregnancy.

6 DPO symptoms: the end of the fallopian journey

Around 6 DPO, the blastocyst will likely be quite close to the uterus, getting itself ready for implantation into the uterine lining. You probably won’t be experiencing any symptoms outside of those listed above, but don’t worry — things may get more exciting around day 7 [2, 3].

7 DPO symptoms: possible implantation

At 7 DPO, the blastocyst has likely made its way to the uterus and attempts to implant into the uterine lining. This is vital for its further growth and development into an embryo, as implantation is how the blastocyst will receive nutrients and energy from the mother. The uterine lining is only receptive to incoming blastocysts for a few days each cycle, usually around 6-10 DPO. This is sometimes referred to as the WOI, or “window of implantation,” meaning that implantation can happen any time from 6 DPO to 10 DPO, and may actually happen over the course of a few days. [3].

If implantation is successful, this marks the beginning of a pregnancy. At the time of implantation, the embryo starts to produce the pregnancy hormone hCG to support the pregnancy in your uterus. Levels of this hormone are still quite low on this day, though, so you probably won’t be experiencing symptoms related to it just yet [4].

Any symptoms you have are likely still related to rising progesterone levels, which naturally peak around 6 to 8 DPO whether you’re pregnant or not. These symptoms can feel like stronger versions of what you may have noticed earlier in your cycle at 1-3 DPO [2].

If implantation happens, your body will sustain this peaking progesterone level. During a regular menstrual cycle, progesterone will drop over the next couple of days to bring on the beginning of your period [5].

$\"Diagram$

8 DPO symptoms: implantation (cont.)

Depending on individual variation in embryo development and transport through the fallopian tube, implantation may happen anywhere from 6-10 DPO [3]. Some people may still experience luteal phase symptoms during this time [2]. Remember: it’s totally normal not to experience any symptoms at this point, and any symptoms you do experience are likely linked to the luteal phase and not early pregnancy..

The tough part of this is that it’s still too early to take a pregnancy test and get an accurate result, and the intensity associated with these symptoms may also be part of your regularly occurring luteal phase. This is why 1-12 DPO is also often referred to as the “two week wait” (TWW).

1-12 DPO and TWW get used somewhat interchangeably because two weeks (about 14 days) post-ovulation is usually when a pregnancy test will show accurate results, so it’s best to “wait” until then to test if you can. There’s no harm in testing earlier, but it’s much more likely that you’ll get a false negative [6, 7].

9 DPO symptoms: light bleeding

At 9 DPO, and typically anywhere from 7-14 DPO, about some individuals experience light bleeding or spotting. This is a common symptom of successful implantation and is sometimes referred to as implantation bleeding. The blood is a result of the blastocyst moving into the uterine lining, which causes a small part of that lining to shed [8].

However, this is not a certain sign of pregnancy. Bleeding around this time can also just be a sign of progesterone dropping around this time in your menstrual cycle. Less likely, it might mean that a very early miscarriage has occurred (also sometimes called a chemical pregnancy), or it may be a symptom of a different underlying health condition [8]. Talk to your doctor about your symptoms if you experience abnormal bleeding.

10 DPO symptoms: hormones surge

At around 10 DPO, levels of the hCG pregnancy hormone should be surging in your body if you’re pregnant. While individual hCG levels varied widely, one study found that urinary hCG concentrations increased significantly in the first week after detection, with the most rapid rise (threefold) occurring on the first day [4].

The progesterone hormone is also at peak levels in your body right now. Progesterone plays a few key roles in supporting early pregnancy:

It helps mature the lining of the uterus (endometrium), preparing it for implantation.
It stimulates the uterine lining to supply nutrients to the new pregnancy.
It thickens and decreases the elasticity of cervical mucus to create a mucus plug that will protect the uterus from infection during pregnancy. [5]

So if implantation is successful, progesterone levels will remain high to fulfill those functions and sustain the pregnancy. However, if the egg is not fertilized during ovulation, or if implantation doesn’t happen, progesterone levels will drop as your luteal phase goes on, potentially leading to PMS symptoms and eventually signaling the start of a period. [5, 9]

Learn more about progesterone’s effect on your body throughout your life here.

11 DPO symptoms: early pregnancy signs

Focusing back on the hCG pregnancy hormone, levels will start rising at around 10-11 DPO if you’ve conceived, so you may start experiencing early pregnancy symptoms associated with this hormone (although many people will still not have any pregnancy symptoms at this point). Symptoms include:

Abnormal cravings or more hunger than usual
Cramping
Darkened color and enlargement of the areolas
Digestive issues like nausea or diarrhea
Fatigue
Increased frequency of urination
Smell sensitivity and altered taste
Swollen or heavy breasts [10]

To make things confusing, these early pregnancy symptoms can happen in addition to the symptoms associated with the luteal phase, symptoms mentioned earlier. Pregnancy can be quite tough on your body! The good news is that these symptoms might be unique enough to help you figure out if your body is giving you signals that you’re pregnant, rather than just going through the luteal phase. Tracking your symptoms with Natural Cycles, each cycle may help you identify your common symptoms to see if anything is out of the ordinary.

Again, we want to share a quick reminder that the only surefire way to confirm a pregnancy is a positive pregnancy test, which brings us to…

12 DPO symptoms: is it time to test yet?

If you are experiencing the symptoms listed above, and they’re not typical for you in a regular menstrual cycle, it’s possible that your hCG levels are now high enough at 12 DPO to be detectable on a pregnancy test. A blood test at a doctor’s office will detect hCG levels sooner than an at-home test, but it’s possible that an at-home test could come back positive as well at this point [11].

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Let’s learn more about timing, false results, and how pregnancy tests work in general:

Can you take a pregnancy test at 12 DPO?

The short answer is yes, although you may receive a false result if you do an at-home urinary test. The long answer is that all urine pregnancy tests work the same way — by detecting the presence of hCG in your body (though the sensitivity of the test can differ).

Let’s do a quick refresher on what needs to happen during ovulation for a pregnancy to occur:

Ovulation: A mature female egg cell must be released from an ovary into the fallopian tubes around the midpoint of your cycle (ovulation).
Sperm: Sperm cells must enter the uterus and make their way to the fallopian tubes.
Fertilization: The egg lives for no longer than 24 hours, and must meet with a sperm cell in the fallopian tubes to become fertilized
Implantation: The fertilized egg cell must also travel through the rest of the fallopian tube (where it grows into a blastocyst) to the uterus and implant in the uterine lining (implantation). This can take a few days, but if it happens, your body starts to produce hCG to support the new pregnancy [3, 6].

Learn more about the process of fertilization and conception here. The hCG hormone is only created when all of this goes off without a hitch. If it does, it will start to be produced at around 6-8 DPO by the developing embryo. However, it can still take a few days for hCG levels to rise to detectable amounts (again, we know that the waiting game can be a huge challenge) [6].

Luckily, a blood test can detect hCG as early as 7-12 DPO. An at-home urine test will detect hCG closer to 12-15 DPO. So, although the 12 DPO may be enough time to provide an accurate test result from a blood test with a doctor, it may still be a bit early for an at-home test. For the most accurate result, the general guidance is to wait until 14 DPO, or the first few days of your missed period, to take a pregnancy test [11]. Keep in mind that if you have a late period but got a negative pregnancy test result at or around 12 DPO, you should test again in a few days.

If you’re using Natural Cycles, our technology can help you figure out if your period is late because you had late ovulation or if you might be pregnant. Either way, going forward, you can use Natural Cycles to track your unique fertility cycle and learn more about when and how to take pregnancy tests.

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Symptoms after ovulation if pregnant or not

To sum it up and help demystify this 12 DPO period, here are some slight distinctions in the symptoms you may be experiencing that can help determine if your symptoms are signaling pregnancy or not:

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n

\n Symptom \n	\n Indications of PMS \n	\n Indications of pregnancy \n
\n Bleeding \n	\n Begins around 14 DPO and signals the start of menstruation [9] \n	\n May happen earlier, between 7 and 14 DPO, and will typically be lighter in flow [10] \n
\n Breast changes \n	\n Tender or sore, slightly swollen [9] \n	\n Darkening and enlargement of the areolas [10] \n
\n Cravings \n	\n Your go-to PMS foods like chocolate, carbs, cheese, etc. [9] \n	\n Very specific and/or abnormal cravings. You may notice changes in your sense of smell, too [10] \n
\n Cramps \n	\n Dull, achy, more severe cramps may be accompanied with nausea, diarrhea and other symptoms [12] \n	\n Typically, cramps have a milder sensation [13] \n

Can DPO symptoms be mistaken for PMS?

All of this means that yes, DPO symptoms can be mistaken for PMS symptoms, but there are slight differences that may be able to help you determine what you’re experiencing. Keep in mind that everyone’s body and symptoms are unique.

Early pregnancy signs

Beyond the 12 DPO, hCG will continue to rise in your body through the first few weeks of pregnancy. During that time, it’s possible to experience early pregnancy signs including:

Missed period or light spotting
Nausea with or without vomiting
Breast changes and/or soreness
Frequent urination
Strange cravings, tastes, and smells [10]
Elevated basal body temperature (BBT)

These are the most common telltale signs of early pregnancy, but remember that each person (and each pregnancy) has its own unique factors that will contribute to how you experience the first trimester. Learn more about your pregnancy journey with the Follow Pregnancy resources and tools from Natural Cycles, including useful information like when you start showing in pregnancy, tips for exercise during pregnancy, guides for sex during pregnancy, and much more.

When to see a doctor

If you think you might be pregnant or you’re TTC, it’s always a good idea to check in with your doctor. They can provide the personalized care and advice you need to boost your chances of pregnancy, and confirm it earlier than at-home tests. If waiting the full 12-14 DPO sounds like forever to you, talk to your doctor about getting a blood test to find out sooner [11].

Consult your doctor about any abnormal symptoms you’re experiencing as well, especially if they’re causing you any pain or distress. They’ll provide specialized testing and treatment to make sure you’re on the right track to a healthy pregnancy.

Plan for pregnancy with Natural Cycles

Did you know that your body temperature can help determine your fertile days, making it easier to conceive at the right time? The road to becoming pregnant can sometimes feel bumpy, but Natural Cycles can support you with the knowledge and tools to optimize your fertility journey. Want to get pregnant faster? Research has shown that Couples using NC° to plan a pregnancy take 3 cycles on average to get pregnant [14]. Sign up to find out more.

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Villines, Z. Early pregnancy symptoms by days past ovulation (DPO). (21 December 2023). Medical News Today. https://www.medicalnewstoday.com/articles/322723
Pregnancy Acronyms and Abbreviations. (N.D.) babyMed by Obiehealth. https://babymed.com/pregnancy-fertility-abbreviations-acronyms
Week-by-week guide to pregnancy - Start for Life. (n.d.). nhs.uk. https://www.nhs.uk/start-for-life/pregnancy/week-by-week-guide-to-pregnancy/
Su, R., Fazleabas, A. Implantation and Establishment of Pregnancy in Human and Nonhuman Primates. (7 Nov 2016). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5098399/
Nepomnaschy, P., Weinberg, C., Wilcox, A., Baird, D. Urinary hCG patterns during the week following implantation. (14 December 2007). https://academic.oup.com/humrep/article/23/2/271/628663?login=false
Pregnancy Tests – Urine and Blood. (N.D.) https://americanpregnancy.org/getting-pregnant/understanding-pregnancy-tests/
Bleeding in early pregnancy | North Bristol NHS Trust. (n.d.). https://www.nbt.nhs.uk/our-services/a-z-services/emergency-zone/ed-miu-patient-information/early-pregnancy-bleeding
Scherwitzl, E. B., Lundberg, O., Kallner, H. K., Rowland, S. P., Holte, J., Trussell, J., Danielsson, K. G., & Scherwitzl, R. (2019b). Short- and long-term effect of contraceptive methods on fecundity. The European Journal of Contraception & Reproductive Health Care, 24(4), 260–265. https://doi.org/10.1080/13625187.2019.1621999

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Welcome to week 23 of your pregnancy! You have now been pregnant for about six months, and have only three left to go! In this week’s guide, we will cover some pregnancy-related body changes like cravings, aversions, forgetfulness, and vision changes. We will also check in on your baby, who you are probably feeling move more and more with each passing week. Finally, we will discuss how to manage piles, or hemorrhoids, during pregnancy and offer some other useful tips for caring for your physical and mental health this week.

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Key takeaways

“Pregnancy”, “baby\", and “mommy” brain are all used to describe changes to your brain structure during pregnancy (and postpartum) that can affect your memory and cognition
As your baby grows, you will notice their movements more — no need to count these just yet, but it’s good to familiarize yourself with what it feels like
Pregnancy affects most of your body’s systems, from taste and smell to even your eyes, resulting in sometimes unexpected changes to your appetite and your vision.

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Your body at week 23

Pregnancy cravings

Food cravings or aversions during pregnancy are normal and expected, though not experienced by everyone. While scientists aren’t sure exactly what causes pregnancy cravings, most studies suggest that changes in your senses of taste and smell are linked to hormone fluctuations [1]. Evidence has also indicated similarities in cravings within certain cultures, suggesting that your cultural background could also play a role.

In most cases, cravings and aversions are harmless and no cause for concern. It’s important to try to maintain a healthy diet, so that you can provide your body with the energy and nutrients it needs. While gaining weight during pregnancy is healthy and expected, unhealthy weight gain can contribute to poorer health outcomes for you and your baby.

Pica is a craving for things that have little or no nutritional value, most often non-food substances like dirt or chalk [2]. It is unknown why some women develop pica during pregnancy. Remember that consuming non-food substances can be harmful to both you and your baby. If you experience pica or are concerned about any of your cravings or aversions, talk with your healthcare provider.

Forgetfulness

Are you having a hard time remaining focused at work or remembering tasks on your to-do list? “Pregnancy brain” or “baby brain” are both common terms used, even in the scientific literature, to describe the memory lapses and forgetfulness experienced by an estimated 50-80% of women during pregnancy. Rather than viewing these changes as cognitive decline, many scientists now believe that forgetfulness and brain fog are actually the result of structural changes your brain makes as it optimizes and prepares for child-rearing [3].

While “pregnancy brain” can disappear for some women soon after giving birth, it is normal for symptoms to linger. Some studies have found that symptoms of “mommy brain” can last for up to two years postpartum, as your neurological system continues to evolve and adapt through the first years of your baby’s life [3]. Both sleep deprivation and mental health conditions like depression (during pregnancy and/or postpartum) are also believed to contribute to cognitive issues during and after pregnancy.

If you are feeling concerned about any issues you are experiencing during pregnancy relating to memory or cognitive functioning, talk with your nurse, doctor, or GP.

Vision changes

Pregnancy causes major changes to pretty much all the body’s systems, and this includes your vision! Vision issues during pregnancy are typically broken into three categories [4]:

First-time issues directly linked to pregnancy

Common issues that can arise because of pregnancy include changes to the pigmentation on the eyelids, dry eyes, cornea or lens changes, and greater instances of eye infections on account of lowered immunity. Changes to the cornea thickness, sensitivity, and curvature can all affect refraction. This can make vision blurry and even make wearing contact lenses uncomfortable. Because of changes to the cornea and lens, ophthalmologists typically recommend waiting at least several weeks after pregnancy to undergo any laser eye treatments or vision correction.

Existing issues that are changed by pregnancy

Pregnancy can also change existing eye conditions like diabetic retinopathy and glaucoma. Diabetic retinopathy is a retina condition caused by type 1 and type 2 diabetes. However, it is not caused by or linked to gestational diabetes. Glaucoma is a type of eye condition that affects the optic nerve. Pressure changes (known as intraocular pressure, or IOP) during pregnancy can affect glaucoma symptoms. It’s important to speak with your doctor about any medications you take to treat pre-existing eye conditions to discuss their safety and efficacy during pregnancy.

Vision issues linked to other conditions or complications

Finally, it’s important to be aware that sudden blurred vision, flashing lights, or vision impairment due to a severe headache might be a sign of preeclampsia, which is a high blood pressure condition that requires immediate medical monitoring. If you experience these vision changes and/or sudden increased swelling in your face, hands, or feet, abdominal pain, or nausea, contact your healthcare provider immediately [5].

Your baby’s development at 23 weeks

With every passing week of your pregnancy, your baby is growing bigger, and it will become easier to feel their movements. This week, your baby is around the size of a grapefruit, likely weighing between 1-1.1 pounds (450 to 500g) and measuring 11 to 11.8 inches (28 to 30 centimeters) [6].

Your baby is developing its own sleep and wake patterns [7]. Remember, these are likely not the same as yours, which means they might be very active when you are sleeping, or trying to get to sleep.

Piles in pregnancy

Piles, also known as hemorrhoids, are unfortunately common, especially during the second and third trimesters of pregnancy, as well as postpartum. These swellings in and around your bottom (rectum and anus) commonly cause itching, burning, aching, soreness, and swelling that you might be able to feel with your hands, pain while pooping, and/or bleeding after passing a stool [8]. Strain and pressure on your rectum and anus, for example on account of constipation or labor, can cause piles.

Because constipation is one of the most widely recognized causes of piles during pregnancy, treating constipation is the main method for prevention. Eating a diet high in fiber, regular exercise (if recommended during your pregnancy), and staying hydrated are all recommended for treating constipation. There are also medicines like ointments, stool softeners, and suppositories that are available by prescription and over-the-counter, which are safe to use during pregnancy. If you are suffering from piles, talk to your pharmacist, nurse, or doctor about which treatment might be best for you.

Tips in week 23

Practice relaxation: Whether you feel you need it or not, week 23 is a great time to start learning about different methods of relaxation. You can use these to calm down during the day, get ready for bed, or even during labor. Experiment with everything from deep breathing to meditation to yoga to music therapy to find out what works best for you.
Hair treatments during pregnancy: You might have already noticed, but your hair can also change during pregnancy. Every pregnancy is different – some might experience hair loss while others might find themselves needing to get a haircut much more often! Hair texture and skin/scalp condition can also change in pregnancy [9]. While most hair treatments are considered safe during pregnancy, keep in mind that the results might vary from what you are used to experiencing [10]. Also be sure to inform your stylist or aesthetician that you are pregnant, and ask your healthcare team if you have questions about the safety of particular treatments.
Remember sunblock: Changes to your skin’s pigmentation, known as melasma, and sensitivity can make you more prone to sunburn when you are pregnant [11]. Whether there are blue skies or clouds, it’s important to protect yourself from the sun by covering up and using a high-factor sunscreen on all exposed skin.
Vitamins and supplements during pregnancy: Your body needs extra vitamins and minerals like folic acid, vitamin D, calcium, and iron during pregnancy to support you and your baby [12]. However, there are a lot of supplements on the market, and it can be confusing to know what to take. Follow the guidance of your healthcare team, and be sure to consult them before starting any extra vitamins or supplements.
Monitoring your mental health: Your mental health is just as important as your physical health for both your well-being and your baby’s [13]. Be sure to keep an eye not only on your physical pregnancy symptoms, but also on how you are feeling day-to-day. If you are experiencing, or start to experience, stress or anxiety, communicate how you're feeling to your nurse, midwife, or doctor. They can offer important advice and recommendations for treating any mental health condition you might experience.

Using Natural Cycles during your pregnancy

If you have enjoyed this article, did you know that there’s an app that provides weekly pregnancy articles, guides on pregnancy-related health issues, and a way to track all your pregnancy symptoms? Natural Cycles is the first FDA Cleared birth control app, and NC° Follow Pregnancy is there to care for you through your pregnancy and as you recover postpartum. Why not see if NC is right for you today?

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Pica cravings during pregnancy [Internet]. American Pregnancy Association. 2023 [Cited 2025 Jun 10]. Available from: https://americanpregnancy.org/healthy-pregnancy/is-it-safe/unusual-cravings-pica/
Younis, J., Bleibel, M., Masri, J.E. et al. Exploring the influence of pregnancy on cognitive function in women: a systematic review. BMC Pregnancy Childbirth 25, 88 (2025). https://doi.org/10.1186/s12884-025-07181-3
Samra, K. (2013). The eye and visual system in pregnancy, what to expect? An in-depth review. Oman Journal of Ophthalmology, 6(2), 87. https://pmc.ncbi.nlm.nih.gov/articles/PMC3779421/
Pre-eclampsia [Internet]. nhs.uk. 2024 [Cited 2025 Jun 11]. Available from: https://www.nhs.uk/conditions/pre-eclampsia/
23 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 Jun 11]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/23-weeks-pregnant/
21 to 24 weeks pregnant [Internet]. HSE.ie. [Cited 2025 Jun 11]. Available from: https://www2.hse.ie/pregnancy-birth/baby-development-pregnancy-stages/stages/21-24-weeks/
Piles in pregnancy [Internet]. nhs.uk. 2024 [Cited 2025 Jun 11]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/piles/
Piérard-Franchimont, C., & Piérard, G. E. (2013). Alterations in Hair Follicle Dynamics in Women. BioMed Research International, 2013, 1–5. https://doi.org/10.1155/2013/957432
Hair treatment during pregnancy [Internet]. American Pregnancy Association. 2022 [Cited 2025 Jun 16]. Available from: https://americanpregnancy.org/healthy-pregnancy/is-it-safe/hair-treatments-during-pregnancy/
Lim, H. W., Piquero-Casals, J., Schalka, S., Leone, G., Trullàs, C., Brown, A., Foyaca, M., Gilaberte, Y., Krutmann, J., & Passeron, T. (2025). Photoprotection in pregnancy: addressing safety concerns and optimizing skin health. Frontiers in Medicine, 12. https://doi.org/10.3389/fmed.2025.1563369
Website N. Vitamins, supplements and nutrition in pregnancy [Internet]. nhs.uk. 2025 [Cited 2025 Jun 15]. Available from: https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/
Chauhan, A., & Potdar, J. (2022). Maternal Mental Health During Pregnancy: A Critical Review. Cureus. https://doi.org/10.7759/cureus.30656

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Welcome to week 24 of your pregnancy! In this week’s article, we will cover some changes you might experience in your appetite, skin, and muscles. We will also check in on your baby, who is working hard at gaining weight and developing their respiratory and neurological systems. We will also discuss what it means that your baby is viable this week and share important information about what preterm labor and delivery mean. Finally, we will wrap up with some tips for things you can do this week to support your health and prepare for your new baby.

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Key takeaways:

Hormones, circulation, and fluid retention are all linked to a variety of skin-related symptoms like dryness, itchiness, hives, and rashes
Your baby is working on producing important cells this week that help their lungs take in oxygen and expel carbon dioxide
Most women will receive a glucose detection test between weeks 24 and 28 to screen for gestational diabetes

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Your body at week 24

Increased appetite

Between the disappearance of first-trimester nausea or morning sickness and the emergence of pregnancy cravings, you might notice you are hungrier than normal. During the second trimester, doctors advise adding around 340 calories daily [1]. Foods that are high in fiber, protein, healthy fats (like certain nuts and seeds, and avocado), and complex carbohydrates (like legumes, fruits, starchy vegetables, and wholegrain products) can all help you maintain a healthy pregnancy diet while keeping you feeling fuller, longer.

Rashes

Changes to hormones, fluid retention, and circulation can all affect your skin in different ways, including the development of itchiness, hives, or rashes linked to your pregnancy.

Itchiness caused by dry skin and stretch marks is common during pregnancy. Stretch marks (which we covered in the 17 weeks pregnant guide) are a type of scarring that is caused by the stretching of skin, like on your lower belly during pregnancy. Try to avoid scratching, as this can make itchiness from dry skin and stretch marks worse.

In rare cases, itchiness can be a sign of an uncommon but potentially serious liver condition known as intrahepatic cholestasis (ICP) of pregnancy [2]. ICP usually appears without a rash, but causes itchiness on the palms of the hands and soles of the feet that is sometimes worse at night. Other symptoms may include dark pee and pale poo [2].If you suspect you might have ICP, contact your healthcare provider immediately.

Hives are an allergic reaction that can result from exposure to certain foods, insect bites, medicine, chemicals, pollen, animal dander, or other substances. It is possible for you to develop hives due to exposure to things you might not have previously had a reaction to. Scientists believe that the body can become more sensitive to certain allergens during pregnancy [3]. It’s important to remember that hives can also be brought on by stress.

Rashes are typically separated into pre-existing or pregnancy-specific conditions. Psoriasis, one common pre-existing condition, usually improves during pregnancy, but can worsen postpartum [4]. Pregnancy-specific skin conditions, like atopic eruption of pregnancy (which includes prurigo and pregnancy eczema) and polymorphic eruption of pregnancy (also known as PUPPP), are less common [5]. Though uncomfortable, they are not known to cause any harm to the baby and are usually treated with pregnancy-safe anti-itch medications. For more on common and uncommon skin conditions, check out our 19 weeks pregnant guide.

Most minor rashes, including hives, typically go away on their own. Try to avoid scrubbing the affected area or using soap, as this can aggravate already sensitive skin. Keeping skin well-moisturized and avoiding long, hot showers and baths can also help prevent dryness and related itchiness. If you are suffering from a rash, or itchiness that does not resolve on its own, contact your healthcare team. There are over-the-counter and prescription medications available to treat skin conditions that are safe to take during pregnancy.

Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) happens when the median nerve, which runs from your shoulder down into your hand, is compressed by the carpal ligament that sits in your lower palm. It is one of the most common hand injuries, more often experienced by women, and is usually caused by repetitive movements. Unfortunately, it is also commonly experienced in pregnancy, linked to hormone changes and fluid retention in the tissues that surround the median nerve in the wrist [6].

The main symptoms of CTS include tingling, aching, or numbness in the fingers and/or in the hand, usually in your dominant hand. CTS can also affect your ability to grip things or use fine motor skills. Symptoms usually resolve postpartum, when hormones balance out, but it's important to continue to be careful of your posture and not overstrain your wrist when feeding or holding your newborn.

Treating CTS during pregnancy can involve a combination of lifestyle changes and physical therapy. Eating a balanced diet that isn’t too high in salt and drinking enough water can help with fluid retention and swelling, while good posture can ensure you don’t place added strain on your already overworked muscular system. Wrist stretches and massage can both encourage fluid and blood circulation. Finally, elevation, rest, and cold compresses can all help with symptoms. In some cases, your doctor or physical therapist might recommend using a supportive hand or wrist splint, particularly at night, to help keep your hand in a neutral position while you sleep.

Your baby’s development at 24 weeks

Your baby’s brain, lungs, and taste buds are all growing and becoming more complex this week [7]. While the brain grows rapidly, the bronchi (main branches) of the lungs are developing special cells that help the lung’s alveoli take in oxygen and expel carbon dioxide. When premature babies have trouble breathing, it’s usually because these cells have not had enough time to develop.

In week 24, your baby is around the size of a small ear of corn, measuring about 11.8 to 12.5 inches (30-32 centimeters) and weighing between 1.25 and 1.4 pounds (600-650 grams) [7].

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Preterm labor and premature birth

Medically speaking, the term “viable” is used in two circumstances during your pregnancy. First, when examination shows that a pregnancy is expected to proceed normally, and second, from week 24, when your baby is considered to have a good chance of survival outside of the uterus, with proper medical care [8]. This might be scary to think about, and it's likely you have many weeks and months left in your pregnancy. However, it’s important to recognize the signs of preterm labor or serious medical issues so that you can seek immediate attention if needed.

Premature labor is labor that occurs before the 37th week of your pregnancy. Signs of premature labor include contractions or tightenings of your uterus, cramping, fluid leaking from your vagina (this could be your water breaking), and a backache that is unusual for you [9]. It is important to remember that preterm labor does not always lead to a preterm birth. Depending on your own health and the health of your baby, it is possible to receive treatment to delay birth, and in some cases, preterm labor can even stop on its own [10].

Tips in week 24

Scheduling your glucose tolerance test: Most pregnant women are advised to receive a glucose tolerance test between weeks 24 and 28 to check for gestational diabetes. Gestational diabetes occurs when your body cannot produce enough insulin to help control your blood sugar levels. While gestational diabetes typically resolves once you give birth, having gestational diabetes increases the likelihood of having it again in future pregnancies and increases chance of developing type 2 diabetes in the future [11]. The goal of a screening test is to detect the condition so that it can be monitored. The test involves fasting for 8 to 10 hours, having a blood test, drinking a very sweet glucose drink, and then having another blood test to see how your body has processed the glucose.
Thinking about contraception: While getting pregnant again might be the last thing on your mind, it’s important to remember that your body can begin ovulating around 4 to 6 weeks postpartum. It’s a good idea to start thinking about contraceptive options now. You can speak to your healthcare provider about the best options for you and use the opportunity to raise any questions about postpartum contraception. If you’re thinking about non-hormonal birth control, you can use Natural Cycles postpartum to support your recovery and help prevent pregnancy when ovulation returns.
Start baby proofing: While it will be some time before your baby is moving around, those first months with your newborn will likely be full. Planning ahead and ensuring your home is safe will save time and stress later. Make sure smoke and carbon monoxide detectors are installed and working properly, cover outlets, and attach shelves, mirrors, and TVs securely to walls so they cannot fall. Baby locks on cabinets can also keep cleaning products and sharp kitchen utensils out of tiny hands.
Go easy on hot showers and baths: While long, hot showers can be relaxing and soothing, they can also dry out your skin. If you find you are suffering from itchiness, unusually dry skin, or rashes, consider going easy on the heat or shortening your shower or bath time.
Schedule your dental cleaning: Changes to your blood flow and body chemistry during pregnancy can contribute to increased prevalence of gum diseases like gingivitis and even tooth decay [12]. In addition to keeping up with daily flossing and brushing, don’t forget to schedule your routine cleanings and visits with a dentist or hygienist.

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In the week or two leading up to your period, you might notice a fluctuating mood, body aches and pains, bloating, and more. You’re not alone — and you’re likely in the luteal phase of your menstrual cycle. During this time, hormones fluctuate, and your body is preparing for either your period or pregnancy. In this article, we’ll demystify the luteal phase by breaking down what’s happening in your body, how to know when the luteal phase starts and ends, and what you can expect in terms of symptoms and treatment.

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Key takeaways

The luteal phase is the latter part of your menstrual cycle, it takes place after ovulation, when levels of female sex hormones fluctuate
While more research is needed, it’s thought that these hormonal fluctuations can cause the physical, mental, and emotional symptoms associated with premenstrual syndrome
Luteal phase symptoms like bloating, headaches, and mood challenges can be managed with certain lifestyle changes and medications, but be sure to consult with your healthcare provider before making any big changes related to your health

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What is the luteal phase of the menstrual cycle?

The luteal phase is the latter part of your menstrual cycle. It usually lasts about two weeks, although this can vary person-to-person. In one study led by Natural Cycles, data from over 600,000 cycles logged in the app observed that the luteal phase lasted an average of 12 days per cycle in this group [1].

This phase is a time when hormone levels are fluctuating as your body prepares for an eventual pregnancy. These hormonal fluctuations cause some major changes in your body that can result in physical, mental, and emotional symptoms each cycle.

Other phases of the menstrual cycle

Let’s zoom out and do a quick overview of the full menstrual cycle, its phases, and the processes that happen during each one before diving deeper into the luteal phase. First off, cycles normally range from 21 to 35 days [2].

A 28 day cycle is typically used by the scientific community to break down cycle phases, but remember that most women don’t have cycles that last exactly 28 days. The study on Natural Cycles users mentioned above found that the average cycle length was actually 29.3 days [1]. The 28 day timeframe is just an estimate to give you an idea of how the cycle usually progresses.

Here’s what happens during each menstrual cycle phase [3, 4]:

Menstruation (Day 1 to 7): Your cycle begins on the first day of your period, which typically lasts for up to 7 days per cycle [2].
Follicular (Day 1 to 14): Technically, this phase includes the menstruation days since it’s defined as all cycle days before ovulation. During this time, the ovaries are working to develop follicles, aka the sacs filled with fluid and egg cells. Levels of the female sex hormone estrogen start to rise, allowing luteinizing hormone to rise as well.
Ovulation (Day 14 to 15): The follicular phase ends when luteinizing hormone spikes, prompting the release of a fully developed egg cell, a process known as ovulation. This is the beginning of a brief 12 to 24 hour window when the egg cell travels from the ovary through the fallopian tubes to the uterus for potential fertilization by a sperm cell.
Luteal (Day 15 to 28): This is the post-ovulation phase until the last day of your cycle, which is the day before you begin bleeding again.

What happens during the luteal phase?

After ovulation, luteinizing hormone levels fall, but estrogen remains present. The progesterone hormone also begins to rise, and peaks half-way through the luteal phase [9]. One of progesterone’s main functions is to continue preparing the body for a potential pregnancy if a fertilized egg implants into the uterine lining. It does this in two ways [4]:

Further prepares the lining of the uterus, filling it with nutrients for the potential embryo (estrogen helps with this, too)
Causes cervical mucus to thicken so that bacteria are less likely to enter the uterus

Progesterone also causes the basal body temperature (BBT) to rise and remain elevated during the luteal phase. If there is no embryo present in the uterine lining, estrogen and progesterone then start to decrease as the luteal phase nears the end, eventually leading to menstruation and the beginning of a new cycle [4, 5].

How long does the luteal phase last?

The luteal phase is one of the most consistent phases of the menstrual cycle with an average duration of 12-14 days for most people who menstruate. Cycle length variability usually comes from variations in the follicular phase, which can last anywhere from 10 to 22 days depending on the timing of ovulation [1]. If you’re using Natural Cycles, we can pinpoint the time of ovulation using BBT to predict your overall cycle length.

An irregular luteal phase, particularly a short luteal phase, is sometimes a sign of a larger diagnosis called luteal phase defect or luteal phase deficiency (LPD) [6]. Some studies have estimated that about a tenth of cycles have luteal phases shorter than 10 days, which is traditionally the indication of LPD. It’s a good idea to mention any cycle irregularities to your healthcare provider, especially if you’re trying to conceive.

How do I know if I am in the luteal phase?

The hormonal fluctuations that occur during the luteal phase can be observed indirectly, and you can look out for:

A sustained increase in BBT [5]
Thick vaginal discharge from the changes in cervical mucus
Progesterone levels in your urine [7]

Using tools like daily body temperature measurement, or by speaking to your healthcare provider about additional testing, you can get a good estimate of where you are in your menstrual cycle timeline.

Luteal phase symptoms

Outside of these indications of the luteal phase, this time also tends to come with some noticeable uncomfortable physical, mental, and emotional symptoms like bloating, headaches, and mood changes. This phenomenon is commonly referred to as premenstrual syndrome (PMS), and unfortunately, scientists still aren’t sure exactly why or how the luteal phase causes PMS symptoms [8]. The leading theory is that it has to do with the drop in hormone levels during the latter part of the luteal phase if embryo implantation hasn’t occurred (i.e., you’re not pregnant!).

In the U.S., about 75% of women experience PMS symptoms, although the severity of the symptoms tends to vary, and it’s common not to experience all of the symptoms at once [8]. But for some, PMS is so severe that daily activities like work, school, or exercise are a struggle. It’s common for PMS symptoms to change over the course of your life, but women in their late 30s and 40s tend to experience worse PMS symptoms as they approach perimenopause.

The good news is that these symptoms tend to subside within a few days after the start of your period, as different hormone levels begin to rise again [8]. You can always track your menstrual symptoms with Natural Cycles to see if there are patterns over time.

Some common PMS and luteal phase symptoms to watch for include:

Physical symptoms

Backache
Bloating or gas
Cramping
Clumsiness
Headache
Lower tolerance for noise or light
Stomach issues like constipation or diarrhea
Swollen or tender breasts [8]

Mental and emotional symptoms

Appetite changes
Cravings
Depression or bouts of sadness
Fatigue
Irritability
Low libido
Mood swings
Sleep problems like insomnia
Trouble concentrating
Tension or anxiety [8]

Some women experience a severe form of PMS called premenstrual dysphoric disorder (PMDD) during their luteal phase. In addition to an intense experience of many of the symptoms listed above, PMDD can come with a sense of hopelessness and overwhelm, frequent conflict, a loss of interest in activities you normally enjoy, and even suicidal thoughts [9]. If you’re struggling with these symptoms, help is always available. You can speak with someone at the National Suicide Prevention Hotline here and access resources on their website.

What separates PMDD from major depressive disorders and other mental health diagnoses is that symptoms usually go away within a few days of starting your period, and then start back up again during the next luteal phase. With that in mind, both PMS and PMDD seem to follow predictable patterns associated with our hormonal cycles, but the exact link between the two is still being explored.

Tips for improving your luteal phase symptoms

While the causes of PMS and PMDD are not well understood, it's thought that certain lifestyle adjustments, supplements, and medications can help ease luteal phase symptoms [8]. We’ll go through some of the most commonly recommended solutions below, but it’s best to consult with your healthcare provider about your medical history and personal needs before making any major health changes.

Lifestyle adjustments

Exercise regularly: Moving your body consistently can help ease symptoms like mood struggles, fatigue, and difficulty concentrating.

Maintain a healthy diet: Eating plenty of fruits, vegetables, protein, and whole grains can help with a host of health concerns, including some of the struggles associated with the luteal phase. You may want to avoid caffeine (try swapping this out with herbal teas), alcohol, salt, and sugar during the luteal phase if you can, but remember to consult with your healthcare provider about your unique dietary needs.

Get enough sleep: A lack of sleep is linked to mental health struggles, along with luteal phase symptoms like mood issues, headaches, and fatigue, so getting enough sleep can make a difference in those areas.

Avoid smoking: Women who smoke report more frequent and intense PMS symptoms than those who do not.

Explore healthy coping methods: Stress seems to be an underlying factor in how intense PMS symptoms tend to be, so finding ways to cope with stress, like journaling, meditation, yoga, massage, or talking with a trusted friend, can all help. [8, 9]

Vitamins and supplements

While not as regulated as pharmaceutical medications, some women find vitamins or supplements helpful in the management of luteal phase symptoms. Just be sure to consult with your healthcare provider first, as some of these may negatively interact with medications you’re already taking.

Calcium is a well-studied supplement for the reduction and management of PMS symptoms like fatigue, cravings, and mood struggles. It can be taken as a supplement, but it’s also found naturally in dairy products.

Vitamin B6 has been shown to improve PMS symptoms like irritability, bloating, difficulty concentrating, and mood struggles. It’s found in food such as fish, poultry, potatoes, and fruit, but you can also take it as a supplement.

Magnesium has shown mixed results for the treatment of luteal phase symptoms, but it may help relieve headaches. You can add it into your diet with more leafy greens, nuts, or whole grains or take a magnesium supplement.

Omegas (omega-3 and omega-6) have also been studied to help reduce cramping associated with PMS. They’re available as a supplement, or you can find them in nuts, fish, flaxseed, and leafy greens. [8]

Medications and treatments

For the cramping, headaches, and other body aches and pains associated with the luteal phase, you can try over-the-counter painkillers like ibuprofen to dull the pain [9]. Hot water bottles or heat packs can also be a source of pain relief.

Depending on the severity of your symptoms and your unique situation, your healthcare provider might also recommend certain medications in addition to, or instead of, the treatments listed above. They include:

Hormonal birth control
Antidepressants or anti-anxiety medicine
Cognitive behavioral therapy with a specialist [8, 9]

Can you get pregnant if you have sex in the luteal phase of your menstrual cycle?

Yes, you can get pregnant during the luteal phase. Conception would happen right at the start of the luteal phase in the 24 hours after ovulation (technically the first day of the luteal phase) [10]. Conception occurs if the egg cell released during ovulation is fertilized by a sperm cell. The fertilised egg will then develop and eventually implant into the lining of the uterus. This usually happens around 8 to 10 days after ovulation.

However, it’ll probably still take a few days to a few weeks for pregnancy tests to detect the pregnancy. It’s generally recommended to wait until the first day of your missed period (what would usually be cycle day 1) to take a pregnancy test.

So although conception happens on the first day of the luteal phase, the probability to conceive is highest when you have sex during the two days before ovulation [10]. If you have intercourse later in the luteal phase after ovulation it will likely not lead to pregnancy (less than 1% chance). It’s important to keep in mind that if you ovulate later than expected without realizing, you are at risk of pregnancy.

Learn more about your menstrual cycle with Natural Cycles

We know that there is a ton of information out there about the luteal phase of your menstrual cycle. It can be tough to parse through and figure out what is most relevant to you, but we hope this guide to the luteal phase has given you some insight into what’s happening in your body and a few ways you can manage luteal phase symptoms. For more information and resources about your period, pregnancy, and beyond, find out how Natural Cycles can support you.

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Bull JR, Rowland SP, Scherwitzl EB, Scherwitzl R, Gemzell K, et al. Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles [Internet]. 2019 (cited 5 June 2025). Available from: https://www.nature.com/articles/s41746-019-0152-7
American College of Obstetricians and Gynecologists. FAQs: Abnormal Uterine Bleeding [Internet]. 2023 (cited 5 June 2025). Available from: https://www.acog.org/womens-health/faqs/abnormal-uterine-bleeding
American College of Obstetricians and Gynecologists. Infographic: The Menstrual Cycle: Menstruation, Ovulation, and How Pregnancy Occurs [Internet]. 2025 (cited 5 June 2025). Available from: https://www.acog.org/womens-health/infographics/the-menstrual-cycle
Thiyagarajan DK, Basit H, Jeanmonod R. Physiology, Menstrual Cycle [Internet]. 2024 (cited 23 May 2025). Available from: https://www.ncbi.nlm.nih.gov/books/NBK500020/
Écochard R, Leiva R, Bouchard T, Boehringer H, Iwaz J, et. al. Descriptive analysis of the relationship between progesterone and basal body temperature across the menstrual cycle [Internet]. 2022 (cited 5 June 2025). Available from: https://pubmed.ncbi.nlm.nih.gov/35065994/
American Society for Reproductive Medicine. Diagnosis and treatment of luteal phase deficiency: a committee opinion [Internet]. 2021 (cited 5 June 2025). Available from: https://www.asrm.org/globalassets/_asrm/practice-guidance/practice-guidelines/pdf/clinical-relevance-of-luteal-phase-deficiency.pdf
Food and Drug Administration. 510(k) SUBSTANTIAL EQUIVALENCE DETERMINATION DECISION SUMMARY [Internet]. [cited 9 June 2025]. Available from: https://www.accessdata.fda.gov/cdrh_docs/reviews/K191462.pdf
OASH Office on Women’s Health. Premenstrual syndrome (PMS) [Internet]. 2025 (cited 26 May 2025). Available from: https://womenshealth.gov/menstrual-cycle/premenstrual-syndrome
National Health Service. PMS (premenstrual syndrome) [Internet]. 2024 (cited 26 May 2025). Available from: https://www.nhs.uk/conditions/pre-menstrual-syndrome/
Wilcox AJ, Dunson DB, Weinberg CR, Trussell J, Baird DD. Likelihood of conception with a single act of intercourse: providing benchmark rates for assessment of post-coital contraceptives. Contraception. 2001 Apr;63(4):211-5. doi: 10.1016/s0010-7824(01)00191-3. PMID: 11376648.

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Perimenopause is a transitional time that leads to menopause, when menstruation stops completely, marking a new chapter in our lives. During perimenopause, we may notice periods becoming irregular, along with a host of other symptoms that are thought to be a result of the hormonal changes happening in our bodies [1].

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Key takeaways

Perimenopause is a natural phase of life leading up to menopause, the permanent stop of menstrual cycles, marking the end of our reproductive years
Symptoms like period irregularities, night sweats, joint pain, and more can happen during perimenopause
While everyone’s perimenopause experience is different, there are treatment options available for those who experience disruptive perimenopausal symptoms

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In this guide to perimenopause, we’ll take a look at the signs and symptoms of perimenopause, commonly recommended treatments, and how tracking changes in your menstrual cycle can help you learn more about your body.

What is perimenopause?

Let’s start by defining perimenopause. It’s a natural phase of life for anyone who has a period. During this time, the body’s hormone levels fluctuate in preparation for the end of menstruation (menopause). It can come with symptoms like irregular periods, night sweats, joint pain, and more. While these symptoms can be disruptive, it’s important to know that everyone’s perimenopause journey is unique. You may experience all, some, or none of these symptoms in the lead up to menopause [1].

Perimenopause vs. menopause

A common point of confusion is the difference between perimenopause and menopause. The distinction between the two comes down to whether or not you still get your period — if you’re still menstruating, this means you’re still in perimenopause (even if it’s irregular).

Menopause is defined as the last menstrual bleed, this is diagnosed retrospectively after you haven't had a period for twelve months. Menopause marks the end of female fertility, your ovaries are no longer releasing egg cells, and your ovarian reserve (the amount of egg cells in your body that you’re born with) has naturally depleted. The period of time after menopause is reached is known as postmenopause [1, 2].

You may have heard the terms “perimenopause” and “menopause” used interchangeably in conversation, or “menopause” used to refer to the entire transitional phase — you may have even done this yourself! That’s okay, but we wanted to take this opportunity to clear up this often confusing terminology. Having access to more accurate terms to describe what happens in our bodies can empower us to identify irregularities, advocate for our bodies, and gain knowledge about our health.

What are the hormonal changes during perimenopause?

It’s thought that the wide hormonal fluctuations that occur during perimenopause may explain many of the symptoms associated with the transition, although more research is needed to confirm this link. For now, we know that there are four notable hormones at play during perimenopause — estrogen, progesterone, follicle stimulating hormone (FSH), and testosterone [2].

Estrogen: Throughout perimenopause, estrogen levels can fluctuate. They’ll eventually end up lower than they were pre-menopause, but there are a lot of ups and downs in between. Estrogen levels affect both the urinary and reproductive systems, so if estrogen is declining at some point during perimenopause, this can lead to symptoms like vaginal dryness or more frequent UTIs.
Progesterone: Similarly, progesterone levels will fluctuate during perimenopause. Progesterone levels can affect things like sleep, cycle length, and bleeding. Perimenopause symptoms will vary based on which of these hormones is dominant at any given time (estrogen or progesterone). More research is needed to understand these particular hormonal fluctuations.
FSH: Follicle stimulating hormone might begin to rise earlier and more sharply during cycles in perimenopause. This is the body’s way of trying to stimulate every last egg cell. Levels of FSH remain high even after menopause.
Testosterone: Testosterone levels tend to decline during perimenopause, which may lead to symptoms like low libido. [2]

Can I get pregnant if I am perimenopausal?

In short, the answer is yes. If you’re still getting periods, you’re probably still ovulating, meaning you can still conceive. However, ovulation becomes more unpredictable during perimenopause, in part due to these fluctuating hormones. With that in mind, it may be much more difficult for some people to get pregnant during these years. The risk of miscarriage and pregnancy complications also increases during perimenopause, but people do still have healthy pregnancies during this time [3].

If you’re experiencing perimenopausal symptoms and trying to get pregnant, it’s best to speak with your doctor for advice. If you don’t want to get pregnant during this time, it’s a good idea to keep using birth control until menopause [3].

Tracking ovulation and looking for patterns in your cycle may help you plan pregnancy or prevent it more effectively while going through perimenopause. Using tools like Natural Cycles, you can detect ovulation and pinpoint symptomatic patterns to understand your body better.

What is the typical age for perimenopause to start?

Most people begin to notice perimenopause symptoms in their 40s and 50s, usually between the ages of 45 and 55. However, it’s possible for perimenopause to start earlier in your 30s. In some cases, early menopause (not perimenopause) can occur due to medical procedures such as the surgical removal of both ovaries, chemotherapy, or radiation. This results in an immediate drop in estrogen levels and is known as induced menopause [1, 4].

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[1, 5]

How long does perimenopause last?

As we mentioned earlier, the perimenopause experience (including symptoms and timeline) is highly variable. Your journey may look very different from someone else’s, so it can be difficult to predict your exact start of perimenopause. But typically, the transition lasts about two to eight years. In the United States, women reach menopause around the age of 52 on average, marking the end of perimenopause [1].

How do you know you’re in perimenopause?

The exact start date of perimenopause may be difficult to predict. Signs of perimenopause can be subtle at first, and easy to overlook or attribute to other causes. Most people notice irregular periods as the first sign of perimenopause — this can mean longer or shorter cycles, longer or shorter periods, or heavier or lighter bleeding. According to some widely used medical frameworks, the perimenopause transition begins when there is at least a seven-day difference in cycle length from one cycle to the next [2]. But keep in mind that there are other causes of cycle variations, including conditions like PCOS.

With all of this in mind, it’s natural to feel a bit uncertain about what’s going on and when you’re in perimenopause. Factors like age and symptoms can be helpful when diagnosing perimenopause, but ultimately, tuning into your body and tracking changes over time can help you understand what phase you’re most likely in.

Perimenopause tests

While changes in our menstrual cycles are often the first sign of perimenopause, blood tests can also detect hormone levels that may indicate that you’re in this transition. Although some of these perimenopause tests detect high levels of FSH, this is actually not as reliable of a marker as a hormone called Anti-Müllerian Hormone (AMH).

Anti-Müllerian hormone (AMH) levels reflect your ovarian reserve and naturally decline with age. While AMH testing can help estimate how close you may be to menopause, sometimes within a window of a few years, it’s mostly used in research settings and not currently recommended as a standard tool to diagnose perimenopause. Research continues to improve the accuracy of these tests, and more sensitive versions are in development, but they are not yet available for routine clinical use [6].

For now, we primarily use menstrual cycle changes, symptoms, and timing to figure out where we are in our reproductive journeys. Making a habit of tracking your cycle length can make the process of identifying the start of perimenopause much easier. Logging dates and symptoms in the Natural Cycles app can give you deeper insight into what’s happening in your body and where you are in the menopause timeline.

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Like mother, like daughter

Did you know that the age your mom reached menopause can be a good indicator of your own journey, too? Research on mother-daughter pairs found that heredity (our genetic link to our mothers) played a substantial role in the timing of menopause [7].

Common signs and symptoms of perimenopause

Here is a list of notable symptoms associated with perimenopause to look out for as you’re assessing your own experience with this transition:

Body odor changes
Brain fog
Breast soreness
Cycle changes
Fatigue
Frequent urination
Hair loss
Heart palpitations
Insomnia/trouble sleeping
Joint pain
Low libido
Mood changes
Night sweats/hot flashes
Period changes
Spotting
Weight gain
Vaginal dryness and painful sex [2, 8]

Remember that although these are common, your body is unique and you may not experience some (or any) of these symptoms. Their severity and duration may vary, as well.

Mood changes: What is perimenopause anxiety?

One of the perimenopause symptoms we want to highlight is mood changes, specifically perimenopause anxiety. It’s possible to experience challenges associated with your mood and emotions during perimenopause, and it’s important to seek the care and support you need to ease the burden. Women with a history of depression and/or anxiety are at risk for future depression, but in one study, researchers found that about 16% of perimenopausal women report new onset depression or anxiety during perimenopause [2]. Women are also twice as likely as men to be diagnosed with an anxiety disorder or depression.

Feeling anxious every now and then due to one-off stressors is a normal part of life, but if you’re consistently struggling with your mental health, it’s a good idea to seek help from therapy, along with exercising regularly and giving yourself opportunities to rest [9]. (We know, easier said than done.)

There’s no need to suffer in silence. Talk to your doctor or a friend you can trust, and if you experience very dark or suicidal thoughts, you can also reach out to the 988 suicide & crisis lifelife or access resources via their website.

Treatments for perimenopause symptoms

For individual advice and treatment options for managing perimenopause symptoms, we recommend speaking to your healthcare professional first and foremost. They can assess your unique situation and help chart the best course forward for you. They’ll likely recommend hormone therapy or lifestyle changes (or a combination of the two) to help you navigate this transition more comfortably.

We’ll go through the most commonly recommended treatments below, but first, we want to note that there’s no “cure” for perimenopause, as this condition will eventually affect anyone who gets a period. However, the symptoms associated with perimenopause can be severe and disruptive, and some may benefit from symptom treatment in an effort to ease the transition.

Hormone therapy

Hormone replacement therapy (also called HRT or menopausal hormone therapy, MHT) is one of the most widely recommended courses of treatment for severe perimenopause symptoms. It works by adding synthetic hormones that are at lower levels in your body during perimenopause and beyond [10].

If you’re looking for a jumping off point for a conversation with your doctor about HRT, here are a few common hormonal treatment options and what you should know about them:

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n

\n Type of hormone therapy \n	\n How it’s administered \n	\n Who is this best for? \n	\n Pros \n	\n Cons \n
\n Estrogen-only (topical or oral) \n	\n Pill, patch, gel, spray \n	\n Only recommended if you have had your womb removed during a hysterectomy. Otherwise, you’ll need to supplement with a progestin or use a combined HRT method to lower risk of endometrial cancer. \n	\n Can address symptoms associated with decreased estrogen during perimenopause. \n	\n You’ll need to supplement with progestin if you have not had a hysterectomy. For oral HRT, there is a risk of forgetting to take pills, and they can have a risk of blood clots. For topical HRT, it can take a few minutes and up to an hour before you can dress, shower, etc. \n
\n Estrogen-only (vaginally inserted) \n	\n Tablet, pessary, ring \n	\n People whose symptoms are localized to the vaginal area and urinary system (such as dryness or pain during sex). Also, those who cannot take HRT with progesterone or those who want to avoid potential risks associated with systemic estrogen. \n	\n Can ease vaginal dryness and pain during sex, as well as urinary symptoms like UTIs. \n	\n May not help with hot flashes, mood swings, or sleeping problems. \n
\n Progestogen- \n only* \n	\n Pill, cream, gel, implant, IUD \n	\n Only recommended if you cannot or should not take estrogen-containing HRT. \n	\n Shown to improve vasomotor symptoms like hot flashes and night sweats. \n	\n Risk of forgetting to take the pill. May not improve mood symptoms. Not as effective at treating vasomotor symptoms as estrogen. Side effects include headaches, vaginal bleeding, and abdominal pain with the implant. \n
\n Combined estrogen and progesterone \n	\n Pill, patch \n	\n Most people who are experiencing moderate to severe perimenopause symptoms. \n	\n Can address most symptoms associated with perimenopause. \n	\n Risk of forgetting to take the pill or change the patch. Possible side effects like breast tenderness, spotting, bloating, mood changes. \n
\n Testosterone** \n	\n Gel \n	\n Usually only recommended if you’re in postmenopause and you have problems with sex drive that other forms of HRT have not helped. \n	\n Can increase energy, libido, and help improve bone health. \n	\n Possible side effects include acne, hair growth, and weight gain, but these are not common at the doses used for perimenopause symptoms. \n

*Progestogen-only can be added to estrogen treatments — consult your provider for more information

**Testosterone is not currently licensed to treat symptoms associated with perimenopause, but speak to your doctor about whether a specialist can prescribe it if you’re interested in learning more. [11, 12, 13, 14, 15]

Healthcare providers generally will not recommend hormone therapy to anyone who has:

Allergies to estrogen or progestin
Current or past breast or endometrial cancer
Vaginal bleeding with an unknown cause
Current or past history of blood clots
High blood pressure
Diabetes
Underactive thyroid
Migraines
Lupus
Epilepsy
Asthma
Dementia
Current or past history of liver problems
Current or past history of angina, heart attack, or other heart problems [16]

Non-hormonal medication

As an alternative to hormone therapy, there are several non-hormonal medications that may help address perimenopause symptoms. Antidepressants can not only help with mood, but also can treat hot flashes. An anti-seizure medication called gabapentin, along with a blood pressure medication called clonidine, can both reduce hot flashes and ease the sleep difficulties associated with perimenopause [17].

What lifestyle changes can I make to manage perimenopause symptoms?

Many people also find that lifestyle changes can ease the severity of perimenopause symptoms as well. Here are some of the most common perimenopause lifestyle adjustments:

Eat a nutritious diet: We’re told this our entire lives — eat your veggies! During perimenopause and beyond, it’s still important. Eating a diet rich in fruits, vegetables, and particularly calcium and protein, can help keep you healthy. The Mediterranean diet is a great guide for most people, but as long as you’re eating plenty of protein, fresh produce, whole grains, and omegas, you’re doing great.
Take care of your body: A regular, gentle exercise routine can contribute to your overall health and support your body during this transition. It’s an individual journey to find what type of movement, intensity, and frequency work best for your body, but resistance training/lifting and recovery methods are generally recommended for this stage of life. Some people also find physical therapies like massage or acupuncture helpful.
Create healthy sleeping habits: Make sure your sleep sanctuary is set up to your liking — a slightly chilly, dark room with minimal noise and comfortable bedding is recommended. Going to sleep and waking up around the same time each day can also make all the difference, and listen to your body’s signals to rest as you need to throughout the day.
Maintain mindfulness: Deep breathing exercises and/or a meditation practice can boost your mental and emotional health day-to-day. Additionally, relaxation methods like certain forms of yoga or tai chi can integrate these practices and help to reduce stress. Undue stress can bring on hot flashes and other symptoms.
Wear light clothing: You may be due for a new look! Try swapping out heavier clothing items for lighter layers and a more flowy wardrobe to keep you cool, relaxed, and comfortable. This is especially true for pajamas if you’re experiencing night sweats. It may help to have an extra pair on hand by your nightstand so that your sleep isn't interrupted by having to get up and change.
Have cool drinks or a fan on hand: Having these resources available can help ease vasomotor symptoms like hot flashes and night sweats whenever they come up.
Avoid common triggers: Spicy food, caffeine, hot drinks, smoking, and alcohol can all worsen the severity of perimenopause symptoms. Endocrine-disrupting chemicals (EDCs) are certain types of chemicals like phthalates and parabens that mimic hormones like estrogen and are found in many consumer goods. Although more research is needed in this area, EDCs have been linked to worsening perimenopause symptoms like hot flashes.
Non-hormonal lubricants and creams: For vaginal dryness, there are non-hormonal options available without a prescription.
Consider herbal supplements: Herbal supplements have been popular on the internet as a treatment for menopause. However, most of these have not been studied extensively, so they may not work the same way, or even be effective, for everyone. Always speak with your doctor before starting any new supplements.
Get mental health support: It can help to speak with a therapist to deal with some of the mental and emotional struggles that come with perimenopause. Talking to others who are going through the same thing as you can also help ease the burden. Even nowadays, there can be so much stigma surrounding the topic of menopause that it stops us from talking about it, but sharing can be a helpful way to lighten the load.

[8, 14, 18, 19, 20, 21]

Signs perimenopause is ending

The end of perimenopause is menopause — that point on the timeline when it’s been 12 months since your last period started. After this point, postmenopause is the body’s new normal. This phase can come with lingering symptoms including hot flashes, sleep disturbances, and mood changes, along with genitourinary symptoms like frequent urination, vaginal dryness, and low libido. These symptoms usually subside in the coming years, but the hormone therapy options and/or lifestyle adjustments listed above can help in the meantime [22].

In postmenopause, there may also be an increased risk for certain health conditions like urinary tract infections (UTIs), heart disease, and osteoporosis due to decreased estrogen in the body. With that in mind, it’s important to maintain a healthy lifestyle and stay up-to-date with doctor visits and screenings throughout postmenopause to get the support you need in this new phase of life [5].

Get to know your body better with Natural Cycles

Staying informed about the hormonal changes happening in your body can help you make empowered decisions about your health, treatment options, and more. Logging your symptoms and cycle over time with a tool like Natural Cycles can give you insight into your perimenopause journey while providing resources during this phase and beyond. See if Natural Cycles fits into your lifestyle today.

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NIH National Institute on Aging. What Is Menopause? [Internet]. 2024 [cited 2025 May 16]. Available from: https://www.nia.nih.gov/health/menopause/what-menopause
Santoro N, Roeca C, Peters BA, Neal-Perry G. The Menopause Transition: Signs, Symptoms, and Management Options [Internet]. 2021 [cited 2025 May 16]. Available from: https://academic.oup.com/jcem/article/106/1/1/5937009
Baldwin M, Jensen J. Contraception during the perimenopause [Internet]. 2013 [cited 2025 May 29]. Available from: https://www.sciencedirect.com/science/article/abs/pii/S0378512213002272
Pillay O, Manyonda I. The surgical menopause [Internet]. 2022 [cited 2025 May 29]. Available from: https://pubmed.ncbi.nlm.nih.gov/35568447/
NHS. After the menopause [Internet]. 2025 [cited 2025 May 19]. Available from: https://www.nhsinform.scot/healthy-living/womens-health/later-years-around-50-years-and-over/menopause-and-post-menopause-health/after-the-menopause
Delamater L, Santoro N. Management of the Perimenopause [Internet]. 2018 [cited 2025 May 19]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6082400/
Asselt KM, Kok HS, Pearson PL, Dubas JS, Peeters PHM, et al. Heritability of menopausal age in mothers and daughters [Internet]. 2004 [cited 2025 June 5]. Available from: https://www.sciencedirect.com/science/article/pii/S0015028204022435
NHS. Menopause - Symptoms [Internet]. 2022 [cited 2025 May 19]. Available from: https://www.nhs.uk/conditions/menopause/symptoms/
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Harper-Harrison G, Carlson K, Shanahan MM. Hormone Replacement Therapy [Internet]. 2024 [cited 2025 May 29]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493191
Rovinski D, Ramos RB, Fighera TM, Casanova GK, Spritzer PM. Risk of venous thromboembolism events in postmenopausal women using oral versus non-oral hormone therapy: A systematic review and meta-analysis [Internet]. 2018 [cited 2025 June 4]. Available from: https://pubmed.ncbi.nlm.nih.gov/29936403/
Chen YY, Su TH, Lau HH. Estrogen for the prevention of recurrent urinary tract infections in postmenopausal women: a meta-analysis of randomized controlled trials [Internet]. 2021 [cited 2025 June 4]. Available from: https://pubmed.ncbi.nlm.nih.gov/32564121/
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Vaginal discharge is perhaps not something you think of every day, but there’s actually a lot we can learn from it. It can give insights into our fertility and also be a helpful indicator when it comes to identifying problems with our vaginal health. In this article, we take a closer look at green discharge, and we’ll cover what causes it, what other symptoms to look out for, how to treat it, and some tips for taking care of your vaginal health.

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Key takeaways:

Green vaginal discharge is a sign of inflammation or infection in the vagina, and can becaused by sexually transmitted infections (STIs), such as trichomoniasis or gonorrhea, or by other conditions like pelvic inflammatory disease, vaginitis, or having a foreign body, like a tampon, left in the vagina
You should always reach out to a healthcare professional if you notice green discharge — it’s important to treat the underlying cause
Using condoms to protect against STIs, testing for STIs when needed, avoiding harsh products around the vagina, and keeping an eye on your discharge are all ways of keeping your vagina healthy

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What is green vaginal discharge?

While vaginal discharge can vary in appearance, green discharge is never normal. It can indicate an STI or another infection, and you should always reach out to a healthcare professional if you notice that your discharge is green [1].

Vaginal discharge is a type of fluid that’s created in the vagina and comes out as discharge. It is generally a combination of cervical mucus, normal bacteria, cells from the vaginal wall, and fluid produced by glands in the vagina. It has several functions, and one of the main ones is keeping the vagina clean and protected from infection [1]. However, if you notice green or light green discharge in your underwear or when you wipe, it’s a sign that something is causing damage or inflammation in the vagina or reproductive tract.

Learning what your discharge usually looks like and keeping an eye on changes in appearance, consistency, or smell can help you understand if something might be going on, so you can get help when you need it.

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What does normal discharge look like?

First things first: before we learn more about green discharge and what that means, let’s talk about what normal discharge looks like. Healthy discharge is typically white or clear in color. The consistency can range from thick and sticky to slippery or watery, and while it doesn’t have to be odorless, it shouldn’t have an unpleasant or strong smell [1].

Another good thing to keep in mind is that your discharge will change appearance during your menstrual cycle. At the beginning of your cycle (right after your period ends), you may have less discharge, and it’s often thicker and more sticky at this stage. When you enter your fertile window and you get closer to ovulation, you may notice your discharge becoming clear and stretchy, with a consistency similar to raw egg whites [2]. This type of discharge is sometimes called “egg white cervical mucus”.

What causes green discharge?

So, back to green discharge. Green discharge can happen for a number of reasons, but it’s usually a sign of some type of infection. That might sound scary, but the good news is that these conditions can be treated — so it’s important to speak to a doctor about it. Let’s go through the most common causes of green discharge.

Sexually transmitted infections (STIs)

If you’ve had unprotected sex and notice green or light green discharge, with or without odor, it’s possible you’ve contracted an STI. There are a couple of STIs that can have green discharge as a symptom, and these include:

Trichomoniasis: This often goes unnoticed since it doesn’t always cause symptoms, but unusual discharge is one sign. You may notice more discharge than usual, and its appearance can be green, yellow, white, or clear. The consistency can be thin or frothy, and you might also experience other symptoms like itchiness or soreness of the vagina or vulva, pain during sex, or pain when you pee. Trichomoniasis is caused by a parasite, and it can be easily treated with medication [3, 1].
Chlamydia: One of the more common STIs, chlamydia can become serious if left untreated. Symptoms include unusual discharge and a burning sensation when you pee, but not everyone notices any symptoms at all. Chlamydia is treated with antibiotics [4, 5].
Gonorrhea: This is another example of an STI that doesn’t always lead to noticeable symptoms, but when it does, you might have green or yellow discharge, pain while peeing, pain in your lower abdomen, or bleeding between periods. The treatment for gonorrhea is antibiotics, which are given as a single-dose tablet or injection [6].

These infections all have one thing in common: they don’t always cause symptoms, which means they can be tricky to spot. At the same time, it’s important to get treatment since they can lead to complications if they’re left unchecked, or be passed on to others. It’s always a good idea to get tested for STIs if you’ve had unprotected sex or start having sex with a new partner. Also, remember that condoms are the only birth control method that offers effective protection against STIs.

Pelvic inflammatory disease (PID)

If bacteria makes its way from the vagina into the uterus, ovaries, or fallopian tubes, it can result in pelvic inflammatory disease, or PID. In short, it’s an infection in the female reproductive system. PID is most often the result of STIs, such as chlamydia or gonorrhea, that are left untreated [7].

Similar to the STIs we mentioned above, PID doesn’t always give obvious symptoms, so it can be hard to spot right away. Keep an eye out for:

Green or yellow discharge that might have an unpleasant smell
Pain during sex
Heavy or painful periods
Bleeding between periods
Pain when you pee
Fever or feeling unwell
Severe stomach pain [8]

If you experience any of these symptoms, contact your healthcare professional so you can get the right treatment. PID can lead to serious complications or even infertility if it’s left untreated, so it’s important to get help as soon as possible if you suspect you might have it.

Tampons or other objects left or stuck in the vagina

Another, albeit less common, cause of green discharge is if you forget to remove an object that’s been inserted into the vagina, or that an object becomes stuck so you can’t get it out. If it’s not removed, this can result in an infection and may cause symptoms such as abnormal or foul-smelling discharge, pain, or bleeding [9]. Worst case, it may even lead to toxic shock syndrome (TSS), a rare but potentially life-threatening condition which is caused by certain bacterial infections [10]. It’s best to get help from a healthcare provider right away to help get the object out and get other treatment for the symptoms if needed.

In adults, the objects in question are usually period products like tampons or menstrual cups, or items used during sex or masturbation, like condoms or sex toys [9].

Tampons should generally be removed after around 4-6 hours (depending on your flow), and should never be left in for longer than 8 hours. But it’s possible sometimes that a tampon gets stuck. Usually, this happens if you forget to take your tampon out before inserting a new one, or if you forget to take it out before having sex. If this happens and you can’t get it out yourself, don’t wait! See a healthcare professional right away so they can help remove it [11].

Vaginitis

Vaginitis is a term that means that there’sinflammation in the vagina. You might feel itchy or sore in or around the vagina, and you may also notice that it’s red or swollen. Vaginitis can cause you to have more discharge than usual, and it may also have an unpleasant smell. In some cases, your discharge can have an unusual color like green or yellow, or have a different consistency than usual [12, 13].

Vaginitis is quite common, and it’s usually caused by another condition, such as an STI, a yeast infection, or bacterial vaginosis (BV). It can also be be the result of an allergic reaction to some product you’ve used in or near the vagina [12]. Remember that the vagina is actually self-cleaning, so you don’t need to clean your vagina — doing so can actually increase your risk of vaginitis.

Vaginitis is treatable, but the exact treatment depends on the cause. Your healthcare provider can help you find the right option for you, so it’s important to reach out if you experience symptoms of vaginitis.

Rectovaginal fistula

A rectovaginal fistula is an abnormal opening between your vagina and rectum, which can lead to poop leaking into the vagina from the rectum, sometimes leading to yellow or green foul smelling vaginal discharge. Rectovaginal fistulas are very rare, but can be caused by Crohn's disease, injuries sustained during childbirth (especially if they aren’t repaired), or cancer. Treatment typically involves treating the underlying cause of the fistula and managing symptoms, but in some cases, surgery can be an option [14].

When to see a doctor for green discharge

Green discharge always merits a visit to your doctor to figure out what’s causing it — it’s never normal to have green discharge and it’s important to start treatment as soon as possible.

You can always speak to your doctor if you’re wondering about the color of your discharge, and it’s also a good idea to keep an eye out for any changes. Reach out to your doctor if you notice symptoms that can indicate an ongoing infection, such as:

Soreness or itchiness in or around your vagina
Foul-smelling discharge
Pain when you pee
Pain in your pelvis, lower abdomen, or back
Pain during sex
Unexpected bleeding between periods
Feeling unwell
Fever [1, 8]

To sum up, green discharge on its own is enough to indicate there’s something going on that needs medical treatment, but noting other symptoms can help your healthcare provider narrow down the cause (alongside any testing they might do during your appointment).

What does green discharge during pregnancy mean?

If you’re pregnant, you may notice that you have more discharge than usual — and that’s normal. However, healthy discharge should still be clear or white and mostly odorless. If you notice green discharge during pregnancy, other symptoms like a strong or fishy smell, or other signs of infection, reach out to your midwife or doctor right away [15].

How to treat green discharge

The treatment you get for green discharge will depend on the underlying cause — that’s also why it’s important that you get help from a doctor who can do tests and take all your symptoms into account. However, since an infection is the most likely culprit for green discharge, medical treatment is needed and in most cases, you’ll be prescribed antibiotics. Don’t try to treat green discharge on your own.

Can you prevent green discharge?

So, can you prevent green discharge? By preventing the conditions that cause green discharge, you can avoid the symptom itself. These are some things you can do:

Use condoms during sex
Get tested for STIs regularly or if you’ve had sex with a new partner
Change tampons or menstrual cups regularly and remember to take them out before having sex or inserting a new one.
Avoid vaginal douching or using harsh products. You don’t need to clean your vagina, but you can use water and a mild soap to clean the vulva as needed.
Wear cotton underwear or loose fitting clothes to let your vagina breathe
Wipe front to back after using the bathroom

Get to know your body with Natural Cycles

Thank you for reading about green discharge! Here at Natural Cycles, we believe that everyone should have the knowledge they need to take charge of their own health — and that includes knowing what different types of vaginal discharge means. The NC° app isn’t just a hormone-free, FDA Cleared birth control and fertility app; it’s also a great tool for understanding your own body. By tracking your discharge during your menstrual cycle, along with other symptoms, you can get to know what your usual patterns look like and spot changes that stand out. Why not see if Natural Cycles could be a good fit for you?

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NHS. Vaginal discharge [Internet]. 2024 [cited 2025 May 27]. Available from: https://www.nhs.uk/conditions/vaginal-discharge/
Reed BG, Carr BR. The normal menstrual cycle and the control of ovulation [Internet]. In: Feingold KR, Ahmed SF, Anawalt B, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2000– [updated 2018 Aug 5; cited 2025 May 27]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/
CDC. About Trichomoniasis [Internet]. 2025 Jan 31 [cited 2025 May 27]. Available from: https://www.cdc.gov/trichomoniasis/about/index.html
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ACOG. Pelvic Inflammatory Disease (PID) [Internet]. 2019 Aug [cited 2025 May 27]. Available from: https://www.acog.org/womens-health/faqs/pelvic-inflammatory-disease
NHS. Overview: Pelvic inflammatory disease [Internet]. 2022 [cited 2025 May 27]. Available from: https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/
Anderson J, Paterek E. Vaginal foreign body evaluation and treatment [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [updated 2023 May 8; cited 2025 May 27]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549794/
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HealthDirect. Retained tampon or other object [Internet]. 2024 [cited 2025 May 27]. Available from: https://www.healthdirect.gov.au/retained-object-or-tampon
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ACOG. Vaginitis [Internet]. 2023 [cited 2025 May 27]. Available from: https://www.acog.org/womens-health/faqs/vaginitis
Tuma F, McKeown DG, Al-Wahab Z. Rectovaginal fistula [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [updated 2023 May 14; cited 2025 Jun 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535350/
NHS. Vaginal discharge in pregnancy [Internet]. 2024 [cited 2025 May 27]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vaginal-discharge/

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The history of birth control is a long one, filled with weird misunderstandings, amazing discoveries, revolutionary inventions, and animal poop (yes, poop). In this article, we’ll travel back in time and walk you through some of the birth control methods that brought us to where we are today. From ancient Egypt to modern-day Sweden, we’ll dive into the history of barrier methods, hormonal contraceptives, and more.

","

Key takeaways:

The history of birth control is paved with methods that range from the strange, like putting fruit in your vagina or jumping backwards, to the dangerous, like drinking toxic copper water
Some methods are really old: the first mention of the withdrawal method dates back 2,500 years, while early versions of barrier methods and spermicides were already being used around 2000 BC
The last 200 years have brought many innovations in the history of birth control, from the rubber condom in the 1860s, the first IUD in 1909, the development and legalization of the birth control pill in the 1960s and ‘70s, to the invention of Natural Cycles in 2013

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What did we even do before birth control?

As long as humans have walked the earth, we’ve had sex. But many birth control methods as we know them today — as pills, implants, shots, and so on — only became available pretty recently, so what did they do back in the day to avoid getting pregnant? Before we jump into the (at times, quite bizarre) history of birth control, let’s travel back even further.

It’s easy to think that people just got pregnant left and right before we had birth control. However, while there aren’t any written sources from back when we were hunters and gatherers, researchers are fairly certain that women tended to have children at least a few years apart. This happened naturally since babies were breastfed for several years, which naturally suppressed fertility [1].

Implications of birth control for women’s reproductive freedom

We can’t talk about the history of birth control without also touching on the implications it’s had for women’s reproductive freedom. The ability to control if and when you have kids without having to abstain from sex has played a huge role in women’s autonomy and in the women’s rights movement. Birth control being legalized and made available meant that more women were able to complete higher education and join the workforce [2].

During the sexual revolution of the 60s and 70s, when perceptions around sex became more open, the birth control pill and other contraceptive methods also meant that women were able to enjoy their sexuality without fear of becoming pregnant [3]. So, without further ado, let’s jump into the history of birth control.

The pull out method is really, really, really old

The pull out method, or withdrawal method, is probably one of the oldest ways of preventing pregnancy. It’s done by removing the penis from the vagina before ejaculation. One of the first mentions of it dates back to the story of Onan in the Torah, and this reference is more than 2,500 years old [3]. There are also records of the pull out method being used in ancient China and India [3]. However, the method itself likely predates these written records. While we’ll never know who came up with it (no pun intended) or when it was first used, we’re certain that it’s been around for a long time.

Today, the pull out method is still widely used [4]. While it does have some natural advantages — it’s free, and easily available — it’s simply not that effective (80% with typical use) [5]. Keep in mind that timing withdrawal can be tricky and even if it’s timed properly, you can get pregnant from pre-ejaculate if it gets into the vagina. That’s right, you can get pregnant from pre-cum!

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Questionable advice from the history of birth control

Let’s fast-forward a bit in history because we need to address some… odd… methods.

Drink something toxic

The ancient Greeks gave us many great things, like democracy, theater and the Olympics, but their advice on the birth control front wasn’t always golden, to say the least.

Different harmful concoctions have been used throughout the history of birth control. Around 500 BC, Hippocrates, who is often referred to as the father of Western medicine, suggested that women drink copper salt water to avoid pregnancy [6]. For obvious reasons, this wasn’t effective (plus, copper is toxic to ingest), so we’re glad this advice didn’t live on.

Advice that might make your partner ask questions…

You’d think giving the ancient Greeks a few hundred years would provide some extra time to think, but it didn’t improve things. During the 2nd century, gynecologist Soranus gave us not one, but three unhelpful tips! He suggested women should:

Hold their breath during sex (making us wonder about Soranus’ stamina)
Sneeze after sex so the semen comes out (bless you?)
Jump backwards seven times after sex (forget about after sex cuddles) [6]

We’d love to tell you that this was where the weirdness stopped. But alas.

You put the lemon where?

In the 1700s, the infamous lothario Casanova reportedly asked his lovers to use halved lemons as a kind of cervical cap to prevent pregnancy, and he even takes credit for this “invention” in his autobiography [3]. In truth, he didn’t come up with the idea that fruit juice might kill off sperm (inserting cotton or wool soaked in fruit juice was done at least since 2000 BC) [7]. But maybe he was the first one to skip the middle step and just put the entire lemon half in there. We’re not sure.

We don’t have any numbers on the birth control effectiveness of these citrus-based contraceptives, but they’re definitely not doctor-recommended today. While it’s possible the natural acidity of a lemon might act as a kind of spermicide and kill off straggling sperm (yes, there are studies on this [8]), the whole thing sounds a bit too… zingy for our taste.

Interestingly, there are some methods today, for example the vaginal gel Phexxi, that build on knowledge that acidity can affect the environment in the vagina and make it harder for sperm to swim. Phexxi isn't suitable for those with a history of UTIs and is 86% effective with typical use [9].

Barrier methods have been around for a long time

Barrier methods are a type of contraception that physically stops the sperm from reaching the egg cell. These types of methods have been around for millennia, and looking back at those first versions, we’re glad that there have been some improvements over the years.

Old-school methods that weren’t for the fainthearted

So, where might Casanova have gotten his inspiration? The earliest use of methods that resemble diaphragms, cervical caps, or spermicides dates back to at least 2000 BC, and the use of these early versions continued well into the Middle Ages [7, 10]. However, they certainly weren’t made of the same materials we’re used to today. Had you lived during that time, you may have found yourself putting some of the following into your vagina:

Cotton or wool soaked in oils, fruit juice, or herbs
Honey
Grass
Seaweed
Crocodile or elephant dung
Wine
Rock salt
Sponges (a version of which is still in use today!) [3, 7, 10]

Essentially, this is a list of things you don’t want to put in your vagina, but we might file this under “make do with what you’ve got”. After all, both barrier methods to stop sperm and spermicides to kill off sperm are still used today, albeit in different formats.

Modern barrier methods take shape

In the 1800s, we start to see the emergence of a diaphragm that looks more like what’s on the market today. The first custom-made rubber cervical caps were developed in Germany in the 1830s, and improvements continued during the rest of the century [3].

After learning about diaphragms during a trip to Holland in 1915, Margaret Sanger, founder of Planned Parenthood, played a big role in making diaphragms available and legal in the US. Because it was illegal to distribute contraception in the US during the beginning of the 20th century (laws at the time prohibited any medication or objects that could be used to prevent conception [11]), she had to smuggle diaphragms into the country. She ended up getting caught, but later won a legal case allowing them to be imported. By the 1940s, diaphragms were the most popular contraceptive method in the US, although it was later outcompeted by other methods, like the birth control pill [3].

Condoms weren’t always a walk in the park either

The condom is one of the most widely used birth control methods today, and it’s actually one of the oldest too. But there was a long road from the first condoms to the modern ones we now know. Let’s take a look at some highlights in the history of the condom:

Condom cave paintings: The earliest record of a condom is from a cave painting in France, which depicts a man using a condom during sex. This painting is estimated to be 12,000–15,000 years old [3]. We don’t know exactly how condoms were used that far back, but we still think it’s pretty cool!
Protection against serpents and scorpions: The first known written mention of a condom comes from the story of King Minos of Crete, who was thought to have lived in 3000 BC. It actually references a female condom — according to legend, King Minos’ sperm contained “serpents and scorpions” and to protect herself, his wife put the bladder of a goat into her vagina [12]. It’s hardly hard facts, but the story does show a cultural awareness of barrier methods and how they are used.
Condoms made from animal intestines: The ancient Egyptians were early adopters of the condom. Records from 1300 BC show that they used sheaths to cover the penis [10], and early condoms were also used in Ancient Rome, Greece, China, Japan, and New Guinea. These early condoms were often made of animal intestines, animal bladders, or silk paper [12].
…or linen: Some early condoms were fashioned out of linen. In fact, one of the earliest mentions of condoms in the modern sense is from the 1500s, when scientist Gabriele Falloppio conducted experiments showing that condoms in the form of linen sheaths protected against syphilis [12]. Hurray for protection against STIs, but does anyone else feel like linen condoms must have been a bit scratchy for everyone involved?
Finally, rubber! It wasn’t until 1844 when Charles Goodyear patented vulcanized rubber that the condom we know today really started to take shape. By 1860, condoms were pretty widely available [12].

Today, condoms are made from latex, polyurethane (a type of soft plastic), or polyisoprene (synthetic rubber). While contemporary condoms might look (and feel!) radically different, the way we use them hasn’t changed — today, many people still rely on condoms both to prevent pregnancy and to protect against STIs. All hail the humble condom!

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A note on male birth control options

Aside from the condom, there aren’t that many options when it comes to birth control for men. Other methods include using the withdrawal method (which isn’t very effective) or permanent options like vasectomy. There have been studies trying to develop hormonal birth control options for men, but none have yet made it to the market [13].

The history of fertility awareness methods

Fertility awareness methods (FAMs) — methods that rely on understanding when you’re fertile during the menstrual cycle — have also been around for a while.

FAMs as we know them today started cropping up during the 1900s, but already in the 17th and 18th centuries, African and Native American women understood that cervical mucus was linked to fertility and used this knowledge to prevent or plan pregnancy. Western medicine only caught onto this in the 1960s, when the Billing Method (or cervical mucus method) was introduced [3].

Using the menstrual cycle to predict fertility

It wasn’t until the 1920s that scientists discovered when ovulation happens in the menstrual cycle. From that initial discovery that ovulation, on average, happens 14 days before the next period bleed starts, the first calendar method was developed [14].

Of course, now we know more. In a study on more than 600,000 cycles from Natural Cycles users, we busted the myth that the average cycle is 28 days and also found that the average luteal phase is actually 12 days long. At the same time, the timing of ovulation varies from person to person, emphasizing the importance of solutions tailored to the individual, like the NC° app [15].

Turning up the heat with the temperature method

The fact that ovulation doesn’t always happen on the same day also played a role in how other FAMs developed, since this highlighted the need for more information than just counting cycle days.

Another important discovery in the field of fertility was that basal body temperature (BBT) is linked to ovulation. In the 1930s, Dr. Rudolf Vollman and his wife, Emmi, found that a rise in BBT is a reliable way to confirm that ovulation has happened [14]. This discovery paved the way for the temperature method, also known as the BBT method, where the user measures their BBT throughout the menstrual cycle to find their ovulation and fertile days.

FAMs continued to develop during the later part of the 1900s, and the sympto-thermal method is one such example — this combines BBT tracking with charting other symptoms during the menstrual cycle, like cervical mucus or luteinizing hormone (LH).

Fertility awareness in the smartphone era

Among the latest developments in the FAM world were smartphones, which allow users to track their symptoms in different types of apps. But advances didn’t stop there: in 2018, Natural Cycles became the first birth control app to be FDA Cleared as a method of contraception, marking a new era of digital birth control.

History of the birth control pill

The launch of the birth control pill is considered a landmark moment in the history of birth control and reproductive health more widely. Even though the first birth control pill was FDA approved in 1960, the research that laid the groundwork for it started decades earlier. A key discovery was that the female sex hormones that govern the menstrual cycle, estrogen and progesterone, could be used to inhibit ovulation in animals [16].

This research started in the 1920s and continued during the following decades, but it wasn’t until the 50s that it started being implemented for birth control. Margaret Sanger, founder of Planned Parenthood, along with her friend Katharine Dexter McCormick, funded research which eventually led to the development of the first ever birth control pill, which contained a combination of synthetic progesterone and estrogen [3].

When did the birth control pill become legalized?

Despite the FDA approval in 1960, it took a bit longer before the pill became widely available in the United States. At the time, the use of contraceptives was still restricted in the US through laws that banned the use of any object or medication designed to prevent pregnancy.

In 1965, Planned Parenthood won a case that rolled back the ban on married couples using contraception [3]. Legal battles over the birth control pill continued for several years, and it wasn’t until 1972 that the Supreme Court legalized all forms of birth control for everyone in the US — meaning that unmarried women were also able to access the pill [1, 2].

The safety concern

Even after the birth control pill entered the market, there were concerns about its safety. The first-generation birth control pills contained much higher doses of hormones than we now know are required, which meant that there was a higher risk of side effects, such as blood clots [16].

Research into the birth control pill continued, and this resulted in many improvements. The birth control pill as we know it today is very different from the first pills in its composition. The doses of the hormones in the pills were reduced, and different types of synthetic hormones were developed [16].

Today, the birth control pill is both a safe and effective birth control option.

Other short- and medium-acting methods

In addition to the pill, there are other methods that are so-called “short-acting”, which means the user needs to replenish them more often (think of the pill which is taken daily, compared to long-acting methods that can be in place for years at a time). Other methods are somewhere in between long- and short-acting, and these are helpfully called medium-acting methods.

The vaginal ring

In addition to the pill, the vaginal ring is another example of a short-acting method. It’s a small ring made of soft plastic that’s inserted into the vagina, where it releases hormones to prevent pregnancy. The very first vaginal ring, designed to be used for a month and then replaced, was FDA approved in 2001, adding one more birth control method to the market. In 2018, another type of vaginal ring which can be used for a full year was also FDA approved [17].

The birth control shot

There are also medium-acting methods, and one example is the birth control shot (also known as the depo shot or injection). It was FDA approved in 1992, but it actually became available in the rest of the world as early as 1971. Initially, there were concerns about whether the shot increased the risk of breast cancer, but studies concluded that this wasn’t the case, and the birth control shot is a safe and effective method that’s used by women globally to this day [3].

Long-acting reversible contraception (LARC)

The IUD: development, side effects, and FDA approval

The intrauterine device, or IUD, has drastically changed how we think about and use birth control. IUDs are highly effective (more than 99%), and paired with the convenience of using a long-term birth control method, make them a great option for lots of people.

The very first IUD was developed by Dr. Richard Richter, and this was made from silkworm gut (yes, you read that right). Even as developments of the IUD continued, silkworm continued to be used in the following decades as well. In the 1930s, silver wire was added, which made the device more effective at preventing pregnancy, but the silver also ended up being absorbed by the body and turning women’s gums blue and black [18]. Yikes. Silver IUDs went out of commission, but this did give an indication that metal can be effective in preventing pregnancy.

The evolution of IUDs continued, and the device we know today started taking form in the late 1960s, when Dr. Howard Tatum made a plastic, T-shaped IUD in an attempt to decrease side effects like cramps and bleeding. At the same time, studies on rabbits led to the discovery by Dr. Jaime Zipper that copper was effective in preventing pregnancy when placed inside the uterus. The two combined their discoveries, and the first copper IUD was created in 1969 [18].

However, it took a while still for the IUD to become widely available as birth control. A later version of the copper IUD was approved by the FDA in 1984, and it’s still in use today. The first hormonal IUD, on the other hand, wasn’t FDA approved until 2000 [18].

The implant

The research that led to the invention of the birth control implant dates back to the 1950s, when pellets containing progesterone were inserted under the skin of rabbits. It took a while for it to get to the human use stage, though. The first implant was approved by the World Health Organization (WHO) in 1984 to be used worldwide as a contraceptive, but the FDA lagged behind. It was only in 1990 that the implant was approved for use in the US [3].

Changing the game: Natural Cycles

While most advances in the history of birth control have been made within the field of medicine, the digital age has also paved the way for new innovations. In 2013, Swedish Physicist Elina Berglund was looking for a hormone-free way to prevent pregnancy. Not finding what she was looking for on the market, she decided to take things into her own hands — and so, Natural Cycles was created.

The NC° app builds on the science of the menstrual cycle and temperature tracking (similar to the fertility awareness methods we mentioned earlier). However, it takes it a step further by combining this knowledge with a customized algorithm that calculates your daily fertility status. By analyzing each user’s unique temperature data and cycle characteristics, along with optional ovulation tests, the NC° app provides natural birth control tailored to each individual.

At this point, you might be wondering, how does Natural Cycles compare to traditional fertility awareness methods? Great question. As it turns out, research shows that Natural Cycles finds fertile days more accurately than calendar-based methods since it adapts to each individual using their unique temperature and cycle data. Its effectiveness — 93% with typical use and 98% with perfect use — is also higher than other calendar-based methods as it relies on the science of body temperature [19].

Natural Cycles became CE marked in Europe in 2017, after a scientific study on more than 22,000 women confirmed the app’s effectiveness as birth control [20]. In 2018, Natural Cycles became FDA Cleared in the US as the first contraceptive app, making birth control history once again. To date, Natural Cycles is still the only available birth control app to be cleared by the FDA.

New innovations making NC° even easier to use

The NC° algorithm requires temperature data to provide a daily fertility status, and you can use a basal thermometer (which measures to two decimals) and input the data directly into the app, either by syncing via Bluetooth using the NC° Thermometer or manually. However, at Natural Cycles, we always continue to push for new innovations — including wearables.

In 2021, Natural Cycles received another FDA clearance, which allows the app to receive overnight temperature trend data from Oura Ring, making the measuring experience even smoother. This was followed by another clearance in 2023 by regulators in the U.S., Europe, and Australia, allowing the NC° app to use overnight wrist temperature data from Apple Watch. We’re constantly striving to offer more ways to measure, making NC° even more accessible for those who want to use it — watch this space for more wearable integrations!

Here, it’s also important to note that these wearables shouldn’t be used to prevent pregnancy on their own — the NC° app is still the only FDA Cleared and CE marked digital birth control.

Understand your options with Natural Cycles

Thanks for reading up on the fascinating history of birth control — it’s sure been a journey! Here at Natural Cycles, we believe that knowledge is power. Everyone should have access to information that enables them to make informed decisions about their own reproductive health, and that includes birth control. We know there’s no one size fits all when it comes to contraception — everyone has different needs, and our needs and wants even change throughout our lives. That’s why we’re proud to not only educate around different birth control options, but also offer a non-hormonal method in the form of NC° Birth Control — the first and only FDA Cleared and CE marked birth control app. Why not see if Natural Cycles could be right for you?

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United Nations Department of Economic and Social Affairs, Population Division. World Family Planning 2022: Meeting the changing needs for family planning: Contraceptive use by age and method [Internet]. 2022 [cited 2025 May 20]. UN DESA/POP/2022/TR/NO. 4. Available from: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2023/Feb/undesa_pd_2022_world-family-planning.pdf
Contraceptive Technology (Table 26 - 1). 21st Edition. 2018 [cited 2025 May 20]. Available from: https://www.datocms-assets.com/21281/1662539230-contraceptive-technologies_failure-rates-table-2018.pdf
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Clarke GN, et al. Sperm immobilizing properties of lemon juice. Fertil Steril. 2006;85(5):1529–30. Available from: https://doi.org/10.1016/j.fertnstert.2005.10.040
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It’s pregnancy week 22! In this week’s article, we will talk about what to do about swelling and growing feet, as well as how to manage unwelcome comments and unwanted touching from those around you who might see your growing stomach and learn about your pregnancy. We will check on your baby and cover a couple pregnancy symptoms you might notice this week, like acne and spider veins.

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Key takeaways:

Changes to your feet during pregnancy are common, and while swelling resolves postpartum, some changes to the size and shape of your feet can be permanent
Your baby is growing eyelashes and eyebrows this week alongside the lanugo hair covering their whole body
It’s OK to say no – allowing others to touch your stomach, and sharing information about your fertility, pregnancy, and breastfeeding plans are decisions that are completely up to you

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Your body at week 22

Growing feet

Are your shoes feeling tight or are previously comfortable shoes making your feet achy or giving you blisters? You are not imagining things – most likely your feet are changing during pregnancy!

A combination of weight gain and the muscle-relaxing hormone relaxin can put new stresses on the musculoskeletal system leading to changes in the foot structure and shape [1]. Changes in the way that you walk during pregnancy also contribute to musculoskeletal changes. Increases in foot length, width, and volume during pregnancy are all common. For some, changes in foot size like those that result from swelling (edema) can resolve postpartum. However, other changes can remain after pregnancy.

Proper-fitting shoes enable you to exercise while supporting your pelvis, hips, and lower back. Keep in mind, though, that your feet can continue to change through the coming weeks and months. Consider shoes and sandals that are adjustable, like those with elastic or adjustable straps and laces, in order to accommodate any changes that might occur throughout the duration of your pregnancy.

Coping with tummy touchers

As your baby grows, your expanding stomach will likely become more and more noticeable to those around you. This can invite unwanted belly-touching from family, friends, or even complete strangers. Surprisingly as this might seem, preparing for any unwanted advances can help you know what to do to feel more comfortable interacting and responding to outreaching hands.

If someone asks if they can touch your stomach, and you do not want them them to, know that it is perfectly OK to respond with “actually, I don’t want you to touch my belly”, “I’m sorry, I don’t feel comfortable having my stomach touched”, or a simple “no”. If you don’t feel comfortable or confident being direct, you can try one these:

“Sorry, but rubbing my belly upsets my stomach”
“My skin is actually really sensitive”
“The baby responds to movement and they’re resting right now”
“I’m sorry, but my doctor (or healthcare provider) doesn’t want anyone touching my stomach”

While people may mean well, it is important for you to set boundaries and feel comfortable. Remember that you don’t owe anyone, even close friends or family, an explanation.

Your baby’s development at 22 weeks

At 22 weeks, your baby looks a lot like a newborn, just smaller! They’re currently around 10 to 11 inches (25-28 centimeters) and weigh around 14 to 15.2 ounces (400 to 430 grams) [2]. Around the size of a bell pepper, they’re pretty wrinkly but gaining weight every day to fill out their skin.

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Eyelashes and eyebrows are beginning to appear on your baby's face, in addition to the thin, soft hair called lanugo that covers their entire body [3]. Your baby’s first poop, called meconium, is also starting to form in their intestines.

Pregnancy symptoms in week 22

Spider veins

Have you noticed thin red, blue or purple lines just under the surface of your skin? These are likely spider veins, or telangiectasia. Spider veins are small, damaged blood vessels that most commonly appear on the legs but can happen anywhere on the body, even the face [4]. Spider veins are rarely a serious health concern, but they can occasionally be painful.

Studies have suggested that spider veins develop as milder varicose veins, which we discussed in the week 18 pregnancy guide [4,5]. During pregnancy increased blood flow and pressure on your veins can weaken and damage the walls of blood vessels, especially small ones. These can cause them to swell (known as varicose veins) or even break, making them visible beneath the skin [5].

Spider veins can fade for some women postpartum. However, others might require additional treatments to minimize their appearance [6]. Because many are not advised during pregnancy, talk with your healthcare provider postpartum if you are interested in treating spider veins.

Acne

Acne is known to affect up to nearly half of women during pregnancy and breastfeeding, mostly in the second and third trimesters [7]. Though pregnancy acne has not been extensively researched, scientists believe that changes to your hormones, circulation, digestion, and immune system during pregnancy can all contribute to pregnancy acne. If you have already suffered from acne before pregnancy, it is possible that pregnancy can worsen or change the nature of your acne.

It is important to talk to your healthcare provider before treating your acne, as many ingredients are not recommended for those who are pregnant or breastfeeding. This includes over-the-counter skincare and acne medications, as well as prescribed treatments.

Swelling in hands, feet, and ankles

Edema, or mild swelling, is common during pregnancy as your body circulates and retains a greater volume of fluid. It is most commonly experienced in the feet and ankles, but can also affect your hands. Staying in one position for a long period of time, which slows fluid circulation, can contribute to swelling. Hand and foot exercises, avoiding shoes that are too tight, and regular exercise (if recommended during your pregnancy) can all improve fluid circulation and reduce swelling [8].

While gradual swelling in pregnancy is normal, particularly at the end of the day, a sudden increase in swelling could be a sign of preeclampsia. Preeclampsia is a serious condition relating to high blood pressure that requires immediate medical monitoring. If you suddenly notice your hands, feet or face are swollen, or if you experience a severe headache, vision problems, pain below your ribs, or nausea, contact your healthcare provider immediately [9].

Tips in week 22

Check your rings: minor swelling in your hands can develop slowly, but it might take you by surprise when you find that you suddenly cannot remove rings or other jewelry! It’s a good idea to regularly check that you can easily remove your rings, or that they are still fitting comfortably, in order to prevent the need to cut them off later.
Managing unwelcome comments and questions: as your pregnancy progresses, more friends, family, and acquaintances will notice that you are pregnant. While it is nice to have the extra support, it can also invite unwelcome, or even inappropriate, questions and comments on everything from your appearance to child-rearing, birth, and breastfeeding. It is always up to you to share, or not share, details or information about your pregnancy and plans. Speak with your partner if the comments or actions of friends or family make you uncomfortable so they can support you as situations arise in the future.
Pelvic floor exercises: incorporating pelvic floor exercises in your daily routine is a safe and easy way to help with pregnancy symptoms like leaking pee, as well as prepare your body for labor and delivery.
Avoiding common infections: during pregnancy, your immune system is compromised and you are more susceptible to germs like those that cause the flu or a cold. Remember to take simple steps to avoid getting sick, like washing your hands regularly with soap and water, avoiding people that are unwell, and making sure that your food is well-prepared. It’s also wise to avoid those leftovers that have been camping out in the fridge, or food that has been left sitting on the counter a bit too long.
Invest in comfortable shoes: changes in your foot size and shape, swelling, and changes in how you walk might all require you to reevaluate your footwear. It might seem like a drag, but choosing the right shoes or investing in new shoes can actually help you stay healthier during your pregnancy by improving circulation and making exercise possible.

Following your pregnancy with Natural Cycles

If you enjoyed this article, did you know that NC° Follow Pregnancy offers weekly pregnancy guidance to support you throughout your pregnancy, all in an easy-to-use app? Symptom trackers and articles provide you the tools to care for your physical and mental health as you navigate your pregnancy and all the changes that come with it. And at the end of your pregnancy, NC° Postpartum is on-hand to guide you through this new stage of life with your baby. Why not check out Natural Cycles today?

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Segal NA, Boyer ER, Teran-Yengle P, Glass NA, Hillstrom HJ, Yack HJ. Pregnancy Leads to Lasting Changes in Foot Structure. American Journal of Physical Medicine & Rehabilitation [Internet]. 2013 Mar;92(3):232–40. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3596423/
22 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 June 2]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/22-weeks-pregnant/
How your baby develops week to week | Ready Steady Baby! [Internet]. NHS Inform. 2024 [Cited 2025 June 4]. Available from: https://www.nhsinform.scot/ready-steady-baby/pregnancy/your-baby-s-development/how-your-baby-develops-week-to-week/#week-17-to-24:~:text=their%20eyebrows%20and%20eyelashes%20are%20growing
Sandean DP, Syed HA, Winters R. Spider Veins. [Updated 2024 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563218/
Varicose veins [Internet]. Johns Hopkins Medicine. 2021 [Updated 2023 Aug 28] [Cited 2025 June 2]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/varicose-veins#:~:text=Varicose%20veins%20are%20caused%20by,can%20collect%20in%20the%20veins
Dugall M, Luzzi R, Ippolito E, Cesarone M, Belcaro G. Postpartum Varicose Veins: Supplementation with Pycnogenol or Elastic Compression—A 12-Month Follow-Up. Int J Angiol [Internet]. 2014 May 29;26(01):012–9. Available from: http://dx.doi.org/10.1055/s-0033-1363784
Ly S, Kamal K, Manjaly P, Barbieri JS, Mostaghimi A. Treatment of Acne Vulgaris During Pregnancy and Lactation: A Narrative Review [Internet]. Vol. 13, Dermatology and Therapy. Springer Science and Business Media LLC; 2022. p. 115–30. Available from: http://dx.doi.org/10.1007/s13555-022-00854-3
Website N. Swollen ankles, feet and fingers in pregnancy [Internet]. nhs.uk. 2024 [Cited 2025 June 2]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/swollen-ankles-feet-and-fingers/
Pre-eclampsia [Internet]. nhs.uk. 2024 [Cited 2025 June 2]. Available from: https://www.nhs.uk/conditions/pre-eclampsia/

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Congratulations – you are now past the halfway point of your pregnancy! You are also about halfway through your second trimester. In this week’s article, we’ll talk about how your center of gravity is changing and explain why it’s normal to continue to feel tired in the second trimester. We’ll also check in on your baby and offer some guidance on what to look out for if you are experiencing symptoms that might indicate a urinary tract or vaginal infection. Finally, we will offer some tips on things you can do this week to support your body in pregnancy week 21.

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Key takeaways:

If your sense of balance feels off, it’s not your imagination – your growing uterus is actually changing your center of gravity
Your growing baby now weighs more than the placenta
Hormonal and physical changes during pregnancy can increase your likelihood of getting a urinary tract or certain vaginal infections, particularly in the second trimester

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Your body at week 21

Clumsiness

Have you noticed your balance is not as steady as it once was? Your growing belly actually affects your center of gravity, making you more unsteady on your feet. Whether you are riding public transportation, practicing yoga, or trying to do everyday tasks like getting something from a high shelf or walking a dog who pulls on the lead, you might discover maintaining your balance is difficult. As your baby grows, this will continue and can even get worse.

Be careful to avoid any situations that risk falling, like using a step stool or wearing high heels. If you live in a cold environment, or if winter is approaching, be especially careful walking on icy or slippery services. Consider investing in winter boots with spikes, or purchasing ice cleats to attach to your shoes.

If you ride public transport, make use of specially marked seats intended for those who are pregnant, older, or who need extra assistance. If you are not yet showing, or nervous about taking these spaces, consider using a “baby on board” badge to communicate to other passengers that you need to sit down during your journey. These badges are often available for free from various transportation providers in the UK, Ireland, and Germany.

Tiredness

While some experience a boost of energy in the second trimester, it’s also normal to continue to feel tired. Growing a baby is hard work! Prioritizing your sleep, resting when possible, and being mindful of your changing energy levels can help you manage fatigue during this time. It’s also important to minimize stress both in your personal and working environments by keeping aware of situations that can contribute to stress or anxiety, and practicing relaxation techniques like deep breathing, meditation, or prenatal yoga whenever possible.

Enjoying a healthy diet and pregnancy-safe exercise are two tools that can boost your energy levels and help fight fatigue. In particular, it's important to make sure you are consuming enough iron. When you are pregnant, your body requires extra iron in order to make more blood to carry oxygen to both you and your baby. One side effect of iron deficiency is fatigue, and adding more iron to your diet can help. Animal-based proteins, beans and peas, and fortified cereals are all good sources of iron. Make sure to talk to your doctor or midwife before starting any new supplements. Exercise, if safe to do so in your pregnancy, can also boost energy levels and might even help you sleep better at night.

Your baby’s development at 21 weeks

Your baby is busy moving around in the uterus, sucking its thumb, and swallowing. At 12 to 12.7 ounces (340 to 360 grams), they now likely weigh more than the placenta [1]. Your baby is also now measured from crown to heel, rather than crown to the end of their bottom. This week, they are around 8.5 to 10.6 inches (21.6 to 27 centimeters), which is about the size of an endive (also called chicory). Your baby’s hearing is also developing, and some studies have suggested that babies in week 21 will even begin responding to your voice, especially when you speak out loud and rub your stomach at the same time [2].

$\"Infographic$

Pregnancy symptoms in week 21

Round ligament pains

If you have been experiencing aching or sharp pains on either side of your stomach, these might be round ligament pains. The round ligaments are located on both sides of your uterus and connect your uterus to your pelvis. The pregnancy hormone relaxin softens your muscles and encourages them to stretch to support your growing baby and uterus. As these muscles expand vertically on each side of your abdomen, the stretching can cause pain on the sides of your stomach and even into your hips and pelvis. Pain can be particularly acute when you make sudden movements and cause the muscles to contract, like when you sneeze, cough, roll over in bed, stand up quickly, or laugh [3].

This pain does not cause any harm to you, or your baby, but it can be both shocking and uncomfortable. Changing positions to alleviate discomfort, rest, and gentle stretching can all help with round ligament pain. It is also recommended that you avoid sudden movements that could cause the muscles to contract quickly, and to bend and flex your hips before coughing, sneezing and laughing.

If pain persists after resting, or if it becomes severe, notify your healthcare provider. It's important to share any pains or discomforts you are feeling with your care team so they can monitor your pregnancy and give advice on pain relief and prevention.

Urine and vaginal infections

Due to hormonal and physical changes in your body during pregnancy, there can be an increased risk of urinary tract (UTI) and certain vaginal infections during pregnancy.

Urinary tract infections during pregnancy are common because as your baby grows, the weight and pressure of the uterus can block parts of the urinary tract increasing the likelihood of infection. Symptoms of a UTI include [4]:

Pain or burning when peeing
feeling the need to pee even when your bladder is empty, or near empty
pee that looks cloudy
Blood in your pee
Painful intercourse
Lower abdominal pain, or pain under the ribs
A high (fever) or very low temperature

If you suspect you have a UTI, contact your healthcare provider. UTIs are most commonly treated with certain antibiotics, which are safe for you and your baby. If left untreated, a UTI can lead to a kidney infection, which can be harmful for both of you. You can try and prevent a UTI by drinking plenty of water, drinking unsweetened cranberry juice regularly, trying not to hold your pee when you feel the need to urinate, urinating before and after sex, and keeping your genital area clean and dry.

Other vaginal infections more common during pregnancy include bacterial vaginosis (BV) and yeast infections. An estimated 10-30% of women experience BV during their pregnancy caused by changes in the bacterial environment of your vagina. A strong fishy odor, vaginal discharge that is grey in color, burning when peeing, itching and pain during sex are all symptoms of BV [5]. If you suspect you have BV, or are concerned about any changes in your vaginal discharge, contact your healthcare provider. You can help prevent BV by showering instead of bathing, keeping your vaginal area clean, and avoiding douching, which can remove good, healthy bacteria.

Yeast infections, including thrush, are most common during the second trimester of pregnancy and are linked to hormonal changes that cause an imbalance of acid and yeast in the vagina. While yeast infections are not known to cause any harm to the pregnancy or your baby, they can be more difficult to control during pregnancy and can be very uncomfortable [6]. The most common yeast infection symptoms include white discharge that resembles cottage cheese, redness, itching or irritation in the vagina, and a burning during urination or sex. It's important to talk to your healthcare provider if you suspect you have a yeast infection, since some medications commonly used to treat yeast infections are not recommended during pregnancy. Finally, you can try to prevent yeast infections by keeping the vagina cool, clean and dry and consuming foods that contain lactobacillus acidophilus like yogurt or kefir.

Tips in week 21

Get your whooping cough vaccination: around week 20, you will likely be offered a whooping cough vaccine. Whooping cough can be very serious for babies, and getting vaccinated is the best way to protect your baby from developing whooping cough in infancy. It is generally recommended to get the whooping cough (also known as pertussis) vaccine before week 32 of your pregnancy.
Eating for energy: as your body's working overtime to support you and grow your baby, it’s important that you try and provide it with as much energy as possible. A healthy diet that is rich in vitamins and minerals can ensure you are giving your body the fuel it needs.
Try the pool: if you are looking to incorporate more physical activity into your routine, try swimming, water aerobics, or water walking. The buoyancy you get in a pool supports your weight, making water exercise a great option if you are experiencing limited mobility or other pregnancy-related discomforts. While swimming is considered one of the safest exercises to do while pregnant, it is important to discuss all exercises with your doctor to ensure they are considered safe for you during your pregnancy.
Stretch out the hip flexor: whether you are suffering from hip or groin pain or not, your pelvis is under a lot of pressure as your baby continues to grow. You can help alleviate current discomfort, and prevent discomfort in the future, by stretching out your hip flexor. One common stretch is runners' lunge, which can be done with your knee elevated or touching the floor. If you have trouble reaching the floor with your arms or elbows, try using an exercise ball or chair for support.

Supporting your pregnancy with Natural Cycles

As the first FDA Cleared birth control app, Natural Cycles’ goal is to give you the tools you need to take care of your reproductive health. After conception, NC° Follow Pregnancy offers weekly guides on the changes going on in your body and your baby’s development alongside tools to track your pregnancy symptoms. Curious about using Natural Cycles during your pregnancy – why not check it out today?

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21 weeks pregnant [Internet]. American Pregnancy Association. 2024 [Cited 2025 May 27]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/21-weeks-pregnant/
Marx V, Nagy E. Fetal Behavioural Responses to Maternal Voice and Touch. Ferrari PF, editor. PLoS ONE [Internet]. 2015 Jun 8;10(6):e0129118. Available from: http://dx.doi.org/10.1371/journal.pone.0129118
Round ligament pain in pregnancy [Internet]. HSE.ie. [Cited 2025 May 27]. Available from: https://www2.hse.ie/conditions/round-ligament-pain-pregnancy/
Urinary tract infection - UTI during pregnancy [Internet]. American Pregnancy Association. 2024 [Cited 2025 May 27]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/urinary-tract-infections-during-pregnancy/
Bacterial vaginosis [Internet]. nhs.uk. 2024 [Cited 2025 May 27]. Available from: https://www.nhs.uk/conditions/bacterial-vaginosis/
Yeast infection during pregnancy [Internet]. American Pregnancy Association. 2023 [Cited 2025 May 27]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/yeast-infections-during-pregnancy/

",{"_298":4338,"_438":4339,"_1695":4340,"_1697":1698,"_1699":4341,"_1701":4342,"_1703":4343,"_1705":4344,"_1707":4345,"_1709":-5,"_1710":4346,"_408":4379,"_410":4381,"_1810":4382,"_1880":4426,"_342":4427,"_1891":1892,"_1893":4434,"_1908":1909,"_1910":4437,"_1923":2845,"_1925":4440,"_1929":4441},"Jyf70DGlSJKGLtapvDD2HQ","Sex during period: How is sex and your cycle connected?","sex-during-period","2025-05-28","2025-05-28T15:04:35+01:00","

Choosing to have sex during your period is a highly individual choice. Generally, sex during your period is safe for most people, and as long as you and your partner(s) are open to it and you feel comfortable, there's no need to avoid it. In fact, there may even be reasons to have sex during this time. Here's everything you need to know about having sex while on your period, including risks, benefits, and how it may affect your cycle.

","

Key takeaways

Having sex during your period is mostly safe, but it may increase your risk of contracting STIs if you don’t use a barrier method as protection [1]
There's no strong evidence that sex causes your period to start early or prolong it
If you have a very short cycle, there's a small chance you may get pregnant if you have unprotected sex during your period [2]
Having sex during your period is a completely personal choice, and may have benefits such as reduced menstrual cramps, better sleep, and improved mood

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Does sex affect your menstrual cycle?

Sex may affect our menstrual cycles. Our menstrual cycles are controlled by cyclical changes of hormones in our bodies over the course of 21-35 days (however long our individual cycles are) [3, 4]. There's no strong scientific evidence that directly shows an influence of sex on these fluctuations. However, there's some evidence that suggests there may be a difference in cycles amongst sexually active people and non-sexually active people.

A study published in 2014, that followed 259 regularly menstruating women aged 18 to 44 years who weren't using hormonal contraception, found that sexually active women had higher levels of certain reproductive hormones compared to women who weren't sexually active. Here’s a few interesting stats the research uncovered:

Estrogen levels were 15% higher in sexually active women
Progesterone levels after ovulation were 41% higher
Luteinizing hormone (LH) levels during ovulation were 23% higher

However, researchers found no difference between the groups when it came to other hormones such as FSH (follicle-stimulating hormone) and testosterone. Also, sexually active women were less likely to have anovulatory cycles (cycles when no ovulation occurs) [5].

A more recent study, published in 2022, followed 530 women for a year and studied 2,564 cycles to compare the menstrual cycles of sexually active and inactive people and found a few interesting differences:

Sexually active women had longer cycles (30.1 days on average compared to 29.1 days)
Sexually active women had a longer luteal phase of their cycle (11.4 days vs. 10.8)—a longer post-ovulation phase is considered a sign of better fertility
Premenstrual spotting was more common in cycles without sex [6]

Why do these findings matter? Well, based on findings from these two studies, cycles without sex had different menstrual cycle characteristics and demonstrated fewer signs of peak fertility. However, more research is needed to make any meaningful conclusions on whether and how exactly sex affects menstrual cycles.

Is it safe to have sex during your period?

Generally, it's completely safe to have sex during menstruation. Whether or not you choose to will depend on your preferences, how you feel at this time, and how open you and your partner(s) are to the idea. Some people enjoy sex during all times of the cycle, while others find period sex to be messy, or they may not be in the mood due to discomfort that comes with bleeding, so they tend to avoid it.

Side effects & risks

Having unprotected sex with a partner(s) whose sexual history or STI test (sexually transmitted infections) results you don’t know always carries the risk of contracting an STI. During your period, the risk of transmission is even higher: unprotected sex during your period involves exposure to blood, which can carry infections like HIV [7] and other STIs.

To ensure you're minimizing your risk of contracting an STI while still enjoying period sex with partner(s) where they or you haven’t been checked yet, you should use a barrier method such as a male condom or a dental dam.

If you're using tampons during your period, make sure you remove them before you have sex. Keeping the tampon inside during intercourse can push it deeper into vagina, which may increase the chances of toxic shock syndrome. You may need to visit a doctor to get the tampon removed, so avoid leaving it inside your body during period sex.

Leaving menstrual discs in during penetrative sex is okay and should be safe. However, if you wear a menstrual cup, it’s recommended to remove it prior to sex, too.

Can you get pregnant during your period?

While it's extremely rare to get pregnant after having sex during your period, it's still possible if you have a short cycle [2]. You see, the sperm can live in the female reproductive tract for up to five days. If you have a short cycle and have sex at the end of your period, the sperm and the egg may still meet even days after you've had unprotected sex. On top of that, if you have shorter cycles and irregular periods, ovulation can be harder to track, which may further increase the likelihood of pregnancy if you’re having unprotected sex during your period [2].

Can sex delay periods?

No. There's no strong evidence that having sex before your period starts could delay menstruation or force it to start earlier [8]. Generally, it's normal for our period length to vary up to 6 days [4]. Most often, the reasons why a period may be late are high stress, pregnancy, hormonal imbalances, health conditions such as PCOS, perimenopause, weight fluctuation (gain or loss), and hormonal contraception [9, 10, 11]

Does having sex affect your period pain?

Potentially, yes. During sex and orgasms, feel-good hormones like oxytocin are released, which may act as natural painkillers and reduce menstrual cramps for some people [12]. Also, research shows that sexual activity can lead to partial or complete relief of other painful conditions, like headaches in people who experience migraines [13]. However, there is very limited high-quality evidence to suggest a direct link between sex and period pain relief, and more research is needed to understand this.

If you feel a desire to have sex and feel comfortable engaging in sexual activities solo or with partner(s) during your period, then there's no harm in having fun. If you notice temporary relief from your period symptoms during sex, then all the better!

Benefits of sex during your period

Having sex and experiencing orgasms may have a positive effect on your well-being, which may feel even more beneficial during your period, where sleep can be disturbed, and mood may be lower [14, 15]:

Stress control: Engaging in sexual activity and being sexually aroused more generally causes the release of hormones like oxytocin, which promote relaxation and reduce stress hormones such as cortisol [16].
Reduced cramps: The feel-good hormones that are released during sex and orgasms may act as natural pain relief and reduce menstrual cramps [12].
Better sleep: Research shows that having an orgasm during partnered sex or masturbation before going to bed helps people fall asleep faster and have better quality sleep [17].
Better wellbeing: A cross-sectional study found that engaging in sexual activities 1 to 2 times per week can have a positive effect on mental health and reduce the chances of developing depression [18].

Whilst some people will experience benefits of having sex during their period and find it an enjoyable experience during this time, for others, it might not be a priority or feel good for them during this point in their cycle. If that’s you, that’s okay!

How does your menstrual cycle affect your sex drive?

It's normal for our sex drive to fluctuate depending on which part of our cycle we're in and which hormones take the lead.

Follicular Phase: There's an increase in our estrogen levels, which may boost our sex drive [19].
Ovulation: Around the middle of our cycle, we experience a peak in estrogen and a surge in luteinizing hormone (LH). “A peak in estrogen and a surge in luteinizing hormone (LH) can lead to heightened libido and, for some, increased confidence,” explains Natural Cycles Advisory Board Member Dr. Sarah Oreck.
Post-ovulatory phase: Once ovulation has occurred, estrogen levels drop and progesterone takes the lead, which may lead to a decrease in sexual desire [19].

A small study found that some women report having no sexual desire for sex during the menstrual phase of their cycle due to pain and discomfort that comes with bleeding, while others report no changes to their desire, and they continue to have sex as usual even while they bleed [20].

More than a period tracker

At Natural Cycles, we believe knowledge is power — especially when it comes to your health and body. Whether you're curious about the connection between sex and your cycle, you're looking for a hormone-free birth control option, or support on your pregnancy journey, our app can help you track your cycle and better understand your reproductive health. Why not try Natural Cycles today and find out if it's a good fit for you?

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Adapen, C., Réot, L., Nunez, N., Cannou, C., Marlin, R., Lemaître, J., D’Agata, L., Gilson, E., Ginoux, E., Grand, R. L., Nugeyre, M., & Menu, E. (2022). Local innate markers and vaginal microbiota composition are influenced by hormonal cycle phases. Frontiers in Immunology, 13. https://doi.org/10.3389/fimmu.2022.841723
Can you get pregnant if you have sex during your period? (2024, November 22). Planned Parenthood. https://www.plannedparenthood.org/blog/can-you-get-pregnant-if-you-have-sex-during-your-period
Fertility Awareness-Based Methods of Family Planning. (n.d.). ACOG. https://www.acog.org/womens-health/faqs/Fertility-Awareness-Based-Methods-of-Family-Planning?utm_source=redirect&utm_medium=web&utm_campaign=otn
Bull, J. R., Rowland, S. P., Scherwitzl, E. B., Scherwitzl, R., Danielsson, K. G., & Harper, J. (2019). Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles. Npj Digital Medicine, 2(1). https://doi.org/10.1038/s41746-019-0152-7
Prasad, A., Mumford, S. L., Louis, G. M. B., Ahrens, K. A., Sjaarda, L. A., Schliep, K. C., Perkins, N. J., Kissell, K. A., Wactawski-Wende, J., & Schisterman, E. F. (2014). Sexual activity, endogenous reproductive hormones and ovulation in premenopausal women. Hormones and Behavior, 66(2), 330–338. https://doi.org/10.1016/j.yhbeh.2014.06.012
Najmabadi, S., Schliep, K. C., Simonsen, S. E., Porucznik, C. A., Egger, M. J., & Stanford, J. B. (2022). Characteristics of menstrual cycles with or without intercourse in women with no known subfertility. Human Reproduction Open, 2022(4). https://doi.org/10.1093/hropen/hoac039
Women and HIV | Office on Women’s Health. (n.d.). OASH | Office on Women’s Health. https://womenshealth.gov/hiv-and-aids/women-and-hiv
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Harris, H., Titus, L., Cramer, D., & Terry, K. (2016). Long and irregular menstrual cycles, polycystic ovary syndrome, and ovarian cancer risk in a population‐based case‐control study. International Journal of Cancer, 140(2), 285–291. https://doi.org/10.1002/ijc.30441
Yamamoto, K., Okazaki, A., Sakamoto, Y., & Funatsu, M. (2009). The Relationship between Premenstrual Symptoms, Menstrual Pain, Irregular Menstrual Cycles, and Psychosocial Stress among Japanese College Students. Journal of PHYSIOLOGICAL ANTHROPOLOGY, 28(3), 129–136. https://doi.org/10.2114/jpa2.28.129
Website, N. (2025, April 16). Missed or late periods. nhs.uk. https://www.nhs.uk/conditions/missed-or-late-periods/
Baxter, R. (2023, August 25). Can sex reduce menstrual cramps? SMSNA. https://www.smsna.org/patients/blog/can-sex-reduce-menstrual-cramps
Hambach, A., Evers, S., Summ, O., Husstedt, I. W., & Frese, A. (2013). The impact of sexual activity on idiopathic headaches: An observational study. Cephalalgia, 33(6), 384–389. https://doi.org/10.1177/0333102413476374
Rugvedh, P., Gundreddy, P., & Wandile, B. (2023). The menstrual cycle’s Influence on sleep duration and cardiovascular health: A Comprehensive review. Cureus. https://doi.org/10.7759/cureus.47292
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Welcome to week 20 and the halfway point of your pregnancy (give or take)! You have done tremendous work thus far and only have around 20 more weeks to go. In this week’s guide, we will talk about nosebleeds and digestive issues – two changes you might experience in your body in your second trimester. We will also talk about your baby’s development in week 20 and what to expect in your upcoming ultrasound. Finally, we will go over a couple of pregnancy symptoms that might be affecting you and offer some tips for managing your mental and physical health this week.

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Key takeaways:

Nosebleeds, digestive issues, and restless sleep are all common in week 20 of your pregnancy
Baby hiccups might feel weird in your stomach, but they are completely normal as your baby is developing its swallowing, lung, and diaphragm muscles
An ultrasound scan around week 20 is important for checking on the development and growth of your baby

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Your body at week 20

Nosebleeds

As the demands on your circulatory system increase during pregnancy, your body's working overtime to produce and circulate an especially large volume of blood. By the end of pregnancy, your blood volume will increase an average of 50% from pre pregnancy levels [1]. One unexpected side effect is an increased frequency of nosebleeds. Nosebleeds, or epistaxis in medical-speak, happen when the tiny blood vessels close to the surface of your inner nose skin injure or break, causing them to bleed. Blowing your nose, breathing dry air, and increased circulation during pregnancy can all make these blood vessels especially sensitive and prone to rupture [2].

In most cases, nosebleeds are minor and not a cause for concern. If you experience a nosebleed, it is recommended to sit upright or lean slightly forward to prevent the blood from flowing down your throat. Gently pinch the soft part of your nose, just above your nostrils, for 10-15 minutes or until bleeding stops. You can try and prevent nosebleeds by avoiding blowing your nose harshly and using a humidifier to increase the moisture in the air in your space.

If the nosebleed is substantial, comes following a head injury, or continues after 10-15 minutes of pinching your nostrils, contact your care team.

Digestive issues

At this stage of your pregnancy, you are probably very familiar with the hormonal fluctuations that come with pregnancy and their related sideeffects like nausea, mood swings, and increased hair and nail growth. In particular, increases in progesterone and relaxin both contribute to muscle relaxation and a slowing down of your digestive tract that can continue through your second and third trimesters. This affects many different organs, including your stomach, small and large intestines, and gallbladder.

Some common second trimester digestive issues include [3]:

Indigestion and heartburn: both are considered part of gastroesophageal reflux disease, or GERD. During pregnancy, these tend to be caused by a relaxation of the muscle that prevents stomach contents from backing up into your esophagus. They can also cause bloating and nausea. If you already suffered from GERD before becoming pregnant, it's possible that these symptoms can worsen during pregnancy.
Gallstones: your gallbladder is responsible for storing bile before it travels to the small intestine. When digestion is slowed during pregnancy there is an increased risk of developing gallstones, which are caused by non-dissolving substances in bile becoming too concentrated. While some gallstones can pass without signs or symptoms, they can also become stuck, causing sudden and severe pain in your upper right or center abdomen, pain between your shoulder blades or in your shoulder, and nausea or vomiting. If you experience any of these symptoms, or suspect you are suffering from gallstones, contact your healthcare team immediately.
Diarrhea: though commonly associated with viruses, bacterial infections, and certain medications, pregnancy can also cause loose or watery stools. You might also experience cramps, bloating or nausea. Iron supplements, which are commonly advised for women during pregnancy, can also cause diarrhea for some women. In general, if diarrhea lasts more than 48 hours, you notice blood in your stools, or you have fever, contact your physician or OB GYN. Be sure to keep drinking fluids, as diarrhea can cause dehydration.
Constipation: seemingly the opposite of diarrhea, pregnancy can also cause infrequent or hard-to-pass bowel movements known as constipation. Strain and pressure caused by passing difficult stools can also cause hemorrhoids, which is a swelling of the veins in and around the anus. If you are taking iron supplements as advised by a nurse or doctor during your pregnancy, these can also contribute to constipation.

The most common treatments for managing digestive issues during pregnancy are maintaining a healthy diet, staying hydrated, and regular exercise. It is also recommended to stick with smaller, frequent meals and reduce foods that are fatty, greasy, and spicy if you are suffering from indigestion or heartburn.

Be sure to communicate with your healthcare provider about any gastrointestinal or digestive issues you are experiencing during your pregnancy.

Your baby’s development at 20 weeks

Your growing baby is around the size of a banana this week, weighing between 9 and 10.6 ounces (260 to 300 grams) and measuring 6.5 to 7.75 inches long (16.4-19.7 centimeters) [4].

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Your baby is likely learning how to suck its thumb and also swallowing this week. They might also start to get the hiccups, which can feel like sudden, jerky movements in your belly, or like a gentle rhythmic tapping. While doctors aren’t quite sure why babies so commonly get hiccups in the womb, it may be linked to lung and diaphragm development, the development of swallowing, and the circulation of amniotic fluid in the uterus [5].

Week 20 scan

You will likely have an ultrasound scan between weeks 18 and 22. Your baby has developed a great deal since the first trimester scan, and there is a lot more you will be able to see. This scan is often called an anatomy or anomaly scan, because the main goal is to check for potential signs of medical conditions that might affect their health and development [6].

Your baby’s major organs, limbs, skull, spine and neck will be examined in this ultrasound, and detailed measurements will be taken to check on their physical development [7]. You will also be able to see your baby’s face, hands, and feet in much greater detail. The midwife or technician will also check the placenta, cervix, and the amount of amniotic fluid in the uterus. Since your baby’s genital organs are also developed, you will be able to find out the sex of your baby (or babies) if you wish, and if you haven’t already found out through other examinations or blood tests.

This scan is very thorough and usually takes 30 to 45 minutes, but can take longer depending on whether your baby is cooperating and giving the midwife or technician the right view!

Pregnancy symptoms in week 20

Restless sleep

There are a number of physical and mental symptoms that can affect your sleep in week 20. Your growing belly, leg cramps, and physical fatigue can all make getting comfortable difficult. Stress, anxiety, and strange dreams can also disrupt sleep or make it more difficult to get to sleep.

Try using extra pillows or a pregnancy body pillow to provide extra support when lying down. A pillow between the knees can also help relieve discomfort in the hips and pelvis. As your belly grows, you might find it most comfortable to sleep on your side, which can also help with circulation. Exercise, meditation, journaling, and avoiding caffeine in the evening can also help ensure the best possible night’s sleep.

If you are concerned about insomnia, or if you suspect sleep disruption might be linked to another mental health issue like depression or anxiety, speak with your doctor or midwife. There are treatments available that can help you.

Growing appetite

Have you been feeling particularly hungry? With nausea and food aversions hopefully behind you, it’s normal to experience a growing appetite this week. While no extra calories are required in the first trimester, scientific studies have shown that your body needs an additional average of around 340 calories per day in the second trimester [8].

However, keep in mind that your growing baby and expanding uterus can crowd your stomach and intestines, prompting you to eat smaller portions. Eating especially large meals, particularly in the evening or if you are already suffering from heartburn or indigestion, can also worsen digestive symptoms and disrupt your sleep. Try opting for slightly smaller meals more frequently throughout the day.

Tips in week 20

Prioritize pleasure: for many women, sex drive can increase in the second trimester. If you are suddenly feeling the urge, talk to your partner about how you’re feeling. Unless not recommended during your pregnancy, sex can be a wonderful way to build strong connections with your partner during this special time. Remember, going solo is also OK, and can be a great mood booster. Check out our guide on having sex during pregnancy with information about both safety as well as guidance and tips.

Planning for childcare: with your baby’s arrival likely many months away, it might seem like an odd time to start thinking about childcare, or daycare. However, depending on where you live and your family leave situation, it might be necessary to start planning how you will manage care for your new family member. In some places, waitlists for infant daycare can be months (or years) long. Starting your search now can save time and stress later.

Consider journaling: feeling overwhelmed by the tasks you are managing or bogged down by brain fog? Journaling can be a great way to get organized mentally and physically. It doesn’t have to be neat or coherent, sometimes even jotting down a list of thoughts or projects on your plate can be a great tool for relieving stress and anxiety, helping you get through your day or even sleep a little easier.

Stay informed with Natural Cycles

Did you know you can use Natural Cycles throughout your pregnancy to stay informed on your baby’s development and the changes going on in your body? NC° Follow Pregnancy provides weekly guides that follow your baby’s growth and provide helpful tips on managing physical and mental pregnancy symptoms. You can also use the app’s symptom tracker to keep track of your individual pregnancy symptoms, which can be helpful in prenatal appointments. It’s more than birth control – why not try Natural Cycles today?

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Sanghavi M, Rutherford JD. Cardiovascular Physiology of Pregnancy. Circulation [Internet]. 2014 Sep 16;130(12):1003–8. Available from: http://dx.doi.org/10.1161/circulationaha.114.009029
Nosebleeds during pregnancy [Internet]. American Pregnancy Association. 2021 [Cited 2025 May 21]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-concerns/nosebleeds-during-pregnancy/
Gastrointestinal issues during pregnancy | Brown University Health [Internet]. Brown University Health. [Cited 2025 May 21]. Available from: https://www.brownhealth.org/centers-services/multidisciplinary-obstetric-medicine-service-moms/gi-issues-pregnancy
20 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 Apr 14]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/20-weeks-pregnant/
Murchison AG. Hiccups and amniotic fluid regulation in early pregnancy. Medical Hypotheses [Internet]. 2015 Jan 31;84(5):448–50. Available from: https://doi.org/10.1016/j.mehy.2015.01.040
20-week screening scan [Internet]. nhs.uk. 2025 [Cited 2025 Apr 14]. Available from: https://www.nhs.uk/pregnancy/your-pregnancy-care/20-week-scan/
Jabaz D, Jenkins SM. Sonography 2nd Trimester Assessment, Protocols, and Interpretation. [Updated 2023 Nov 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570574/
Weight gain during pregnancy [Internet]. Maternal Infant Health. 2024 [Cited 2025 May 26]. Available from: https://www.cdc.gov/maternal-infant-health/pregnancy-weight/index.html

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Welcome to week 19 of your pregnancy! In this week’s guide, we’ll dive deep into your skin and cover both the common and more uncommon skin conditions that can arise during pregnancy. We’ll also check in on your baby and touch on some pregnancy symptoms you might be experiencing this week. Finally, we’ll offer some tips on things you can do this week to take some time to care for yourself.

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Key takeaways:

Pregnancy is linked to a number of common skin conditions like melasma and acne, as well as uncommon conditions that might require medical attention — learning what to look out for can help you stay prepared
Your baby is beginning to cover itself in vernix caseosa, that white creamy substance that can be seen on most newborns at birth
Leg cramps and shortness of breath are some new pregnancy symptoms that can start around week 19

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Your body at week 19

Common skin changes

There are a number of changes to your skin that are common during pregnancy, particularly starting in the second trimester, including melasma, linea nigra, and acne.

Melasma, also known as chloasma, is the darkening of skin patches due to an increase in melanin, the body’s natural pigmentation substance. You might also notice that areas of your skin that are already darker, like freckles, moles, nipples, areolas (the skin around your nipples), and labia, can become even darker. Melasma is not harmful, but doctors advise wearing sunscreen, using a hat while outside, and staying out of the sun to prevent melasma from getting worse. While some spots and patches can fade postpartum, it’s also possible that they remain after pregnancy [1].

Linea nigra refers to the dark line that might develop vertically across your pregnant belly. Despite what you might have heard, the length and size of linea nigra has not been proven to be linked to your baby’s sex. For most of us, this line will fade postpartum, but a faint line might remain for years after pregnancy.

Pregnancy is unfortunately also linked to flare-ups of acne, and for some, can worsen existing acne. The American College of Obstetricians and Gynecologists (ACOG) advise that over-the-counter (OTC) acne treatments that contain topical benzoyl peroxide, azelaic acid, topical salicylic acid, and glycolic acid are all safe to use if you are suffering from breakouts [1]. Unfortunately, many common acne prescription medications, as well as some OTC treatments for acne, are not advised for use during pregnancy. Speak with your healthcare provider if you have any questions regarding ingredients or the use of acne treatments during pregnancy.

Finally, certain skin diseases like dermatitis and psoriasis may worsen (or improve) during pregnancy. Every woman and every pregnancy is different. If you are suffering from a skin condition, or an existing condition is worsening during your pregnancy, be sure to review any medications you would commonly take with your care team.

Uncommon skin changes

Some women can develop other skin-related health conditions during pregnancy. Though uncommon, familiarizing yourself with their symptoms can help you alert your physician if you suspect you’ve developed any of the following:

Pruritic urticarial papules and plaques of pregnancy (PUPPP), also known as polymorphic eruption of pregnancy (PEP), is the most common of the rare gestational dermatoses [2]. Small, red bumps and hives usually appear first on the stomach and can develop into large itchy patches that can spread to the thighs, butt and breasts. The condition is not known to cause any harm to mother or baby, though it is very uncomfortable. A physician will likely prescribe anti-itch medication, and PUPPP usually clears up about 3-6 weeks postpartum [2]. PUPPP occurs mostly in first-time pregnancies, is more common in multiple pregnancies (carrying twins or triplets), and tends not to recur in future pregnancies.

Prurigo is another itchy skin condition that resembles small insect bites. They can appear anywhere on the skin, and can develop at any point during pregnancy. Doctors believe that changes in your immune system during pregnancy are the culprit. Prurigo is usually treated with anti-itch medication, and usually resolves postpartum, although it can last for some time after your baby is born [1]. Prurigo is not known to pose any harm to mother or baby, though it can be very uncomfortable [3].

Pemphigoid gestationis (PG) is a rare autoimmune disease that usually starts in the second or third trimester, or right after birth. The main symptom is skin blisters that appear on the stomach. Because the condition slightly increases your risk of pregnancy complications like preterm birth, your doctor will likely monitor your pregnancy more closely if you are diagnosed with PG. You also might be prescribed medication to control your skin condition and relieve discomfort [1]. If you develop PG, there is around a 50-70% chance it will return in subsequent pregnancies [3].

Intrahepatic cholestasis of pregnancy (ICP) is a serious liver condition whose main symptom is itching on the soles of the feet and palms of the hands that commonly worse at night, occurring with no rash [4]. Studies have shown that ICP is more prevalent amongst certain patient populations, like those with South Asia origins [5]. Family history and maternal age also increase the risk of developing ICP during pregnancy. The ICP requires medical attention, as there is significant risk posed to mom and baby if left untreated [3].

Your baby’s development at 19 weeks

At week 19, your baby is already preparing for life outside of the uterus. While they continue to practice their kicks and punches, they are also starting to be covered by vernix caseosa. This white, creamy substance is actually made from your baby’s old skin cells. Its job is to help moisturize and hydrate your baby’s skin, to help them regulate their temperature, and to protect against microbes [6]. Vernix will still likely be on your baby when they are born.

Your growing baby is now weighing 7 to 8.5 ounces (200 to 240 grams) and measuring 6 to 7 inches in length (15.3 to 17.8 centimeters) [7]. Now that they are around the size of a mango, it’s likely you will be able to feel their movements more strongly. But remember, there’s no need to start counting their movements just yet.

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Pregnancy symptoms in week 19

Leg cramps

Cramping in your calf muscles, and even your feet, is common in week 19. These painful spasms are more likely to occur at night, which can be quite a shock to wake up to! While there is no specific cause, or cure, they are linked to changes in your circulation and fatigue in your leg muscles.

While leg cramps aren’t preventable, staying active, drinking enough water, and maintaining a healthy diet can help [8]. You can also try stretching out your calves with your hands, a foam roller, or a muscle gun (if you and your doctor agree it is safe to use during your pregnancy) to help relieve tension.

Shortness of breath

As your baby grows throughout your second trimester, this can put pressure on your diaphragm and lungs causing shortness of breath. Your heart is also working overtime to pump extra blood throughout your body, which can make you feel out of breath. If you suffer from asthma or a lung infection like the flu, COVID-19, or pneumonia, pregnancy can worsen breathing issues. Iron deficiency, which is common in pregnancy, could also be the culprit [9].

Though mild shortness of breath is considered normal, if you find that your shortness of breath is sudden or severe, or if you experience chest pain, contact emergency services immediately. Similarly, if you experience shortness of breath alongside other symptoms like swelling in the hands, feet, or face, a headache, changes to your vision, or nausea, contact your healthcare provider as this might be a sign of preeclampsia [10]. Preeclampsia is a blood pressure-related disorder that develops most commonly in the second half of pregnancy and requires medical monitoring for the health of both mother and baby.

Tips in week 19

Take some time for yourself: you might be hearing this constantly from family or friends, but your life is going to be changing in a major way after your baby is born. Try to take some time for yourself this week, whether that means taking a walk, reading a book, binging your favorite show, or spending some quality time with a friend or partner.
Schedule your next ultrasound: you will likely have an ultrasound between weeks 18 and 22 to check on the baby’s development. If you haven’t scheduled this ultrasound, contact your care team. It will also be possible, if you want, to find out the sex of your baby at this ultrasound.
Stretching out during the day: if you work at a computer all day, think about taking some extra time to stretch out during the day. Carpal tunnel, which can present as tingling, numbness or pain in your hand, is commonly experienced during pregnancy due to hormonal changes and fluid retention in the tissues of the wrist [11]. Taking regular breaks to walk around can also help relieve cramps and aches in your legs and hips.
Consider adding extra magnesium to your diet: if you are experiencing leg cramps, recent studies have shown that adding extra magnesium to your diet might help [12]. Dark leafy vegetables, soy products, nuts like almonds and cashews, peanuts and peanut butter, whole grains breads and cereals, and bananas are also good sources of dietary magnesium.

Using Natural Cycles during your pregnancy

Did you know that Natural Cycles, the only FDA Cleared birth control app, can also support you throughout your pregnancy? With weekly guides, informative articles, and pregnancy symptom trackers, NC° Follow Pregnancy is designed to keep you up-to-date with interesting and useful information about the development of your baby and changes to your health. Feel supported throughout your pregnancy journey and beyond with Natural Cycles.

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Kurien G, Carlson K, Badri T. Dermatoses of Pregnancy. [Updated 2024 Jan 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430864/
Itching and intrahepatic cholestasis of pregnancy [Internet]. nhs.uk. 2024 [Cited 2025 May 16]. Available from: https://www.nhs.uk/pregnancy/related-conditions/complications/itching-and-intrahepatic-cholestasis/
Jamshidi Kerachi, A., Shahlaee, M.A., Habibi, P. et al. Global and regional incidence of intrahepatic cholestasis of pregnancy: a systematic review and meta-analysis. BMC Med23, 129 (2025). Available from: https://doi.org/10.1186/s12916-025-03935-0
Bamalan OA, Moore MJ, Menezes RG. Vernix Caseosa. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559238/
19 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 May 16]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/19-weeks-pregnant/
Muscle cramps during pregnancy [Internet]. American Pregnancy Association. 2021 [Cited 2025 May 21]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/muscle-cramps-during-pregnancy/
Shortness of breath or chest pain in pregnancy [Internet]. HSE.ie. [Cited 2025 May 16]. Available from: https://www2.hse.ie/conditions/shortness-of-breath-or-chest-pain-in-pregnancy/
Pre-eclampsia [Internet]. nhs.uk. 2024 [Cited 2025 May 16]. Available from: https://www.nhs.uk/conditions/pre-eclampsia/
Carpal tunnel syndrome (CTS) in pregnancy - South Tees Hospitals NHS Foundation Trust [Internet]. South Tees Hospitals NHS Foundation Trust. 2024 [Cited 2025 May 16]. Available from: https://www.southtees.nhs.uk/resources/carpel-tunnel-syndrome-cts-in-pregnancy/
Supakatisant C, Phupong V. Oral magnesium for relief in pregnancy‐induced leg cramps: a randomised controlled trial. Maternal and Child Nutrition [Internet]. 2012 Aug 22;11(2):139–45. Available from: https://doi.org/10.1111/j.1740-8709.2012.00440.x

",{"_298":4618,"_438":4619,"_1695":4620,"_1697":1698,"_1699":4621,"_1701":4622,"_1703":4623,"_1705":42,"_1707":4624,"_1709":-5,"_1710":4625,"_408":4626,"_410":4629,"_1810":4630,"_1880":4672,"_342":4673,"_1891":1892,"_1893":4680,"_1908":1909,"_1910":-5,"_1923":2845,"_1925":-5,"_1929":-5},"RIQE-jP-SlGhgra0htCgqw","Natural Cycles Refer-a-Friend: How to get NC° for free","refer-a-friend","2025-05-19","2024-03-19T14:50:35+00:00","

At Natural Cycles, we don’t just think we’ve got the best community of users — we know we do. That’s why we’ve refreshed our refer-a-friend program — to give back to you and make it easier to earn rewards when a friend signs up to Natural Cycles using your unique link. In this article, we’ll outline the changes to our referral program and cover the steps so you can get NC° for free!

","

Earn free months faster — our best referral program yet!

We’ve listened to your feedback and are excited to announce that we’re introducing the chance to earn free months when you tell your friends about NC°. Our new referral program also has tiers, meaning the more friends you refer, the greater the rewards become.

You’ll get one free month for the first friend you refer, and after that, you get an increasing number of free months as you hit certain milestones, e.g., three free months for referring two friends, and six free months after referring five friends. Once your friends sign up, you’ll automatically get the free month(s) discounted on your next renewal (so if you’ve earned six free months, you get your next annual renewal at half price).

Of course, we’ve saved our biggest reward of all for when you successfully refer 10 friends: NC° free for life! Check out the table below for a breakdown of our new referral program:

Your friend gets a great Natural Cycles offer too!

When someone signs up with your referral link, you’re not the only one who lucks out: they also get a reward. Your friends are eligible for 20% off their annual subscription, plus a free NC° Thermometer or Oura Ring discount when they sign up.

Know someone who is thinking about switching to natural birth control or is talking about starting a family? Why not let them know about Natural Cycles? It’s a win for everyone.

5 Ways to tell your friends about NC° (and get it for free)

Wondering how to get the conversation started? We get it. Talking about birth control or fertility can be a sensitive topic, but one that deserves more attention. You know your besties best but here are a few tips to help you get started:

1. Share on social media

Sharing your Natural Cycles referral link is quick and simple to do whether you choose to post it on your instagram, Facebook, TikTok, or Snapchat account. You’ll find the link on your referral page under the main menu in your Natural Cycles app. You’ll be able to see how many people have signed up with your link, as well as your upcoming rewards, directly in the app.

2. Slide into their DMs

Know someone who’d be a great fit for NC°? Why not send them a direct message with your link attached? They’ll be able to access NC° with our best value offer, with the knowledge they’ve got you in their corner for this exciting new journey.

3. Post in the group chat

We all know that the real conversation happens in the group chat. This is a great space to share your referral link and answer any questions your nearest and dearest may have about making the switch.

4. Do it over coffee

The best plans make it out of the group chat — and talking to your friends in person can be a great way to introduce them to all the benefits of NC° while you’re right by their side. You can help them get set up and show them how your app works.

5. Talk about different journeys

Natural Cycles is built to support you throughout your fertility journey, not just to prevent pregnancy. If you have a friend who’s going through a different life experience to you, it can also be a helpful time to talk about how Natural Cycles can support them as they navigate this new stage. Whether it’s support during conception, following pregnancy, or during recovery after birth, Natural Cycles is built to adapt to every individual’s needs.

Who’s eligible for the new Natural Cycles refer-a-friend program?

Our referral program is designed to benefit the entire Natural Cycles community. Remember — anyone who refers 10 friends will get NC° free for life. However, due to some registration limitations, we aren’t currently able to offer free months to everyone along the way. In these cases, you may be offered a gift card or NC° Shop discount for every referral you make instead. Visit the main menu in the Natural Cycles app to find out what rewards are available to you. If you have questions, or would like to contact our Customer Care Team, check out this article to learn more.

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Welcome to week 18 of your pregnancy! In this guide, we will get into changes you might see and feel in your body this week, including baby kicks and varicose veins. We will check in on your baby’s development and talk about what you can expect in your upcoming ultrasound. Finally, we will touch on some week 18 pregnancy symptoms and offer some tips for taking care of your body and mind as you head towards the halfway point of your pregnancy.

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Key takeaways:

As you get more familiar with your baby’s movements, you will begin to notice them getting stronger and more frequent
Your body is working hard to circulate a greater volume of blood through your body during pregnancy, which can have a knock-on effect on things from the development of varicose veins to swelling and dizziness
The anatomy or second-level ultrasound, usually offered between weeks 18 and 22, is used to check your baby’s physical development and can also let you know the sex of your baby (if you want to know ahead of the birth)

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Your body at week 18

Baby kicks

Between weeks 18-25, you will likely begin to feel your baby move in your belly. These movements can take some getting used to, especially because they can be very faint at the beginning. At first, it’s easy to confuse them with your own stomach gurgling or gas. Keep in mind that first-time moms tend to feel these movements later, so if you are not yet feeling much movement, try not to worry. At week 18, your baby still has a lot of space to move around in the uterus, and so while they are constantly moving, you might not be able to always feel it. The placement of the placenta also matters – if your placenta is in the front of your stomach (anterior) or the top, it can affect where and how much you feel movement.

As you become familiar with your baby’s movements, you will likely notice a pattern or times of the day when they are more active. In general, babies tend to be the most active after you eat a meal or something sweet, and in the evenings. It will be easiest to feel movements when you are sitting comfortably or lying down on your side.

At the start of your third trimester, your doctor or midwife might suggest you start keeping track of your baby’s movements, also known as counting kicks. The goal of counting kicks is to stay aware of your baby’s activity and to notice if there are any significant changes you need to communicate to your healthcare team. To count movements, it is recommended to pick a time of day when your baby is normally active, sit comfortably or lie down, and use one of two methods [1]:

Start a timer and record how long it takes to feel 10 movements
Count how many movements you feel in a set length of time (30 minutes to 2 hours)

At week 18, there is no need to count kicks, but rather focus on trying to familiarize yourself with your baby’s movements and patterns. If you are ever concerned about what you feel, or don’t feel, don’t hesitate to contact your healthcare provider.

Varicose veins

Have you noticed swollen, twisted, or lumpy veins just under the skin’s surface? These are known as varicose veins. They happen most commonly on the legs, but can appear anywhere, even on the vulva, during pregnancy. While common and usually not serious, they can cause sores, heaviness, burning, or aching where they appear. Purple, blue, or red spider-like veins on the surface of your skin are also varicose veins, but these are a milder version called spider veins [2].

Varicose veins happen in the superficial veins, which are those closest to the surface of the skin. Veins carry blood towards the heart (arteries carry blood away from the heart) and contain one-way valves. When these valves become damaged or weakened, blood can collect and cause veins to dilate, or expand. Increased pressure within your veins due to increased blood flow during pregnancy, as well as sitting or standing for long periods of time, can also weaken the walls of your veins and damage the valves [2].

For some, varicose veins that develop during pregnancy will go away or reduce significantly in size postpartum. However, it’s also possible that they remain [3]. During pregnancy, you can try to prevent and treat varicose veins by resting with your legs elevated whenever possible. Exercises like walking and swimming, if recommended in your pregnancy, can also help with blood circulation. Compression socks can also help reduce or prevent varicosities for some women, but check with your doctor or pharmacist about getting the correct compression strength. If you are concerned about your varicose veins, if sores develop, or if you experience pain on account of varicose veins, contact your healthcare provider.

Your baby’s development at 18 weeks

Even if you can’t always feel it, your baby is moving around constantly! They are practicing all kinds of different movements, including rolling around and kicking their arms and legs. Your baby can also hiccup, yawn, suck and swallow. They have been busy these last 18 weeks! Your baby’s genitalia are also fully formed and visible on an ultrasound scan, if your baby cooperates and gives the technician a good view [4].

This week your baby is around the size of an artichoke, measuring around 5.6 to 6.3 inches (14.2 to 16 centimeters) and weighing around 5.5 to 6.7 ounces (160 to 190 grams) [5].

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Mid-pregnancy ultrasound

You will likely have an ultrasound, commonly called an anomaly, anatomy, or level-two ultrasound, between weeks 18 and 22 [6]. The purpose of this ultrasound is to check on the baby’s development and general health. A technician or midwife will take detailed measurements of the width and circumference of the head, the circumference of your baby’s abdomen, and the length of their humerus to check that they are growing on track. These measurements can also be used to estimate the baby’s weight.

At this point of your pregnancy, if you haven’t found out already, you can also ask to know the sex of your baby at this ultrasound. Choosing whether or not you find out the sex of your baby is a personal decision, and there is no right or wrong approach. Because the baby’s external sex organs are completely developed, an experienced midwife or technician should be able to tell you the sex with nearly 100% certainty. In some cases, your baby might not cooperate for the ultrasound, but hopefully with a little patience, they will give the right view.

Pregnancy Symptoms in week 18

Swelling in the feet and ankles

Swelling during pregnancy, called edema, is caused by your body retaining water. If you have been standing a lot, or if the weather is particularly warm, you will likely experience swelling in your feet and ankles. This tends to worsen as your pregnancy progresses. Pressure from your growing uterus can also worsen blood flow to your legs, contributing to swelling. While normal, you can help reduce swelling by trying not to stand for long periods of time, wearing comfortable shoes, resting with your feet up, and doing foot exercises or taking walks to improve circulation [7].

In some cases, sudden swelling, particularly in the face, hands, and feet, can be a sign of preeclampsia. Preeclampsia is a hypertensive disorder (relating to high blood pressure) that usually develops in the second half of pregnancy. While many cases of preeclampsia are considered mild, it requires immediate medical attention and monitoring for the safety of both mother and baby. If you notice your hands, face, or feet are suddenly swollen, or if you experience a bad headache, problems with your vision, or sudden severe nausea, contact your healthcare provider immediately [7].

Dizziness

Dizziness, or feeling faint, is commonly associated with the first trimester but can be experienced later in pregnancy as well. Dizziness is most commonly caused by low blood pressure and/or low blood sugar. Help ward off spells of dizziness by avoiding standing for long periods of time, sitting and standing up slowly, and eating regularly. Dizziness can be worse if you get overheated, and in the warmer months, so avoid taking hot showers and be sure to stay cool and hydrated outdoors.

If you experience dizziness alongside any pain in your abdomen or bleeding, contact your healthcare provider immediately [8].

Tips in week 18

Think about maternity leave: as you reach the halfway point of your pregnancy, it’s a good idea to start thinking about maternity leave. Be sure to check what benefits are available to you where you live, as well as what benefits might be available through your employer. In some cases, your partner might be eligible for benefits through their employer or your local government as well.
Learning about birth: whether you are interested in attending birthing classes or just want to do some research yourself, it is never too early to begin preparing for the process of birth. Familiarizing yourself with what you can expect before, during, and after labor can help you feel more prepared for the journey ahead to meet your little one.
Make sure you’re getting enough iron: growing a baby requires your body to make a lot of extra blood. Whether or not you have been advised by your care team to take extra iron supplements, make sure you are getting enough iron in your daily diet. Beans, nuts, dried fruits, red meat, and fortified breakfast cereals (cereals that have added vitamins and minerals) can be good sources of dietary iron [9].
Sleeping on your side: while many doctors will recommend sleeping on your side from the start of your third trimester, you can try starting to sleep on your side already in the second trimester. Side sleeping has been shown to provide the best circulation for you and your baby, and places the least amount of pressure on your veins and organs. Good circulation can also help with swelling, varicose veins, and hemorrhoids [10].
Find a body pillow: a body or pregnancy pillow can help you get comfortable sitting or sleeping by providing extra padding and support. If you are suffering from pelvic or hip discomfort, or leg cramps, you can place part of the pillow between your knees when you sleep. The pillow can also help elevate your legs when you’re sitting to relieve swelling.

Tracking your pregnancy using Natural Cycles

As the first FDA Cleared birth control app, Natural Cycles aims to support you throughout all phases of your fertility and reproductive life. During your pregnancy, NC° Follow Pregnancy provides weekly guides and pregnancy symptom tracking so you can remain up-to-date on the changes going on in your body and with your baby’s development. After birth, NC° Postpartum provides daily guidance to help you navigate this new phase of life with your new baby. Why not see if Natural Cycles is right for you?

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Counting baby kicks [Internet]. American Pregnancy Association. 2025 [Cited 2025 May 15]. Available from: https://americanpregnancy.org/healthy-pregnancy/while-pregnant/counting-baby-kicks/
Varicose veins [Internet]. Johns Hopkins Medicine. 2021 [Updated 2023 Aug 28]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/varicose-veins#:~:text=Varicose%20veins%20are%20caused%20by,can%20collect%20in%20the%20veins
Varicose veins in pregnancy [Internet]. HSE.ie. [Cited 2025 May 12]. Available from: https://www2.hse.ie/conditions/varicose-veins-pregnancy/
P A A, Arbor TC, Krishan K. Embryology, Sexual Development. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557601/
18 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 May 12]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/18-weeks-pregnant/
Swollen ankles, feet and fingers in pregnancy [Internet]. nhs.uk. 2024 [Cited 2025 May 12]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/swollen-ankles-feet-and-fingers/
Bethune M, Alibrahim E, Davies B, Yong E. A pictorial guide for the second trimester ultrasound. Australas J Ultrason Med [Internet]. 2013 Aug;16(3):98–113. Available from: http://dx.doi.org/10.1002/j.2205-0140.2013.tb00106.x
Dizziness during pregnancy [Internet]. American Pregnancy Association. 2023 [Cited 2025 May 12]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/dizziness-during-pregnancy/#:~:text=During%20the%20second%20trimester%2C%20dizziness,lower%20body%20to%20your%20heart)
Iron [Internet]. nhs.uk. 2023 [Cited 2025 May 12]. Available from: https://www.nhs.uk/conditions/vitamins-and-minerals/iron/
Best sleeping positions while pregnant [Internet]. American Pregnancy Association. 2024 [Cited 2025 May 12]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/sleeping-positions-while-pregnant/

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Missing a period can be a signal from your body that something has changed. Whether you’re trying for a baby or trying to prevent pregnancy, a missing period is a common sign of pregnancy, but many other conditions and circumstances can also cause menstrual irregularities. In this article, we’ll go over what defines a “late” or missing period, along with the most common causes. We’ll also walk you through what to do if you have a late period and a negative pregnancy test, and answer the question of “can you be pregnant and test negative”? (Spoiler alert: yes, but you may have skipped your period for another reason, too).

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Key takeaways

A late or missed period can be caused by a variety of hormonal and lifestyle factors
While it doesn’t always indicate pregnancy, a missed period is worth speaking to your healthcare provider about
If you got a negative result on a pregnancy test after your period is late, it’s possible (but unlikely) that you are pregnant — more likely, it’s a signal from your body that something is out of balance hormonally and/or in your lifestyle

","

How late can a period be before pregnancy becomes likely?

If a week or more has passed since your expected period due date, you’re in your reproductive years (between puberty and menopause), and you’ve been having sex, there’s a chance you may be pregnant [1].

There’s more nuance to this though — remember that pregnancy can only happen if ovulation, fertilization, and implantation have occurred. In other words, your ovary needs to release an egg cell, sperm needs to meet with the egg cell to fertilize it, and the fertilized cell then needs to attach to your uterine lining. It’s only once all of these processes have happened that you can become pregnant [2].

Considering that all of that needs to go off without a hitch for pregnancy to happen, it’s also very possible that you missed your period for a variety of other reasons, especially if you got a negative pregnancy test result.

Dr. Karen Tang, member of the Natural Cycles Medical Advisory Board, shared more about how ovulation affects our cycles and may cause a skipped period. “Ovulation, or releasing an egg from the ovary, is a trigger that regulates cycles, and if you don’t ovulate, you’ll skip a period or have a delayed period. Lots of things can throw off ovulation and hormones, including physical or emotional stress, illness, certain medications, medical conditions like thyroid problems, PCOS, or changes in weight, exercise, or nutritional status.”

How do you know if your period is late?

To make matters a bit more complicated, it can be difficult to tell if your period is late (and if you should test for pregnancy) if you’re not sure when to expect it. Logging the dates of your period over time in tools like the Natural Cycles app can help predict your cycle length to make informed decisions about your health and notice patterns over time.

But in general, periods are considered regular if they fall anywhere between 21 to 35 days. If it’s been more than 35 days since your last period (or about one week after it’s due), it may be late or you may have skipped it [3].

“The normal range of cycle length (days between the 1st day or full period flow to the 1st day of full flow the next period) is 21-35 days,” said Dr. Tang. “Some variation from month to month is normal. But if you’re having periods 2 weeks apart or more than 5 weeks apart, skipping multiple months, or having wildly unpredictable cycles, that is something to see your doctor for.”

Causes of a negative pregnancy test with no period

Seeing your doctor can be helpful in determining the most likely underlying cause of a late period and a negative pregnancy test, but below we’ll list some of the most likely causes for a missed period aside from pregnancy.

We’ll start with common hormonal reasons like birth control, hormone levels, breastfeeding, and menopause, then get into circumstances that may be causing a missed period. We’ll finish it off with some rare, but possible, medical conditions that may cause missed periods.

Hormonal birth control

Hormonal birth control methods, like the pill and the implant, work to prevent pregnancy by thinning the uterine lining and preventing ovulation (the release of an egg cell), among other processes. Since a period includes the shedding of the uterine lining and an unfertilized egg cell, it’s common for periods to be lighter or to skip them altogether while on hormonal birth control [4, 5].

For the pill particularly, you have the option to skip the placebo week and keep taking the birth control pills in order to skip a period. It’s highly unlikely that you’re pregnant if you’re on hormonal birth control and skip a period, but it’s always a good idea to reach out to your healthcare provider with any questions or concerns to be sure [6].

Abnormal hormone levels

Another potential cause of a missed period is abnormal hormone levels in the body. The menstrual cycle is regulated by a complex hormonal system, consisting of many signals and changes throughout the cycle to first prepare the body for pregnancy, and if pregnancy doesn’t happen, to menstruate. The glands that contribute to and regulate this system include the hypothalamus, the pituitary gland, and the ovaries. When this system doesn’t function as expected, it can cause abnormal hormone levels and potentially, a missed period [7].

Breastfeeding

On the other hand, it is normal to skip a period while breastfeeding [7]. After you give birth, it can be difficult to predict exactly when your periods will start again, especially if you’re breastfeeding. If you’re only breastfeeding without any bottles, your periods may not start again until you stop, or reduce, breastfeeding, but the timeline can look a bit different for everyone [8].

Menopause

It’s also possible that you’re in the perimenopause phase of life, approaching menopause (the time when you haven’t had a period for a full year and you can no longer get pregnant). If you’re between the ages of 45 and 55 and you’re noticing other perimenopause symptoms such as hot flashes, night sweats, incontinence, or weight gain, this may explain the missed or late period and negative pregnancy test [9].

Sleep quality

Aside from hormonal changes, lifestyle circumstances like your sleep hygiene and fatigue levels can also affect your cycle. One study found that shorter average sleep duration, poor sleep quality, and higher fatigue levels were associated with menstrual irregularity. While more research is needed in this area, improving sleep can contribute to an overall healthier lifestyle [10].

Stress

Stress can also cause a missed period — this includes emotional/mental stress as well as physical stress, such as excessive exercise or not eating enough. Emotional stress can look like anxiety or depression, and physical stress is common in female athletes or those who have recently lost weight. Stress on the body can cause the hypothalamus to malfunction, which can cause menstrual irregularities [7].

Medications

Some prescription medications, including anti-psychotics, antidepressants, and high blood pressure medication, may cause missed periods as a side effect. Medical treatments like chemotherapy and radiotherapy can also cause hormonal imbalances. Some allergy medications may also affect your hormone levels. Speak to your doctor about side effects of medications they prescribe so that you know what to expect [11].

Polycystic ovary syndrome

In terms of conditions that may cause missed periods and negative pregnancy tests, polycystic ovarian syndrome (PCOS) is a common hormonal disorder that may lead to late or skipped periods. One in 10 women of reproductive age experience PCOS, and it’s caused by a hormonal imbalance. This imbalance can cause the egg cell to not develop as it should, or it may not be released correctly during ovulation. This can cause anovulatory cycles (when you don’t ovulate), which in turn can lead to late or missed periods [12].

Other medical conditions

A few other medical conditions to consider that may cause missed periods include:

Chronic disorders involving the lungs, digestive system, blood, kidneys, or liver
Some autoimmune disorders
Cancer
HIV
Head injuries
Cushing syndrome
Overgrowth of placenta tissue
Scarring of the uterus
Polyps
Fibroids [7].

What should you do if your period is late?

If your period is late and you got a negative pregnancy test result, you may have nothing to worry about, especially if you’re on hormonal birth control, breastfeeding, in perimenopause, or on a certain medication that may cause skipped periods as a side effect.

If you think it’s a lifestyle factor like sleep or stress, see if there’s anything you can do to improve these circumstances and help your body relax (we know this is easier said than done!) It can be helpful to share your problems with a friend or family member, and you can always reach out to your doctor or a mental health support provider for assistance, if you prefer to speak to someone impartial.

If you’re still thinking you may be pregnant, take another test a few days after your missed period. Dr. Natalie Crawford, also on the Natural Cycles Medical Advisory Board, told us the best time to take a pregnancy test for the most accurate results. “Home pregnancy tests are extremely accurate with a 99% accuracy rate if taken at the correct time. Since hCG levels rise as the pregnancy is implanting, taking a pregnancy test too early can result in a negative result. This is why we recommend you take a test once you have missed your expected period.”

When to speak to a doctor

It’s worth contacting your healthcare provider to assess your condition if you think you may have abnormal hormone levels, or any of the medical conditions listed above that may contribute to missed periods. They can get to the bottom of the cause and suggest treatment options to get your cycle back on track. Doctors also recommend reaching out if you’ve missed three periods in a row, or if you have fewer than nine periods in one year [7].

Get to know your body better with Natural Cycles

So to wrap it all up, yes, you can be pregnant and test negative, and if you’ve missed a period and are sexually active, you may be pregnant. But that’s not the only circumstance that can cause a missed period. Hormonal factors, lifestyle factors, and certain medications all play a part in the regularity of your cycle. Tracking the timing of your cycle and your symptoms with the Natural Cycles app can help you get the information you need to prevent pregnancy, plan a pregnancy, and more. Plus, you’ll learn loads about the regularity of your cycle along the way! See how Natural Cycles can support your fertility journey today.

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Having sex for the first time may come with a variety of emotions — excitement, anticipation, or even some anxiety or worry. You may have heard that losing your virginity hurts, and while that can happen for some people, far from everyone’s first time is painful. In this article, we’ll dive into why first-time sex can hurt (spoiler: we’ll be busting some myths), how to make your first time less painful and more enjoyable, safety precautions, plus some tips for different types of sex.

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Key takeaways:

You may feel a bit of pain the first time you have sex, but not everyone finds it painful or uncomfortable
Pain during first-time sex is often related to nervousness or not feeling aroused enough before penetration — the muscles in the vagina can tense up, while a lack of lubrication (wetness) may increase the chances of pain and discomfort
Making enough time for foreplay, going slow, communicating with your partner, and using lube are great ways to increase pleasure and decrease the likelihood of pain during first-time sex

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Does it hurt to lose your virginity?

The short answer is that it depends. All our bodies are different, and some of us may experience a bit of pain or bleeding when having sex for the first time. However, far from everyone does — and it’s completely normal not to experience pain the first time you have sex, too.

There’s limited research on this topic, but one 2009 study, which surveyed 300 teenage girls and young women in Sweden, found that 65% experienced pain when they had sex for the first time [1]. To shed some more light on this, we asked a few of our users to share their experiences. Here’s what they said:

“Painful and was nervous” –Lua
“Painful and uncomfortable, but not unbearably so. Then he helped me wipe off all the blood” –Rachel
“With my husband and so sweet and gentle” –Rylie

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A note on the many different types of sex

When talking about “losing your virginity”, many people only refer to the first time you have vaginal sex (penis-in-vagina sex). We’ll mainly discuss vaginal sex in this article, but it’s important to call out that this doesn’t cover everyone’s experience and that there are many other types of sex too.

Why can first-time sex hurt?

Just inside the vagina, there’s a small fold of vaginal tissue that surrounds the vaginal opening, sort of like an elastic band. This is the hymen. When we have sex for the first time, the hymen stretches, which can feel a little painful for some. It may also get small tears as it stretches, which is why some people bleed a little [2]. We’ll come back to the hymen, but first, there are a couple of other reasons why losing your virginity can hurt.

The vagina creates its own lubrication when you’re aroused — that’s why you become “wet”. Penetrating the vagina without enough lubrication, whether that’s due to nerves or because you’re not aroused enough yet, causes friction, which can make sex can feel uncomfortable or painful, or even result in small tears in the hymen [3, 4].

In fact, pain during first-time sex often has to do with our nerves. What typically happens when you’re aroused is that the vagina widens and deepens, which makes penetration more pleasurable. However, if you’re feeling a bit nervous (totally normal the first time you have sex), the muscles in the vagina can tense up or cramp a bit, which can lead to pain during penetration instead [2, 3].

What is the hymen, and what does it have to do with virginity?

Most of us have probably heard the phrase “popping your cherry” in the context of losing your virginity, and this saying illustrates the myth of the hymen quite well.

Historically (and inaccurately), the hymen has been thought of as a membrane that completely covers the vaginal opening and tears when you have sex for the first time. In reality, the hymen is a small fold of tissue located just inside the vagina, where it surrounds the vaginal opening — it does not cover it. How it looks varies from person to person, and the hymen also changes appearance and becomes more elastic as we get older, for example, due to the hormonal changes that happen during puberty [2].

You might be wondering why we’re making such a big deal out of such a small piece of tissue. At Natural Cycles, we’re passionate about empowering people with knowledge about their bodies. The myth of the hymen is, at best, unhelpful and at worst, it can be harmful to young women.

In many cultures, women and girls are expected to feel pain or bleed the first time they have sex, as this is considered evidence that the hymen was intact and that she’s a virgin. However, that’s also part of the hymen myth. In fact, it’s not possible to tell if someone is a virgin by looking at their vagina or by whether or not they bleed or have pain during sex [5]. There’s also no evidence that sports or using tampons result in injuries to the hymen [2].

Dealing with pain after sex

Pain during first-time sex can feel scary, but the good news is it usually doesn’t last long, if it happens at all. It might sting or feel a bit sore afterwards, but it should go away within a couple of days [2].

If the pain doesn’t go away, you experience severe pain, or you continue to have pain during sex, always reach out to your healthcare provider as soon as possible. Sex shouldn’t be painful, and there is help available. And remember, there are other ways to have sex than just penetration — so you can still enjoy yourself if you’re in the mood but find vaginal sex painful or uncomfortable.

Is pain during first-time sex a one-time thing?

In general, sex shouldn’t hurt, though some people may experience discomfort the first few times. Persistent pain during sex is usually an indication of an underlying condition, such as:

Yeast infections: Symptoms of a yeast infection includes itchness and soreness in and around the vagina, and you may also have pain during sex [6].
Sexually transmitted infections (STIs): Some STIs, such as chlamydia, gonorrhea or trichomoniasis, may cause symptoms like pain, redness, or swelling in and around the vagina [7].
Allergies or skin irritation: If you’re allergic or sensitive to certain substances used around the vulva or in the vagina, like soaps, lubricants, or latex, this can cause painful irritation [3].
Pelvic inflammatory disease (PID): An infection in the female reproductive system, which is usually caused by bacteria entering the uterus, fallopian tubes, or ovaries. Symptoms include pain during sex, pain in the abdomen and pelvis, and fever [8].
Endometriosis: A condition where tissue similar to the uterine lining grows outside the uterus. Common symptoms are painful and heavy periods, and pain during sex [9].
Fibroids: Non-cancerous growths that develop in or around the uterus, which can cause pain in the belly or lower back, frequent or heavy periods, and pain during sex [10].
Vaginal dryness due to hormonal changes, for example during perimenopause [3].
Vaginismus: a condition where the muscles around the opening of the vagina tighten in a way that makes penetration painful [3].
Vulvodynia: Pain affecting the vulva (the external parts of the female genitalia) that lasts for at least three months and isn’t caused by another diagnosed medical condition [11].

If you continue to have pain during sex or if the pain is severe, it’s important to speak to your healthcare provider to understand the cause so it can be treated.

Things to consider before having sex for the first time

Whether your first time will be a spur-of-the-moment thing or planned, there are some things that can be helpful to think of in advance. You may even find it helpful to talk these through with your partner to make sure you’re both on the same page.

First off, make sure you have protection on hand. Condoms are a great first-time option since they are the only method that protects against both pregnancy and STIs, plus they are easy to come by. You can buy condoms at your local pharmacy, supermarket, or online. There are also many different types of birth control you can use to prevent pregnancy. Talk to your doctor to learn what’s the right fit for you.

Secondly, set realistic expectations. Because let’s face it, the first time you have sex will likely not be your best — as with anything, it requires practice and learning what works for you (and what doesn’t). Here’s what two of our users said about their first times:

“Awkward because we didn't know, but with my life partner so we learned the 2nd time much better” –Peyton
“Too long and not what the movies make it seem like!” –Gracie

So, the first time might feel a bit awkward and strange, but don’t worry, it does get better. Just try to relax and be in the moment with your partner.

How to make losing your virginity less painful

Not everyone feels pain when losing their virginity, so chances are you won’t either. We like to come prepared, though, so let’s go over some things that can make your first time more enjoyable and decrease the likelihood of pain.

Take it slow

It’s totally normal to feel nervous, but unfortunately, anticipating pain can make us tense up without meaning to. Be patient with yourself and your partner — sex isn’t a race, and especially not the first time. When you both feel ready, take the time to get into the right mood. Go as slow as you need and listen to your partner if they ask to slow down — this can help you feel more comfortable and relaxed. Don’t try to “push through” or tolerate pain, you’re always in control of the pace.

Here’s what two of our users said about taking it slow their first time:

“[Did it] With my high school bf who did it before me, made a playlist and went really slow” –Jackie
“I waited until I met someone I really liked and it was a really good experience” –Emily

Communication is key

Communication is key when it comes to sex. Talking about what you like, don’t like, or feel unsure about beforehand can help you feel prepared for your first time, but it’s equally important to communicate during sex. Let your partner know what feels good or if they should try touching you in a different way, and make sure to listen to your partner as well. And remember: not all communication is verbal, so tune into your partner’s non-verbal signals too.

Make time for foreplay

Even if we feel emotionally aroused, it can take a while for our bodies to catch up — that’s where foreplay comes in. Foreplay may include kissing, touching, giving your partner a sensual massage, or other types of intimacy to help our bodies prepare for sex. When we’re aroused, the vulva swells and becomes blood-filled [12], while the vagina widens and deepens, plus creates lubrication, all of which makes penetration easier and more enjoyable. Basically, don’t skip the foreplay!

Lube is your friend

Even though the vagina creates its own lubrication when aroused, you may want to use additional lube too. Touching or penetrating the vagina without enough lubrication can be uncomfortable or even painful, so don’t hesitate to add lube if you feel like you need to.

Not getting wet can be a sensitive subject, but try not to worry — there are plenty of reasons why we might not create “enough” lubrication even if we’re aroused, including if we’re nervous or stressed [13]. Using additional lube will only enhance the experience during sex. Make sure you use a water-based lube if you’re using condoms, since oil-based ones can increase the likelihood of them breaking.

Learn about your body (and your partner’s too)

Everyone has different preferences when it comes to sex, including where we like to be touched and how. Before you have sex with a partner for the first time, take the time to learn what you like. Masturbation is a great way of getting to know your own body and what works for you, and then you’ll be able to guide your partner on how to give you pleasure.

Make sure you have (and give) consent

Sex is meant to be enjoyed, so consent is really important to make sure everyone involved feels safe. You can check for consent verbally by asking your partner if it’s okay to touch them a certain way or if they like how it feels, and pay attention to non-verbal cues too. Pause to check in if your partner seems uncomfortable.

Remember that it’s always okay to stop if something doesn’t feel right — you should never have to do anything you’re not comfortable with. Even if it feels okay at first, you’re allowed to change your mind at any time, and your partner should always listen and respect your decisions.

Try different positions

Don’t hesitate to try different sexual positions. In positions that allow for deeper penetration, like doggy style or the seashell, the penis may push on the cervix, which connects the vagina and uterus, in a way that can feel uncomfortable or even painful. Switching to a position that allows more shallow penetration, switching so you’re on top and can control the depth, or asking your partner not to go as deep can help you feel more comfortable.

Bonus tips: give shallow penetration a try! One study which looked at survey responses from 3,000 US women found that almost 85% use a technique called shallowing, meaning shallow penetration just inside the vaginal opening, to make vaginal sex more pleasurable [14].

Not all sex is penetration

Many people go straight to vaginal penetration when thinking about sex, but there’s more to sex than just penis-in-vagina. There are many types of sex that don’t involve penetration at all, like erogenous touching, fingering, or hand-jobs, outercourse, phone sex — really anything that gives you sexual pleasure can be counted as sex. So, if you’re not ready for vaginal sex or find penetration painful, there are options you can explore if you want.

Treat any conditions that might cause painful sex

If you have any medical condition that can cause pain during sex, for example, a yeast infection, treat it first so you don’t have to endure unnecessary pain. Reach out to your healthcare provider to find what treatment options would work best for you.

Tips for vaginal sex

Now that we’ve covered some tips to make the first time less painful, let’s keep it going and run though a few more for general tips to make vaginal sex enjoyble every time you have sex:

Make time for foreplay: Foreplay isn’t just for the first time — it’s always important. Experiment and find what you like best!

Stimulate the clitoris: When it comes to female pleasure, the clitoris really is the star of the show. Research has found that only 18% of women can orgasm from vaginal penetration alone, while about 70% orgasm or enjoy vaginal penetration more when stimulating the clitoris at the same time [15].

Use lube: Lubrication (either natural or added) is a must to make vaginal sex enjoyable, so don’t hesitate to use additional lube if you need to. It will only make things better.

Try different positions: Experiment with different positions, angles, and depths of penetration.

Use birth control: Vaginal sex comes with a risk of pregnancy, so be sure to use a birth control method if you don’t want to become pregnant. Remember that condoms are the only method that protects against STIs.

Tips for anal sex

Anal sex can be painful, especially the first time. While the vagina is made to be able to be penetrated, the anus is made up of much tighter muscles so penetration can result in pain. Anal sex isn’t for everyone, so it’s also okay if you don’t want to do it. If you want to give anal sex a try, here are some things you can do:

Use lube: Unlike the vagina, the anus doesn’t produce any lubrication of it’s own, so you should always use plenty of lube for anal sex.

Go slow: It can be difficult to relax the muscles in the anus, so it’s key to take things slow and warm up the area with other types of touching. Don’t rush! If you’re comfortable with it, it can help to start with smaller objects like fingers or toys (make sure to only use toys meant for anal stimulation).

Use condoms: You should always use a condom if you’re penetrating the anus with a penis, both to prevent STIs and to avoid bacteria entering the urethra [16]. Put on a new condom if you switch from anal to vaginal sex.

Tips for oral sex

Oral sex doesn’t typically hurt, but it can feel uncomfortable if your partner is touching you in a way you don’t like. As always, when it comes to sex, communication is key, so tell your partner what feels good for you. If you’re the one giving oral sex, be gentle and listen to what your partner wants. Now, let’s look at a few tips:

Try different techniques and speeds: You can experiment with different techniques or speeds to see what works best for you.

Use your hands: Oral sex doesn’t mean you can only use your mouth. Erotic touching or caressing your partner can enhance the experience, and you can use your finger or fingers to gently penetrate the vagina and stimulate the clitoris from within.

Use dental dams: Dental dams are small sheets made of latex or polyurethane that are used to cover the vulva during oral sex. It’s possible for STIs to be transmitted through oral sex, and using dental dams reduces the risk [17].

Take the right safety precautions

Practicing safe sex means that you can focus on enjoying yourself without having to worry about unwanted consequences, so let’s turn our attention to safety.

If you don’t want to risk pregnancy, make sure you use an effective birth control method. There are many options to choose from, ranging from hormonal methods, like the pill, to non-hormonal methods, such as Natural Cycles or the copper IUD. Your healthcare provider can help you find the best fit for you.

It’s also important to protect yourself against STIs, and condoms are the only method that does this effectively. Even if you’re already using a birth control method, like the pill or Natural Cycles, using condoms with new sexual partners will offer another layer of protection.

Learn about sexual health with Natural Cycles

At Natural Cycles, we’re passionate about busting myths about sexual and reproductive health, and we believe that knowledge about your own body puts you in control. We’ve also created NC° Birth Control, the first and only FDA Cleared birth control app, offering a non-hormonal option that also lets you learn about your body and menstrual cycle. NC° Birth Control is for those over 18 and doesn’t protect against STIs. Why not see if Natural Cycles could be right for you?

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Moussaoui D, Abdulcadir J, Yaron M. Hymen and virginity: What every paediatrician should know. J Paediatr Child Health. 2022;58(3):382–7. Available from: https://doi.org/10.1111/jpc.15887
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Office on Women’s Health. Vaginal yeast infections [Internet]. 2025 [cited 2025 May 12]. Available from: https://womenshealth.gov/a-z-topics/vaginal-yeast-infections
ACOG. How to Prevent Sexually Transmitted Infections (STIs) [Internet]. 2023 [cited 2025 May 12]. Available from: https://www.acog.org/womens-health/faqs/how-to-prevent-stis
ACOC. Pelvic Inflammatory Disease (PID) [Internet]. 2019 [cited 2025 May 12]. Available from: https://www.acog.org/womens-health/faqs/pelvic-inflammatory-disease
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Welcome to week 17 of your pregnancy! In this week’s article, we will dive deep into two important body changes you might become more aware of this week. We will also check in on how your baby is doing and touch on some pregnancy symptoms you might experience in the second trimester. Finally, we will offer some tips on things you can do this week to ensure you are caring for your body and mind.

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Key takeaways:

Stretch marks are the result of your growing, changing body, and affect up to 90% of all pregnant women
A balanced, healthy diet and regular light to moderate exercise can help ensure you are supporting your own and your baby’s health as you gain weight during pregnancy
Weird, vivid, or scary dreams are more common in the second trimester, with studies suggesting that dreaming is your body’s way of processing the enormous emotional and psychological changes you are experiencing in your pregnancy

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Your body at week 17

Stretch marks

It is estimated that up to 90% of women develop stretch marks, or striae gravidarum, during pregnancy [1]. They most often appear on the breasts and stomach, but can also develop on the butt, hips, and thighs. They can be narrow or wide and white, pink, red, purple, or brown, depending on your natural skin pigmentation. After your baby is born, stretch marks might gradually fade or become paler, but they likely will not go away completely. Stretch marks are not known to cause any medical harm to you, or your baby. Though they are a sign of the amazing things your body is doing, it is also normal to find their them stressful or distressing.

There are two main factors that cause stretch marks. The first is the physical stretching of the skin as your stomach and breasts grow and you gain weight during pregnancy. This stretching can damage the connective tissue in your top layer of skin, causing small tears and scars that appear as stretch marks. Scientists have also hypothesized that certain hormones you produce when pregnant decrease the production of collagen and elastin in the skin, making it more difficult for your body to repair tears in the connective skin tissues [1].

Scientists have suggested a number of additional factors that influence if and how you develop stretch marks. These include maternal factors like age, personal history, body mass index, skin color, and race, as well as pregnancy factors relating to weight gain, increases in body mass index, and if you have lower levels of serum vitamin C and serum relaxin [1]. Relaxin is a hormone produced by the body specifically during pregnancy that helps to relax muscles, joints, and ligaments, and helps the body stretch as the baby grows and you prepare to give birth. Your baby’s size and weight during gestation and delivery can also affect stretch mark development.

While there are products that are marketed to reduce or treat stretch marks, there is unfortunately no evidence

that stretch marks can be prevented or significantly reduced during pregnancy. Early studies have suggested that topical creams containing centella may be effective for reducing or preventing stretch marks, though more research is needed [1]. While stretch marks are a normal and common part of most pregnancies, there are treatments and products that can be used to help minimize or reduce their appearance postpartum, if that’s something you want to do. Treatments for stretch marks include laser therapy, light therapy, microneedling, and retinoids. If you are interested in exploring these options, we recommend consulting with a healthcare provider to understand what options might be best suited to you.

Weight gain

If your appetite has returned after the first trimester, or if you find you are hungrier than normal now in your second trimester, you might be wondering what is considered healthy weight gain during pregnancy. Everyone’s pregnancy is different and studies have shown that total weight change during pregnancy can vary widely – from weight loss to a gain of more than 66 pounds (30 kilograms) – and is affected by many different factors [2].

In general, weight gain is considered a combination of two parts: the weight of the baby, placenta, and amniotic fluid, and the expansion of maternal tissues. Scientists estimate that the baby accounts for about 25% of the total gain, with the placenta representing about 5% and the amniotic fluid about 6% [2]. Increased blood volume during pregnancy is responsible for about 10% of your weight gain, while increased fluid volume in the cells and muscles can account for up to 13% of total weight gain [2].

The US Center for Disease Control (CDC) and American College of Obstetricians and Gynecologists (ACOG) both suggest that weight gain recommendations during pregnancy be based on your body mass index, or BMI, before pregnancy [3,4]. It is also important to note that recommendations are different if you have a single or multiple pregnancy (e.g., twins). Depending on your BMI, the recommendations of weight gain in the second and third trimesters vary from 0.5 pounds (if your BMI is over 30) to around 1 pound a week [4]. While no extra calories are generally required in the first trimester, it is recommended to consume around 340 additional calories per day in the second trimester and around 450 calories per day in the third trimester [4].

A balanced, healthy diet and light to moderate aerobic activity (if safe to do so in your pregnancy), ensure that your body is getting the nutrition and exercise it needs to help you and your baby stay healthy during pregnancy. Check out our tips for exercise during pregnancy and what to eat when pregnant for more information.

Your baby’s development at 17 weeks

During week 17, your baby’s bones are hardening, and their muscle tissues are continuing to develop. Your baby’s ears have reached their final position, and hearing is maturing, while the umbilical cord, which connects the baby to the placenta, is getting longer and thicker [5].

Your baby weighs between 4 and 4.9 ounces (110 to 140 grams) and measures around 5.1 to 5.75 inches (13 to 14.5 centimeters) long this week [5]. This is around the size of a turnip!

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Pregnancy Symptoms in week 17

Itchiness

Skin itchiness is a common pregnancy symptom in the second trimester. Stretched skin on your growing body and stretch marks can cause itchiness on the breasts, abdomen, hips, and thighs. It is also possible to experience itchiness elsewhere. Increased blood supply, hormones, and dehydration can all contribute to dry, itchy skin. Try to opt for natural, breathable fabrics and use a body moisturizer regularly to treat dry skin and prevent irritation.

In rare cases, itchiness can be a sign of a rare, potentially serious liver condition called intrahepatic cholestasis of pregnancy (ICP). ICP tends to be more common in women of South Asian origin and is also more common if you have had ICP in a previous pregnancy [6]. If you experience itching (usually without a rash) that is more noticeable on the palms of the hands and the soles of the feet or is worse at night, contact your healthcare provider. Other symptoms of ICP can include dark urine, pale poop, and jaundice (yellowing of the skin and whites of the eyes).

Weird or vivid dreams

You might notice that your dreams are changing this week. This can include having more vivid, intense, or frequent dreams than what is normal for you. Anxiety-based, sexual, or scary dreams are all common. Your body is going through dramatic emotional, physical, and mental changes, which can all affect your dream patterns.

While scientists are unsure what exactly causes these changes, an increase in hormone production is believed to impact the way your brain processes information and emotions throughout your day [7]. Studies have suggested that the frequency of dreams and nightmares might also depend on your individual sleep patterns during pregnancy [8]. If you find you are sleeping longer, or deeper, in your second trimester, this might contribute to more vivid dreams or dreams that you can remember the next day. Though you might find these changes startling, or even worrying, remember that dreams are your body’s way of regulating emotions and dealing with stress, fears, and anxieties. Keeping a dream diary can be a good tool to help you process your dreams, as well as a keepsake to remember what you experienced after pregnancy.

Tips in week 17

Stay hydrated, inside and out: drinking enough water daily remains very important, but you might also notice your skin is dryer than normal. Consider using body moisturizers or lotions regularly to help avoid skin irritation on account of dryness.
Start practicing relaxation and deep breathing techniques: it is never too early to start practicing relaxation and breathing techniques. Not only can these help during childbirth, but they can also come in handy throughout your pregnancy as you navigate changes to your mental and physical health.
Stick to breathable fabrics: your body is making extra fluids, including perspiration and vaginal discharge. If you notice excessive sweat under your arms or are experiencing a lot of vaginal discharge, try switching to breathable natural fabrics like cotton or linen to keep you dry and comfortable. An extra layer of deodorant and a pantyliner can also help.
Strengthening your pelvic floor: starting regular pelvic floor exercises can help you throughout your pregnancy and in childbirth. A strong pelvic floor can help prevent leaking urine when you sneeze or cough, aid pelvic and hip discomfort, and has been shown to support your body in labor and in postpartum recovery.

Natural Cycles during pregnancy

Did you know that you can use NC° Follow Pregnancy to stay up-to-date on your health and your baby’s development throughout your pregnancy? Weekly guides and reference articles help you monitor the progression of your pregnancy, while symptom trackers offer a tool for logging your pregnancy symptoms. It's all part of Natural Cycles’ mission to empower every woman with the knowledge she needs to take charge of her reproductive health. Learn how Natural Cycles can support you today!

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Korgavkar K, Wang F. Stretch marks during pregnancy: a review of topical prevention. Br J Dermatol. 2015 Mar;172(3):606-15. doi: 10.1111/bjd.13426. Epub 2015 Feb 8. Available online: https://deepblue.lib.umich.edu/handle/2027.42/110856
Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Pregnancy: Part I Weight Gain: Part II Nutrient Supplements. Washington (DC): National Academies Press (US); 1990. 5, Total Amount and Pattern of Weight Gain: Physiologic and Maternal Determinants. Available online: https://www.ncbi.nlm.nih.gov/books/NBK235227/
Weight gain during pregnancy [Internet]. Maternal Infant Health. 2024 [Cited 2025 May 6]. Available from: https://www.cdc.gov/maternal-infant-health/pregnancy-weight/index.html
Weight gain during pregnancy [Internet]. ACOG. [Cited 2025 May 6]. Available from: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/01/weight-gain-during-pregnancy
17 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 May 6]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/17-weeks-pregnant/
Itching and intrahepatic cholestasis of pregnancy [Internet]. nhs.uk. 2024 [Cited 2025 May 6]. Available from: https://www.nhs.uk/pregnancy/related-conditions/complications/itching-and-intrahepatic-cholestasis/
Pregnancy dreams [Internet]. American Pregnancy Association. 2021 [Cited 2025 May 6]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/pregnancy-dreams/
Scarpelli S, Alfonsi V, De Gennaro L, Gorgoni M. Dreaming for two: A systematic review of mental sleep activity during pregnancy [Internet]. Vol. 163, Neuroscience & Biobehavioral Reviews. Elsevier BV; 2024. p. 105763. Available from: http://dx.doi.org/10.1016/j.neubiorev.2024.105763

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You’re trying for a baby, tracking your ovulation, and had intercourse at the right time — now what? The next two weeks become a waiting period before you can take a pregnancy test. Referred to as the two week wait (or TWW), it’s an exciting, complicated, and often emotional time between trying for a baby and finding out you’re pregnant.

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Key takeaways

For those trying to conceive, the two week wait (TWW) is the time between ovulation and either a positive pregnancy test or the start of your period
This waiting period can be emotionally challenging due to the anticipation, uncertainty, and overlapping symptoms of PMS and early pregnancy
During the TWW, prioritize self-care by eating nourishing foods, managing stress, and staying active—and follow the guidelines to support a healthy potential pregnancy

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In this article, you’ll learn what to expect during the two week wait, including what symptoms you might experience. We also provide tips on what to do (and not do) during the TWW, foods to eat, and how to cope during this notoriously tricky time. Plus, we’ll cover how and when you should take a pregnancy test—and how we can help.

What is the two week wait (TWW)?

For those trying to conceive, the two week wait is a colloquial term referring to the period of time between an attempt to get pregnant and the confirmation of pregnancy. This attempt to get pregnant would consist of either timed intercourse or fertility treatments like IUI or IVF. After the two week wait, you’ll be able to determine whether or not conception has occurred, through either a positive pregnancy test result or the start of your period. (Keep reading for more information on when to take a pregnancy test).

It’s important to note that, while the term “two week wait” is widely used, this period can be shorter or longer. Depending on your cycle, the amount of time between ovulation and your period can range from 7 to 19 days. Keep in mind that this timeline refers to a “regular” period, which is defined as 24 to 38 days. For women with irregular cycles, the length of the two week wait can vary even more [1].

The TWW happens after the ovary releases an egg into the fallopian tube (known as ovulation). If the egg is fertilized by a sperm cell (known as conception) and attaches to the lining of the uterus (known as implantation), pregnancy occurs. If conception and implantation don’t occur, your uterus will shed the lining and you’ll get your period [2].

What symptoms can you expect during the two week wait?

While symptoms like breast tenderness and cramping may be a sign of early pregnancy, having these symptoms doesn’t necessarily mean you’re pregnant. This is because many early pregnancy symptoms are also symptoms of PMS—which is another complicated reality of the TWW [3].

You may or may not experience symptoms during the two week wait. If you do, you’re more likely to notice symptoms at the end of the TWW (rather than at the beginning)—and these symptoms will be mild. These symptoms are caused by hormonal changes, which won’t occur until implantation happens roughly 8-10 days after conception. Even then, hormone levels are very low.

If you are pregnant, these are the symptoms you may experience during the two week wait:

Breast tenderness: Due to an increase in progesterone, your breasts may feel extra sensitive during the two week wait. In addition to your breasts being sore, heavy, or tingly, you may notice slight changes in their appearance. Your breasts may look (or feel) larger in size, and your nipples may become darker [3,4].
Fatigue: While it’s common to experience that sluggish, low-energy feeling before your period, fatigue is also an early pregnancy symptom. You may feel tired during the two week wait due to hormone fluctuations and increased blood production during the early weeks of pregnancy [3, 5].
Light bleeding: You may experience spotting during the process of implantation, when the fertilized egg attaches to the uterine wall. This light bleeding—referred to as implantation bleeding—is not uncommon, scientific research has shown it to happen in as many as 25% of pregnancies [6].
Headaches: Again, we have hormonal shifts to thank (or blame) for headaches during the two week wait. These hormones include increased progesterone [3].
Mood changes: You may find yourself feeling extra moody during the two week wait, which can make the waiting period even more tricky. While mood swings are another common symptom of PMS, these are also seen in early pregnancy [3].
Bloating: That uncomfortable feeling in your belly is another symptom you may experience during the two week wait [3].

What should you do during the two week wait?

During the two week wait, you should prioritize self care and healthy habits, and follow the general best practices to prepare your body for pregnancy.

These are the things you should do during the two week wait:

Eat nutritious foods: It’s recommended to prioritize nutrition both before and during pregnancy. During the two week wait, reach for fresh, healthy foods like fruits and vegetables, lean proteins, and whole grains [7]. (Read on for what foods to eat during the two week wait.)
Prioritize relaxation: Whether it’s through yoga, meditation, or journaling, it’s important to find ways to relax during the two week wait. Quieting your mind and releasing any tension you’re feeling will help you unwind and support your mental health during this time.
Take your vitamins: If you haven’t already, this is a good time to add prenatal vitamins to your routine. (In fact, it’s recommended that you begin taking prenatals even before the two week wait, or when you decide to start trying for a baby.) There are tons of prenatals on the market—learn how to choose the right prenatal vitamin for you. Always talk to your doctor before starting any new supplement [7, 8].
Move your body: Regular exercise has positive effects on your mental and physical health, and it’s encouraged when you’re trying to conceive and throughout pregnancy. During the two week wait, it’s a great idea to do your favorite workout class, go on a hike, or hit the gym [7]. Just be mindful of not taking part in any overly strenuous exercise during this time, as this can put extra stress on your body. Talk to your doctor if you have questions about what movements are safe during early pregnancy and the two week wait.
Surround yourself with support: Your support system is crucial during the two week wait, as this can be an emotionally charged and vulnerable time. It can also be a particularly isolating period, since many people choose not to disclose their pregnancy this early on. To the extent that you feel comfortable, leaning on your loved ones can help. Remember, you’re not alone in this experience.
Give yourself grace: The two week wait is challenging. Whatever emotions you’re feeling, remember that they are completely normal. Do your best to validate your experience, show yourself compassion, and trust your body.

Remember, now that you’ve arrived at the two week wait, you’ve already done what’s necessary to get pregnant. There are no further steps to take. This is because there is very little you can do to influence the outcome of your pregnancy test after you’ve had timed intercourse or fertility treatments [9].

What should you not do during the two week wait?

You may be wondering if there’s anything you shouldn’t do during the two week wait. There are several things to avoid, and many of these are consistent with the guidelines you’d follow if you are pregnant. These best practices help create a safe and healthy environment for your potential pregnancy.

These are the things you should not do during the two week wait:

Stress: Do what you can to decrease your stress levels, whether it’s through mindfulness, exercise, or any of the relaxation tactics above. Stress can lead to a number of issues, including unhealthy eating, poor sleep, and headaches [10]—all of which can negatively impact your health and well-being during the two week wait.
Take a pregnancy test too early: While there is technically no harm in taking a pregnancy test early (before your missed period), we recommend waiting until your period is due. The results likely won’t be accurate—especially prior to implantation (at least one week after conception), a pregnancy test won’t be able to detect pregnancy at all. In addition to a high rate of false negatives, taking a test too early may cause unnecessary anxiety and expense.
Do something that’s not recommended during pregnancy
It’s best to avoid anything that’s considered unsafe for a developing pregnancy. These include:

Drinking alcohol: There is no amount of alcohol that is considered safe to consume while you’re pregnant [11]. Given that you may be pregnant during the two week wait, it’s best to avoid drinking (especially during the second week, when implantation has potentially occurred).
Smoking or taking illegal (or pregnancy-unsafe) drugs: If you smoke or use illegal drugs, now is the time to get help and quit. Smoking and drug use are not only linked to issues like miscarriage and low birth weight (among many more), but they are harmful to your overall health [11, 7]. A number of common medications shouldn’t be used in pregnancy, either. These include ibuprofen and stimulant decongestants. It’s best to speak with your doctor about any over-the-counter and prescription medications you’re taking.
Risking a potential infection: During the two week wait, it’s best to err on the side of caution when it comes to anything that may cause an infection. This is because foodborne illnesses and viruses can be more severe for pregnant people, and can also be harmful to a developing baby. Skip the raw eggs and undercooked meat, and wash your fruits and veggies well. To avoid getting sick, be extra mindful of germs and practice good hygiene [12].
Changing the litter box (exposure to toxic substances): It’s recommended that you avoid exposure or contact with a number of substances that can be harmful to a developing baby. These include pesticides, fertilizer, lead, mercury, and animal feces, as well as radiation (X-rays). Lastly, it’s recommended to avoid certain hair coloring and treatments, including formaldehyde-based dyes or straightening treatments [11].
Participating in a strenuous or intense activity: During the two-week wait, it’s also recommended to avoid activities that are considered pregnancy-unsafe due to the potential risks on your body and developing baby. Skip the strenuous workouts and adrenaline-pumping activities that pose an injury risk. It’s also recommended to avoid using saunas and hot tubs (or taking very hot baths).

These guidelines help promote a healthy pregnancy, but if you did something that’s not recommended—i.e. had a glass of wine or caught a cold—during the two week wait, don’t panic. Now that you’ve taken the necessary steps to get pregnant, there is very little you can do to influence the outcome of your pregnancy test. Early miscarriages do happen, but most miscarriages are not caused by actions of the mother. (Rather, most miscarriages are a result of chromosomal issues with the developing fetus [9]). For this reason, it’s best to be gentle with yourself, and focus on caring for your body and mind.

How do you cope during the two week wait?

The two-week wait can be a difficult stretch of time if you’re trying to conceive, and, as a result, emotions can be running high. You may find yourself riding waves of excitement, picturing what life could look like in just a few days. Or, you may find yourself overwhelmed and anxious, and struggling with the experience of not-yet-knowing. For many, this time period can feel like the longest two weeks of your life—and that’s perfectly normal, too.

Managing the two week wait will look different for everyone. While there is no one-size-fits-all solution, we recommend finding strategies to help you relax and move through this time as peacefully as you can. This could mean treating yourself to your favorite restaurant or beauty treatment, or getting cozy with your comfort TV show and go-to snacks. You may be the type of person who benefits from staying busy, so adding some healthy distractions to your calendar—like an exercise class, your favorite hobby, or a shopping trip—is a great idea.

It’s very possible that you find yourself needing extra support, beyond the type that your loved ones can provide. Booking a therapist appointment or attending a support group are other ways to cope during the two week wait. (Online support forums are particularly helpful during this stage, as you have the option to be anonymous.) Above all, remember that you’ve taken the necessary steps to get pregnant, and you’ll have your answers soon.

What foods should you eat during the two week wait?

You may be wondering if there’s anything you can eat during the two week wait that will affect the outcome of your positive test. Unfortunately, there is no magical fruit or elixir for that. (Again, this part of the process is largely out of your control).

That said, it’s recommended to follow the nutritional guidelines you would if you were pregnant, including avoiding the pregnancy-unsafe foods stated above, such as undercooked meat and raw eggs. In addition, there are a number of foods that help nourish your body and support your early pregnancy [11, 13]. These are the foods to eat during the two week wait:

Whole grains: Carbohydrates like wheat bread, brown rice, and oatmeal help fuel your body—and potential pregnancy—during the two week wait. Many whole grains contain fiber, which is great for digestion, as well.
Fruits and vegetables: Fruits and veggies are full of the vitamins that your body needs to support a potential pregnancy. These include vitamin A, which is found in carrots and leafy greens like kale, and vitamin C, which is found in oranges and strawberries.
Healthy fats: Healthy fats are key because they support your body’s absorption of vitamins [11], which is even more important if you’re pregnant. Nuts, seeds, avocado, and olive oil are great things to eat during the two week wait.
Lean protein, including fish: Tofu, turkey breast, and lentils are great sources of lean protein that give your body the energy it needs during the two week wait. Eating fish, such as salmon, is also advised during pregnancy. It contains Omega 3, a fatty acid that supports fetal development [14].

The best time to take a pregnancy test

Now that you’ve reached the end of the two week wait—hooray!—it’s time to take a pregnancy test. Here’s what you need to know:

This pregnancy test will detect whether or not a certain hormone is present in your urine. This hormone, often referred to as the “pregnancy hormone” is human chorionic gonadotropin, or hCG [15].
In general, the best time to take a pregnancy test is on the first day of your missed period (in other words, the day after your period was supposed to arrive). However, your healthcare provider may recommend you test earlier depending on your medical history (for example, if you have a history of ectopic pregnancy or infertility).
If you don’t know when your period will start, plan to take a pregnancy test 21 days after you had unprotected sex or you think ovulation occurred [16].

You can use the Natural Cycles app during this step of the process. Natural Cycles will notify you when it’s time to take a pregnancy test, which will ensure you’re testing at the optimal time. This can help ease your anxiety, since you don’t have to worry about counting down the days and triple-checking your calendar.

Natural Cycles can help you get pregnant faster

The Natural Cycles app can help you before, during, and after the two week wait. For those hoping to get pregnant, Natural Cycles helps you conceive faster by measuring your basal body temperature, tracking ovulation, and identifying your fertile days. In fact, research shows that couples using Natural Cycles get pregnant in three cycles on average [17].

You can also use the Natural Cycles app as birth control, during pregnancy, and postpartum. Wherever you are in your journey, find out how Natural Cycles can work for you.

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Your menstrual cycle | Office on Women’s Health [Internet]. OASH | Office on Women’s Health. Available from: https://womenshealth.gov/menstrual-cycle/your-menstrual-cycle
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Villines Z. Early pregnancy symptoms by days past ovulation (DPO) [Internet]. 2025. Available from: https://www.medicalnewstoday.com/articles/322723#7-10-dpo
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Pregnancy symptoms [Internet]. NewYork-Presbyterian. Available from: https://www.nyp.org/womens/pregnancy-and-birth/symptoms
Hasan R, Baird DD, Herring AH, Olshan AF, Funk MLJ, Hartmann KE. Patterns and predictors of vaginal bleeding in the first trimester of pregnancy. Annals of Epidemiology [Internet]. 2010 Jun 9;20(7):524–31. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2884141/
How to prepare for pregnancy [Internet]. Johns Hopkins Medicine. 2024. Available from: https://www.hopkinsmedicine.org/health/wellness-and-prevention/planning-a-pregnancy
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Causes of miscarriages [Internet]. HSE.ie. Available from: https://www2.hse.ie/conditions/miscarriage/causes/
Will stress during pregnancy affect my baby? [Internet]. http://www.nichd.nih.gov/. 2023. Available from: https://www.nichd.nih.gov/health/topics/preconceptioncare/conditioninfo/stress#f1
Do I need to change my lifestyle before I get pregnant? [Internet]. Planned Parenthood. Available from: https://www.plannedparenthood.org/learn/pregnancy/pre-pregnancy-health/should-i-change-my-lifestyle-when-i-am-planning-pregnancy
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The top 6 pregnancy questions I hear from First-Time Moms [Internet]. ACOG. Available from:https://www.acog.org/womens-health/experts-and-stories/the-latest/the-top-6-pregnancy-questions-i-hear-from-first-time-moms
Coletta JM, Bell SJ, Roman AS. Omega-3 fatty acids and pregnancy [Internet]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3046737/
Knowing if you are pregnant | Office on Women’s Health [Internet]. OASH | Office on Women’s Health. Available from: https://womenshealth.gov/pregnancy/you-get-pregnant/knowing-if-you-are-pregnant
Website N. Doing a pregnancy test [Internet]. nhs.uk. 2024. Available from: https://www.nhs.uk/pregnancy/trying-for-a-baby/doing-a-pregnancy-test
Berglund Scherwitzl, E. et al. (2019), Short- and long-term effect of contraceptive methods on fecundity, Eur J Contracep Repr)

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Your body goes through many major changes throughout pregnancy, and these changes can begin as early as within one week of conception [1]. From nausea to sore breasts to strange cravings, we’ll go through some of the most commonly reported early pregnancy symptoms in this article, along with what else may be causing these symptoms besides pregnancy, and when to see your doctor.

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Key takeaways

Early pregnancy symptoms can start as soon as a week after conception
First signs of pregnancy often include nausea, tender breasts, and a missed or light period
Everyone has their own pregnancy journey, so you may have some, none, or all of the most commonly reported early pregnancy symptoms
A positive pregnancy test result is the most accurate way to confirm if you’re pregnant

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While most people experience early pregnancy symptoms within the first eight weeks [2], each pregnancy and each person is unique. With that in mind, you may only have some or none of the most commonly reported symptoms outlined below. It’s still worthwhile to be aware of what’s happening in your body and what you may experience if you’ve just become pregnant.

How early can you spot the first signs of pregnancy?

If you’re noticing some out of the ordinary symptoms or conditions and you’re wondering, “is it even possible to know that I’m pregnant already? ” The answer is yes — early pregnancy symptoms can start as soon as the first week after conception [1]. For some individuals, it can take a few weeks or months for these symptoms to kick in, and for others, they never do.

But either way, by the end of the first week of pregnancy, the fertilized egg has attached itself to your uterine lining and become an embryo (a process called implantation). The cells around the embryo start to link with your body to provide the embryo with the nutrients it needs to grow [3].

Dr. Natalie Crawford, member of the Natural Cycles Medical Advisory Board, shared some insight about the hormonal shifts that can cause early pregnancy implantation symptoms in our bodies. “Once a pregnancy implants, your progesterone levels will increase leading to many of the early pregnancy symptoms. These symptoms can include nausea, lack of appetite, sensitivity to smell, food aversions, enlarged and/or tender breasts, bloating, and fatigue. Every person and every pregnancy is different.”

Could you experience pregnancy symptoms before missing your period?

Yes, you can start experiencing these symptoms before your missed period. Let’s recall that ovulation needs to happen in order for a successful conception to occur, so if you’re pregnant and experiencing symptoms about a week after ovulation, this would be around the time that your luteal phase of the menstrual cycle would normally happen (before your normally scheduled period).

Most common early pregnancy signs & symptoms

Now that we’ve gone through what happens inside of our bodies during early pregnancy and how that causes implantation symptoms, let’s explore the external physical symptoms you may be experiencing as a result of those hormonal shifts. Here are some of the most common early pregnancy symptoms to look out for:

Missed period or light spotting
Breast changes
Frequent urination
Tiredness
Strange cravings, tastes, and smells
Nausea with or without vomiting
Elevated basal body temperature (BBT)

Now you know what are some common symptoms of early pregnancy — let’s take a closer look at each.

Missed period or light

The most telltale sign of pregnancy is a missed or very light period, especially if you’re usually on a regular cycle. A missed period may mean that the egg cell, and uterine lining that normally would’ve been shed during your period are now supporting an early pregnancy. You may still experience spotting or a light bleed, also known as implantation bleeding, which is thought to happen as the embryo attaches to the uterine lining [4].

Breast changes

You might notice your breasts becoming larger and feeling more tender (or even more sore) than usual. They may also have a tingling sensation, and the veins may be more visible than you’re used to. Your areolas, the area around the nipples, can darken as well. Breast pain is common throughout pregnancy [4].

Frequent urination

Do you find yourself heading to the bathroom much more often? Needing to pee frequently is a common early pregnancy symptom, and it can happen all throughout the day or even at night while you sleep [4].

Tiredness

Exhaustion and tiredness are very common during the first few weeks of pregnancy. This may be due to more frequent sleep disruptions (like needing to use the bathroom), or it may be an effect of the changing hormone levels in your body after implantation [4].

Strange cravings, tastes, and smells

Another telltale symptom that is generally unique to pregnancy is new cravings, which may be accompanied by a change in your sense of taste and smell as well. You may find yourself reaching for foods or drinks you’ve never liked before, or shying away from your go-to favorites. Some people also notice a metallic taste in the mouth, and/or a heightened sense of smell [4].

Nausea

This symptom is most commonly first reported around 4-6 weeks of pregnancy, but it may pop up sooner for you. Also referred to as morning sickness (although it can happen any time of day), you may experience random bouts of nausea if you’re pregnant. It can be severe or mild, and may lead to vomiting or not. Nausea is most common during the first trimester and usually subsides as the pregnancy progresses. There is also a condition called hyperemesis gravidarum, which is a rarer but severe form of nausea and vomiting that requires medical attention [4].

Elevated basal body temperature (BBT)

If you track your BBT regularly, you may notice that it changes over the course of your menstrual cycle. It’s typically higher during the second half of your cycle before you get your period. If your period doesn’t arrive and your temperature stays elevated, this could be a sign of pregnancy. Natural Cycles is the FDA cleared app powered by this BBT data, making it simple to keep track of these patterns in your cycle [5].

Other less common signs and symptoms of pregnancy

As we’ve mentioned, you may experience some, none, or all of the most common early pregnancy signs outlined above. There are a few more symptoms that are not as commonly reported, but they still may come up for you in your early pregnancy journey during the first trimester. They include:

Backaches
Headaches
Bloating
Mood swings [1]

Furthermore, one set of guidelines mentions abdominal pain, dizziness, low blood pressure, and fast heart rate as symptoms that would warrant a pregnancy test as well if these symptoms are accompanied by a missed period [6]. If you’re experiencing any of these, contact your doctor for next steps.

Your body has many ways of communicating with you that something has changed, and while these symptoms don’t necessarily mean that you’re pregnant, being mindful of shifts and signals from your body can help you make empowered decisions about your health.

Are you really pregnant?

Sometimes, symptoms that may look or feel like early pregnancy are actually signs of a different condition. For example, nausea may be a sign of food poisoning or stress rather than shifting hormones. Tiredness or exhaustion may be due to mental health stressors, a change in diet or exercise, or even the common cold [1].

A missed or light period is usually a hormonal signal, but instead of pregnancy, it could be a side effect of losing or gaining weight, taking on a lot of stress, or switching birth control methods [1]. Many of the symptoms outlined above are side effects of going on or coming off of hormonal birth control, too.

PMS symptoms vs. pregnancy symptoms

You may have noticed that a majority of the symptoms associated with early pregnancy seem very similar to premenstrual syndrome (PMS) symptoms. In the venn diagram of PMS vs early pregnancy symptoms, the ones that overlap include:

Mood swings
Tiredness
Bloating
Tender breasts
Headache
Changes in appetite

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Considering that early pregnancy symptoms can happen right around the time of when your luteal phase typically happens, and PMS usually begins during the phase as well, it can be quite difficult to discern whether your symptoms indicate pregnancy or PMS. The clearest indicator that these symptoms are in fact pregnancy and not PMS symptoms will be if you continue to miss your period. If you are measuring basal body temperature, you may also notice that this remains high.

When to take a pregnancy test

Luckily, you can always take an at-home pregnancy test if you’re unsure about your symptoms, but there are some things to keep in mind. “Home pregnancy tests are extremely accurate with a 99% accuracy rate if taken at the correct time,” said Dr. Crawford.

“Importantly, each test manufacturer sets a different level of hCG (the pregnancy hormone human chorionic gonadotropin) to turn a test positive. Since hCG levels rise as the pregnancy is implanting, taking a pregnancy test too early can result in a negative result. This is why we recommend you take a test once you have missed your expected period,” she said.

So while a positive result on an at-home pregnancy test is highly accurate, a negative test result is less reliable. In other words, if you take a test before your missed period to see if it’s PMS or pregnancy and get a negative result, but you miss your period that month, it’s a good idea to do another test [1]. If you’re using the Natural Cycles app, it will also prompt you on the best day of your cycle to take a pregnancy test, if you’re trying to conceive.

When to see a doctor

To further confirm or deny pregnancy, you can always reach out to your healthcare provider for different forms of testing as well. You can also contact them if any of your symptoms seem to be disrupting your daily life, whether they’re due to pregnancy, PMS, or another condition.

Reach out to your provider as soon as possible if you get a positive at-home pregnancy test and you’re also experiencing severe abdominal pain and/or vaginal bleeding (more than spotting or a light bleed). These may be signs of complications, and your healthcare team can provide support [5].

Get to know your body better with Natural Cycles

Whether you’re planning a pregnancy or looking for a non-hormonal birth control option, Natural Cycles is here to support your fertility journey. The app makes it easy for you to track pregnancy symptoms, along with other important indicators such as basal body temperature tracking, and ovulation detection, Plus there’s loads to learn, with the Cycle Matters online library full of information like preparing your body for pregnancy, how long does it take to get pregnant, and what to expect week-by-week during pregnancy, NC° has something for everyone. See if you can benefit from Natural Cycles’ offerings today.

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The birth control patch and pill are two commonly used hormonal contraceptive methods that are used to prevent pregnancy. While both are similarly effective, they differ in how they’re used. Choosing the right method depends on a variety of personal, lifestyle, and health factors. Ultimately, the best option is one that fits conveniently into your routine and causes minimal negative side effects. In this article, we’ll break down how the birth control patch and pill work, highlight their similarities and differences, and help you make an informed decision on which method is right for you.

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Key takeaways

Both the birth control patch and pill are hormonal methods of contraception that are 93% effective at preventing pregnancy with typical use and 99% effective at preventing pregnancy with perfect use
While they both require regular use, they work slightly differently
Both methods have similar benefits, side effects, and risks
Ultimately, the best choice for you depends on your medical history, family planning goals, and personal preferences

","

What is the birth control patch?

The birth control patch is a contraceptive adhesive patch that releases hormones to prevent pregnancy [1]. You apply one patch to your skin each week for three consecutive weeks (21 days), then remove it for one week (7 days) before starting a new patch. You can apply the patch to your upper back, upper arm, abdomen, buttocks, or chest (but not your breasts) [1].

The patch releases estrogen and progestin (a synthetic form of progesterone), which are absorbed through the skin. Together, they prevent pregnancy by suppressing ovulation to stop the ovaries from releasing an egg [3]. Additionally, estrogen helps regulate bleeding patterns [4], while progestin is responsible for:

Thickening cervical mucus to prevent fertilization [3]
Thinning the uterine lining to prevent implantation [5]

How effective is the birth control patch?

Now you know what the patch is, you may be wondering how well it works. The birth control patch is over 99% effective at preventing pregnancy with perfect use [6]. This means following all instructions correctly and sticking to a consistent schedule—you're applying a new patch on the same day of the week for three weeks and then removing it on the fourth week as scheduled.

Here's an example schedule:

Week 1: Apply the birth control patch on Friday morning.

Week 2: Apply the birth control patch on Friday morning.

Week 3: Apply the birth control patch on Friday morning.

Week 4: Remove the birth control patch on Friday morning. You do not wear the patch for the entire week.

Missing or delaying a patch can increase your chances of getting pregnant. With typical use (which reflects how a method is used in the real world), the patch is 93% effective at preventing pregnancy [6]. Meaning out of 100 women using this method over a year, 7 will get pregnant while using the patch.

Benefits of the birth control patch

The birth control patch offers several advantages that might make it a great choice for you. Here are some key benefits:

You only need to apply the patch once a week
It doesn't interfere with sex
It can make your periods lighter, shorter, and more regular
It may reduce menstrual cramps, menstrual migraine frequency, unwanted hair growth, and improve acne
It can reduce the risk of uterine, ovarian, and colon cancers [1]

Does the birth control patch cause weight gain?

The relationship between the birth control patch and weight gain is unclear. Research has found no evidence linking the patch to weight gain [7, 8]. If you do notice weight gain while using the patch, it's a good idea to consult your healthcare provider for further guidance and support.

What are birth control pills?

Birth control pills are oral contraceptives that contain hormones to prevent pregnancy [2]. They should be taken every day at the same time. There are two main types: combined oral contraceptives (COCs), which contain both estrogen and progestin, and progestin-only pills (POPs), which contain only progestin.

Combined oral contraceptive birth control pills

COCs, commonly known as \"the pill,\" are taken once a day at the same time. There are various formulations and hormone doses, and your healthcare provider will help determine the one that best suits your individual needs.

Progestin-only birth control pills

Your healthcare provider may recommend POPs, also known as the \"minipill,\" if COCs aren't suitable based on your medical history. POPs are a safe contraceptive option right after childbirth or if you're breastfeeding, since estrogen can decrease milk production at the beginning [9]. Like COCs, POPs are taken once daily, but it's especially important to take them at the same time every day to ensure maximum effectiveness.

How effective are birth control pills?

Both COCs and POPs are highly effective at preventing pregnancy: 93% effective with typical use and 99% effective with perfect use [6]. Perfect use means taking the pill every day at the same time. If you miss a dose or don't take your birth control regularly, it might not work as well. This can increase your risk of getting pregnant, especially if you're taking POPs. If you miss a POP dose by more than three hours, take it as soon as you remember, and use a backup method of birth control or avoid having vaginal sex for 48 hours [5].

Benefits of birth control pills

Birth control pills offer several advantages and may be the right contraceptive option for you. For example, some benefits of COCs include:

It can make your periods lighter, shorter, and more regular
It can reduce the risk of uterine, ovarian, and colon cancers
It may reduce menstrual cramps, menstrual migraine frequency, unwanted hair growth, and improve acne
It can help with certain disorders that cause heavy menstrual bleeding and pain, such as endometriosis [11]

Do birth control pills cause weight gain?

Similar to the birth control patch, there is no clear evidence regarding weight gain and birth control pills [7, 8]. Some women report weight gain when they start birth control pills, but most of it is based on personal experience rather than scientific findings. That said, you know your body best. If you experience weight gain while using birth control pills, it's important to talk to your healthcare provider for personalized advice and support.

Birth control patch vs. pill: what are the side effects?

Both the birth control patch and pill are considered safe and effective contraceptive methods, but they may cause side effects, especially when you first start using them. It's totally normal to experience mild symptoms during the initial adjustment period. In many cases, these symptoms get better over time and as you keep using them [2]. However, if you don’t notice any improvement after three months, contact your healthcare provider for support. They can help you explore alternative brands, adjust the dose, or prescribe a different method that may be a better fit.

Side effects of the patch

Side effects can vary from person to person, and some may experience only mild symptoms. Common side effects of the birth control patch include [12]:

Skin irritation at the patch site
Upset stomach
Mood swings
Sore or tender breasts
Headache
Weight gain
High blood pressure
Breakthrough bleeding

Side effects of the pill

Side effects can vary depending on whether you're taking a combined pill (with both estrogen and progestin) or a progestin-only pill [12].

Side effects of COCs

Headache
Abdominal cramps or pain
Sore and tender breasts
Mood swings
High blood pressure
Breakthrough bleeding
Increased vaginal discharge
Decreased libido

Side effects of POPs

Unscheduled, irregular bleeding or spotting
Sore and tender breasts
Headache
Nausea

Birth control patch vs. pill: What are the potential complications?

While the birth control patch and pill are generally considered safe, there are some potential risks and complications to be aware of. For example, if you smoke and are over the age of 35, you have a higher risk of serious complications with COC or the patch [11]. Although these risks are relatively rare, it's important to stay informed when selecting a contraceptive. Be sure to discuss your medical history with your healthcare provider, so you can choose a method that's safe for you.

Risks of COCs

Deep vein thrombosis (DVT)
Heart attack
Stroke
Breast cancer
Cervical cancer [11]

Risks of POPs

Ovarian cysts [13]

Risks of the birth control patch

Deep vein thrombosis (DVT)
Stroke
Heart attack [10]

Birth control patch vs. pill: What's the best contraceptive for you?

Before starting any type of contraceptive, it's important to discuss your options with your healthcare provider. They can help you choose the best method based on your medical history and family planning goals. To help you decide whether the birth control patch or the pill is right for you, consider the following factors [12]:

If and when you want to get pregnant
Potential side effects
How often you have sex
Medical history
Your daily schedule and routine
Convenience
Ease of use
Whether you are breastfeeding
Your age
Lifestyle habits, such as smoking

Ultimately, choosing between the birth control patch and the pill is a personal decision. It depends on what fits best with your lifestyle, health and medical needs, as well as your plans for pregnancy. Both methods are highly effective when used correctly, but factors like side effects, ease of use, and personal preference will influence your decision.

Contraceptive alternatives to consider

If the birth control patch or pill doesn't seem like the right fit for you, there are several other options worth exploring.

Non-hormonal birth control

If you prefer a hormone-free method, consider a natural family planning method, such as tracking your ovulation using basal body temperature. The Natural Cycles app is a temperature-based app that pairs with a wearable device or Bluetooth thermometer. The app will analyze your unique cycle data to identify your fertile window, so you know which days to use protection to prevent pregnancy.. With perfect use, Natural Cycles is 93% effective with typical use and 98% effective with perfect use.

Birth control implant

The birth control implant is a small, thin plastic rod that is inserted under the skin of your upper arm by a healthcare provider. It continuously releases progestin to prevent pregnancy and can last for three to four years. The implant is over 99% effective at preventing pregnancy for both typical and perfect use [6].

Vaginal ring

The vaginal ring is a thin, flexible ring that you insert into the vagina. It continuously releases hormones for three weeks, and you remove it during the fourth week. After the break week, you insert a new ring. The vaginal ring releases both estrogen and progestin to prevent pregnancy. When used correctly all the time, it is 93% effect with typical use and 99% effective at preventing pregnancy [6].

Intrauterine device (IUD)

An intrauterine device (IUD) is a small, T-shaped device that your healthcare provider inserts into your uterus. There are two types: hormonal IUDs and copper IUDs. The hormonal IUD releases progestin and can stay inside your uterus for 3 to 8 years (depending on the brand). The copper IUD releases copper into the uterus, which interferes with the sperm's ability to move. It's approved for up to 10 years of use. Both types of IUDs are 99% effective at preventing pregnancy [6].

Condom

A condom is a thin sheath made of latex or polyurethane that covers the penis during sex to collect sperm and prevent it from entering the woman's body. To effectively prevent pregnancy, your partner must wear the condom every time you have sex. Condoms are widely available at drug stores, pharmacies, and grocery stores. With perfect use, condoms are 87% effective with typical use and 98% effective at preventing pregnancy [6].

Say goodbye to side effects with Natural Cycles

We hope you’ve learned more about the birth control patch vs pill. If you’re thinking about switching birth control methods, but want to avoid negative hormonal side effects, why not consider Natural Cycles? The first FDA Cleared birth control. Natural Cycles works with your body to find your fertile days so you can plan or prevent pregnancy naturally. Find out if it could work for you today!

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Know your options with Natural Cycles.",{"_1813":5329,"_1707":-5,"_1815":1820},{"_1818":1830,"_1707":5327},{"_1813":5331,"_1707":-5,"_1815":1820},{"_39":1833,"_1707":5327},{"_1813":5333,"_1707":-5,"_1815":1820},{"_1818":1836,"_1707":5334},"https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg?auto=format&fit=max&w=1200",{"_1813":5336,"_1707":-5,"_1815":1820},{"_1818":1840,"_1707":1841},{"_1813":5338,"_1707":-5,"_1815":1820},{"_1818":1844,"_1707":1845},{"_1813":5340,"_1707":-5,"_1815":1820},{"_1818":1848,"_1707":5341},"Illistration of a person wearing the birth control patch with a packet of birth control pills floating to the side",{"_1813":5343,"_1707":-5,"_1815":1820},{"_39":1852,"_1707":5334},{"_1813":5345,"_1707":-5,"_1815":1820},{"_39":1855,"_1707":5341},{"_1813":5347,"_1707":-5,"_1815":1820},{"_1818":1858,"_1707":44},{"_1813":5349,"_1707":-5,"_1815":1820},{"_1818":1861,"_1707":1862},{"_1813":5351,"_1707":-5,"_1815":1820},{"_1818":1865,"_1707":222},{"_1813":5353,"_1707":-5,"_1815":1820},{"_1818":1868,"_1707":5354},"2025-05-02T15:42:15Z",{"_1813":5356,"_1707":-5,"_1815":1820},{"_1818":1872,"_1707":1873},{"_1813":5358,"_1707":-5,"_1815":1820},{"_39":1876,"_1707":1588},{"_1813":5360,"_1707":-5,"_1815":1820},{"_39":1879,"_1707":1584},{"_1826":5327,"_1697":1698,"_438":5320,"_1587":1588},{"_345":5341,"_41":5363,"_422":5364},"https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg",{"_424":5365,"_426":5366,"_428":1887,"_430":5367,"_432":1889,"_434":1890,"_436":437,"_345":5341,"_438":-5},"https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg?dpr=0.25&w=900 225w,https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg?dpr=0.5&w=900 450w,https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg?dpr=0.75&w=900 675w,https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg?w=900 900w","https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg?dpr=0.25&fm=webp&w=900 225w,https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg?dpr=0.5&fm=webp&w=900 450w,https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg?dpr=0.75&fm=webp&w=900 675w,https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg?fm=webp&w=900 900w","https://www.datocms-assets.com/21281/1746199317-bc-pills-to-patch_illustration_0425.jpg?w=900",{"_39":5369,"_1896":5370,"_1898":5371},"Dahlia Rimmon","Dahlia Rimmon is a writer and a registered dietitian. She writes for various publications and health brands, covering everything from food and supplements to women's health and wellness. When she’s not working, you’ll find her hiking, trying new foods, or playing endless rounds of Candyland with her kids. 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Birth Control Method: Patch [Internet]. Acog.org. 2021. Available from: https://www.acog.org/store/products/patient-education/fast-facts/patch
Planned Parenthood. Birth Control Pill [Internet]. [cited 2025 May 2]. https://www.plannedparenthood.org/learn/birth-control/birth-control-pill
NIH. Eunice Kennedy Shriver National Institute of Child Health and Human Development - NICHD [Internet]. www.nichd.nih.gov. Available from: https://www.nichd.nih.gov/health/topics/factsheets/contraception
Archer DF, Mansour D, Foidart JM. Bleeding Patterns of Oral Contraceptives with a Cyclic Dosing Regimen: An Overview. J Clin Med. 2022 Aug 8;11(15):4634. doi: 10.3390/jcm11154634. PMID: 35956249; PMCID: PMC9369460.
American College of Obstetricians and Gynecologists. Progestin-Only Hormonal Birth Control: Pill and Injection [Internet]. 2020. Available from: https://www.acog.org/womens-health/faqs/progestin-only-hormonal-birth-control-pill-and-injection
Contraceptive Technology. (2018). 21st Edition. (Table 26 - 1). https://www.datocms-assets.com/21281/1662539230-contraceptive-technologies_failure-rates-table-2018.pdf
Does the pill make you gain weight? (2023, August 10). Planned Parenthood. https://www.plannedparenthood.org/blog/does-the-pill-make-you-gain-weight
Gallo MF, Grimes DA, Schulz KF, Helmerhorst FM. Combination estrogen-progestin contraceptives and body weight: systematic review of randomized controlled trials. Obstet Gynecol. 2004 Feb;103(2):359-73. doi: 10.1097/01.AOG.0000107298.29343.6a. PMID: 14754709.
American College of Obstetricians and Gynecologists. Postpartum Birth Control [Internet]. 2023. Available from: https://www.acog.org/womens-health/faqs/postpartum-birth-control
The American College of Obstetricians and Gynecologists . Combined Hormonal Birth Control: Pill, Patch, and Ring [Internet]. 2018. Available from: https://www.acog.org/womens-health/faqs/combined-hormonal-birth-control-pill-patch-ring
The National Health Service. Combined pill [Internet]. 2024. Available from: https://www.nhs.uk/contraception/methods-of-contraception/combined-pill/
U.S. Department of Health and Human Services. Birth control methods [Internet]. OASH Office on Women’s Health. 2018. Available from: https://womenshealth.gov/a-z-topics/birth-control-methods
The National Health Service. Side effects and risks of the progestogen-only pill [Internet]. 22 February 2024. Available from: https://www.nhs.uk/contraception/methods-of-contraception/progestogen-only-pill/side-effects-and-risks/

",{"_298":5385,"_438":5386,"_1695":5387,"_1697":1698,"_1699":5388,"_1701":5389,"_1703":5390,"_1705":5391,"_1707":5392,"_1709":-5,"_1710":5393,"_408":5426,"_410":5427,"_1810":5428,"_1880":5471,"_342":5472,"_1891":1892,"_1893":5478,"_1908":1909,"_1910":5481,"_1923":2845,"_1925":5484,"_1929":5485},"SpPudvwXSxqbmM86n0C2pw","16 Weeks pregnant: Baby development, symptoms and signs","16-weeks-pregnant","2025-04-29","2025-04-29T15:30:03+01:00","

At week 16 you are soon approaching the half-way point of your pregnancy! In this week’s guide, we will talk about changes in your body and some pregnancy symptoms you might experience in week 16. We will also check in on how your baby is doing and offer some tips for things you can do to take care of your mind and body.

","

Key takeaways:

Hormonal and physiological changes are linked to skin changes like acne during pregnancy, which might become more noticeable around week 16
When sitting or relaxing try, to see if you can feel quickening, another name for your baby’s first movements
Pain and discomfort in your back, pelvis, and hips are unfortunately common in the second trimester, and familiarizing yourself with the different types can help you find treatments and relief

","

Your body at week 16

Changes to your nipples and areolas

In the second trimester, you can expect to experience changes to your nipples and the surrounding skin, which is known as the areola. First, the color of your nipples and areola can get darker. The cause is melasma, which we talked about last week in the 15 Weeks pregnant guide. Hyperpigmentation, which is a darkening of skin tone caused by an increase in melatonin, is the most common skin change during pregnancy and typically comes in the second trimester. Areas of the body that are already darker, like the nipple areola, are more commonly affected by hyperpigmentation [1].

You also might see small bumps develop on your areolas, which are known as Montgomery tubercles. These small papules, or raised spots, are oil producing glands that provide lubrication to the nipples and areolas during breastfeeding.

Finally, your areolas might get larger and your nipples can become more erect. All of these physical changes occur because of hormonal and metabolic changes that support the development of your baby and the breast milk-producing mechanisms in your body [1]. Most changes resolve during your postpartum recovery. If you are concerned about any changes you observe, contact your healthcare provider.

Acne in week 16

Acne is a skin condition where dead skin and the skin’s naturally produced oils clog hair follicles, resulting in different kinds of bumps and inflammation on the face and upper trunk. Studies have shown that acne affects up to 43% of women during pregnancy and lactation [2]. While the causes of pregnancy-related acne are understudied and complex, scientists believe that hormonal and physiological changes are the culprits. Acne tends to be most severe in the second and third trimesters [2].

If you would like to treat your acne during pregnancy with topical, medical, or therapeutic treatments, it is important to investigate what methods are considered safe during pregnancy. There are certain ingredients that healthcare providers advise avoiding during pregnancy, so speak with your care team about what treatments and products might be best for you. If you seek treatment from an esthetician or dermatologist, be sure to let them know you are pregnant.

Your baby’s development at 16 weeks

This week your baby is hard at work growing and developing their urinary and circulatory systems[3]. Fine hair, called lanugo, is continuing to develop on your baby’s head and your baby is constantly moving and stretching.

When sitting or resting, you might even be able to feel some of these movements, which are called quickening. They probably won’t feel like kicks and can even be hard to distinguish from gas or other digestive functions. If you don’t feel anything, or if you think you feel something and then don’t feel it again for a while, even days, it’s completely normal. While quickening can usually be felt between weeks 13 and 16, if it’s your first pregnancy, it’s also normal not to feel anything until weeks 18-20 [4].

At week 16, your baby is around the size of an avocado, weighing between 2.5 and 3.5 ounces (70-100g) and measuring around 4.5 to 5.3 inches long (11.6 to 13.5 centimeters) [3].

$\"Infographic$

Pregnancy Symptoms in week 16

Indigestion

Indigestion, or an upset stomach, can continue in week 16 even after morning sickness has subsided. Symptoms of indigestion include upper abdominal discomfort, heartburn, bloating, and nausea. While first trimester morning sickness is usually attributed to the rapid changes in estrogen levels in first twelve weeks of pregnancy, indigestion in the second and third trimesters is linked to a combination of pregnancy hormones slowing digestion, the sphincter muscle of the esophagus relaxing, and pressure from your growing uterus on your digestive tract [5].

If you are suffering from indigestion, there are steps you can take to ease your symptoms. Try to avoid or minimise spicy, greasy, or fatty foods, as these are known to worsen heartburn especially for women who are pregnant. You can try to eat smaller meals, more frequently to ease the burden on your slower moving digestive tract. Finally, try to stick to a healthy, balanced diet that is rich in fiber – think whole grains, fruits, vegetables, and beans. For more tips on healthy eating during pregnancy, check out our guide on what to eat when pregnant.

Pain in your pelvis, back, and hips

There are lots of different aches and pains you might start to feel in your pelvis, back, and hips in the second trimester. Your growing baby, and growing uterus, are putting a lot of pressure on your pelvis and hips. There are a couple of distinct kinds of pain that have slightly different causes, including:

Pelvic girdle pain (PGP) refers to pain in the front or back of your pelvis that can also radiate into your hips and thighs [6]. PGP is caused by the joints of your pelvis moving unevenly resulting in instability and pain when, for example, you walk on uneven surfaces, move your knees apart, or have to stand on one leg.
Round ligament pain is caused by strain and stretching of the round ligaments, which run from the front of the uterus on both sides to the lower abdomen. Round ligament pain is a sharp, stabbing, or aching sensation on one or both sides of the lower abdomen. Sudden movements like coughing, laughing, and sneezing can trigger round ligament pain.
Back pain – general soreness or pain in the lower back is common during the second trimester, caused by the softening and stretching of your back muscles and pelvic joints and the strain of carrying your growing baby. It can be worse when standing or sitting for long periods of time.
Sciatic nerve pain, or sciatica, can afflict some women during pregnancy. There are two sciatic nerves that run from your lower back down each leg. If your uterus puts pressure on one of these nerves, it can result in numbness, pain, or tingling in your butt, hip or thighs [7].

If you are suffering from any hip, back, or pelvic pain, try to rest as much as possible. To relieve discomfort and avoid aggravating any existing joint or muscle problems, avoid lifting heavy objects, and when lifting and carrying anything, bend your knees, lift with a flat back, and balance the weight as equally as possible. Supportive shoes, chairs, and even a mattress can also ensure that existing issues do not get worse. Finally, try to maintain good posture whenever sitting and standing, and consider some light exercise to help stretch and strengthen your pelvic floor, back, and hips. For more information, visit our guide on tips for exercise during pregnancy.

If pain gets worse, or you are unable to sleep or function in your day-to-day activities, talk to your healthcare provider to see what other treatment options might be right for you.

Tips in week 16

Consider weight training: light weight or resistance training (if considered safe during your pregnancy) can help strengthen large muscle groups and treat pains in your back, hips, and pelvis. Weight training, or resistance training, not only helps support you during pregnancy, but also during childbirth and postpartum.
Prenatal massage: for most women with low-risk pregnancies, massages are considered safe while pregnant. In fact, many certified massage therapists offer prenatal massages that focus on problems in the pelvis and lower back. Massages can relieve muscle tension, reduce swelling, and help relieve stress and anxiety.
Focus on posture when sitting and standing: if you are experiencing any back, hip or pelvic discomfort, keep an eye on your posture. This is especially true if you’re spending a lot of time sitting or in front of a computer at work. If you suspect your seating could be the culprit, try finding a more ergonomic chair or a support pillow to sit on or to place on your lower back.
Update your bras: if you are finding your old bras are no longer comfortable because of changes to your breasts, consider investing in a couple of maternity or nursing bras. Soft and stretchy fabrics can provide comfort and stability for changes in breast size, skin texture, and shape.
Take notes: if brain fog (or “pregnancy brain”) is making it difficult at work and at home to stay on top of tasks, consider making a list or note taking to help you remember everything from shopping lists to meeting minutes.

Following your pregnancy with Natural Cycles

Natural Cycles is the first and only FDA Cleared birth control app. In addition to being a non-hormonal, non-invasive birth control, Natural Cycles aims to support women through all phases of their reproductive and fertility health. That’s where NC° Follow Pregnancy comes in. After conceiving, Follow Pregnancy provides weekly guides that keep you informed on the physical and mental changes going on in your body and up-to-date with your baby’s development. You can also use the app to log and track all your pregnancy symptoms. If you enjoyed this article, why not see if Natural Cycles is right for you?

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Pregnancy and heartburn [Internet]. Stanford Medicine Children’s Health. [Cited 2025 Apr 28]. Available from: https://www.stanfordchildrens.org/en/topic/default?id=pregnancy-and-heartburn-134-10
Pelvic girdle pain and pregnancy | RCOG [Internet]. RCOG. [Cited 2025 Apr 28]. Available from: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-girdle-pain-and-pregnancy/
Hip pain during pregnancy [Internet]. American Pregnancy Association. 2024 [Cited 2025 Apr 28]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/hip-pain-during-pregnancy/

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Masturbation, especially female masturbation, is still a stigmatized topic that we definitely don't talk enough about. That includes the health benefits of masturbation, how often women masturbate, and the best ways to enhance pleasure when masturbating. We'll dive into everything you were curious to know about female masturbation, how often women masturbate, how they like to masturbate, the health benefits of masturbation, and much more. Let's dive in!

","

Key takeaways

Female masturbation is more common than you may think – 79% of women below the age of 60 report having masturbated in their lifetime [1]
Data from 2021 shows that around 37% of women had masturbated in the last month [2]
While women are masturbating, they're doing it less often than men – 60% of men have masturbated in the last month compared to 37% of women [2]

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Female masturbation: How often do women masturbate?

Despite the fact that masturbation is still not talked about enough, there are a number of studies that looked into female masturbation frequency to figure out just how often women masturbate. The findings vary depending on the year of the studies and the countries where researchers surveyed women.

Findings from a 2009 National Survey of Sexual Health Behavior (NSSHB) suggest that female masturbation is fairly common. Researchers surveyed 5,865 people (2,929 of the participants were women) and found that 66% to 85% (depending on age) of women below the age 60 report having masturbated in their lifetime, 60% to 72% reported masturbation during the past year, and 26% to 52% reported masturbation during the past month [1].

A more recent large-scale survey that studied data from 1,958 women and 1,784 men in the United States found that 37% of women reported having masturbated in the last month. Only 9% of women reported having masturbated at least once a week in the past year [2].

How often should women masturbate?

Our sexuality and self-pleasure habits are very individual, and there are no two people alike. Because masturbation is still not talked about enough, it's natural to feel confused about the “normal” masturbation frequency. According to ISSM (International Society for Sexual Medicine), there's no \"normal\" for how often one may masturbate [3].

Some people may choose to masturbate once a month, twice a week, or once per day. Some may choose to never engage in self-pleasure. No matter where in the frequency spectrum you fall, it's okay. You know what's normal for you and what feels good.

Why does the frequency vary?

Pinpointing the exact reasons why some of us masturbate more often than others is hard because sexuality is so individual. That same recent large-scale survey found that there are many different reasons why people choose not to masturbate, such as it's against their religion, they don't feel comfortable in their bodies, they felt that they were cheating or their partner or their partner didn't like it [2] (just to name a few).

Researchers also found that certain groups of people were more likely to masturbate than others. Being younger, being male, being non-heterosexual, having a higher education, or having a higher annual household income each increased chances of having masturbated more recently and more frequently in the past year [2].

What's interesting is that the researchers in the 2021 study also observed that among women, those who had partnered sex more often also masturbated more often in the prior year [2]. Additionally, women who had a desire for more frequent partnered sex reported a higher frequency of masturbation, which could mean that they simply have a high libido and engage in self-pleasure because the current partnered sex frequency is not satisfying their high libido.

How to know if you’re masturbating too much

While normal masturbation frequency will be different for everyone, there are some universal signs that may indicate that self-pleasure has become an issue.

If you notice that masturbation is taking up most of your time, and in exchange, your work and personal relationships are suffering, it could be a sign that you're overdoing it. If you choose self-pleasure over participating in other activities, such as going for dinner with friends or a partner, it could also be a sign of an issue, and it may be a good idea to seek out a therapist to talk to.

What is the masturbation gap?

The masturbation gap refers to the difference between how often women masturbate compared to how often men masturbate.

It turns out, more men than women masturbate – approximately 60% of men reported having masturbated in the last month (compared to 37% of women) in 2021. Masturbation frequency was also apparent between the sexes – 36% of men reported having masturbated at least once per week in the last year (compared to only 9% of women) [2].

How do women masturbate?

A study that surveyed over 2000 women on their masturbation habits and reasons looked into the most popular ways women typically like to self-pleasure among a list of 11 activities:

97% of participants engaged in clitoral stimulation
45% engaged in vaginal stimulation
45% used audiovisual materials (such as porn) or mirrors
39% used sexual fantasies that include their partners

Other activities included things like anal stimulation, masturbation on the back or on the stomach, fantasies that do not include their partners, breast stimulation, and more [4].

What is mutual masturbation?

Mutual masturbation is a sexual sexual activity when you self-pleasure in the presence of your partner. There are no rules here – you can watch your partner masturbate, have them watch you, or both do it at the same time. You may choose to only stimulate yourself or give each other a hand.

A study involving around 300 adults observed that mutual masturbation can be a popular practice in relationships – 49% of men and 54% of women in that study masturbated with their partners. This study found that couples who engage in mutual masturbation sessions on a weekly basis reported higher sexual satisfaction and self-esteem [5].

Is masturbation harmful to your sex life?

Contrary to popular belief, masturbation doesn't cause harm to your sex life. Self-pleasure is not the enemy or a competition to your partnered sex life – it's a healthy and pleasurable addition to your overall erotic repertoire.

Some research shows that women who masturbated during adolescence report less arousal difficulties and higher orgasm frequency during partnered sex compared to those who didn’t. They also tend to take more initiative in sexual activities and have a broader list of sexual activities they engage in [4].

Health benefits of masturbation

Masturbation can be very pleasurable, but that's not all! Not only does it feel good, but it also has numerous health benefits. That includes physical and mental health benefits, such as:

Better sleep: Research shows that orgasms, whether achieved with a partner or through self-pleasure, before bedtime may improve perceived sleep quality and sleep onset [6].
Relieves stress: Many studies on female masturbation observe that stress relief is often cited as a motivation to engage in self-pleasure, particularly clitoral stimulation [7, 4, 8].
Better orgasms: Masturbation helps us to understand our sexuality better and get to know our bodies. Some research shows that women who masturbated during adolescence report less arousal difficulty and higher orgasm frequency during partnered sex compared to women who didn’t masturbate as adolescents [8] – the better we know our bodies and what brings us pleasure, the more enjoyable sex can be.
Promotes sexual function: A review of different studies found that using vibrators can have a positive impact on men and women who experience sexual dysfunction, such as erectile dysfunction or anorgasmia (when a person has difficulty achieving orgasm) [9].

Tips on how to masturbate

Whether you're just getting started with female masturbation or you already have an established masturbation routine and simply want to find ways to enhance pleasure and infuse some novelty into your routine, we have a number of useful tips:

Use plenty of lube: Personal lubricant was invented for a reason, and it's something that everyone can benefit from, not only those who have sexual dysfunction. Lube removes friction and enhances all the sensations, which makes masturbation much more pleasurable. So, consider using it during your self-pleasure sessions to make them even more fun. There are plenty of great lubes on the market, but water-based lubes tend to work best because they're safe to use with condoms and sex toys, are easy to clean, and they also won't stain your clothes or bed sheets.
Address negative thoughts: Masturbation is a natural part of human sexuality – it's nothing to be ashamed of. However, if you find yourself in a negative thought loop when you engage in self-pleasure, don't ignore it. You may want to address those negative thoughts and try to reframe them in a positive light. Try to reframe masturbation as a self-care practice, something you do to appreciate your body, understand your pleasure, and reap the health benefits (which there are plenty of!).
Introduce sex toys: Sex toys can be a great way to add extra stimulation and different forms of sensations to your masturbation routine. Consider what form of stimulation (clitoral, anal, G-spot) you enjoy the most and buy a toy designed to enhance it. Adding a vibrator to the mix allows you to explore blended stimulation (ex: G-spot and clitoral stimulation at once or anal and clitoral stimulation) easier, which can bring stronger orgasms for some.
Invite your partner: Masturbation doesn't have to be a solo adventure – mutual masturbation can be fun and exciting. It's a perfect practice to add to your erotic routine to rediscover what feels good. Consider asking your partner to watch while you pleasure yourself, watch them pleasure themselves in front of you, or engage in self-pleasure together.
Switch up the positions: It's normal to fall into a routine when we find something that works well. However, from time to time, you may want to switch up the position in which you masturbate, which allows you to experience sensations in a different way. Even small shifts like elevating your hips with a pillow or propping your legs on the wall can make a difference.

Is masturbation safe?

Masturbation is one of the safest sexual activities we can engage in [10]. If you're masturbating solo, the risks of contracting STIs are extremely low (if non-existent), and so is the risk of pregnancy. Even if you do masturbate with a partner, the risk of STIs and pregnancy is low if you're careful, more on that below.

When masturbating solo using sex toys, consider keeping these things in mind:

Always wash your sex toys before and after each use to ensure no harmful bacteria are present on the toys
Use personal lubricant to prevent discomfort and pain
Avoid using the same-sex toy anally and vaginally in the same session to prevent the bacteria spread, which can disturb the vaginal microflora (use a condom or wash the toy in-between) [11]

When masturbating with a partner, there are also some things you want to consider to make the experience as safe as possible:

If sharing sex toys, make sure you clean them in between uses, or use different condoms over the sex toy
If using a sex toy anally and then vaginally in the same session, use different condoms or clean the toy as you switch
If you're masturbating with a male partner, avoid getting precum or semen on the sex toys or anywhere close to the vulva to avoid unwanted pregnancy

Know your body better with Natural Cycles

At Natural Cycles, we’re passionate about busting myths and misconceptions around reproductive health and giving you the right tools to feel empowered. Our app is packed with facts about female health. It has tailor-made content to help you learn about your unique menstrual cycle and sex drive while achieving your fertility goals, whether that’s planning or preventing pregnancy.

Natural Cycles is 100% hormone-free, non-invasive, and FDA Cleared for use as birth control in the US and CE marked in Europe. We’ve helped millions of women worldwide plan or prevent pregnancy. Why not find out if the world’s first birth control app is a good fit for you?

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Herbenick, D., Reece, M., Schick, V., Sanders, S. A., Dodge, B., & Fortenberry, J. D. (2010). Sexual Behavior in the United States: Results from a National Probability Sample of Men and Women Ages 14–94. The Journal of Sexual Medicine, 7(Supplement_5), 255–265. https://doi.org/10.1111/j.1743-6109.2010.02012.x
Herbenick, D., Fu, T., Wasata, R., & Coleman, E. (2022). Masturbation Prevalence, Frequency, Reasons, and Associations with Partnered Sex in the Midst of the COVID-19 Pandemic: Findings from a U.S. Nationally Representative Survey. Archives of Sexual Behavior, 52(3), 1317–1331. https://doi.org/10.1007/s10508-022-02505-2
Baxter, R. (2015, December 7). What is the “normal” frequency of masturbation? ISSM. https://www.issm.info/sexual-health-qa/what-is-the-normal-frequency-of-masturbation
Rowland, D. L., Kolba, T. N., McNabney, S. M., Uribe, D., & Hevesi, K. (2020). Why and How Women Masturbate, and the Relationship to Orgasmic Response. Journal of Sex & Marital Therapy, 46(4), 361–376. https://doi.org/10.1080/0092623x.2020.1717700
Kılıç, D., Armstrong, H. L., & Graham, C. A. (2023). The Role of Mutual Masturbation within Relationships: Associations with Sexual Satisfaction and Sexual Self-Esteem. International Journal of Sexual Health, 35(4), 495–514. https://doi.org/10.1080/19317611.2023.2237950
Lastella, M., O’Mullan, C., Paterson, J. L., & Reynolds, A. C. (2019). Sex and Sleep: Perceptions of Sex as a Sleep Promoting Behavior in the General Adult Population. Frontiers in Public Health, 7. https://doi.org/10.3389/fpubh.2019.00033
Wehrli, F. S. V., Bodenmann, G. J., Clemen, J., & Weitkamp, K. (2024). Exploring the role of masturbation as a coping strategy in women. International Journal of Sexual Health, 36(3), 237–256. https://doi.org/10.1080/19317611.2024.2344812
Carvalheira, A., & Leal, I. (2013). Masturbation among women: associated factors and sexual response in a Portuguese community sample. Journal of Sex & Marital Therapy, 39(4), 347–367. https://doi.org/10.1080/0092623x.2011.628440
Rullo, J. E., Lorenz, T., Ziegelmann, M. J., Meihofer, L., Herbenick, D., & Faubion, S. S. (2018). Genital vibration for sexual function and enhancement: a review of evidence. Sexual & Relationship Therapy, 33(3), 263–274. https://doi.org/10.1080/14681994.2017.1419557
Is masturbation healthy? (n.d.). Planned Parenthood. https://www.plannedparenthood.org/learn/sex-pleasure-and-sexual-dysfunction/masturbation/masturbation-healthy
Masturbation | Facts about Male & female masturbation. (n.d.). Planned Parenthood. https://www.plannedparenthood.org/learn/sex-pleasure-and-sexual-dysfunction/masturbation

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If you’re currently using the Depo-Provera birth control shot and thinking about planning a pregnancy, you may be wondering how to transition off of it and when you can start trying to conceive.

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Key takeaways

Most people get pregnant about 10 months after stopping the Depo-Provera birth control shot, but it can take up to 18 months to conceive
If you notice symptoms like nausea, fatigue, or tender breasts together with a missed period, these might be signs of early pregnancy
Using hormonal birth control like the shot does not affect your ability to conceive once ovulation and cycles normalize, although this process can take a while

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While everyone’s journey is different, most people are able to conceive within 18 months after stopping the shot [1]. Pregnancy may happen faster or slower for you depending on a number of factors. In this article, we’ll share a few tips on getting pregnant after Depo-Provera, along with common signs of pregnancy after depo that you can look out for.

How does Depo-Provera prevent pregnancy?

Let’s review how the birth control shot, commonly known by its brand name Depo-Provera or “the depo shot,” prevents pregnancy. The shot is a highly effective medium-term contraceptive. It contains a synthetic hormone called progestin that mimics progesterone. It’s administered by your healthcare professional every three months, and this steady flow of progestin prevents pregnancy by stopping ovulation and thickening cervical mucus. Both of these effects make it extremely difficult for sperm cells to fertilize egg cells, thus preventing pregnancy [2].

You’ll need to keep getting the shot every three months to maintain these effects and prevent pregnancy. Depending on your circumstances, your doctor may not recommend using the depo shot for more than two years at a time due to a risk of bone density loss, especially during perimenopause [1]. However, it’s worth noting that bone density loss is usually reversible once you stop the shot.

This two year timeframe makes the birth control shot is a great option for people who want a medium-term contraceptive — you don’t have to think about taking the pill everyday or using a condom every time you have sex, but you also don’t want a longer term birth control option like an IUD or the implant (these can prevent pregnancy for three to twelve years depending on the brand).

Getting pregnant after Depo-Provera

While it does not cause infertility, it can be hard to predict exactly when ovulation will return after stopping the depo shot [3]. Your body may need time to get back to its natural hormonal rhythm without the steady supply of progestin. You can track your temperature to monitor ovulation with Natural Cycles, or use other fertility awareness methods, to see how your body is adjusting over time. After stopping the shot, you might start to notice some signs of ovulation including:

Luteinizing hormone (LH) levels
Changes in cervical mucus
A spike in basal body temperature (BBT) [4]

Once you’ve confirmed that ovulation is happening, there’s a good chance of getting pregnant after Depo-Provera. Everyone’s timeline will be different, but you can always reach out for guidance from your healthcare provider.

How long does it take to get pregnant after Depo-Provera?

There are quite a few variable factors that play into how long it will take to get pregnant after the shot. These include (but are not limited to) the person’s age, weight, and the dosage level they were getting [7]. Interestingly, the length of time you were using Depo-Provera doesn’t seem to have an effect on how long it takes to become pregnant after stopping it [1].

Overall, it can take up to 18 months after your last shot to get pregnant. Since it’s a long-acting birth control, it will take some time for its effects to wear off even if you’re not actively getting a new shot every three months [1]. Again, everyone’s body and pregnancy journey is unique, and technically, there is always a small chance of getting pregnant as soon as you stop getting the shot.

Can Depo-Provera cause infertility?

The birth control shot does not cause infertility after you stop getting it. It just prevents you from getting pregnant while you’re on it. It may delay conception time, but overall fertility rates stay the same [1, 3]. If you have questions or concerns about fertility, reach out to your healthcare provider. They can provide testing for you and/or your partner to understand your pregnancy chances and chart the best course forward, potentially using methods like IVF to conceive. NHS guidelines recommend talking to your doctor if you’re under 35 and have been trying without success for one year [5].

Tips on getting pregnant after Depo-Provera

To prepare yourself for a healthy pregnancy, here are some tips on getting pregnant after hormonal birth control like the Depo-Provera shot:

Stop all forms of birth control: This includes non-hormonal birth control methods like condoms and the pull out method.
Sexually transmitted infection (STI) screening: With barrier birth control methods out of the picture, it’s worth getting tested for STIs while trying to conceive (commonly referred to as TTC).
Preconception care: In certain countries, you may be able to meet with your healthcare provider to assess you and your partner’s medical history and current health circumstances for support in creating the best environment for conception.
Track your cycle, paying close attention to ovulation: Getting to know your body’s ovulation signals with tools like Natural Cycles or luteinizing hormone testing can help you time intercourse for the best chances of fertilization (learn more about your fertile window).
Avoid stress: This goes for your partner too — excess stress can make it harder to conceive (although it’s not impossible). Relaxation techniques and healthy habits can make a big difference in the TTC journey, although we know this one is often easier said than done!
Maintain a healthy lifestyle: Exercising regularly, taking prenatal vitamins, and eating whole foods with lots of fruits, vegetables, and plenty of protein in your diet can positively impact fertility. Avoiding smoking and drinking can also contribute to an overall healthier lifestyle.
Fertility testing: If you’ve been TTC for a while and want to understand your chances better, you can speak to your provider about fertility testing for you and/or your partner. Healthcare providers generally recommend this type of testing if you’ve been trying for a year, you’re under 35, and you have irregular cycles.
Have pregnancy tests on hand: It’s great to be ready with at-home tests to confirm pregnancy if you start noticing signals from your body. Your healthcare provider will probably want to test and confirm as well, but having at-homem tests on hand can help give you peace of mind [6].

These tips can help you get started preparing for pregnancy after stopping the depo shot, but remember that your body will have its own timing. It’s important to stay in tune with how you’re feeling and stay in touch with your healthcare provider as you navigate the TTC journey.

Signs of pregnancy after stopping Depo-Provera

If you’ve recently stopped the shot and all other forms of birth control and you’re wondering if you’ve conceived, there are some common symptoms that usually indicate early pregnancy, including:

Missed period
Light bleeding
General nausea or morning sickness
Fatigue
Sore or tender breasts
Frequent urination
Cravings [8]

All of these signs of early pregnancy after depo indicate changing hormone levels to support the newly fertilized egg in your body. Every pregnancy is different though, so you may not notice any or all of these symptoms. Consult with your healthcare provider if you have any questions about pregnancy.

Get support on your pregnancy journey with Natural Cycles

Trying for a baby can be an exciting (and nerve-racking) time in life. Remember that you can always lean on your healthcare provider and community for support as you navigate the TTC journey, while using tools like Natural Cycles to help you plan your pregnancy.

Research shows that couples using Natural Cycles get pregnant in three cycles or less on average [9]. When using NC°, the app will tell you the best day of your cycle to take a pregnancy test for the most accurate results. And when you do conceive, you can seamlessly switch from NC° Plan Pregnancy to NC° Follow Pregnancy to see how your pregnancy is progressing. Natural Cycles can be a supportive tool for you at any point in your fertility journey, so get started today.

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Pfizer. DEPO-PROVERA® CI (medroxyprogesterone acetate injectable suspension, for intramuscular use) [Internet]. 2025 [cited 2025 April 18]. Available from: https://www.pfizermedicalinformation.com/patient/depo-provera
Planned Parenthood. Birth Control Shot [Internet]. [cited 2025 April 18]. Available from: https://www.plannedparenthood.org/learn/birth-control/birth-control-shot
Girum T, Wasie A. Return of fertility after discontinuation of contraception: a systematic review and meta-analysis [Internet]. 2018 [cited 2025 April 18]. Available from: https://pubmed.ncbi.nlm.nih.gov/30062044/
Owen M. Physiological signs of ovulation and fertility readily observable by women [Internet]. 2013 [cited 2025 April 18]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6081768/
The IVF Network. IVF Through The NHS – The Facts [Internet]. [cited 2025 April 24]. Available from: https://www.theivfnetwork.com/blog/ivf-through-the-nhs-the-fact
Planned Parenthood. Pre-Pregnancy Health Care & Prep [Internet]. [cited 2025 April 21]. Available from: https://www.plannedparenthood.org/learn/pregnancy/pre-pregnancy-health
Halpern V, Fuchs R, Brache V, Bahamondes L, Miranda M J, et al. Suppression of ovulation and pharmacokinetics following subcutaneous administration of various doses of Depo-Provera®: a randomized trial [Internet]. 2021 [cited 2025 April 18]. Available from: https://www.sciencedirect.com/science/article/pii/S2590151621000174?via%3Dihub
National Health Service (NHS). Signs and symptoms of pregnancy [Internet]. 2024 [cited 2025 April 18]. Available from: https://www.nhs.uk/pregnancy/trying-for-a-baby/signs-and-symptoms-of-pregnancy/
Berglund Scherwitzl E, Lundberg O, Kopp Kallner H, et al. Short- and long-term effect of contraceptive methods on fecundity [Internet]. 2020 [cited 2025 April 24]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6689758/

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There are many physical and emotional changes that can signal that your period is on the way, including tender breasts, mood changes, and tiredness. While we all experience symptoms differently, most women start to notice these symptoms between one and two weeks before they get their period [1]. In this article, we’re going to take a look at some more signs your period may be on its way and what to look out for.

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Key takeaways:

Not everyone gets PMS symptoms, but for those who do, they generally start to appear one to two weeks before their period arrives
Common signs your period is coming include changes in your mood, tender breasts, feeling tired, and food cravings
There are some times when you may have symptoms of PMS, but your period doesn’t come — but in most cases, there’s an explanation, such as stress, hormonal birth control, or pregnancy

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What do I need to know about my period?

Whether you’ve never had a period before, or you just need a little refresher on what menstruation is, it’s always a good idea to brush up on the facts of the menstrual cycle, and why we have periods at all!

Bringing it back to basic biology, your menstrual cycle helps your body to prepare for pregnancy. Throughout the month, your body goes through a series of changes, including fluctuations in your hormone levels and a build-up of the lining in your uterus. But if you don’t get pregnant, your uterus will shed that lining, which leaves your body through your vagina — in other words, that’s the reason for your period starting.

Your period can last anywhere from two to seven days [2]. When you first get your period, its length may vary from month to month, but it usually settles into a regular pattern by the time you’re in your late teens [3].

The signs your period is coming for the first time are mostly the same as the ones you’ll experience later in your life in the weeks and days before your period comes. Knowing the signs your period is coming can help you get to know your body better, and help you avoid any surprises!

What is premenstrual syndrome (PMS)?

Premenstrual syndrome – more commonly known as PMS – is the name for a set of symptoms many of us experience in the weeks leading up to their period. These can include:

Craving foods or being very hungry
Cramps
Bloating
Painful, tender or swollen breasts
Mood swings
Feeling depressed or anxious
Feeling more irritable than usual

It’s different for everyone, and these are just some of the symptoms you might experience [4]. Around 20% of women experience severe PMS symptoms that disrupt their normal everyday activities [5], while a smaller number still are affected by PMDD (premenstrual dysphoric disorder). This is a very severe form of PMS, with symptoms including feeling hopeless, anhedonia (lack of interest in activities you normally enjoy), and suicidal feelings. You should consult with a healthcare professional if you think you might be experiencing PMDD, as there are ways you can reduce the condition and symptoms.

Does everyone get PMS?

Premenstrual syndrome doesn’t affect everyone, but it is very common to experience at least a couple of PMS symptoms in the days and weeks before your period [1]. Some people will get PMS every time they have a period, while others will never experience PMS symptoms – and others still will experience PMS every so often [4].

The severity of symptoms can also vary from person to person. Some of us will barely notice our PMS symptoms, while for others, it can be debilitating. It all comes down to your genetics, hormones, stress, and overall health — but if you find that your PMS symptoms are significantly affecting your daily life, you should consult your healthcare provider.

How long does PMS last?

As the symptoms of PMS vary, so too does the amount of time these symptoms last. Symptoms like mood swings, fatigue, and sore breasts usually start one to two weeks before your period arrives, while other symptoms like cramps start just a couple of days before you start menstruating.

For most people, PMS symptoms get better once your period begins, and they usually disappear completely by the end of your period [6].

Signs your period is coming

Here are some signs and symptoms to look out for that might just indicate that your period might be on its way in the next week or two.

Physical signs your period is coming

1. Your breasts hurt

Tender breasts can be a sign your period is coming soon. You might even notice your breasts increase in size in the days before your period. This is due to shifting hormone levels - as with other premenstrual symptoms, breast swelling and tenderness should disappear when your period arrives. [7]

It’s really important to keep an eye on any changes to your breasts, and we recommend you make it part of your routine to carry out regular self-breast checks in the days after your period when your breasts should be less tender.

2. You feel bloated

Bloating is another common symptom you might experience right before your period. It’s thought that this is caused by the changing levels of hormones in your body, which can cause you to retain more water and salt.

Reducing the amount of salt in your diet can help to reduce that bloated feeling, as can staying well hydrated. And — while it might be the last thing you feel like doing — exercise can actually help to reduce your symptoms [8]. So whether it’s a brisk walk, a gentle jog, or a relaxing yoga class, it’s a good time to give your body and mind a break.

3. Your discharge has dried up

Another sign your period is coming is discharge, or rather a lack of it. Cervical mucus is a type of vaginal discharge that changes in amount and consistency throughout the menstrual cycle. When we’re most fertile, cervical mucus is sometimes visible in our underwear or when we wipe after using the toilet. Since we’re not fertile in the days directly before we get our period, there should be very little or no discharge to see [9].

Even after your period has ended, it will likely be a few days before discharge is visible. You can look out for the changes in your cervical mucus throughout your cycle as it varies in amount and consistency as you approach your fertile window.

4. You’re getting a pimple or two

Have you noticed a link between your skin and hormones? If you regularly notice a change in your complexion, it may be one of the signs your period is coming. Change in the levels of sex hormones can also make our skin oilier in the days leading up to menstruation, and you might notice your hair is a little bit greasier, too [10].

Sticking to a healthy diet and drinking plenty of water can help reduce breakouts when your period is about to arrive. Everyone's skin is different and has different needs, so our best advice is to listen to your body and build a routine that works for you.

5. You have cramps

Many women experience cramps during their period, but they’re also a classic PMS symptom. Period cramps, otherwise known as dysmenorrhea, can happen just before your period — unlike the other symptoms listed here, you’ll usually start to feel cramps in the day or two before your period — and they often last for the first few days of your period, too [11].

Cramps are caused by your uterine muscles contracting as your body starts to shed the uterine lining — and as this lining leaves your body, you get your period [12]. As well as cramps in your lower belly, you might have a sore lower back. A heat pad or hot water bottle can help to relieve the pain.

6. You’re experiencing changes in your bowel movements

In the days before your period, you might notice a change in your usual bowel movements, resulting in either constipation or diarrhea.

An increase in progesterone levels in your body can have a relaxing effect on your muscles, which can, for some people, lead to constipation as your bowel movements slow down [13].

The phenomenon of period poop is caused by higher levels of prostaglandins (these cause your uterus to contract); the bowel is close by, and these contractions can cause diarrhea! So if you ever thought it was strange that you needed to go to the toilet more on your period, know that it’s a totally recognized symptom, and you’re not alone.

Emotional signs your period is coming

7. Your mood keeps changing

While the main female sex hormone, estrogen can make us feel pretty good during ovulation [14], towards the end of your cycle, estrogen levels have dropped off [15]. If you’ve noticed changes to your mood, it might be because menstruation is right around the corner.

8. You’re craving certain foods

While it can be a source of comfort to reach for the chocolate box in the days before our periods, there’s a reason you may be craving chocolate (and other foods) on your period. Once again, it all comes down to changes in hormone levels. These hormonal fluctuations can make us crave sweet or salty foods and can affect our appetite at different points in the cycle too [16].

Sometimes, a treat is exactly what we need to pick us up on those difficult days, but keep in mind that maintaining a healthy diet and drinking lots of water can reduce bloating and other PMS symptoms in the lead-up to your period.

9. You’re feeling sluggish

Fatigue is another of the signs your period is coming. Experiencing tiredness in the days before you’re due is fairly common. Even if you’re well-rested, you might find your energy levels are lower than at other points in your cycle. While keeping a regular sleep routine can help, some may experience insomnia despite tiredness. As with other PMS symptoms, this is caused by a change in hormones and should go away once your period starts.

Did you know tiredness can also be a sign of early pregnancy? In fact, many PMS symptoms are very similar to early pregnancy signs because of the presence of progesterone, which plays a big role both in the second part of the menstrual cycle and in the first trimester [17]. If you think you might be pregnant, the best time to take a pregnancy test is the first day of your missed period.

10. You have a lower sex drive

There are lots of different things that can affect your sex drive, but one part of it is your hormones. That means you might find that you’re less interested in sex in the days before your period is due.

For most women, their sex drive is highest during ovulation — that is, in the middle of the menstrual cycle, usually around 14 days before you get your next period [18].

Progesterone is at its highest right before it drops off at the end of the cycle, and research has shown that progesterone has a strong negative impact on libido [18]. It stands to reason, then, that your sex drive may decrease in the days before your period as your progesterone levels rise.

11. One bonus reason: your birth control will tell you

Additionally, If you’re using Natural Cycles as birth control, you’ll get regular updates about the changes happening in your cycle, including when your period is due. NC° Birth Control has two parts: an app and a measuring device (like a thermometer, or compatible wearable like an Oura Ring, or Apple Watch).

The app learns the pattern of your cycle based on the science of body temperature. It’s possible to measure ovulation with temperature readings, and that’s how Natural Cycles can identify where you are in your cycle. So, as well as learning the signs your period is coming, by noticing changes in your body, you’ll get in-app updates, too!

Did you know that if you’re using hormonal birth control you don’t really get periods? Instead, methods like the birth control pill often cause a certain type of spotting called a withdrawal bleed. Since you don’t ovulate on hormonal birth control, this isn’t technically a period but rather a symptom of changing hormone levels.

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How to prepare for your first period

If you’re waiting for your first period to arrive – or are supporting a young person who may get their first period in the near future – you may have lots of questions.

Most people get their period between 12 and 15 years old, but everyone’s different and you may be older or younger than this [19]. Most girls will get their first period around 2 years after their breasts begin growing [20]. You may also notice white or off-white discharge in the months leading up to your first period, so this is a sign that your period may be on its way soon [21].

As we noted earlier, you may experience some of the same signs that we’ve discussed already like tender breasts or cramps in your lower belly or back, although not everyone will have these symptoms [22]. Periods are normal and healthy but it’s normal to be worried or curious about getting your first period. If you have any questions or concerns, you can talk to a trusted adult like a parent, older sibling, school nurse, or doctor. They can help answer your questions and provide support as you navigate this new experience.

It’s a good idea to be prepared with a few supplies so that you’re not caught short if your period starts unexpectedly. But don’t worry if it does – almost everyone who gets a period has been there at some point, and it’s nothing to be ashamed of.

There are a few different period products available to use when you’re on your period – and the choice is completely up to you. You can use:

Pads: These are absorbent pads that stick to the inside of your underwear. They come in different lengths and absorbencies, and some come with wings that wrap around the edges of your underwear for extra security. You should change your pad every 3–4 hours (even if you have a light flow) and throw the pad away once it’s used – but be sure not to flush it down the toilet. Reusable period pads are also available which you can wash and reuse instead of throwing away
Tampons: Tampons are inserted inside your vagina to soak up blood, with a string on one end which you pull to remove. They also come in different sizes and absorbencies. It’s important to always use the lightest absorbency for your flow – so don’t use a ‘super’ tampon if there’s not very much blood, for example. Tampons either come with an applicator (when they come inside a small plastic or cardboard tube to make them easier to insert) or are non-applicator (without the tube – you simply insert it yourself with clean fingers). Always change your tampon regularly (every 4-6 hours depending on your flow) and carefully read the instructions. These will tell you how to insert them properly.
Period underwear: These are washable, reusable briefs that you wear like regular underwear but they’re designed to soak up blood and prevent leaks. Some people wear them as their only period product while others use them along with a tampon or menstrual cup for added protection.
Menstrual cup: This is a small cup made from medical-grade silicone that you put inside your vagina to collect blood during your period. Most are made to be worn all day, for 8-12 hours at a time. They’re designed to be washed and used again, making them a more environmentally-friendly option than tampons or pads, which are thrown away after each use. It can be tricky to get the hang of inserting it the first time, so always make sure to read the instructions that come with the cup.

Carrying your preferred period product and a spare pair of underwear in a small pouch can help you to feel more confident, comfortable and prepared when your first period arrives.

Period symptoms but no period

Your breasts hurt, you feel tired and moody, and you’ve developed pimples on your chin — all sure signs that your period is about to arrive. But what if it doesn’t happen?

There are some times when you may have symptoms of PMS, but your period doesn’t arrive — but in most cases, there’s an explanation. It could be down to:

Hormonal birth control: Some types of hormonal birth control, like the pill, implant, and IUD can cause side effects that resemble PMS. However, one of the other side effects of hormonal contraception, for many women, is that they don’t get a monthly bleed. Sometimes, this may just last a few months after starting a new type of birth control, while for others, it might be a long-term change [23], [24]. It’s also possible to delay your period by taking pills back to back without taking the usual break or placebo pills.
Stress: Stress affects our bodies in many ways — including some that you might not be aware of. If you’re going through a time of increased stress, it can have an impact on your menstrual cycle, sometimes resulting in a lack of period [25].
Polycystic ovary syndrome: PCOS is a common disorder that’s associated by hormonal imbalance in the body. There are various symptoms of PCOS including irregular periods, acne, and excess body hair — as well as late and missed periods [26].
Thyroid conditions: The thyroid is a tiny gland that is responsible for the regulation of many hormonal functions in the body, including the menstrual cycle. If you have either an overactive or underactive thyroid, it could cause PMS symptoms without a period [27].
Pregnancy: Many PMS symptoms are similar to those of early pregnancy. If you think it’s possible you could be pregnant, take a test the day your period is due or speak to your healthcare provider.

Get to know your cycle better

Here at Natural Cycles, we’re on hand to help you learn more about your cycle so you can predict and prepare for symptoms such as PMS, menstrual cramps, and more. With our birth control app, it’s easy to document symptoms and keep track of your unique cycle, making it easier to spot patterns in your cycle and keep track of your PMS symptoms so you’ll be better prepared for your period arriving.

The first FDA Cleared birth control app, Natural Cycles can help you plan or prevent pregnancy on your timeline. Why not find out if it could work for you today?

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Learn more about your body online with Natural Cycles. 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Office on Women's Health. Premenstrual syndrome (PMS) [Internet]. 2023 [cited 2025 Apr 24]. Available from: https://womenshealth.gov/menstrual-cycle/premenstrual-syndrome
National Health Service. Periods [Internet]. 2022 [cited 2025 Apr 24]. Available from: https://www.nhs.uk/conditions/periods/
NHS Inform. Periods (menstruation) [Internet]. 2024 [cited 2025 Apr 24]. Available from: https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/periods-menstruation/
Planned Parenthood. What can I do about cramps and PMS? [Internet]. 2023 [cited 2025 Apr 24]. Available from: https://www.plannedparenthood.org/learn/health-and-wellness/menstruation/what-can-i-do-about-cramps-and-pms
Gudipally, P. R., & Sharma, G. K. (2023, July 17). Premenstrual syndrome. StatPearls - NCBI Bookshelf. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560698/
Royal College of Obstetricians and Gynaecologists. Managing premenstrual syndrome (PMS) [Internet]. 2022 [cited 2025 Apr 24]. Available from: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/managing-premenstrual-syndrome-pms/
Mount Sinai. Premenstrual breast changes [Internet]. New York: Mount Sinai Health System; [cited 2025 Apr 24]. Available from: https://www.mountsinai.org/health-library/symptoms/premenstrual-breast-changes
National Health Service. Bloating [Internet]. 2023 [cited 2025 Apr 24]. Available from: https://www.nhs.uk/conditions/bloating/
Planned Parenthood. What's the cervical mucus method? [Internet]. 2023 [cited 2025 Apr 24]. Available from: https://www.plannedparenthood.org/learn/birth-control/fertility-awareness/whats-cervical-mucus-method-fams
National Health Service. Acne - Causes [Internet]. 2022 [cited 2025 Apr 24]. Available from: https://www.nhs.uk/conditions/acne/causes/
National Health Service. Period pain [Internet]. 2022 [cited 2025 Apr 24]. Available from: https://www.nhs.uk/conditions/period-pain/
ACOG. Painful Periods [Internet]. 2023 [cited 2025 Apr 24]. Available from: https://www.acog.org/womens-health/faqs/painful-periods
Bernstein, M. T., Graff, L. A., Avery, L., Palatnick, C., Parnerowski, K., & Targownik, L. E. (2014). Gastrointestinal symptoms before and during menses in healthy women. BMC Women S Health, 14(1). Availble from: https://doi.org/10.1186/1472-6874-14-14
Wharton, W., Gleason, C. E., Sandra, O., Carlsson, C. M., & Asthana, S. (2012). Neurobiological underpinnings of the estrogen - mood relationship. Current Psychiatry Reviews, 8(3), 247–256. Available from: https://doi.org/10.2174/157340012800792957
Reed, B. G., & Carr, B. R. (2018, August 5). The normal menstrual cycle and the control of ovulation. Endotext - NCBI Bookshelf. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/
Gorczyca, A. M., Sjaarda, L. A., Mitchell, E. M., Perkins, N. J., Schliep, K. C., Wactawski-Wende, et al. (2015). Changes in macronutrient, micronutrient, and food group intakes throughout the menstrual cycle in healthy, premenopausal women. European Journal of Nutrition, 55(3), 1181–1188. Available from: https://doi.org/10.1007/s00394-015-0931-0
Sundström-Poromaa, I., Comasco, E., Sumner R., Luders, E. (2020). Progesterone – Friend or foe?. Frontiers in Neuroendocrinology, 59. Available from: https://doi.org/10.1016/j.yfrne.2020.100856
Roney J.R, Simmons Z.L. (2013) Hormonal predictors of sexual motivation in natural menstrual cycles, Science Direct. Available from: https://doi.org/10.1016/j.yhbeh.2013.02.013
Planned Parenthood. What's up with periods? [Internet]. 2022 [cited 2025 Apr 24]. Available from: https://www.plannedparenthood.org/learn/teens/puberty/whats-periods
National Health Service. Starting periods [Internet]. 2022 [cited 2025 Apr 24]. Available from: https://www.nhs.uk/conditions/periods/starting-periods/
KidsHealth. All About Periods [Internet]. The Nemours Foundation; 2023 [cited 2025 Apr 24]. Available from: https://kidshealth.org/en/kids/when-period.html
ACOG. Your First Period [Internet]. 2022 [cited 2025 Apr 24]. Available from: https://www.acog.org/womens-health/faqs/your-first-period
National Health Service. Contraceptive implant - Side effects and risks [Internet]. 2022 [cited 2025 Apr 24]. Available from: https://www.nhs.uk/contraception/methods-of-contraception/contraceptive-implant/side-effects-and-risks/
National Health Service. IUS (hormonal coil) - Side effects and risks [Internet]. 2022 [cited 2025 Apr 24]. Available from: https://www.nhs.uk/contraception/methods-of-contraception/ius-hormonal-coil/side-effects-and-risks/
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Welcome to week 15 of your pregnancy! In this article, we will delve into some changes going on in your body and pregnancy symptoms you might experience this week. We will also check in on your baby’s development and discuss genetic testing in the second trimester. Finally, we’ll offer some tips on things you can do this week at home and at work.

","

Key takeaways:

Yeast infections, melasma, and round ligament pain are all caused by changes going on in your body in the second trimester
Your growing baby is developing their ears and taste buds this week
If recommended by your healthcare team, certain prenatal genetic tests like amniocentesis and a quad blood test are possible beginning in week 15

","

Your body at week 15

Yeast infections

Yeast infections are more common during the second trimester of pregnancy. They are linked to pregnancy hormonal changes along with more common causes like antibiotics, high blood sugar, and vaginal intercourse [1]. Thrush, oral (in the mouth) or genital (in the vagina), is one common yeast infection during pregnancy caused specifically by the Candida fungus.

Symptoms of yeast infections include [2]:

White, cottage cheese-like discharge that usually does not smell
Itching, irritation, and redness around your vagina and vulva
Soreness, burning, or stinging sensations during urination or intercourse

If you suspect you have a yeast infection, contact your healthcare provider. Yeast infections are most commonly treated during pregnancy with cream or a suppository inserted into the vagina. Oral antifungal medications are not recommended during pregnancy. Though uncomfortable, there is no evidence that yeast infections can harm your baby [1,2].

Melasma

Melasma, also known as chloasma or pregnancy mask, is a skin hyperpigmentation condition that affects women from around the fourth month of pregnancy. Increased production of melanin, which your body naturally produces to give color to skin and hair, causes dark skin patches to develop on the face, particularly the forehead and cheeks [3]. While scientists are not sure what causes melasma during pregnancy, it is believed to be the result of a combination of hormonal factors, sun exposure, and genetic background [4]. Having previously experienced melasma in past pregnancies and having a multiple pregnancy (carrying more than one baby) has also been shown to increase your risk of melasma.

Dark spots and melasma often fade away on their own after childbirth, but can sometimes last for years. You can help prevent melasma from getting worse by wearing sunscreen, avoiding direct sun exposure as best you can, and wearing a wide-brimmed hat while outside. If you are concerned about melasma or are interested in treatments after recovering from childbirth, speak with a healthcare provider or dermatologist.

Round ligament pain

During the second trimester, your growing baby stretches the ligaments that connect your uterus to your groin. This can cause pain in your abdomen, hip, or groin area, known as round ligament pain. The pain can present differently — for some it can be brief and sharp, for others it can be a prolonged dull ache. Though considered a normal change to your body during pregnancy, round ligament pain is uncomfortable and can disrupt your day-to-day life.

Rest is one of the best ways to alleviate round ligament pain. You can also try to change positions more slowly, as movements that cause your muscles to quickly contract can worsen round ligament pain. Before you sneeze, cough, or laugh, try to bend and flex your hips to reduce any pulling on the ligaments [5]. If your pain is consistent or getting worse, ask your healthcare provider for advice on exercises and treatments that can help you.

Your baby’s development at 15 weeks

At 15 weeks, your baby’s ears are beginning to look recognizable on the outside of their head, and their eyes are moving closer to their nose as their face begins to take shape [6]. Your baby is also developing its first taste buds on its tongue. Though you might not be able to feel it yet, your baby is moving constantly!

Your baby is about the size of an orange, weighing around 2 to 2.5 ounces (57-70 grams) and measuring 4 to 4.75 inches long (10.1 to 12 centimeters) [6].

$\"Infographic$

Genetic testing in week 15

There are many different kinds of prenatal genetic tests [7]. These tests, which are optional, can give parents-to-be information about the risk and prevalence of certain genetic disorders. The most common genetic abnormalities that are tested for include trisomy 21 (Down syndrome), trisomy 18 (Edward syndrome), and trisomy 13 (Patau syndrome). It is also possible to test for genetically inherited disorders, like sickle cell disease and cystic fibrosis.

There are two main types of prenatal genetic tests:

Screening tests tell you the risk of your baby having a certain disorder. The results are usually presented as a proportional fraction that indicates the chance, or risk, that your baby has a genetic disorder. The results can also be communicated as “positive” or “negative”. A “positive” result from a screening test means your baby is calculated to be at an increased risk of a genetic condition (or more than one), while “negative” means that no increased risk was calculated.
Diagnostic tests tell you whether your baby has a genetic disorder. A positive test result indicates that a chromosomal abnormality is present, while a negative result means that it is not.

Prenatal screening tests are typically performed in the first and second trimesters. In the first trimester, a combined screening test uses a blood sample taken from the mother, measurement data taken from the baby’s first ultrasound, and maternal factors like age and weight. If you receive results from a combined screening that suggest an elevated risk, a further screening test is often recommended.

A noninvasive prenatal test, known as a NIPT test, and a “quadruple” or “quad” test are both screening tests that use a blood sample taken from the mother. NIPT tests analyze fetal genetic material in your blood to assess the risks of certain chromosomal disorders and can be done from around the 10th week of pregnancy. Quad tests are usually performed between weeks 15 to 22 and screen for different abnormalities [8]. There is always a possibility of false positives or false negatives from screening tests. Your healthcare provider can give you more information about the rates of false positives and negatives in any test you take.

Only a diagnostic test can tell with certainty if your baby has a genetic disorder. There are three main types of diagnostic tests: chorionic villus sampling (CVS), amniocentesis, and percutaneous umbilical blood sampling. Amniocentesis, which relies on a sample of amniotic fluid, is the most common and can be performed from week 15 [9]. Diagnostic tests are known as invasive procedures because a testing instrument must be inserted into your body to collect fetal genetic material. For this reason, all diagnostic tests have a slight increase in the chances of miscarriage and harm to the fetus.

If you would like to receive genetic testing, it is important to talk with your healthcare provider to discuss what test or tests are best suited for you.

Pregnancy Symptoms in week 15

Headaches

Hormonal changes, dehydration, low blood sugar, and lack of sleep can all cause headaches during the second trimester [10]. Try to make sure you are drinking enough water and eating small, regular, healthy meals throughout the day. It is safe to treat your headache pain with over-the-counter medication. Be sure to talk with your healthcare provider or pharmacist about what medications are best to take during your pregnancy.

In some cases, a sudden or severe headache can be a sign of preeclampsia. Preeclampsia is a very serious high blood pressure disorder that commonly occurs in the second half of pregnancy. In addition to a headache that does not go away, other signs of preeclampsia include swelling in the face or hands, changes to your eyesight, nausea, and difficulty breathing [10]. If you experience any of these symptoms, it is important to contact your healthcare provider immediately.

Nosebleeds

Nosebleeds are common in pregnancy because of changes to your hormones and increased blood flow throughout your body. Nosebleeds can be light or heavy, and can last anywhere from a couple of seconds to over ten minutes [11]. To treat a nosebleed at home, pinch the soft part of your nose, just above your nostrils, for 10 to 15 minutes. Sit or stand upright, lean forward slightly, and breathe through your mouth to help the blood drain through your nose and not down your throat. Avoid blowing your nose or strenuous activity after a nosebleed. If the bleeding does not stop, contact a healthcare provider.

Tips in week 15

Stretch it out: if you are experiencing round ligament pain or any discomfort in your pelvis or groin, try incorporating some stretching into your daily routine. Try a supported hip flexor stretch, sometimes called runner’s lunge, by placing your back knee on the ground and leaning over a chair, sofa, or exercise ball to open those hips. For more, check out tips for exercising during pregnancy.
Remember sunblock: studies have shown that melasma, or hyperpigmentation, during pregnancy is related to sun exposure. Remember to use sunscreen regularly, even on those cloudy days!
Consider telling your work about your pregnancy: many women share news of their pregnancy with their workplace in the second trimester. If you feel comfortable doing so, consider telling your employer. Depending on where you live, you have certain maternity rights, and it’s good to familiarize yourself with the legal benefits available to you, such as antenatal care, maternity leave, and other forms of support.

Natural Cycles from pregnancy planning through birth

If you enjoyed reading this article, consider checking out the Natural Cycles app! As the first FDA Cleared birth control app, Natural Cycles can support your reproductive health from pregnancy planning all the way through birth and postpartum. Use NC° Follow Pregnancy to track your pregnancy symptoms and receive weekly updates with the changes going on in your body and your baby’s development. You can also use the app to access articles and references about reproductive health issues during your pregnancy.

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Yeast infection during pregnancy [Internet]. American Pregnancy Association. 2023 [Cited 2025 Apr 23]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/yeast-infections-during-pregnancy/
Thrush [Internet]. nhs.uk. 2024 [Cited 2025 Apr 23]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/thrush/
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Zhao L, Fu X, Cheng H. Prevention of Melasma During Pregnancy: Risk Factors and Photoprotection-Focused Strategies [Internet]. Vol. Volume 17, Clinical, Cosmetic and Investigational Dermatology. Informa UK Limited; 2024. p. 2301–10. Available from: http://dx.doi.org/10.2147/CCID.S488663
Round ligament pain during pregnancy [Internet]. American Pregnancy Association. 2021 [Cited 2025 Apr 23]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/round-ligament-pain-during-pregnancy/
15 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 Apr 23]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/15-weeks-pregnant/
Genetic Alliance; The New York-Mid-Atlantic Consortium for Genetic and Newborn Screening Services. Understanding Genetics: A New York, Mid-Atlantic Guide for Patients and Health Professionals. Washington (DC): Genetic Alliance; 2009 Jul 8. APPENDIX H, PRENATAL SCREENING AND TESTING. Available from: https://www.ncbi.nlm.nih.gov/books/NBK115544/
Quadruple screen test [Internet]. Mount Sinai Health System. [Cited 2025 Apr 23]. Available from: https://www.mountsinai.org/health-library/tests/quadruple-screen-test#:~:text=The%20quadruple%20screen%20test%20is,risk%20for%20certain%20birth%20defects
Jindal A, Sharma M, Karena ZV, et al. Amniocentesis. [Updated 2023 Aug 14, Cited 2025 Apr 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559247/
Headaches and pregnancy [Internet]. ACOG. [Cited 2025 Apr 23]. Available from: https://www.acog.org/womens-health/faqs/headaches-and-pregnancy
Nosebleeds in pregnancy [Internet]. nhs.uk. 2024 [Cited 2025 Apr 23]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/nosebleeds/

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Looking for long-term birth control, but not sure what your options are? Birth control methods like the pill or the shot don't work for everyone, but there are a number of other contraceptives available, including ones that you can get from a healthcare provider once and not think about it again for years. In this article, we’ll detail the key similarities and differences to take into consideration when deciding if either an IUD or an implant is the right birth control option for you.

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Key takeaways

Intrauterine devices (IUDs) and implants (sometimes called their name brand Nexplanon) are long-lasting birth control options that are inserted into the body
They are both over 99% effective at preventing pregnancy
There are some key differences in the way they work to prevent pregnancy
Every body is different —speak to your healthcare provider about your medical history and preferences for birth control to make the best decision for you

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Intrauterine devices (IUDs) and implants are both long-acting, reversible contraceptive (LARC) devices that are inserted into your body by a healthcare professional. It’s important to note that neither protects against sexually transmitted infections (STIs) [1], but they’re both highly effective at preventing pregnancy — over 99% effectiveness with typical use [2].

How do implants and IUDs work?

LARCs are effective at preventing pregnancy for three to 12 years depending on the type of device. They work with your body in a few different ways to make sure you don’t get pregnant. We’ll go over the implant first, then the two types of IUDs: hormonal and non-hormonal copper IUDs.

Nexplanon implant

The implant, also known by its brand name Nexplanon, is a tiny, thin rod about the size of a matchstick that sits under the skin of your upper arm [3]. This rod gradually releases the hormone progestin (a synthetic version of progesterone) into your body over time. This steady supply of progestin works to prevent pregnancy in two ways:

Prevents egg cells from leaving your ovaries, so there is no egg cell for sperm to fertilize in the first place
It thickens your cervical mucus, making it much more difficult for sperm cells to fertilize the egg cell [3]

Both of these processes work together to effectively prevent pregnancy for up to three years. When the three-year period is up, you can choose to get a new implant for another three years, or leave it out if you’re planning a pregnancy or just want to switch birth control methods [3].

Hormonal IUD

The hormonal IUD is a T-shaped device that sits inside your uterus. It works similarly to the implant — the hormones it releases over time into your body thicken the cervical mucus and prevent ovulation (the process of eggs leaving your ovaries). This makes the hormonal IUD very effective at preventing pregnancy [5].

Non-hormonal copper IUD

The copper IUD has the same T shape as the hormonal IUD, and it also sits inside of your uterus. But instead of releasing hormones to prevent pregnancy, its active ingredient is copper. Copper prevents sperm cells from reaching and fertilizing egg cells. It also changes the uterine lining and prevents implantation of a fertilized egg cell. This is how the copper IUD effectively prevents pregnancy [6].

IUDs and implants: what are the options?

You can get IUDs and implants at any reproductive age — from when you get your period to menopause. They can also both be inserted at any time during your menstrual cycle (more on that later). There are a few different kinds of IUDs, all with different brand names and lengths of effectiveness:

Mirena (hormonal IUD, effective for 8 years)
Liletta (hormonal IUD, effective for 8 years)
Kyleena (hormonal IUD, effective for 5 years)
Skyla (hormonal IUD, effective for 3 years)
Paragard (copper IUD, effective for 10 years) [5, 7]

The implant only has one current name brand — Nexplanon. It’s effective for up to five years [4].

IUD vs. implant insertion procedure

IUDs and implants are placed in different parts of the body, so the insertion procedures are quite different (although they both need to be performed by a healthcare provider).

IUD insertion

The IUD insertion process is pretty quick — the procedure will take about five to ten minutes, but the whole appointment may take up to 30 minutes. Before the procedure, your healthcare provider might want to test for STIs and pregnancy, as STIs need to be treated first, and the IUD can’t be fitted if you’re already pregnant [9].

It’s also a good idea to speak with your healthcare provider before the procedure about how you experience pain and what kinds of pain medications are available to you before, during, and/or post-procedure. Most people experience some sort of pain during and after the IUD insertion, so your doctor may be able to provide anesthesia or recommend an over-the-counter pain relief medication [5, 9].

Then, during the procedure, a smooth, tube shaped tool called a speculum will be inserted into your vagina to open it up, like a pap smear. The doctor will then insert the IUD through your cervix and up into your uterus. One or two small strings will come out of your uterus and into the top of your vagina — you won’t notice this, but it’s there so that the IUD can be removed or replaced in a few years [5].

Some people feel fine after getting an IUD inserted while others need to rest and recover for a while. You may experience some cramping and back pain similar to menstrual symptoms after the insertion, and you may also have some spotting. All of this should subside within a few days, but it’s a good idea to speak with your healthcare provider about any pain you’re experiencing [5].

IUDs can be inserted at any time, and you’re protected from pregnancy right away if you get Mirena, Liletta, or Paragard (the copper IUD). If you get Kyleena or Skyla, they’ll prevent pregnancy right away if they’re placed within the first seven days of your period. If they’re inserted at any other time during your cycle, you’ll need to use a backup contraception method like condoms or abstain from intercourse for the next seven days to make sure you don’t get pregnant [5].

Implant insertion

Inserting the implant is also a quick procedure that only takes a few minutes. Your healthcare provider will use local anaesthesia to numb the area on the inside of your upper arm, which is where the rod will be placed. Then, they’ll use a tool to insert the rod into the numbed area. It probably won’t hurt any more than getting a shot, but when the anesthesia has worn off, you may feel an ache where the rod was inserted. It should subside soon, and you may also have some slight bruising or swelling in the area for the next few days. Your healthcare provider will share more about what to expect and how to care for the area [4].

The implant can be inserted at any time as long as you’re not pregnant, but if it’s placed within five days of starting your period, you’ll be protected from pregnancy immediately, and you won’t need to use backup birth control. If it’s placed five days or more after your period starts, you’ll need to use a backup contraception method or abstain for seven days after the insertion [8].

IUD vs. implant removal

If you’re ready to remove your IUD or implant, the same provider that inserted it can remove it. If you’ve moved or want to try a different provider, most medical offices that insert IUDs can also remove them — just be sure to check with your provider(s) and your insurance for more information [5, 10].

There are a variety of reasons to get an IUD or implant removed — you may want to start trying for a pregnancy, you might not want to deal with hormonal side effects anymore, or it might be time to replace the device to maintain pregnancy prevention. Whatever the case may be, here’s what you need to know about getting these methods of birth control removed:

IUD removal

To remove the IUD, your healthcare professional will gently pull on the strings of the IUD in your vagina. The arms of the T shape of the device will fold in, and it will slip out. It’s usually less painful than getting the device inserted, but you may feel some cramping right as it comes out. You can always take over-the-counter pain medication before getting the IUD removed if you’re concerned about pain. You may also experience some light spotting, which will go away soon after [5].

You can get the IUD removed at any time during your cycle, but it’s possible to get pregnant right away once it’s removed. If that’s not your plan and you’re not getting a new IUD inserted to replace it, be sure to explore other types of birth control to stay protected from pregnancy [5].

Implant removal

If you want to get the implant removed, your doctor will use local anaesthetic to numb the area, just like they did during insertion. Once you’re numb, they’ll make a small cut in the skin and pull the implant out [10].

Most people don’t have side effects after removal, but you may feel some slight swelling or tenderness in the area over the next few days. Similarly to the IUD, you can get the implant removed at any time, and you’ll no longer be protected against pregnancy once it’s removed [4].

IUD vs. implant side effects

While the most common side effects of these contraceptives usually aren’t dangerous, and you may not experience any of them depending on your medical history and circumstances, they’re worth noting as you’re exploring your birth control choices. The IUD and the implant have slightly different potential side effects, and the hormonal IUD options have different side effects compared to the non-hormonal copper IUD. Let’s go through each:

Hormonal IUD side effects

Hormonal IUDs can actually have positive side effects for some, like less menstrual cramps and premenstrual syndrome (PMS) symptoms. They can also make your periods lighter, and some may stop getting periods altogether while the hormonal IUD is inserted (note that this will all come back if you get the IUD removed and don’t replace it with another IUD or alternative form of hormonal birth control) [5].

However, you may also experience some unpleasant side effects including irregular periods or spotting between periods. This usually goes away within three to six months though, once your body has gotten used to the new hormones in your body [5].

Copper IUD side effects

The non-hormonal copper IUD may actually make your menstrual period worse, with people often reporting more bleeding and cramps, especially in the first three-to-six-month adjustment period. After this, the symptoms usually get better over time. You may also experience spotting and irregular periods with the copper IUD [5].

Implant side effects

Similarly to the hormonal IUD, the most common negative side effect of the implant is spotting and irregular periods during the adjustment period. You may also experience headaches, breast pain, and nausea as your body works with the new hormones. For the implant, this adjustment period may take up to 12 months. But people have also reported lighter periods and less PMS on the implant — for many, periods can stop completely [10].

IUD vs. implant complications

While those side effects can be reasonably expected on any new hormonal medication, there are also some quite serious (but very, very rare) complications and disadvantages of the IUD and the implant alike.

IUD complications

Speak with your healthcare provider about your existing conditions and medical history before deciding which birth control method to use, but it’s important to note that IUDs are not recommended if you have lupus, breast cancer, or a copper allergy (for Paragard IUD) [7].

Furthermore, there’s a very small chance that your IUD can move or slip out of your uterus. This is very rare, but if it happens, it won’t work the same way, and you can get pregnant. There’s also an extremely rare chance that the IUD can get stuck to the wall of your uterus. If this happens, your healthcare provider will need to remove and replace it [5].

During the insertion process, as with any medical procedure, there is a slight chance of infection that will need treatment from your doctor. Finally, while the chances of pregnancy with an IUD are extremely low, it’s more likely to be an ectopic pregnancy if you do get pregnant. An ectopic pregnancy is when a fertilized egg cell implants outside of the uterus — this needs immediate medical attention. Contact your doctor as soon as possible if you notice:

Painful cramping or soreness in your lower belly
Bleeding or pain during sex
Fever, chills, or trouble breathing
Abnormal discharge
Heavy vaginal bleeding [5]

Implant complications

Complications with the implant are also rare, but worth considering. You may experience arm pain that lasts for longer than a few days post-procedure, an infection from the insertion procedure that may require medication to address, or a scar in your arm from the implant [4].

Even more rarely, the implant may bend or break in your arm. If this happens, it needs to be removed and/or replaced [4]. Contact your provider if you experience any of the following symptoms after getting the implant:

Bleeding, pus, discoloration, or pain at the injection site that doesn’t stop within a day or so
Much heavier or longer menstrual bleeding than normal
Yellowing of your eyes or skin
The implant has moved in your arm [4]

Cost comparison: IUD vs. implant

One more important difference to take into account when deciding between the implant or the IUD is the cost and your type of healthcare system. The device, the cost of the insertion procedures, and the cost of removal are all considerations as you’re choosing your birth control.

According to Planned Parenthood, getting an IUD can cost up to $1800 in the U.S. The implant may be a bit more expensive — up to $2300 for insertion and up to $300 for removal. The good news is that most U.S. health insurance plans, including Medicaid and some government programs, may cover some or all of the cost. In the UK, birth control is typically covered by the NHS. Check with your insurance provider or the healthcare plan in your area to learn more [4, 5].

IUD vs. implant similarities

Let’s sum it all up with some key similarities to consider between the IUD and the implant:

Both are external devices inserted into your body to prevent pregnancy
They’re both effective for years
You don’t need to think about them every day or every time you have sex
They both need to be inserted and removed by a trained healthcare professional
Neither protects against STIs

IUDs vs. implants differences

There are also some differences between the two to think about which one would be better suited for you:

The IUD is inserted into your uterus, and the implant is inserted into your arm
IUDs prevent pregnancy for a few more years on average than the implant does (depending on the IUD brand)
The implant and some of the IUD brands are hormonal birth control options, while the Paragard copper IUD is non-hormonal
The implant may be a bit more expensive than an IUD, depending on your healthcare coverage

Which one should you choose?

Ultimately, the decision between the implant vs. the IUD (or another form of birth control) is up to you, after informed conversations with your healthcare provider considering your medical history and current circumstances. They can help you make the best decision for your body and lifestyle, but here’s a handy, high-level comparison chart that may help you kick off the discussion:

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n

	\n Length of Effectiveness \n	\n Uses hormones to prevent pregnancy \n	\n Area of body \n	\n Cost \n
\n Implant (Nexplanon) \n	\n Up to 3 years \n	\n Yes \n	\n Arm \n	\n $0-$2300 depending on insurance coverage \n
\n Hormonal IUD \n	\n 3-8 years depending on brand \n	Yes	\n Uterus \n	\n $0-$1800 depending on insurance coverage \n
\n Copper IUD \n	\n Up to 10 years \n	No	\n Uterus \n	\n $0-$1800 depending on insurance coverage* \n

*Keep in mind that costs and access can vary depending on where you live.

Explore non-hormonal birth control with Natural Cycles

When considering all of your birth control options, remember that non-hormonal, non-invasive birth control that works with your body is also an option. Natural Cycles predicts ovulation based on your body temperature each cycle, so you know when to abstain from sex to avoid pregnancy. Natural Cycles is 93% effective with typical use and 98% effective with perfect use. See if Natural Cycles fits your needs today.

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American College of Obstetricians and Gynecologists (ACOG). Long-Acting Reversible Contraception (LARC): Intrauterine Device (IUD) and Implant [Internet]. 2024 [cited 2025 April 10]. Available from: https://www.acog.org/womens-health/faqs/long-acting-reversible-contraception-iud-and-implant
Contraceptive Technology. (2018). 21st Edition. (Table 26 - 1). https://www.datocms-assets.com/21281/1662539230-contraceptive-technologies_failure-rates-table-2018.pdf
Food and Drug Administration (FDA). NEXPLANON [Internet]. 2023 [cited 2025 April 10]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/021529s021s022s024lbl.pdf
Planned Parenthood. Birth Control Implant [Internet]. [cited 2025 April 10]. Available from: https://www.plannedparenthood.org/learn/birth-control/birth-control-implant-nexplanon
Planned Parenthood. IUD [Internet]. [cited 2025 April 10]. Available from: https://www.plannedparenthood.org/learn/birth-control/iud
Kaneshiro B, Aeby T. Long-term safety, efficacy, and patient acceptability of the intrauterine Copper T-380A contraceptive device [Internet]. 2010 [cited 2025 April 16]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC2971735/
Food and Drug Administration (FDA). PARAGARD [Internet]. 2024 [cited 2025 April 16]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/018680Orig1s074lbl.pdf
Center for Disease Control (CDC). Implants | Contraception [Internet]. 2024 [cited 2025 April 10]. Available from: https://www.cdc.gov/contraception/hcp/usspr/implants.html?CDC_AAref_Val=https://www.cdc.gov/reproductivehealth/contraception/mmwr/spr/implants.html
National Health Service (NHS). Getting an IUD (intrauterine device) or copper coil fitted or removed [Internet]. 2024 [cited 2025 April 11]. Available from: https://www.nhs.uk/contraception/methods-of-contraception/iud-coil/getting-it-fitted-or-removed/
National Health Service (NHS). Contraceptive implant [Internet]. 2024 [cited 2025 April 11]. Available from: https://www.nhsinform.scot/healthy-living/contraception/contraceptive-implant/

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Welcome to week 14 of your pregnancy. In this article, we cover some changes you might be experiencing in your body and discuss how your baby is developing this week. We will also explain some pregnancy symptoms that can appear in week 14 and offer some tips for things you can do to support your physical and mental well-being during this time. Read on to learn more…

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Key takeaways:

Morning sickness and fatigue can start to improve as you move further into your second trimester, resulting in a return of your appetite and increased energy levels
Developments in your baby’s brain are making it possible for them to start making facial expressions this week
Pregnancy symptoms like bleeding gums and constipation commonly start at the beginning of the second trimester

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Your body at week 14

Increased appetite

If you have experienced morning sickness during the first trimester of your pregnancy, your symptoms are hopefully starting to improve this week. A welcome side effect of this might be the return of your appetite! A healthy diet is crucial during pregnancy because your body needs extra vitamins, minerals, and energy to grow a new human.

It's best to get your nutrients from the foods you eat, like fruits, vegetables, starches (carbohydrates), and proteins. Be sure to avoid raw or undercooked meats, fish, or eggs. Some eating guidelines, like those surrounding unpasteurized dairy, can vary by country or region. It is recommended to check with the health guidelines where you live.

While your body needs extra nutrients during this time, pregnant women only need about 300 extra calories a day [1]. And where those calories come from is important! We know pregnancy cravings are real, and maintaining a healthy diet is often easier said than done, but it’s good to keep in mind that foods that are high in fat and sugar tend to be high in calories but low in nutritional benefits. While gaining weight during pregnancy is completely normal and expected, excessive weight gain can increase your risk of pregnancy complications like gestational diabetes, sleep apnea, and high blood pressure disorders like preeclampsia [2]. It can also worsen breathlessness, heartburn, and back pain. For more information, check out our guide on what to eat during pregnancy.

Increased energy

Alongside a return of your appetite, you might experience a surge in energy this week, particularly if you suffered from heavy fatigue in your first trimester. Doctors believe a return of energy levels is linked to a decrease and plateau in the pregnancy hormone human chorionic gonadotropin (hCG) and adjustments to your estrogen and progesterone levels in the second trimester [3]. However, it is also perfectly normal to still experience a lack of energy. Try not to give yourself a hard time — growing a baby is tough work!

If you are still experiencing tiredness or fatigue, or if you want to try to boost your own energy levels, there are a couple things you can try. Healthy eating and regular exercise (unless not advised by your healthcare provider) can both contribute positively to energy levels. Similarly, giving yourself permission to rest and even say “no” to new responsibilities or tasks (when possible) to help you conserve energy and recharge.

Your baby’s development at 14 weeks

At 14 weeks pregnant you’re at the start of a very important period of development for your baby. Their spleen is beginning to produce red blood cells and the growth of your baby’s brain is beginning to make it possible for your baby’s facial muscles to form expressions like frowning, scowling, and squinting [4]. Your baby might even begin sucking their thumb this week.

At week 14 your baby weighs around 1.5-2 ounces (43-50 grams) and measures 3.4-4 inches (8.7-10 centimeters) [4]. This is around the size of a peach.

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You might be wondering when you will start feeling your baby moving. Most women feel movements between weeks 16 and 24. This is a big range, but it depends on many factors — whether it is your first pregnancy, the position of the baby in your uterus, and the position of the placenta [5]. The first movements, referred to as quickening, are usually subtle and can feel like swirling or fluttering. You might even mistake it for a rumbling stomach or gas. Don’t worry if you don’t feel anything yet, this is totally normal.

Pregnancy Symptoms in week 14

You might notice some new pregnancy symptoms as the second trimester continues. These can include:

Bleeding gums

Have you noticed that your gums have become more sensitive or have you experienced bleeding when you floss or brush? This could actually be caused by your pregnancy. Hormone changes, particularly increased progesterone levels, and increased blood volume can both contribute to gum sensitivity, plaque build-up, and inflammation in your gums [6].

It is important to keep up a good oral hygiene routine during pregnancy, which includes twice daily brushing, daily flossing, and routine visits to your dentist and dental hygienist. You can also try to avoid foods high in sugar and acidic foods and beverages, which can worsen tooth decay and gum irritation. Staying hydrated is also important, since saliva is the body’s most natural defense against oral bacteria.

Constipation

If you return to more regular eating patterns this week you might face another pregnancy symptom — constipation. Constipation is very common during pregnancy because progesterone levels can affect your digestive system and slow down the movements of your bowels [7]. Common symptoms of constipation include difficulty pooping, hard or small stools, cramping, and gas. If you are taking iron supplements, these can also worsen constipation symptoms for some pregnant women.

If you are suffering from constipation, try to increase the amount of fiber you consume. Foods that are rich in fiber include bran, avocados, edamame, prunes, and whole grains, such as whole wheat pasta. Staying hydrated and getting regular exercise can also help relieve constipation too.

If your constipation becomes severe, or if the symptoms are unmanageable, talk to your healthcare provider about other supplements or over-the-counter medications.

Tips in week 14

Schedule your next teeth cleaning: it is safe and highly recommended to continue to see a dentist and to get your teeth cleaned during pregnancy. Just be sure to let them know that you’re expecting before your appointment.
Check out prenatal exercise: whether you are showing or not, you might notice that your body is responding differently to exercise. Activities that might have felt great before you got pregnant might no longer feel comfortable or possible. Consider trying exercises classes or workouts that are designed for pregnant women. These can include everything from weight training to yoga, stretching, and pilates.
Making adjustments at work: working while pregnant can be challenging, particularly if you have a physically or mentally strenuous position. If you feel comfortable, consider talking with a trusted colleague or supervisor about making changes to your schedule or tasks if you are finding it difficult to go about your day-to-day. If your work is very physical, requiring standing for long periods of time or heavy lifting, talk with your doctor or midwife.
Clothing adjustments: depending on how your bump grows, you might be finding it increasingly difficult to dress for your changing body, and for comfort. One tip for expanding the life of your pants is to loop a hair elastic around the buttonhole and use it to fasten the button. Pair it with a longer shirt and keep your pants unzipped and unbuttoned! You can even continue to add more hair elastics to make a longer chain.
Schedule your flu shot: if you are in flu season (typically October through May in the northern hemisphere), talk to your healthcare provider about getting a flu shot. Influenza during pregnancy is more likely to cause severe illness than it would in an otherwise healthy adult, and can pose health risks to your baby [8]. Flu vaccines are considered safe and effective for pregnant women.

Support from planning through birth and beyond with Natural Cycles

With a mission to empower women to take charge of their reproductive health, Natural Cycles supports your entire fertility journey from pregnancy planning through birth and postpartum. After getting pregnant, NC° Follow Pregnancy provides weekly guides on changes you might be experiencing in your body and on your baby’s development. You can also use the app to track your pregnancy symptoms and access important articles about physical and mental health. FDA Cleared and certified, why not see if Natural Cycles is right for you?

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Flu & pregnancy [Internet]. Influenza (Flu). 2024 [Cited 2025 Apr 15]. Available from: https://www.cdc.gov/flu/highrisk/pregnant.htm#:~:text=Flu%20shots%20have%20been%20given,during%20any%20trimester%20of%20pregnancy

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One of the most common symptoms associated with menopause and perimenopause is night sweats. Whether you’re curious about this symptom, or experiencing it yourself, you’ve come to the right place! In this article, we’ll cover exactly what night sweats are, what they feel like, what causes them, how to treat them, and more.

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Key takeaways

Night sweats are hot flashes that happen while you’re asleep — they’re one of the most common symptoms during perimenopause, menopause, and postmenopause
More research is needed, but one cause is the brain's increased sensitivity to temperature changes
There are many different ways to treat night sweats in perimenopause, including hormonal and non-hormonal medication, as well as environmental and lifestyle changes

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What are night sweats?

Night sweats are hot flashes (sometimes called hot flushes) that happen while you’re asleep. They are a common symptom of perimenopause through menopause and postmenopause. Both hot flashes and night sweats are sometimes called vasomotor symptoms. In Latin, “vaso-” refers to blood vessels and “motor-” means movement. So vasomotor symptoms involve the movement (constriction and dilation) of blood vessels [1].

There isn’t a universal definition for night sweats, but they generally refer to excessive sweating that happens because you get too hot while you sleep — and that isn’t necessarily caused by factors in your bedroom environment alone (i.e., too hot in the room, blanket too thick, etc.). They can happen suddenly and might be strong enough to soak through your clothes or sheets [2].

Most people’s sleep is disturbed enough that they wake up during night sweats, but it is possible to sleep through them [3].

What do night sweats feel like?

Often, a sensation of heat starts in the face, neck, chest, or upper body and then spreads. Your skin might turn red (looking flushed) or you might experience palpitations. You may also be asleep during the onset and just wake up feeling hot and sweaty. Like hot flashes, night sweats last a few minutes on average, but they can also be shorter or longer [4].

How common are night sweats around menopause?

Night sweats are a common complaint in perimenopause, which is the transition period leading up to menopause. Even though people often talk about menopause as a longer phase, it technically refers to the last menstrual bleed. This can only be confirmed retrospectively, after you've had twelve consecutive months with no period.

According to one study comparing women who did and did not experience menopausal symptoms, among those with symptoms, two-thirds reported night sweats [5] — but this can vary widely based on factors such as where you live, your cultural background, and ethnic origin [4]. The reason for this wide variation isn’t yet known.

Up to 80% of women will experience hot flashes or night sweats at some point in their menopause journey, but this often depends on how close someone is to their final menstrual period (FMP) [6].

According to one study, five to ten years before their FMP, only 20% of women reported hot flashes or night sweats, although 40% reported trouble sleeping. Four years before their FMP, 40% had night sweats and 60% had hot flashes [6].

Perhaps unsurprisingly, the research indicates that these symptoms are more commonly reported during the warmer months, particularly during the summer. The study also suggests that ambient temperature variation (not necessarily specific temperature levels) and variations in daylight exposure might contribute to these seasonal differences [6].

While night sweats can be merely uncomfortable and inconvenient for some, everyone’s experience is different. The International Menopause Society reports that for up to 25% of women, they can significantly lower quality of life “due to physical discomfort, social embarrassment, sleep disruption, mood changes, and associated stress” [7]. However, it’s important to note that the impact of menopausal symptoms can be often underestimated [4].

There can be a lot of stigma around talking about menopause and its symptoms, but it’s becoming more openly discussed. The more we can normalize the conversations around the perimenopause experience, the more likely it will be that women can get the help they need to thrive through this transition.

What causes night sweats?

The short answer as to what causes night sweats in perimenopause is changes in the brain related to hormonal shifts that occur as the body transitions beyond its reproductive years. Estrogen levels generally decrease during this time — although it’s not a straight line and it can certainly feel like a roller coaster at times — but estrogen alone isn’t enough to explain it because different women can have very different experiences.

Temperature regulation in the brain

The exact mechanism is not yet fully understood, but part of the cause of night sweats appears to be related to how the brain controls body temperature. The hypothalamus, which regulates both body temperature and circadian rhythms, seems to play a crucial role in how menopausal symptoms are expressed [4].

Your brain likes to keep your core body temperature within a narrow range to keep everything running smoothly. This is called the thermoneutral zone (TNZ). It’s normal for your core temperature to vary within the TNZ throughout the day [1], and as long as you’re in the zone, your body is neutral. However, if your temperature rises above this zone, you sweat. If it dips below this zone, you shiver [4].

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Sweating is one of the body’s main mechanisms for cooling itself when it’s too hot. In people who are more symptomatic, it seems that the TNZ is narrower than in people who aren’t. Basically, the brain becomes extra sensitive to smaller temperature changes, so it’s easier to cross the threshold for your body to start producing sweat. This means that things that might have caused a slight temperature rise that stayed within the TNZ before, suddenly are enough to push your body out of the zone and cause sweating [4].

Triggers for night sweats (and hot flashes) can include:

Stress [4]
Alcohol
Caffeine
Spicy foods
Smoking
Certain foods, particularly ultra-processed [8]
Too little, or too vigorous, activity [9, 10]
Bedroom, bedding, or pajamas that are too hot
Sudden ambient temperature change [10]

Estrogen and temperature

Another contributing factor is the role that estrogen plays in lowering body temperature [11]. This is part of why your temperature is lower in the follicular phase, when estrogen levels are higher compared to post-ovulation in the luteal phase, when more progesterone contributes to a slightly elevated temperature. As estrogen levels generally decrease toward menopause, this could be one explanation for why the body gets warmer.

Night sweats unrelated to menopause

Since night sweats can be caused by shifting hormone levels, they can also occur in other phases besides peri- and post-menopause. They can happen in the first and third trimesters of pregnancy, and may continue for a while postpartum as hormones readjust [12]. Night sweats can also be caused by illness, infection, or certain medications [2]. If you’re experiencing night sweats and they’re disruptive — regardless of the reason — it’s a good idea to reach out to your healthcare provider.

Treatment for perimenopausal night sweats

Night sweats aren’t just an inconvenience at nighttime. Sleep disruption from night sweats can cause fatigue, worsen mood, cause individuals to withdraw socially, make it harder to concentrate, and generally interfere with daily life. So they are definitely worth treating! There are many options available — some medical, and some you can try on your own. Everyone is different, so it might be worth experimenting a bit to see what gives you the best results.

Remember that if your symptoms are disrupting your life, you should contact your healthcare provider to talk about your options. It can be helpful to record your symptoms to facilitate a productive discussion.

Environmental changes can help manage perimenopausal night sweats

Keep the bedroom cool: Use an air conditioner, fan, or open window to ensure a steady stream of cool air at night.

Put an ice pack under your pillow: If you wake up hot, you can flip your pillow over and rest your head on the cooled side.

Wear light pajamas: Natural fibers often breathe better than synthetic, so try materials like linen, cotton, lightweight merino wool, etc.

Sleep with layers: Try having more lightweight layers of bedding instead of one thick blanket, so it’s easier to adjust if you feel your temperature change during the night.

Have clean pajamas nearby: If you have an extra pair of pajamas next to the bed, it’s easier to change quickly without having to get up all the way in the middle of the night.

Try a cooling mattress topper: Some mattress pads are made out of materials that stay cooler, which can help your body not overheat.

Have ice water on hand: Keeping a thermos of ice water on your bedside table can help you cool down quickly.

Lifestyle changes can reduce the likelihood of hot flashes and night sweats

Limit alcohol and caffeine intake: These can make hot flashes and night sweats more likely.

Reduce consumption of foods that trigger symptoms: For some, ultra-processed and spicy foods tend to make symptoms worse [13]. One study of over 6000 women showed that diets high in fat and sugar increased the risk of vasomotor symptoms, while fruit and Mediterranean-style diets were associated with fewer symptoms [14].

Maintain a healthy weight: While managing weight during perimenopause poses its own set of challenges due to the natural hormonal shifts, it’s worth being aware that overweight and obese people may experience hot flashes or night sweats that are more frequent and severe [4, 13].

Avoid smoking or try to quit: Stopping smoking is associated with many health benefits, including the easing of menopausal symptoms [13]. Smoking is a risk factor for more severe vasomotor symptoms in menopause [4].

Find your optimal activity level: Research has shown sedentary time can lead to an increase in hot flashes [15]. However, there is also research that correlates moderate to vigorous activity with worse or more frequent hot flashes — possibly because intense activity can increase body temperature [9, 10]. To reduce night sweats, it could help to do your higher intensity activities earlier in the day.

Like many topics in women’s health, more research is needed, but for now we can say that staying active with light-intensity activities, such as walking or gentle yoga, are likely to be beneficial compared to sitting still for long periods during perimenopause. However, we also know that physical activity is important for maintaining body composition as women age. Aerobic exercise helps regulate fat mass and BMI in younger women, while resistance training seems to be particularly important for preserving lean muscle mass in older women postmenopause [16]. Everyone’s experience is different, so you should experiment to find a balance that works for you to promote overall health and symptoms.

Reduce stress: Symptomatic women often have higher levels of stress markers in their nervous system [4]. Mindfulness practices, such as paced respiration (deep slow breathing) and hypnotherapy, promote relaxation and have been shown to reduce the frequency and perhaps intensity of hot flashes [10]. Cognitive behavior therapy (CBT) can also be beneficial in treating symptoms [4].

Acupuncture: The research on acupuncture for relieving menopausal hot flashes is limited, and evidence for its effectiveness isn’t clear yet. Some research has shown no difference between acupuncture and simulated acupuncture. However, other research has shown that acupuncture is more effective than no acupuncture [17, 18].

Avoid your triggers: Keep track of the behaviors that seem to correlate with your night sweats or hot flashes and do your best to limit them.

Limit exposure to endocrine-disrupting chemicals (EDCs): While more research is still needed, there is evidence that suggests that exposure to certain types of chemicals (including phthalates and parabens, found in many consumer goods) is linked to worsening of some symptoms of menopause, including hot flashes [19]. These chemicals mimic hormones like estrogen in the body, so they can disrupt natural processes. There are a lot of EDCs and exposure to them is more or less inevitable in modern society, but it is possible to reduce exposure and observe how your body reacts.

Dietary supplements

If you search for foods, herbs, and supplements to relieve menopausal symptoms, the internet has a lot of advice. However, most of these have not been thoroughly studied, so evidence is lacking and we can’t reach any clear conclusions about their effectiveness based on the available science [4, 18, 20]. Always talk to your doctor before taking new supplements.

Medication can be an effective form of symptom management

Hormone replacement therapy (HRT)/Menopause hormone therapy (MHT): Treatments that provide estrogen are currently the most effective for reducing the frequency and severity of night sweats/hot flashes and other perimenopausal symptoms [4]. If you’re interested in trying this option, work with your healthcare provider to find the right type of medication and dosage for you.

Non-hormonal medication: Certain anti-depressants, such as SSRIs and SNRIs, as well as gabapentin, have been found to help with hot flashes and can be prescribed for those who can’t take hormones, or who prefer to avoid them [21, 22].

When to See a Doctor

If your night sweats or hot flashes are interfering with your quality of life, you don’t have to suffer through it and there is help available. Reach out to your healthcare provider to talk about your options.

While night sweats are a common symptom of perimenopause, they can also be caused by medications, infections, or underlying health issues [2]. If you have other symptoms that don’t make sense with perimenopause, it’s a good idea to consult your healthcare provider.

Learn more about your body with Natural Cycles

Perimenopause is a unique journey for everyone, and there will be lots of changes during this transition. Natural Cycles is a temperature-based app that is FDA Cleared as non-hormonal birth control, but it can also help you spot changes to your cycle. The app can identify if you’re still ovulating, and you’ll be able to download a record of cycle symptoms that you can use to facilitate productive discussions with your healthcare provider as you navigate potential treatment options. Want to start tracking cycle symptoms today? Find out if Natural Cycles can work for you!

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National Center for Complementary and Integrative Health. Menopausal symptoms: in depth [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; [updated 2023 Sep; cited 2025 Apr 3]. Available from: https://www.nccih.nih.gov/health/menopausal-symptoms-in-depth
Inman ZC, Flaws JA. Impact of real-life environmental exposures on reproduction: Endocrine-disrupting chemicals, reproductive aging, and menopause. Reproduction. 2024;168(5):e240113. doi:10.1530/REP-24-0113. https://pubmed.ncbi.nlm.nih.gov/39222443/
Kang S, Jo H, Kim MR. Safety assessment of endocrine disruption by menopausal health functional ingredients. Healthcare (Basel). 2021;9(10):1376. doi:10.3390/healthcare9101376. https://pubmed.ncbi.nlm.nih.gov/34683056/
National Institute on Aging. SWAN fact sheet: hot flashes [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; [2023; cited 2025 Apr 3]. Available from: https://www.swanstudy.org/wps/wp-content/uploads/2023/04/SWAN-Fact-Sheets-Hot-Flashes.pdf
Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause. 2015 Nov;22(11):1155–74. doi:10.1097/GME.0000000000000546. https://pubmed.ncbi.nlm.nih.gov/26382310/

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Welcome to week 13 of your pregnancy! Week 13 marks the end of the first trimester and the beginning of the second trimester. You might begin to experience some relief from first trimester pregnancy symptoms like mood swings, fatigue, and morning sickness through this week. In this article, we will go through some changes in your body and pregnancy symptoms you might experience as you finish your first trimester. We will also check in on how your baby is doing and offer some tips on things you can do this week to keep healthy both mentally and physically.

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Key takeaways:

Pregnancy bellies usually begin showing during the second trimester, but everyone is different so try to avoid comparing your bump to anyone else’s
Improvement in some unpleasant first trimester pregnancy symptoms can coincide with the return of your sex drive
Your baby’s bones are beginning to harden this week, their finger and toenails are forming, and tooth buds begin to appear

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Your body at week 13

Your belly

At week 13, it is possible you are already seeing a small baby bump. You also might not see anything! Everyone is different, and everyone begins showing their pregnancy at different times. When you begin to show depends on a number of factors, like whether you have previously been pregnant, the position of the uterus in your body, the position of the placenta in your uterus, and your general body shape and composition.

If you are not yet showing, try not to worry. In your prenatal visits and ultrasounds, your medical team is ensuring your baby is developing normally. If you have any concerns or questions, contact your nurse, midwife or doctor for advice.

Vaginal discharge

You might notice an increase in vaginal discharge as you start your second trimester. This is usually sticky, clear, or white, and is considered completely normal. This extra discharge is produced by your body to help fend off any infections that might travel from your vagina to your uterus [1].

If you notice your discharge has a strong smell or odd color, or if you experience bleeding of any kind, contact your healthcare provider.

Libido

If you are beginning to experience relief this week from first trimester pregnancy symptoms like fatigue, mood swings, and morning sickness, you might notice the return of something else - your libido.

Research has shown that the frequency of sexual intercourse during pregnancy tends to increase from the first to second trimesters [2]. Scientists have attributed this to a lessening of physical and emotional pregnancy symptoms.

You might be wondering if sex is safe during pregnancy. Unless unadvised by your healcare proffesssional , sex during pregnancy is safe. Sex and intimacy can be a helpful way to reduce stress and anxiety and to help build close physical and emotional connections with a partner. You might find that certain preferences or desires change during pregnancy. Some positions might even become uncomfortable.

Whether you are feeling in the mood, or not, it is important to communicate with your partner and let them know how you are feeling and what is comfortable for you.

Your baby’s development at 13 weeks

At 13 weeks, your baby’s working hard growing and developing [3]. Their head is still the largest part of their body, but their limbs will start catching up soon. Their bones are long and thin, but will start to harden and nails will begin to appear on their fingers and toes. Tooth buds, which will become their baby teeth, start to develop in their gums. Your baby can also clench their little hands into fists.

Your baby is about the size of a lemon this week, weighing around 1.5-2oz (43-50g) and measuring approximately 3.4-4in (8.7-10cm) long.

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Pregnancy Symptoms in week 13

Morning sickness

From the end of the first trimester to the beginning of the second trimester, you might experience a decrease in morning sickness. Morning sickness refers to pregnancy-related nausea or vomiting. Despite the name, it can be experienced any time of day or night. For most of us, this unpleasant symptom peaks between pregnancy weeks 8-10 and tends to improve as we move into the second trimester. However, it is unfortunately also normal to continue to suffer from morning sickness well into the second trimester.

Scientists have suggested that morning sickness is caused by a combination of factors: increases in pregnancy hormones, blood pressure fluctuations, and changes in your metabolism [4]. These changes are felt most severely in the first trimester. It can also be worse if you are having twins or triplets.

If you continue to suffer from morning sickness into your second trimester, there are medicines available that can help relieve your symptoms. As your healthcare provider if these or other treatments might be appropriate for you.

Round ligament pain

As pregnancy hormones continue to relax and loosen muscles and ligaments, it is normal to experience round ligament pain from the second trimester [5]. Your round ligaments are the two cords of tissue located on either side of your uterus and attach the uterus to the pelvis. As your baby grows, these tissue bands stretch and can cause spasms that can feel sharp or stabbing in your pelvis, lower abdomen, or groin.

You might also experience this type of pain after certain sudden movements like sneezing, coughing, standing up quickly, laughing or rolling over in bed. It can help to maintain good posture, with your pelvis slightly tucked when sitting and standing. You can also try engaging your abdominals when sitting up or rolling over and bending your hips before sneezing, coughing or laughing.

Round ligament pain is normal and does not cause harm to your or your baby. However, if you experience severe abdominal pain, pain when you urinate, or any bleeding from your vagina, contact your healthcare provider immediately.

Heartburn

Heartburn, along with indigestion, are common pregnancy symptoms that can begin at the second trimester. If you have never experienced heartburn before, it can come as quite a surprise! It can present as an unpleasant or even painful burning feeling in your chest caused by stomach acid rising from your stomach into your esophagus. You might also burp more or experience a sour taste in your mouth. Heartburn can be worse when lying down and bending over or after eating certain spicy, greasy, or fatty foods.

Although doctors aren’t sure exactly why heartburn tends to affect pregnant women, they believe it’s caused by hormones that relax and loosen muscles and ligaments in your body and slow the digestive tract [6]. Your growing baby can also push upward pressure from your uterus into your stomach.

If you are suffering from heartburn, there are some things you can do to help reduce or prevent symptoms. Try avoiding foods that trigger your heartburn (for many, that is fatty, greasy, or spicy food or foods that are highly acidic like citrus). You can also try eating smaller meals, more frequently, rather than large portions. Many antacids, available as chewable tablets or liquids, are safe to take during pregnancy, so check with your doctor or pharmacist.

Tips in week 13

Continue taking vitamins and minerals as directed: during pregnancy, your body needs extra folic acid, iron, and calcium. Remember to keep taking them through the duration of your pregnancy, as directed by your doctor.
Familiarize yourself with the common signs of pregnancy complications: gestational diabetes and preeclampsia are two conditions that your healthcare providers will be watching for throughout your pregnancy. It can be helpful to familiarize yourself with the early signs and symptoms of each.
Sleeping on your side: during pregnancy it is recommended that you sleep on your side [7]. This puts the least pressure on your veins and organs and maximizes good circulation. If you are not used to sleeping on your side, it is good to start practicing now. Try using extra pillows or a pregnancy pillow to find a comfortable sleeping position.
Getting back to exercise (if you feel up to it): first trimester pregnancy symptoms might have made exercise impossible to fathom. However, if you are feeling better and exercise is part of your normal lifestyle, you can try getting back to it this week. If you have a low-risk pregnancy (and your doctor has not advised against it), most exercise is considered safe during pregnancy. Avoid any activities with a risk of falling or impact. Check out our tips for exercising during pregnancy to learn more.

Following your pregnancy with Natural Cycles

You might be familiar with Natural Cycles as the first FDA Clearedapproved birth control app. But did you know that Natural Cycles can provide support throughout pregnancy? NC° Follow Pregnancy supports your entire journey from conception to birth. The app provides weekly guides and enables you to track your pregnancy systems to monitor your physical and mental health. It also offers important articles and reference guides about reproductive health. Why not see if Natural Cycles is right for you?

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Vaginal discharge in pregnancy [Internet]. nhs.uk. 2024 [Cited 2025 Apr 10]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vaginal-discharge/
Fernández-Carrasco FJ, Batugg-Chaves C, Ruger-Navarrete A, Riesco-González FJ, Palomo-Gómez R, Gómez-Salgado J, Rodriguez Diaz L, Vázquez-Lara MD, Fagundo-Rivera J, Vázquez-Lara JM. Influence of Pregnancy on Sexual Desire in Pregnant Women and Their Partners: Systematic Review. Public Health Rev. 2024 Jan 19;44:1606308. doi: 10.3389/phrs.2023.1606308. PMID: 38312526; PMCID: PMC10835432.
Fetal development [Internet]. Mount Sinai Health System. [Cited 2025 Apr 10]. Available from: https://www.mountsinai.org/health-library/special-topic/fetal-development
Morning sickness [Internet]. Mount Sinai Health System. [Cited 2025 Apr 10]. Available from: https://www.mountsinai.org/health-library/symptoms/morning-sickness
Round ligament pain in pregnancy [Internet]. HSE.ie. [Cited 2025 Apr 10]. Available from: https://www2.hse.ie/conditions/round-ligament-pain-pregnancy/
Pregnancy and heartburn [Internet]. Stanford Medicine Children’s Health. [Cited 2025 Apr 10]. Available from: https://www.stanfordchildrens.org/en/topic/default?id=pregnancy-and-heartburn-134-10
Best sleeping positions while pregnant [Internet]. American Pregnancy Association. 2024 [Cited 2025 Apr 10]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/sleeping-positions-while-pregnant/

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Have you ever experienced the need to pee during sex but paused because you were worried you might actually pee? Chances are you were well on your way to squirting. Or have you ever noticed a creamy, milky liquid appear when you're extremely aroused or right after an orgasm? That can be a sign of female ejaculation.

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Key takeaways

Squirting and female ejaculation are caused by different parts of the pleasure anatomy and are not the same thing
Squirting is an involuntary release of a clear, watery fluid during sex that may or may not happen during an orgasm [1]
Female ejaculation is the release of a small amount of milky fluid when aroused or during an orgasm [1]
Not everybody experiences squirting or female ejaculation, but there are some ways you can increase your chances if that's something you’d like to try

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The term \"squirting\" is often thought to be the same as female ejaculation, but these two things are different. Squirting often involves more fluid – typically clear and watery. Female ejaculation, on the other hand, produces a smaller amount of milky discharge.

In this article, we’ll dig deeper into the difference between these two and answer the question: what is squirting? Plus, we’ll also cover how common squirting and female ejaculation are, what they feel like, and how to squirt if that's something you're curious to explore.

What is squirting?

Squirting refers to a specific type of fluid that’s released from the urethra (where you pee from) during sex [1]. This is different from the sexual secretion that’s created during arousal, which typically lubricates the vagina (sometimes called ‘getting wet’). Squirting often happens during the female orgasm, but that's not always the case. Not everyone may experience squirting, and not everyone who squirts does so all of the time.

What does squirting feel like?

Some people say squirting feels more intense than a regular orgasm or like a deep sexual release. An online survey of more than 320 women who reported experiencing squirting/female ejaculation worldwide found that almost 80% of women found squirting enriched their sex lives [2]. Others may find squirting more of a side effect from other pleasure, and some people describe it as feeling a bit like needing to pee. Everyone experiences sex and sexual pleasure differently. There’s no right or wrong way to feel about it.

How can I tell if I squirted?

How squirting feels will vary from person to person, and it's not uncommon for women to simply not realize they squirted until after the fact. Swedish researchers interviewed 28 women aged between 23 and 69 on their squirting experiences (all women participating in the study reported experiencing the release of fluids during sexual stimulation). What they found is that while some women were able to tell they squirted and felt a deep sense of satisfaction, others didn't feel much when it happened and only realized they squirted because their bedsheets were wetter than usual after sex [1].

Do all women squirt?

All of our bodies are different and we all experience pleasure in own own unique ways, so no – not everyone with a vagina may squirt during sex, and not everyone will ejaculate. While squirting has become very common to see in porn, it doesn't mean it's a universal experience.

What's interesting about squirting is that some women may start to experience it later in life. That same study published in Sweden asked the 28 participants about their first squirting experiences. A few participants admitted that squirting only started happening for them later in life due to new sensations in the vagina after giving birth or as a result of them becoming more relaxed and open-minded about sex.

It is, however, important to note that the authors of this study relied on volunteer participants from specific networks (for example, a Swedish podcast about sexuality), and the experiences of this group of women might not represent the full range of experiences or be typical for all women, as volunteers often have different perspectives or levels of openness compared to the general population [1].

How common are squirting and female ejaculation?

Studies into squirting show different results. One piece of research suggests that anywhere between 10% and 54% of women may experience female ejaculation during orgasm [3], while another study suggests that as many as 69% of women can squirt during sex [4].

Most recent data on squirting in the United States shows that around forty percent of adult women report squirting in their lifetime. About 60% of those women report squirting to be pleasurable, but only 20% of women always experience squirting at the same time as an orgasm [5].

Keep in mind that there is a lot of stigma surrounding female pleasure, and squirting in particular. This can influence how much it’s talked about and may also lead to it being underreported.

Squirting vs. female ejaculation

Until recently, squirting and female ejaculation were considered to be the same thing, and even the majority of the older research used these two terms interchangeably. However, more new research has finally acknowledged that these are actually different [3].

Squirting is an emission of clear, watery fluid (most likely from the bladder [6]) that may happen during orgasm, or it may not [5]. Female ejaculation looks very different – it's a smaller amount of milky fluid. This milky fluid is produced in the Skene’s gland (sometimes called the female prostate) and exits through the urethra with sexual release [3].

While it's true that the fluid produced when someone squirts contains urine, it’s not the same as peeing during sex. Squirting is different from sexual incontinence (also called coital incontinence) when the bladder leaks during intercourse — this usually happens if you already have urinary incontinence, e.g., you let out a small amount of pee when you laugh or sneeze [7].

It is possible to experience both squirting and female ejaculation at the same time. However, some people will experience one but not the other [3].

Tips on how to squirt

Want to learn how to squirt by yourself or with a partner? As with all things related to sex, this is a learning journey. Here are a few tips to get you started:

Masturbate: Research suggests that slightly more people may find it easier to squirt from masturbation than from sexual intercourse [2]. Self-pleasure is a useful way to explore what feels good and gives you time to focus on your own experience.
Try different sex positions: Change things up with your partner. Try some positions that offer deep vaginal penetration, such as reverse cowgirl or being penetrated from behind.
Use sex toys: Introducing toys can help you experience pleasure in new ways. Toys come in a range of shapes and sizes and can offer deeper penetration or stimulate the clitoris externally. You can use toys on your own, or you may want to use them as part of intimacy with a partner. See what works and feels best for you.
Relax: Just like with a regular orgasm, worrying or feeling anxious can make it difficult to climax and can make sex less enjoyable. Try not to stress too much about the end result. It’s all about the journey, after all!
Take your time: One small study with seven participants found that it took anywhere from 25 to 60 minutes of finger stimulation for women to squirt [8]. So, take your time warming up, engaging in foreplay, and building arousal as you explore by yourself or with a partner.
Focus on the body: Women who squirt report that they and their partner spent time stimulating not only the inside of the vagina and the clitoris but also other parts of the vulva and the rest of their body [1]. Our bodies are full of erogenous zones (ears, inner thighs, neck, nipples, etc.) that all feel amazing when stimulated, so consider expanding your exploration beyond the genitals to build arousal.

What can you do to help your partner squirt?

Are you excited to explore squirting with your partner and want to help your partner feel great while being supportive? Here are a few tips to help you navigate your new sexual exploration together:

Avoid putting pressure on them: Always be supportive and kind when exploring something new in the bedroom, and avoid putting pressure on your partner to perform. They may be able to squirt, or they may not – frame the experience as a fun experiment and something novel you get to together.
Ask them what works best: Work with your partner to find what feels best for them. Maybe they want assurance and sweet words while you explore – engage in erotic talk and give them plenty of affirmations. Maybe they prefer a certain type of rhythm and speed – try different techniques and check in with them. Listen not only to their words but also their body cues and how your partner's body reacts to different touch and stimulation.
Engage in plenty of foreplay: Even if you generally engage in a lot of foreplay, spend even more time on activities that build arousal and sexual tension. Give your partner a sensual full-body massage, go down on them, and spend a lot of time kissing and exploring their body with your lips until they're melting in your arms.
Know the spots: Clitoris and the G-spot are the critical spots that bring the most pleasure when stimulated for many people, and combined stimulation of the two involving your mouth and fingers can offer the best results when trying to figure out how to squirt.

Safety advice and special considerations

While new sexual partners can be great and can highly enhance the pleasure we experience, if you're having sex with a partner whose results of STI screening you don't know, you may want to be aware of STIs (sexually transmitted infections).

STIs are spread when we come in contact with bodily fluids, even if penis-inside-vagina isn't involved, and squirting often comes with plenty of bodily fluids. So, be sure you're protecting yourself from STIs by using the barrier method when necessary – use dental dams during oral sex, condoms for penetrative sex (even with sex toys), and gloves for finger stimulation.

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Myths & misconceptions about squirting

There are plenty of myths surrounding squirting and female ejaculation. Let’s take a minute to debunk a few of the most common ones:

Myth: Everyone squirts

Squirting comes more easily to some people than others. For some people, it's a normal part of their sex lives, while other people prefer to engage in other forms of sexual activity [5]. Everybody is different, as are our sexual desires and preferences. If you’re interested in finding out if squirting is something you can do, we wish you all the best on this learning journey. If it’s not for you, that’s good too!

Myth: Squirting doesn’t exist

Squirting and female ejaculation have had mythic status themselves for a long time. This is most likely due to a lack of research on female health and the stigmatized nature of female pleasure. In recent years, more research has been done into this topic and is revealing that squirting and female ejaculation is very much a real thing.

Myth: Squirting always produces a lot of fluid

While squirting may produce more fluid than female ejaculation or regular sexual arousal, it’s not always enough to soak the bed sheets. Everyone's body is different and will produce varying amounts of liquid. Like many things, this is often exaggerated in porn and may not reflect your own sexual experience.

Myth: Squirt is just pee

It's a highly debated topic, with many different opinions. A common misconception is that the fluid produced during squirting is urine. That's not entirely true. Squirting fluid has a lot in common with pee and comes from the bladder. However, research found that it also contains other secretions [8].

Get to know your body better with Natural Cycles

At Natural Cycles, we’re dedicated to busting myths and misconceptions around reproductive health. Our app is packed full of female health facts and has tailor-made content to help you learn about your unique menstrual cycle while achieving your fertility goals, whether that’s planning or preventing pregnancy.

Natural Cycles is 100% hormone-free, non-invasive, and FDA Cleared for use as birth control in the US. We’ve helped millions of women worldwide plan or prevent pregnancy. Why not find out if the world’s first birth control app is a good fit for you?

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Påfs, J. (2021). A sexual superpower or a shame? Women’s diverging experiences of squirting/female ejaculation in Sweden. Sexualities, 26(1–2), 180–194. https://doi.org/10.1177/13634607211041095
Wimpissinger, F., Springer, C., & Stackl, W. (2013). International online survey: female ejaculation has a positive impact on women’s and their partners’ sexual lives. BJU International, 112(2). https://doi.org/10.1111/j.1464-410x.2012.11562.x
Pastor, Z. (2013). Female Ejaculation Orgasm vs. Coital Incontinence: A Systematic Review. The Journal of Sexual Medicine, 10(7), 1682–1691. https://doi.org/10.1111/jsm.12166
De La Hoz, F. E. (2017). PM-05 Prevalence and characterization of female ejaculation. cross-sectional study. The Journal of Sexual Medicine, 14(Supplement_6), e382. https://doi.org/10.1016/j.jsxm.2017.10.044
Hensel, D. J., Von Hippel, C. D., Lapage, C. C., & Perkins, R. H. (2023). Vaginal Squirting: Experiences, discoveries, and strategies in a U.S. probability sample of women ages 18-93. The Journal of Sex Research, 61(4), 529–539. https://doi.org/10.1080/00224499.2023.2243939
Inoue, M., Sekiguchi, Y., Ninomiya, N., Kobayashi, T., & Araki, M. (2022). Enhanced visualization of female squirting. International Journal of Urology, 29(11), 1368–1370. https://doi.org/10.1111/iju.15004
Lau, H., Huang, W., & Su, T. (2017). Urinary leakage during sexual intercourse among women with incontinence: Incidence and risk factors. PLoS ONE, 12(5), e0177075. https://doi.org/10.1371/journal.pone.0177075
Salama, S., Boitrelle, F., Gauquelin, A., Malagrida, L., Thiounn, N., & Desvaux, P. (2014). Nature and origin of “Squirting” in female sexuality. The Journal of Sexual Medicine, 12(3), 661–666. https://doi.org/10.1111/jsm.12799

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We know that weight gain can be a sensitive subject during every stage of life, and perimenopause is no exception. In this article, we’ll unpack the science behind perimenopause weight gain and the factors that contribute to it. We’ll also offer some practical strategies for how to lose weight during perimenopause if that’s something you want to explore.

","

Key takeaways

While it doesn’t happen for everyone, weight gain is fairly common among people going through perimenopause
It’s most likely caused by hormonal fluctuations that happen during this phase of life, but other factors like stress and lack of sleep can also contribute
For those who want to know how to lose weight during perimenopause, there are a few things you can try including making dietary changes and increasing physical activity

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Bear in mind that creating a healthy lifestyle is a deeply personal journey — one that is best done with the guidance of healthcare providers who can support your unique health circumstances and goals. Make sure to consult them before making any major changes to your lifestyle.

If you’re in or nearing midlife, you might have already noticed signs that you’re entering perimenopause (like unexpected weight gain). Perimenopause is a transitional time that leads up to menopause — when your menstrual period stops and you can no longer get pregnant. This time can come with some frustrating symptoms that stem from the hormonal changes happening in your body [1, 2]. Let’s take a closer look at the root causes of perimenopause weight gain.

What causes perimenopause weight gain?

Perimenopause is a phase characterized by irregularities in your menstrual cycle [1], and the underlying cause of these irregularities may also be causing weight gain. You can thank shifting hormones for most perimenopause symptoms, but metabolism changes and lifestyle factors like excess stress may also contribute to a changing body shape during this time [2].

Hormonal imbalance

During perimenopause, the regular rise and fall of estrogen and progesterone (the female sex hormones that control our menstrual cycle) starts to be disturbed and becomes increasingly irregular [3]. As they fluctuate, they also gradually decline over time until menopause, at which point levels of both are very low in your body [4]. Both of these hormones contribute to a variety of bodily functions, including your cycle, weight distribution, and more. With that in mind, the hormonal shifts that happen during perimenopause may play a part in weight gain [5].

Metabolic changes

These hormones also help regulate your metabolism (the way that your body uses energy). When they’re out of balance, this can change the way your body uses the energy you consume. For example, you may retain more fat than you did pre-menopause [6]. It’s also common for women to gain weight around the midsection specifically during this time [1].

Stress levels

Weight gain can also come from stress. Perimenopause usually happens during your 40s and/or 50s, a time that might coincide with major life stressors like caring for an aging parent, making career decisions, or managing personal health issues (not to mention the stress of managing perimenopause itself with symptoms like joint pain, and period changes). These challenges can increase stress levels, leading to hormonal imbalances particularly with cortisol — a hormone linked to increased body fat [7].

On top of that, stress and fluctuating hormones can lead to fatigue and disrupted sleep patterns, which can also cause weight gain [8]. All of this can make weight loss quite difficult during this time because it’s hard to determine if the root cause is hormone shifts, stress, a lack of sleep, or all three. The ongoing cultural pressure to lose weight and keep it off can also be a stressor.

If you’re feeling like this is far too much to address all at once, you’re not alone. There are millions of women experiencing similar pressure and struggles, and it’s important to lean on your community and reach out for support when you can. Before we offer some solutions, let’s get clear on why maintaining a healthy weight during perimenopause is a valuable endeavor.

How risky is perimenopausal weight gain?

Although the underlying causes of weight gain can be complex and difficult to address, it’s still worthwhile to explore what a healthy lifestyle looks and feels like to you, and work on building it as best you can — even if that just means making small changes in your day-to-day life.

This is because weight gain during perimenopause has been associated with an increased risk of certain health conditions such as diabetes, arthritis, high cholesterol, and cardiovascular issues [8]. Declining estrogen levels associated with perimenopause can also cause disruptive conditions like sarcopenia and low libido. We’ll explore these two conditions more in depth below:

Sarcopenia

Age-related muscle atrophy, also called sarcopenia, is a progressive disorder that involves low skeletal muscle mass and low muscle strength [7]. It’s thought that estrogen directly influences skeletal muscle metabolism while playing a role in carbohydrate and fat metabolism. It also indirectly regulates growth hormone (which is responsible for building muscle). All of this means that decreasing estrogen levels during perimenopause may lead to sarcopenic conditions in the body. Low protein intake, low vitamin D levels, and low physical activity can also lead to sarcopenia [7]. With all of that in mind, it’s worth creating a healthy lifestyle in order to prevent as much perimenopausal muscle loss as possible.

Lower libido

As many as 10% of women experience decreased libido during the perimenopause years [4]. While there are many factors that contribute to this symptom (including vaginal dryness and a decrease in testosterone), declining estrogen and weight gain can also contribute to lower sexual desire, or even sexual dysfunction [1, 4, 8]. Some people may also find that gaining weight has an effect on their self-confidence and general mood, which can also have an effect on libido.

Can you lose weight during perimenopause?

Losing weight during perimenopause can be challenging, but it’s definitely possible. To stay motivated, it may help to know that even modest weight loss can improve your mood and overall health while reducing other perimenopause symptoms like hot flashes. In fact, losing just 3% of your body weight (if you’re overweight) can lower your risk of diabetes and cholesterol issues. Up to 10% can help improve your blood pressure, blood sugar, liver function, and chronic pain [9].

Consult with your healthcare professional about your body’s unique needs and goals before starting any sort of workout or diet regimen, but in general, remember that it’s never too late to start living a healthier lifestyle.

The science behind perimenopausal weight loss

A comprehensive approach to weight loss that includes increased physical activity, new dietary habits, and support from friends, family, and professionals, is essential for sustainably reaching and maintaining your goals. We’ll go through each of these elements individually below to help you understand the science behind weight loss during perimenopause a bit better, but keep in mind that they all need to work together to create sustainable, healthy changes [8]. Here’s a few tips on how to lose weight during perimenopause:

Exercise: Regular exercise can have major positive impacts on your mental and physical health. It can boost your mood while improving insulin sensitivity, which lowers your risk for diabetes. Physical activity also helps manage your cholesterol and blood pressure levels while decreasing your odds of cardiovascular issues. Resistance or strength training in particular can decrease midsection fat and improve your lean body mass, and this can improve your overall metabolism and contributes to weight loss. The American College of Cardiology recommends 150 to 175 minutes of gentle moderate physical activity per week for healthy weight loss [8].

Manage your diet: Eating lots of fruits and vegetables, healthy fats, whole grains, and high protein can help you maintain a healthy weight and thus manage the symptoms associated with perimenopause more effectively. If a diet or meal plan is easier for you to follow, check out the Mediterranean diet — it’s been shown to decrease cardiovascular risk, which is the biggest disease risk for perimenopausal women [8, 11].

If your intention is weight loss specifically, you may want to follow a calorie-restricted diet, meaning that your body burns more calories than you consume. It’s important to keep this modest and avoid a “crash diet” so that the weight loss is sustainable over time. The obesity guidelines from the American College of Cardiology recommend a daily calorie deficit of about 500 to 750 calories to facilitate sustainable, healthy weight loss, but speak with your healthcare provider or a nutritionist to assess your unique dietary needs and create a plan for success. There are also certain apps available on most smartphones that can help you track your calorie intake and meet your goals [8].

Accountability: Consulting a nutritionist, your doctor, a counselor, or even a trusted family member or friend can really improve outcomes for any weight loss or weight maintenance journey. These accountability partners can help you stay on track to reach and maintain your goals [8].

What's the best way to prevent menopause weight gain?

If you haven’t gained perimenopause weight yet and you’re just looking to prevent it in the first place, good old-fashioned nutrition and exercise are still going to be your go-to methods for healthy weight maintenance. Women who consistently exercise before perimenopause and continue their routine, or those who become more active during or after menopause, are less likely to experience significant weight gain compared to those who do not [8]. Creating a sustainable, active lifestyle is key to maintaining your health during this phase of life — and it’s possible you may not gain any weight at all.

Learn more about your perimenopause journey with Natural Cycles

The perimenopause years come with all sorts of changes, and it’s important to support your health — physically, mentally, and emotionally — as best you can. Remember that you’re not alone in this transition. Millions of women have experienced or are currently going through this struggle with perimenopause weight, and there are solutions available to support your health.

Natural Cycles is an FDA Cleared app packed full of useful guidance and resources designed to assist you throughout your fertility journey, so find out how Natural Cycles can help you get more in tune with your body today.

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Chopra S, Sharma KA, Ranjan P, Malhotra A, Vikram NK, Kumari A. Weight Management Module for Perimenopausal Women: A Practical Guide for Gynecologists [Internet]. 2019 [cited 2025 April 2]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6947726/
Motlani V, Motlani G, Pamnani S, Sahu A, Acharya N. Endocrine Changes in Postmenopausal Women: A Comprehensive View [Internet]. 2023 [cited 2025 April 2]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10823308/
Santoro N, Roeca C, Peters BA, Neal-Perry G. The Menopause Transition: Signs, Symptoms, and Management Options [Internet]. 2020 [cited 2025 March 24]. Available from: https://academic.oup.com/jcem/article/106/1/1/5937009
Koo S, Ahn Y, Lim JY, Cho J, Park HY. Obesity associates with vasomotor symptoms in postmenopause but with physical symptoms in perimenopause: a cross-sectional study [Internet]. 2017 [cited 2025 March 24]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5721621/
Mauvais-Jarvis F, Clegg DJ, Hevener AL. The role of estrogens in control of energy balance and glucose homeostasis [Internet]. 2013 [cited 2025 March 24]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3660717/
Buckinx F, Aubertin-Leheudre M. Sarcopenia in Menopausal Women: Current Perspectives [Internet]. 2022 [cited 2025 March 24]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9235827/
Kapoor E, Collazo-Clavell ML, Faubion, SS. Weight Gain in Women at Midlife: A Concise Review of the Pathophysiology and Strategies for Management [Internet]. 2017 [cited 2025 March 24]. Available from: https://www.mayoclinicproceedings.org/article/S0025-6196(17)30602-X/fulltext
The Menopause Society. Menopause Topics: Perimenopause [Internet]. 2025 [cited 2025 March 24]. Available from: https://menopause.org/patient-education/menopause-topics/perimenopause
Isenmann, E., Kaluza, D., Havers, T. et al. Resistance training alters body composition in middle-aged women depending on menopause - A 20-week control trial [Internet]. 2023 [cited 2025 April 2]. Available from: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02671-y
Erdélyi A, Pálfi E, Tűű L, et al. The Importance of Nutrition in Menopause and Perimenopause-A Review [Internet]. 2023 [cited 2025 April 2]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10780928/#sec2-nutrients-16-00027

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Your due date has come and gone, and you have reached week 41 of your pregnancy. You might be thinking — when will this baby finally come out? Whatever the reason, your baby has decided to camp out a little bit longer. It’s normal to feel a mix of feelings like excitement, exhaustion, and stress in these final days of your pregnancy. In this article, we will talk about managing some symptoms you might be experiencing this week and check in on how your baby is doing. We will also discuss what it means to be overdue and cover labor induction. Finally, we will offer some tips on how to manage physically and mentally as you wait patiently (or impatiently) to meet your baby.

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Key takeaways

Be on the lookout for labor signs — uncontrolled leaking might not be urinary incontinence, but rather your water breaking
Indigestion and heartburn can be worse this week, but contact your doctor if you experience severe nausea or vomiting
At week 41, your baby is considered overdue. While this is normal, and often no cause for concern, your doctor or midwife might talk to you about labor induction

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Your body at week 41

Frequent urination

At 41 weeks, your baby has likely moved farther down into your pelvis in preparation for birth. This can put even more pressure directly on your bladder, causing you to constantly feel like you need to go to the bathroom and making leaking worse. You can use panty liners or sanitary pads to help keep you comfortable and ease fears of leaking through underwear or pants. Continuing with those Kegel exercises, particularly at the end of pregnancy, can also ease leaking and help strengthen your pelvic floor in preparation for childbirth and postpartum recovery.

If you find you are leaking uncontrollably, or if the leakage is clear or pink-colored (and doesn’t smell like urine), this might be a sign that the membranes of your amniotic sack have ruptured. In other words, your water has broken! When your water breaks, the liquid can come out suddenly in a large rush, or it can trickle out more slowly. If you suspect that your water has broken, you should contact your birthing center or hospital immediately, even if you are not yet experiencing contractions.

Pelvic discomfort

As you get closer to labor, you might experience increased pressure in your pelvis. This can happen as your baby moves further down in your uterus in preparation for birth. You might also feel discomfort in your lower back and hips, even if you have not yet started having contractions. Increased pressure, pain, and discomfort could also be a sign that labor is beginning soon. Try to rest comfortably, using pillows for extra support. Also be sure to maintain good posture and equal weight between your legs when standing, sitting, and walking [1].

If the pain becomes severe, or if it is becoming impossible to get comfortable, contact your nurse, midwife, or doctor for advice.

Anxiety

Knowing you’re past your due date and that your baby can come at any time can take a toll on your mental health. Try to remember that around 5% of babies come on the exact day they are predicted to arrive, and that the calculation of due dates is not an exact science. While doctors still cannot determine with certainty why a baby passes its due date, research suggests genetic predisposition (hereditary trends that run in the family), as well as first births, can make it more likely for a baby to come late [2].

Though due dates, and the 40 week mark, can carry a great deal of emotional weight, being born after week 40 rarely harms the baby [2]. Your midwife or doctor will regularly check you and your baby’s health especially after you pass your due date, sometimes two or more times a week. This is to ensure that you and your baby are both healthy, that the placenta is still supporting your baby, and that there are no signs of infection for either of you [2].

While you wait for your baby to make its grand entrance, try to take some time to celebrate yourself and the tremendous job you have done growing your baby for 40+ weeks. Tired of responding to texts from family and friends asking “has the baby arrived yet”? If it helps, give yourself permission to take mental and physical space to be present and abstain from situations that will make you more stressed or anxious. As always, contact your healthcare team if you have any questions or concerns about your baby or your own health.

Nausea

Indigestion, heartburn, bloating and constipation can all contribute to feelings of nausea in your final weeks of pregnancy. Even if you have been suffering from these pregnancy symptoms for weeks, they can sometimes get worse at the very end of pregnancy, as your baby is at its largest [3]. Try to avoid eating large meals, eating before bedtime, and fatty or spicy foods, as these can make heartburn and indigestion worse.

If you experience sudden severe nausea and/or vomiting, contact your healthcare provider right away. Vomiting can be a sign of preeclampsia, a serious condition that requires medical attention. While doctors still do not know what exactly causes preeclampsia, it is widely understood as a hypertensive disorder (meaning related to high blood pressure) linked to issues with the placenta [4]. Preeclampsia can range from mild to severe, but requires immediate monitoring to prevent complications for both mother and baby.

Your baby’s development at 41 weeks

Your baby is overdue - what are they doing in there? If your baby has settled in with no signs of wanting to leave the warmth of the uterus, they are most likely comfortably growing and gaining more fat with each passing day. At 41 weeks, all their organs and bodily systems are developed and ready for life outside of the uterus.

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In your weekly, or likely more frequent, appointments with your nurse, midwife or doctor, they will monitor you and your baby’s health for any signs of distress. This can include a non-stress test to measure the baby’s heart rate and/or an ultrasound to check your baby’s heart rate, breathing, movement, and size. In addition to general health and condition, your healthcare team is also checking that your baby is not getting too big for a safe vaginal delivery and that there is still enough amniotic fluid in your uterus. Your doctor or midwife might also perform an internal exam to check if your cervix has begun softening or opening.

Natural labor and induced labor 41 weeks

Most medical professionals try to wait for labor to begin naturally [5]. This means that your body will begin having contractions on its own, you will discharge your mucus plug, and your water will break (sometimes before contractions start, sometimes after). You might have the signs of labor seared into your memory at this point, but here’s a recap:

Contractions: these are the most universal and easily observable sign of labor. Labor contractions can start off mild, but will come at regularly timed intervals and get stronger and closer together.
Mucus plug: this is the mucus that sits in the mouth of the cervix and is released before or during labor. It might be hard to distinguish from vaginal discharge, but your mucus plug is generally thicker than other vaginal discharge and can have red, brown, or pink blood in it.
Rupture of membranes, or breaking water: this is when your amniotic sack opens, releasing the liquid inside. It can come in a sudden gush or can leak out slowly and steadily. Your water can break before you start experiencing contractions, or more commonly, after. If you experience an uncontrollable leak, or you notice leaking fluid that is clear or slightly pink in color, contact your healthcare team right away because only they can determine if it is amniotic fluid.

At 41 weeks pregnant, your healthcare team can suggest artificially, or medically, inducing labor. While being overdue is generally considered safe, depending on the age, weight, and health conditions of the mother alongside the condition of the baby, your doctor or midwife might decide that it is time to medically help start labor. In most cases, doctors will not let pregnancies continue past 42 weeks.

There are generally two approaches to labor induction, ripening the cervix and inducing contractions. Let’s take a closer look at both:

Ripening the cervix: during labor, your cervix narrows and opens (or dilates) so that the baby can come out. The hormone prostaglandin can also be used to help soften and open the cervix [6]. Doctors or midwives can also use a small balloon, called a catheter, or a sponge, known as an osmotic dilator, to help open the cervix.
Starting contractions: in order to get your uterus to start having contractions, the hormone prostaglandin can be administered as a tablet or gel in your vagina, as oral medication, or the hormone oxytocin can be administered through an IV.

It is possible during induction that your water will also be broken by a midwife or doctor. This is known as the artificial rupture of membranes, or AROM.

Labor induction is considered safe and is very common, used in approximately a quarter of births in high-income countries [5]. However, having an induction usually requires you to give birth at a medical center or hospital. Inductions can also be more painful than labor that begins naturally [8].

Remember that having an induction does not limit your pain relief options in any way, so be sure to communicate constantly with your healthcare team if you need pain relief during induced labor. It is also important to know that inductions do not always work. In some cases, babies will need to be born via caesarian section (or c-section).

Tips in week 41

Consider putting down the phone: whether it’s friends and family eagerly awaiting news of your baby’s arrival or social media constantly feeding you pictures of births and babies, consider taking a little break from technology. But don’t let the phone get too far away, remember that labor can begin at any time and you’ll want to make sure you can track your contractions and call your birthing or maternity center when the time comes.
Remember, there is no proven way of starting labor on your own: you might have heard or read about certain methods for starting labor. Unfortunately, there is no medical or scientific evidence that any of these methods work and in some cases, they can be harmful to you or your baby.
Treat yourself: whether it is a mani-pedi (avoiding gel or acrylic), some takeout, or a (pregnancy-safe) massage, treat yourself this week. You deserve it!
Double-check your hospital plan: make sure you know the right phone numbers of doctors or hospitals to call, the phone tree of who to inform when you go into labor, how you’re getting to the hospital, and who is responsible for caring for other children and pets. This can help put your mind at ease as you wait for labor to begin.
Pack some extra snacks or entertainment: induced labor can sometimes take longer than natural labor. Consider adding some extra snacks or entertainment to your hospital bag, just in case.

Natural Cycles after giving birth

Did you know that Natural Cycles, the first FDA Cleared birth control app, can also support your recovery after birth and beyond? NC° Postpartum offers access to resources and guides for your mental and physical help after childbirth and during your transition to motherhood. When your fertility returns, NC° Birth Control is a great option for non-invasive, hormone-free birth control tailored to you. Find out how Natural Cycles can support you, today.

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Pelvic girdle pain and pregnancy | RCOG [Internet]. RCOG. [Cited 2025 Mar 31]. Available from: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-girdle-pain-and-pregnancy/
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Birth: Learn More – When your baby’s due date has passed. [Updated 2022 Oct 20, Cited 2025 Mar 31]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279571/
Heartburn, indigestion and acid reflux in pregnancy | NCT [Internet]. NCT (National Childbirth Trust). 2024 [Cited 2025 April 1]. Available from: https://www.nct.org.uk/information/pregnancy/body-pregnancy/heartburn-indigestion-and-acid-reflux-pregnancy
Karrar SA, Martingano DJ, Hong PL. Preeclampsia. [Updated 2024 Feb 25, Cited 2025 Apr 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570611/
Amis D. Healthy Birth Practice #1: Let Labor Begin on Its Own. J Perinat Educ. 2019 Apr 1;28(2):68-80. PMID: 31118543; PMCID: PMC6503903. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6503903/#:~:text=Current%20evidence%20and%20professional%20organizations,interventions%20required%20for%20labor%20induction
Gill P, Lende MN, Van Hook JW. Induction of Labor. [Updated 2023 Feb 20, Cited 2025 Apr 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459264/
Inducing labour [Internet]. nhs.uk. 2024 [Cited 2025 Apr 1]. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/signs-of-labour/inducing-labour/

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Have you noticed some thick and sticky mucus in your underwear or when going to the bathroom during the last few weeks of pregnancy? That may have been your mucus plug! In this article, we’ll go through what the mucus plug looks like, what its function is during pregnancy, and how to tell it apart from regular discharge. We’ll also cover some other signs of early labor to look out for and when to reach out to your healthcare provider.

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Key takeaways:

The mucus plug forms in the cervix early in pregnancy and protects the growing fetus by preventing harmful bacteria from entering the uterus
Mucus plugs are made of thick, sticky mucus which can be clear, off-white, pink, brown, or streaked with red, while regular discharge is typically thinner and either clear, white, or light yellow
You’ll lose your mucus plug when your cervix begins to open and become thinner in preparation for labor, and this normally happens after week 37

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What is the mucus plug?

Similar to how your cervix produces cervical mucus during your menstrual cycle, it does so in pregnancy too. As the name suggests, the mucus plug is made up of mucus that forms in the cervix early in pregnancy. It works kind of like a seal, or plug, and helps to protect your baby by preventing harmful bacteria from entering the uterus [1, 2].

Once formed, the mucus plug stays in place for most of your pregnancy. During the last few weeks or days leading up to labor, the mucus plug comes loose and is discharged through the vagina as your body prepares to give birth [1].

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What does the mucus plug look like?

Mucus plugs are made up of thick, sticky mucus that can feel jelly-like in consistency. They are typically odorless and often off-white or clear in color, but they can also be brownish, pinkish, or reddish if there’s blood mixed in [3].

Each mucus plug covers the entire cervix and is quite large compared to other cervical mucus “blobs” that you may have noticed at other times (for example, during your fertile window in your menstrual cycle). The whole thing measures around 1-2 tablespoons (roughly 10 g) in volume [1]. However, a mucus plug doesn’t always come out all at once, which can make it a bit tricky to tell apart from other cervical mucus.

How to tell the difference between mucus plug and discharge

Because it’s common to have more discharge during pregnancy [3], it can sometimes be hard to know if you’re looking at regular discharge or your mucus plug. So, let’s go through some key differences between the two:

Color: The color can be a clue — the mucus plug can have blood in it (but doesn’t always) which can make it look brown, pink, or reddish. Regular discharge during pregnancy doesn’t have blood in it and is typically white or light yellow in color.
Texture: The mucus plug is thicker and stickier compared to other discharge, which tends to be thinner and more slippery.
Timing: The mucus plug typically comes out during the last few weeks of pregnancy, in week 37 or later, while you’ll have other discharge throughout your pregnancy. You may lose the mucus plug all at once in one large clump, or it can come out in smaller pieces which can be more tricky to tell apart from normal discharge — you may just notice more discharge than before [3, 4].

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Mucus under the microscope

Both the cervical mucus you normally see during the menstrual cycle and the mucus plug is made up of little mucus “strings” (called mucin), which form a kind of mesh-like structure. If you want to get nerdy and look at both under a microscope, you can actually see the difference between the two! Regular discharge has a more open structure, which, for example, allows sperm to swim through it. The mucus plug, on the other hand, has a much tighter structure to stop bacteria (and sperm) from passing through [1].

Mucus plug vs bloody show

If you’ve looked for information about the mucus plug or talked about it with others, you may have come across the term “bloody show”. The two are sometimes used interchangeably, and while they are linked, there is a slight difference between them.

The mucus plug refers specifically to the mucus that seals the cervix during pregnancy. Losing the mucus plug is a sign that labor is on its way, and it happens when the cervix starts to open and become thinner in preparation for childbirth [5]. Bloody show is another early sign of labor and it’s also related to how the cervix changes in preparation for labor. It refers to light bleeding that can happen when small blood vessels break as the cervix dilates [6]. Because the mucus plug comes loose when the cervix dilates, this bleeding can mix with the mucus plug so that it looks a bit bloody when it comes out — which is why the mucus plug is sometimes called a bloody show as well.

When do you lose the mucus plug?

Typically, you’ll lose your mucus plug at some point after you’ve reached week 37 of your pregnancy, although the timing varies from person to person. It’s considered one of the early signs of labor, but it’s important to know that losing your mucus plug doesn’t necessarily mean that labor will start soon — some lose their mucus plug a few weeks before they give birth, while others only lose it a few days or hours before, or even during labor itself [3].

How do you know if you’ve lost your mucus plug?

If you notice a clump of mucus in your underwear or when going to the bathroom towards the end of your pregnancy, it may be your mucus plug. For some, it comes out all at once and that’s easier to spot since it will be a larger and thicker blob compared to other discharge you see during pregnancy.

You can also lose your mucus plug more gradually so that it comes out in small pieces over time, which can make it hard to distinguish from other discharge. Not everyone will notice when they lose their mucus plug, so don’t worry if you haven’t.

What causes the mucus plug to come out?

Losing the mucus plug is a natural part of pregnancy as your body prepares to give birth, so it will happen eventually for everyone. There are two main reasons why the mucus plug comes out at this point, and both have to do with how the cervix changes as labor approaches:

Dilation: The cervix will start to dilate, or open, during the weeks or days before labor starts. This causes the mucus plug to loosen and eventually be dislodged and come out through the vagina. By the time you’re ready to start pushing if you have a vaginal delivery, the cervix will have dilated to 10 cm.
Effacement: As labor approaches, the cervix will also become thinner — this is called “cervical effacement”. When it’s time to start pushing, the cervix will be 100% effaced [5].

Can I go into labor without losing my mucus plug?

Yes! Losing the mucus plug isn’t a definitive sign of when labor will start. Some lose their mucus plug weeks or days before, while others don’t lose the mucus plug until labor has already started [1]. And some don’t notice it happening at all — everyone is different.

Losing the mucus plug early in pregnancy

Losing the mucus plug early can be an indication of preterm labor [1], so you should call your healthcare provider right away if you think you’ve lost the mucus plug before week 37, especially if you’re also having other symptoms of preterm labor like contractions or vaginal bleeding. The cervix can continue to produce mucus even after the mucus plug is lost [7], but you should still contact your doctor as a precaution so that they can determine the next steps.

What should I do after losing the mucus plug?

In most cases, if you’re 37 weeks or more into your pregnancy, you don’t need to do anything in particular when you lose the mucus plug (unless you’ve been given specific instructions by your healthcare provider). Even though it can still be a while before labor starts, this is a good time to prepare your hospital bag and make sure you have everything ready for when it does. However, if you’re less than 37 weeks along, or you’re having contractions or other signs of labor, you should call your healthcare provider to see if you need an examination [3].

Things to avoid after losing your mucus plug

Again, if you’re in week 37 or more, you don't need to worry about changing your behavior or steering clear of anything new at this stage of pregnancy unless you're told otherwise by your doctor. It’s okay to go about life as you normally would, and you can have sex even after you’ve lost the mucus plug if you want [7]. That said, if you’re feeling unsure or have any questions, you can always check in with your healthcare provider.

How soon will I go into labor after losing my mucus plug?

While losing the mucus plug is a sign that your body is getting ready to give birth, it’s not possible to say exactly when it will happen. For some, it may still be a couple of weeks until labor starts, while for others it can be a matter of days or even hours.

If you notice that you’ve lost your mucus plug, now is a good time to start keeping an eye out for other signs of labor, such as:

Contractions: Labor contractions come at regular intervals that get closer together as time goes on, and they also get progressively stronger. You may feel them in your stomach or lower back. Especially in late pregnancy, you may also have experienced Braxton Hicks contractions, which can be confused with labor contractions. However, these come and go and don’t indicate labor is starting. It’s a good idea to time your contractions to know when to go to the hospital.
Water breaking: Your baby sits in a fluid-filled sac in the uterus which breaks shortly before labor starts — this is often referred to as your water breaking. As the fluid comes out through the vagina, you may feel it as a gush or a slow trickle.
Lightening: As labor approaches, your baby will get into position lower in your pelvis with its head down. When this happens, the pressure on your diaphragm is reduced which can lead to a “lightening” feeling. You may instead feel pressure in your pelvis and like you need to use the bathroom since the baby is now pressing down on your pelvis, bladder, and bowels [8].

When to talk to a doctor

Losing your mucus plug usually isn’t a cause on its own to call your healthcare provider (as long as it’s after week 37 and you haven’t received other instructions). That said, it’s good to keep an eye on your discharge during pregnancy as it can give an indication that there’s something else going on. For example, if you notice a foul smell, it can be an indication of infection or bacterial vaginosis which can be a risk factor for preterm labor if it’s not treated [2]. Reach out to your healthcare provider if you notice any of the following:

Foul-smelling discharge
Green, yellow, or gray discharge
Pain in or around your vagina or vulva
Redness or swelling
Itchiness [9, 4]

You should also contact your healthcare provider right away if:

You’re bleeding heavily (more than a period)
You lose the mucus plug before week 37
Your water breaks
You’re having contractions every five minutes or less
Your baby is moving less than usual
You have constant pain between contractions [8, 10]

Support your pregnancy journey and beyond with Natural Cycles

There’s a lot going on both physically and mentally in pregnancy. Natural Cycles is a helpful tool that’s here for you throughout your fertility journey — from planning to following your pregnancy, to the postpartum period and beyond. NC° Follow Pregnancy lets you keep track of symptoms and gives you weekly updates on your baby’s development and the changes going on in your body. Once you give birth, you can seamlessly switch to NC° Postpartum for support while you recover from childbirth. Why not see if Natural Cycles could be right for you?

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Becher N, Adams Waldorf K, Hein M, Uldbjerg N. The cervical mucus plug: Structured review of the literature. Acta Obstet Gynecol Scand. 2009;88(5):502–13. Available from: https://doi.org/10.1080/00016340902852898
Lacroix G, Gouyer V, Gottrand F, Desseyn JL. The cervicovaginal mucus barrier. Int. J. Mol. Sci. 2020;21(21):8266. Available from: https://doi.org/10.3390/ijms21218266
American Pregnancy Association. Mucus Plug – What Is It & What Does It Look Like? [Internet]. [cited 2025 Mar 28]. Available from: https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/mucus-plug/
NHS. Vaginal discharge in pregnancy [Internet]. 2024 [cited 2025 Mar 27]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vaginal-discharge/
American Pregnancy Association. Signs of Labor [Internet]. [cited 2025 Mar 28]. Available from: https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/signs-of-labor/
Aslih N, Walfisch A. Clinical approach to pregnancy-related bleeding. In: Sheiner E, editor. Bleeding during pregnancy. New York (NY): Springer; 2011. 3-21. Available from: https://doi.org/10.1007/978-1-4419-9810-1_1
NTC. Mucus plug – what is it and what does it look like? [Internet]. 2024 [cited 2025 Mar 28]. Available from: https://www.nct.org.uk/information/pregnancy/body-pregnancy/mucus-plug-what-it-and-what-does-it-look
ACOG. How to Tell When Labor Begins [Internet]. 2023 [cited 2025 Mar 27]. Available from: https://www.acog.org/womens-health/faqs/how-to-tell-when-labor-begins
American Pregnancy Association. Vaginal Discharge During Pregnancy [Internet]. [Cited 2025 Mar 28]. Available from: https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/vaginal-discharge-during-pregnancy/
NHS. Signs that labour has begun [Internet]. 2023 [cited 2025 Mar 31]. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/signs-of-labour/signs-that-labour-has-begun/

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Your due date is here — congratulations! Now you might be wondering, when is this baby going to arrive? This week, we will check in on how your body is doing at full term, and with your baby, who is developed and ready to meet you. We will also talk about the signs of labor, including what to expect and what happens if labor does not begin on its own. Finally, we will offer some tips for things you can do this week to try to calm your mind and body and prepare for your baby’s arrival.

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Key takeaways

Braxton Hicks contractions can get stronger this week, and it might be more difficult to decide if they are labor contractions — when in doubt, contact your care team
You won’t be able to know your baby’s size before they are born, and no two newborns are exactly alike
While most babies will be born in the week before or after their due date, sometimes labor has to be induced artificially for the safety of the mother and the baby

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Your body at week 40

Contractions

At week 40, your Braxton Hicks contractions might be getting stronger, more intense, or coming more often. It might become difficult to decide whether these are false contractions or labor contractions. Remember that Braxton Hicks contractions can last anywhere from 30 seconds to 2 minutes, while labor contractions will consistently last around a minute [1]. Labor contractions also come at regular times intervals and at a quicker pace as labor progresses, while Braxton Hicks contracts will be irregular. Finally, Braxton Hicks contractions can go away completely while labor contractions won’t.

You might have read about another type of “false labor”, known as prodromal labor. Prodromal labor can be difficult to distinguish from labor (or “real”) contractions, because prodromal contractions can come at regular intervals and feel very much like the “real thing” [2]. Prodromal labor contractions, however, will stay at the same interval and intensity rather than get stronger or come at a quicker pace.

If you are unsure and have any suspicions you might be in labor, contact your midwife or doctor. It is better to be sure, and only your healthcare provider can check to see if your cervix is dilating, which is the best indication of labor’s progression. Remember to keep track of your contractions by writing down the timing between intervals, as well as how long they have been going on.

Back pain

Back pain during pregnancy is often caused by a number of factors — changes to your posture on account of your large belly, hormones that make your back and pelvis feel weaker, the pressure of your uterus on your pelvis, and general tiredness [3]. Try to maintain good posture, with your head tall, shoulders pulled back and down, and pelvis slightly tilted forwards when sitting and standing. You can also physically support your bump with your hands or a support belt when you are standing. You can also try light gentle exercise like swimming or walking (if safe to do so in your pregnancy).

Back pain can also accompany labor contractions, known as back labor. Back labor is pain, discomfort, and even cramping in your lower back that is usually most painful during a contraction but also lingers between contractions [4]. If you are experiencing back labor at home or in the hospital, try walking, sitting on a birthing ball, or tilting your pelvis back and forth to provide relief. If you are in the hospital, or a maternity center, tell your healthcare team so they can help you try to find a more comfortable position.

Your baby’s development at 40 weeks

At 40 weeks, your baby is full term, fully developed, and ready to be born. You might be wondering how big they will be and what they will look like. While your healthcare team has likely been trying to estimate their size based on ultrasounds and measurements of your stomach, it will be impossible to know their exact size until they are born. This week, your baby is probably around 19 to 21 inches long (48.3 to 53.3 cm) and weighs between 6.75 and 10 pounds (3 to 4.5 kilograms) [5].

All newborns will look slightly different, with different amounts of hair and vernix, which is the white substance that protects neonatal and newborn skin in the uterus and just after birth [6]. Right after birth, most babies will look reddish-purple, changing to red or pink after they begin breathing on their own [7]. Their heads can also seem a little oddly shaped, which is the result of the skull moving through the birth canal. This is completely normal, and their heads will return to their natural shape usually by the end of the first week [7]. Your baby also might have little white bumps on their nose, cheeks, chin, and forehead, known as milia.

Signs of labor at 40 weeks

At this point, you are likely anxiously waiting for any signs of labor. Discharging your mucus plug, contractions, and rupture of membranes (known more commonly as your water breaking) are the main signs of early labor. You might also experience a backache and the need to go to the bathroom. If you are already experiencing an increase in discharge, you might not notice if you discharge your mucus plug. Be on the lookout for any streaks of blood or slightly pink-tinged mucus. However, if you experience any bleeding, contact your healthcare provider right away.

Though only a small percentage of women experience their water breaking before contractions begin (when this happens, it’s called a premature rupture of membranes), it’s probably the most well-known labor symptom. That said, it might not always be obvious that your water has broken! When your water breaks, the amniotic fluid can come out as a slow, steady trickle or a larger rush of liquid. Amniotic fluid tends to be thinner than discharge, with a water-like consistency that can be clear, pink, or yellow. If you already feel like you need to pee all the time, it might be hard to determine whether your leak is urine or amniotic fluid. While urine can be stopped using your Kegel muscles, you will have no control over any leak of amniotic fluid. If you suspect you might be leaking amniotic fluid, even if you aren’t completely sure, it’s best to check with your nurse, midwife, or doctor.

Is it normal to still be pregnant at 40 weeks?

What happens if labor doesn’t start on its own?

It is widely estimated that only around 5% of babies are actually born on their due date, so try not to place too much importance on that particular day. In the US, statistics indicate that around 55% of babies are born in weeks 39 and 40, while around 5% of babies are born after week 40 [8]. Remember that week 40 begins with your due date — you are only considered past due starting 1 whole week after your due date passes. Doctors and scientists still don’t understand why labor begins when it does, or why some babies are born early or late.

You might be eager to go into labor, but be wary of home or natural remedies. Unfortunately, there is no scientific or medical evidence that you can induce labor yourself. Some suggestions you might see, like exercise or sexual intercourse, are not proven to induce labor but are considered safe unless unadvisable during your pregnancy. However other suggested methods you might read about may actually cause harm to you or your baby [9].

In weeks 39 or 40, your doctor or midwife might offer a membrane or cervical sweep, to help encourage your body to begin labor naturally. In this procedure, a doctor or midwife will use their finger to physically separate the membrane of the amniotic sack from your cervix. Some may find this uncomfortable or painful, and you might experience cramping or bleeding afterward.

While most doctors recommend letting labor begin naturally [10], sometimes it becomes necessary to induce labor medically, or artificially. This can happen if you are overdue, if your waters break but labor is not beginning on its own, or if you or your baby have a health problem [10]. There are two main methods for labor induction: hormonal and physical. Let’s break down what these two methods entail:

Hormonal induction: certain hormones, usually prostaglandin or oxytocin, will be given to you either as a suppository in your vagina, a gel, as tablets, or through an IV [11]
Physical induction: a device such as a balloon catheter (a small, water-filled balloon) or a dilator can be used to widen your cervix. In some cases, your amniotic sack will be broken (artificial rupture of membranes) to encourage your body to produce more prostaglandin and speed up contractions.

If you require induction, it might affect where you can give birth or require you to be in the hospital longer. Some women who are induced also experience more painful labor, so keep communicating with your healthcare team if you require pain relief. Induction does not restrict your pain relief options during labor [9].

Tips in week 40

Take it easy: resting as much as you can in these final days of your pregnancy can help you physically and mentally prepare for childbirth and the big changes that will happen after your baby is born.
Try some breathing exercises: breathing exercises can help you relax and you can also use them during labor to help you manage your pain. Try focusing on taking slow, deep breaths in through your nose and exhaling out through your mouth. Practice counting the length of your inhales and exhales, trying to make them as long and equal as possible.
Learn about what happens to your baby after delivery: learning about the benefits of skin-to-skin contact and what the doctors and midwives will check after your baby is born can help you feel more comfortable in the delivery room.
Consider a waterproof mattress cover: whether you are waiting for your water to break, or you are planning ahead for messes and spills, it might be a good time to get a waterproof mattress cover for your bed.
Gas up and charge up: labor can begin at any time, so make sure that there’s enough gas in the tank of your car or your EV’s battery is fully charged. It’s also a good time to make sure that phones and tablets are charged, and double check that you have packed chargers in your hospital bag.

Transitioning to postpartum with Natural Cycles

As the first FDA Cleared birth control app, Natural Cycles can support you during all stages of fertility. During your pregnancy, NC° Follow Pregnancy offers support through weekly guides and trackers to monitor your pregnancy symptoms. Make the most of NC° Postpartum after giving birth to access resources to support your physical and mental recovery and transition to motherhood. Switch to NC° Birth Control for non-invasive, hormone free birth control when your fertility returns.

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Tubal ligation is a safe and effective surgical birth control procedure. It’s also commonly referred to as “female sterilization” medically or “getting your tubes tied” conversationally [1]. It’s over 99% effective at preventing pregnancy, making it one of the surest forms of contraception available [2].

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Key takeaways

Tubal ligation is a surgical procedure designed to provide permanent birth control for people who no longer want to get pregnant
It involves closing off the fallopian tubes so that egg cells cannot be fertilized by sperm cells, thus effectively preventing pregnancy
Tubal ligation and other sterilization procedures do not protect against sexually transmitted diseases and infections

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Curious about tubal ligation, but still have questions about the procedure? In this article, we’ll answer some FAQs about tubal ligation including what you can expect from the surgery itself, plus information about the tubal ligation recovery process. Use this article as a jumping off point — remember to consult your healthcare team about your goals and medical history before making any major surgical decisions.

What is tubal ligation?

Let’s start with the basics. At a high level, a tubal ligation involves blocking your fallopian tubes, whether that’s by tying them, cutting them, or removing parts of them (more on the different methods used during the procedure later) [1].

The fallopian tubes are located on either side of the uterus and extend toward the ovaries. They receive egg cells from your ovaries once a month and transport them to your uterus. The eggs either get fertilized or they exit the body during your period later in your menstrual cycle [1]. You can get this procedure at any time, including right after childbirth or at any point during your menstrual cycle [3].

With that in mind, if the fallopian tubes are blocked, sperm cells cannot reach or fertilize the egg cells, thus preventing you from becoming pregnant. After tubal ligation, your body will still release an egg cell during ovulation each cycle, but instead of moving through the tubes to your uterus, it will break down and be absorbed by your body just like any other cells your body isn’t using. This means that you’ll still have a monthly period where the uterine lining sheds, just without the egg cell reaching the uterus [1].

Why do people get their tubes tied?

Tubal ligations are typically performed for people who are sure that they don’t want to get pregnant in the future. This may be the case for a variety of reasons — it’s possible that they don’t want to get pregnant at all or that they’ve had all the children they want. It’s a very personal decision based on your lifestyle, genetics, and more [4].

Dr. Karen Tang, member of the Natural Cycles Medical Advisory Board, shared her professional opinion with us. “You should only consider a tubal or vasectomy if you’re 100% certain you do not desire future fertility,” she said. “For women and people with a uterus, sterilization is usually done via salpingectomy now (removal of both fallopian tubes) and this is not reversible, so you’d need IVF to conceive if you changed your mind. If you’re even a little bit unsure, you should choose a method that is not permanent.”

It’s always best to consult with your healthcare provider about the decision to get your tubes tied. Most won’t recommend making this decision during times of high stress and/or if you’re under pressure from a partner or others [5].

Effectiveness rate and failure rate of tubal ligation

Tubal ligation is one of the most effective forms of birth control available. Fewer than one out of every 100 women will get pregnant following the procedure. That effectiveness can be credited to the fact that tubal ligation is permanent and starts working immediately. Also, there’s no way it can be used the wrong way, like other long-acting birth control methods (such as IUDs and implants). It’s a “get it and forget it” type of contraception [1].

Tubal ligation procedure

Still, tubal ligation is a surgical procedure that calls for proper preparation and recovery. Let’s go through some of the most commonly asked questions about tubal ligation to see if it’s a good choice for you to explore with your doctor.

How do I get ready for tubal ligation surgery?

In the days or months prior to the procedure, your healthcare provider will probably have a conversation with you about your reasons for wanting permanent birth control, while discussing other contraceptive options available to you. If you settle on tubal ligation as the path forward, they’ll also go over the risks and benefits of it, the details of the procedure itself, any possible reasons why the surgery may not work, and recovery information (like any other surgery consultation).

They’ll also discuss scheduling — tubal ligation can be done at any time, but if you’re pregnant, keep in mind that you can also get a tubal ligation shortly after giving birth during the same hospital stay. Once these initial preparatory conversations are complete, they’ll ask you to sign consent documents and schedule the surgery [3].

What happens before the procedure?

In the week or so before the tubal ligation procedure, you may need to stop taking any blood clotting medications like aspirin and ibuprofen [4]. You may also be asked to take a pregnancy test (if the surgery isn’t being done post-childbirth) to be sure you aren’t pregnant at the time of the surgery [1].

It’s likely that the doctor will tell you not to drink or eat anything for some time before your surgery, and will give you other detailed instructions on how to prepare including at what time to arrive [4].

How is tubal ligation performed?

There are two main types of tubal ligation procedures: laparoscopic and minilaparotomy. Both methods involve closing off or removing the fallopian tubes so that egg cells cannot be fertilized. Either way, you’ll receive anesthesia so that you won’t be able to feel pain, but the type of tubal ligation you get depends on your circumstances. Let's go through the logistics of each one.

Laparoscopic tubal ligation: This method is typically done with general anesthesia, and if you haven’t just gone through childbirth. Once you’re asleep, the doctor will pump gas into your belly to see the organs, and will make a small incision near the belly button. A device called a laparoscope is then inserted into that small incision. It has a light and lens to allow the surgeon to see the fallopian tubes. Once the tubes are located, the surgeon will use heat, clips, or rings to close them. The device is then removed and you’re all done! The entire procedure takes about 20-30 minutes and there is usually very little scarring [1, 6].

Minilaparotomy tubal ligation: This alternative method is usually done right after childbirth and involves either local or general anesthesia, or an epidural from the delivery. There will still be an incision made near the belly button if you had a vaginal delivery. If you had a cesarean section, the same incision from that surgery will be used for the tubal ligation procedure. The surgeon brings the fallopian tubes up through the incision and either closes them off with a special thread, or removes parts of the tubes. They’re put back in place and the incision is closed with stitches and/or a bandage [1, 7].

Your doctor may also want to discuss a similar surgical procedure called a salpingectomy with you, as Dr. Tang mentioned earlier. This is when the fallopian tubes are removed entirely, and may be recommended if you’re at increased risk for certain cancers [1].

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Tubal ligation recovery

What should I expect after getting my tubes tied?

After the procedure, you’ll be taken to a recovery area for monitoring as the anesthesia wears off. If you had a laparoscopic tubal ligation, you’ll probably be allowed to go home within just a few hours (you’ll need a ride home). If you’ve had a minilaparotomy, your doctor may recommend staying overnight for more monitoring. If you had the procedure done after childbirth, you’ll already have a hospital stay scheduled and the tubal ligation shouldn’t add extra time to that stay [1].

How long does it take to recover from a tubal ligation?

This is very dependent on your circumstances, specifically what type of surgery you had and your health. If you had a laparoscopic procedure without childbirth, you should be able to go back to your normal daily activities within a few days (make sure to check in with your body and be sure you’re feeling better before returning to your normal schedule). A minilaparotomy with childbirth will take longer, since it generally takes several weeks to months to recover from childbirth anyway [1].

You’ll be given post-operative instructions from your healthcare provider, and it’s important to follow these closely to ensure a smooth recovery. You’ll likely have at least one follow up appointment with your doctor in a few weeks to make sure you’ve healed from the tubal ligation and remove any stitches if necessary [1].

When is it safe to have sex after getting my tubes tied?

Check with your healthcare provider about when it’s safe to have sex again. As we mentioned earlier, tubal ligation works right away, so you won’t have any risk of getting pregnant, but your body will still be healing for at least a few days and up to a few months if the surgery was done in conjunction with childbirth. It’s best to wait until you’re fully healed to have sex after childbirth or after tubal ligation surgery in general [1].

Do you get your period after you get your tubes tied?

Yes, you’ll still get your period after tubal ligation [5]. Your ovaries will still release eggs, your body will still produce the reproductive hormones it normally does, and your uterine lining will still shed each cycle. The egg cells just won’t be able to reach your uterus anymore.

You may also notice some vaginal discharge or bleeding in the days following the surgery. This is normal, but call your doctor as soon as possible if that’s accompanied by rash, swelling, fever, dizziness, nausea, or any other signs of infection [1].

Can I still get an STD if I have my tubes tied?

Yes, you can. STDs and STIs are typically transmitted via direct contact with skin, semen, or pre-cum, so while sterilization procedures like tubal ligation prevent pregnancy, they do not prevent the spread of STIs. Using external or internal condoms is still the best way to lower your chance of getting or spreading infection, even if you get a tubal ligation.

What are the side effects of having a tubal ligation?

You may have some discomfort and pain around the abdomen after the procedure, and you’ll likely be tired. You may also experience some swelling and changes to your bowel movements. Your healthcare provider will prescribe pain medication if necessary, or let you know which over-the-counter pain medication is best for you. You may also notice shoulder pain — this is from the gas used during the surgery. It can be relieved by lying down [4]. In general, side effects from tubal ligation are usually pretty mild, but remember that resting is important when it comes to recovery from any surgery.

What is post-tubal ligation syndrome?

While it isn’t common, some patients experience some or all of the following abnormal symptoms after the procedure:

Painful sex
Low back pain
Irregular periods (that weren’t irregular before surgery)
Menopausal symptoms

These postoperative symptoms are referred to as “post-tubal ligation syndrome,” or PTLS. It’s not clear why this happens to some patients, and because research is limited in this area, there isn’t a clear treatment for the syndrome. Your doctor may still be able to treat the symptoms though, so be sure to mention them if you’re struggling [8].

Can I have the procedure reversed later if I choose?

It is sometimes possible to reverse tubal ligation, but sterilization reversals (for both vasectomies and tubal ligations) are often quite costly and complex procedures. Also, there are no guarantees that you’ll be able to get pregnant after the reversal [1]. Dr. Tang shared her perspective with us about tubal ligation reversals.

“Some tubal sterilizations could be reversed (only if most of the tube was left in place, and only a small amount of the tube was cut, clipped, or removed). However, these would be very costly surgeries as they are not covered by insurance, surgeons who can perform tubal reversals especially are rare, and for tubal reversal there’s a risk of ectopic pregnancy (when pregnancy grows outside the uterus) from tubal scarring, or scar tissue could prevent the tube from functioning,” she said.

So overall, while it may be possible, the risks of reversal are fairly high and it’s best to consider tubal ligation a permanent birth control procedure. If you’ve already had tubal ligation but you’re looking for alternative ways to get pregnant, IVF is one option to consider [4]. Anyone considering tubal ligation should consider it a permanent birth control option. If you’re not sure whether or not you’d like to get pregnant in the future, a long-acting birth control option like a copper IUD (that works for up to 10 years) may be a better fit.

Pros and cons of tubal ligation

Although tubal ligation is a very safe and effective birth control method, it isn’t right for everyone. Make the most of your initial consultation with your healthcare provider to be sure you understand all of the pros, cons, and risks associated with the procedure before you make your final decision. Here are some common points to consider:

Pros:

Effective: It’s a highly effective form of birth control, more than 99% effective at preventing pregnancy [2].
Convenient: If you’re sure you do not want to get pregnant in the future, you never have to worry about follow up appointments, renewing or replacing birth control, or using it daily or every time you have sex like some other birth control methods.
Low risk: The procedure has very low chances of complications. Most reported complications are related to anesthesia rather than the procedure itself [7].
Non-hormonal: Tubal ligation is a non-hormonal birth control that won’t mess with your hormones or your cycle, and it won’t cause any of the hormonal birth control side effects that some people struggle with [1].

Cons:

Reversal difficulty: As we’ve discussed, the tubal ligation reversal process — when possible — is complex, costly, and may not result in fertility.
Regret: Some patients ultimately regret getting the procedure — this is most common for women who get their tubes tied before the age of 30 [4].
Risks: Like with all surgeries, there are risks of bleeding, pain, infection, or poor reactions to the anesthesia. These are rare, but certain conditions like obesity, diabetes, or past abdominal surgeries may increase your risk of complications [3, 8]. It’s also worth noting that in very rare cases, some women have an ectopic pregnancy after getting tubal ligation [7].
No protection against STDs: You will not be protected against sexually transmitted infections after you get tubal ligation, so you may still need to use condoms if you’re at risk [1].

If you’ve consulted with your doctor and weighed these pros and cons, we hope you’ll have a good idea of whether this birth control method is right for you. If you’re not ready for permanent birth control like this, but you like the idea of a highly effective and convenient birth control, discuss methods like the IUD or the implant with your doctor. Both have over 99% effectiveness and can last for several years [2].

Explore non-hormonal birth control with Natural Cycles

Overall, tubal ligation is a highly effective, convenient, non-hormonal birth control procedure best suited for someone who is sure that they do not want to get pregnant in the future. “Talk with your gynecologist about your particular situation including your preferences, concerns, anatomy and medical history, risk factors, goals for future fertility, to help determine which method would be the best fit for you,” said Dr. Tang.

If you like the idea of non-hormonal contraception, but you’re looking for a non-invasive method, see if Natural Cycles is a good fit for you. It’s the first FDA Cleared non-hormonal birth control app that works with your body to prevent pregnancy.. Explore Natural Cycles contraception today.

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Planned Parenthood. Sterilization (multiple pages) [Internet]. [cited 2025 March 18] Available from: https://www.plannedparenthood.org/learn/birth-control/sterilization
Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception and the percentage continuing use at the end of the first year. [Internet]. [cited 2025 March 18]. Available from: https://www.datocms-assets.com/21281/1662539230-contraceptive-technologies_failure-rates-table-2018.pdf
Marino S, Canela C D, Jenkins S M, Nama N. Tubal Sterilization [Internet]. 2024 [cited 2025 March 18]. Available from: https://pubmed.ncbi.nlm.nih.gov/29262077/
Martinez L, Dugdale D. Tubal ligation [Internet]. 2024 [cited 2025 March 18]. Available from: https://medlineplus.gov/ency/article/002913.htm
American College of Obstetricians and Gynecologists (ACOG). Sterilization for Women and Men [Internet]. 2023 [cited 2025 March 18]. Available from: https://www.acog.org/womens-health/faqs/sterilization-for-women-and-men
American College of Obstetricians and Gynecologists (ACOG). Sterilization by Laparoscopy [Internet]. 2022 [cited 2025 March 18]. Available from: https://www.acog.org/womens-health/faqs/Sterilization-by-Laparoscopy
American College of Obstetricians and Gynecologists (ACOG). Postpartum Sterilization [Internet]. 2023 [cited 2025 March 18]. Available from: https://www.acog.org/womens-health/faqs/postpartum-sterilization

Sung S, Abramovitz A. Tubal Ligation (Archived) [Internet]. 2024 [cited 2025 March 18]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549873/

",{"_298":6968,"_438":6969,"_1695":6970,"_1697":1698,"_1699":6971,"_1701":6972,"_1703":6973,"_1705":6974,"_1707":6975,"_1709":-5,"_1710":6976,"_408":7009,"_410":7010,"_1810":7011,"_1880":7054,"_342":7055,"_1891":1892,"_1893":7062,"_1908":1909,"_1910":7065,"_1923":1924,"_1925":7068,"_1929":7069},"CR3p6aUmTRC6jngE6WMuTQ","Coregasm: Why it happens, how to have one & more","coregasm","2025-03-26","2025-03-26T14:47:47+00:00","

Have you ever had this weird, tingly feeling in your abdominal region during an intense core-focused workout? If the answer is yes, then you may have experienced a coregasm.

","

Key takeaways

A coregasm is an exercise-induced orgasm (EIO) that can occur during certain workouts, mostly core-focused exercise
Coregasms are not sexual in nature and can happen without any psychological or physical sexual stimuli
Scientists are not sure why coregasms happen — more research is needed to learn about the mechanism of EIO and who can experience it

","

It's a unique phenomenon that was first mentioned by a famous sexologist, Dr. Alfred Kinsey, in the 1950s. In his book Sexual Behavior in the Human Female, he noted that young men and women use muscle tension without direct genital touch as a way to masturbate. Around 5% of respondents he and his colleagues studied reported experiencing sexual pleasure from exercise [1].

In recent years, popular magazines and Internet blogs have described exercise-induced orgasms, frequently identifying them as “coregasms.” Up until the 2010s, when the first official research on the topic started to show up, most of the data we had on coregasms was anecdotal. Exercise-induced orgasms (EIO) are wildly underresearched to this day. Despite having very little understanding about coregasms or why they occur, we know they are real and happen to enough people for us to believe it may be something more common than we think.

In our article, we'll discuss everything we know so far about what coregasms are, why they happen, who can have them, and how to have them (or avoid them) if you're curious to experience one.

What is a coregasm?

A coregasm is an exercise-induced orgasm (EIO) that often happens during an intense core-focused workout. It's different from regular orgasms because coregasms are not sexual by nature — no sexual stimuli of the body or the mind are necessary for these types of orgasms to occur.

A 2014 National Survey of Sexual Health and Behavior, which featured findings from 1,012 men and 1,083 women, found that about 9% of people have experienced an exercise-induced orgasm (EIO) [3].

Why it happens?

We don't entirely know why and how exercise-induced orgasms (EIO) happen. For many years, it was believed that orgasms are a fully sexual experience for people. But research on coregasms has shown that exercise-induced orgasms (EIOs) can happen without any sexual arousal at all.

What we do know is that most of the time, coregasms happen during certain types of exercises. Of the 530 women surveyed, 124 reported experiencing EIO, and 246 reported experiencing exercise-induced pleasure but not orgasms. 124 participants who reported orgasms said these activities were most likely to trigger them:

Abdominal exercises: 45%
Pole or rope climbing: 9%
Weight lifting: 7%
Running: 7%
Stretching, yoga, aerobics: 3.5%

There were also other exercises that induced a coregasm, such as swimming, chin-ups, pull-ups, and more [2]. As you can see, though, the most popular form of exercise that may cause coregasms is abdominal workouts, which focus on stimulating our core.

Core muscles are crucial to sexual health and function. One group of core muscles is the pelvic floor muscles, which control bladder, bowel, and genital functions [4]. Research shows that strong pelvic floor muscles can significantly improve orgasms and sexual arousal [5].

Can everyone have them?

Out of 530 women researchers surveyed, 23% of women reported experiencing exercise-induced orgasm on multiple occasions, which means that it's not an uncommon occurrence. What's also interesting is that while only 23% of women experienced EIO, around 46% of participants reported experiencing sexual pleasure while exercising, even if they didn't orgasm [2].

The majority of the limited research available on EIOs has been done on women, so there is not much data on men. However, based on the 2014 National Survey of Sexual Health and Behavior data, we do know that men can experience coregasms.

Researchers also looked at factors that might predict someone's ability to have a coregasm — like whether they’d recently had an orgasm during sex with a partner. Turns out, there was no correlation between coregasms and the timing of a partnered orgasm. But they did find a link between coregasms and sleep orgasms — both men and women who had experienced sleep orgasms were more likely to report exercise-induced orgasms EIOs [3].

What does it feel like?

Generally, the way orgasms feel will vary from person to person — we're different and experience sexual pleasure and arousal in a way that is unique to us. The same goes for coregasms.

According to blog posts and personal accounts, coregasms have been described as feeling more like deep, full-body orgasms than intense, clitoral climaxes.

How to have a coregasm

Are you curious about trying to experience a coregasm yourself? Let's talk about the how!

How to increase your chances of having one

A surefire way to increase your chances of experiencing an exercise-induced orgasm is to exercise and strengthen your core muscles. While we don't know how coregasms happen, there's some research that shows strong pelvic floor muscles may lead to better sexual arousal and stronger orgasms [6, 7]. However, our bodies are different, and strengthening pelvic floor muscles doesn’t guarantee improved sexual function for everyone.

Since coregasms are linked to exercise involving core muscles, you may also want to find a way to incorporate more core strength-building workouts like yoga, pilates, or simple crunches to build muscle strength.

Exercises that are known to trigger coregasms

We do know that exercises that engage our core muscles, especially lower abdominal muscles, tend to be the type of exercise that induces coregasms:

Crunches
L-sits
Planks
Hanging leg raises
Captain’s chair leg raise
Hip thrusts
Pull-ups
Chin-ups
Role climbs
Pole climbs

Yoga is another form of exercise that targets core strength and was mentioned as a workout that induced coregasms for people in both studies.

Coregasms happen naturally, and workouts should feel good, no matter what — so don't overthink it! Putting too much pressure on reaching an exercise-induced orgasm might have the opposite effect. Instead, treat this as a fun experiment and focus on the sensations in your body rather than stressing about whether or not you're able to have a coregasm.

How to prevent a coregasm

While a coregasm might sound fun because who doesn't love pleasure, for some people, it may be uncomfortable or even anxiety-inducing [2]. That's totally understandable, considering that coregasms might happen in the middle of a public place, which may be the last place you want to climax in.

The best way to prevent a coregasm is to understand what exercise triggers one for you. Because all of our bodies are different, a workout that causes a coregasm for one person may not have the same effect on another. Once you know what types of exercises trigger coregasms, consider avoiding those specific exercises.

If you don't want to skip workouts just because of the threat of a coregasm (which is totally valid!), you may want to be more mindful of what's happening in your body at all times. Once you pay more attention, you'll be able to spot the cues of an upcoming coregasm easier, which can help you develop better control over them.

If you feel a coregasm approaching in the middle of a workout, slow down the pace and ease off — removing intense stimulation of the muscles should prevent the coregasm from happening.

Understand your body better with Natural Cycles

Increasing awareness about the body, sexual health, and cycle is key to our mission here at Natural Cycles. Our FDA Cleared app can help you track the changes in your body throughout the length of your cycle, which helps you feel empowered in your health and sexuality. Try it to discover if Natural Cycles is right for you!

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Alfred C. Kinsey. Sexual Behavior in the Human Female. Indiana University Press, 1953.
Herbenick, D., & Fortenberry, J. D. (2011). Exercise-induced orgasm and pleasure among women. Sexual & Relationship Therapy, 26(4), 373–388. https://doi.org/10.1080/14681994.2011.647902
Herbenick, D., Fu, T., Patterson, C., & Fortenberry, J. D. (2021). Exercise-Induced Orgasm and Its Association with Sleep Orgasms and Orgasms During Partnered Sex: Findings From a U.S. Probability Survey. Archives of Sexual Behavior, 50(6), 2631–2640. https://doi.org/10.1007/s10508-021-01996-9
Bordoni, B., Sugumar, K., & Leslie, S. W. (2023, July 17). Anatomy, abdomen and pelvis, pelvic floor. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK482200/
Kanter, G., Rogers, R. G., Pauls, R. N., Kammerer-Doak, D., & Thakar, R. (2015). A strong pelvic floor is associated with higher rates of sexual activity in women with pelvic floor disorders. International Urogynecology Journal, 26(7), 991–996. https://doi.org/10.1007/s00192-014-2583-7
Sartori, D. V. B., Kawano, P. R., Yamamoto, H. A., Guerra, R., Pajolli, P. R., & Amaro, J. L. (2020). Pelvic floor muscle strength is correlated with sexual function. Investigative and Clinical Urology, 62(1), 79. https://doi.org/10.4111/icu.20190248
Kanter, G., Rogers, R. G., Pauls, R. N., Kammerer-Doak, D., & Thakar, R. (2015). A strong pelvic floor is associated with higher rates of sexual activity in women with pelvic floor disorders. International Urogynecology Journal, 26(7), 991–996. https://doi.org/10.1007/s00192-014-2583-7

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You’re nearly there — welcome to week 39 of your pregnancy! In these final days and weeks, before you give birth, it’s important to rest as much as you can and to take care of your mental and physical health. This week, we’ll go through some symptoms and changes you might be experiencing in your body and check in on your baby’s development. We’ll also review the early signs of labor and offer some tips for things you can do this week to care for yourself and prepare for childbirth.

","

Key takeaways

Though your baby’s movements might be feeling different, they will still move as much as ever all the way up to delivery
Diarrhea, pelvic pain, and changes to the cervix are all common in week 39, but they are not necessarily signs that labor is imminent
Contractions are key — discharging your mucus plug, having your water break, and contractions are all signs of labor beginning, though not everyone will experience all of them in the same progression

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Your body at week 39

Baby kicks

Your baby will stay active all the way up until they are born, so you should still be feeling their movements as frequently as ever. You might experience different kinds of movement, though, as your baby is taking up more and more room in your uterus. There is no set number of movements to expect and at this stage of pregnancy, you’re probably pretty familiar with your baby’s movements [1]! However, if you notice a decrease in their activity, contact your midwife or doctor right away.

Diarrhea

In the final days or weeks before you give birth, it’s not uncommon to experience diarrhea. Before and during labor, your body produces hormones called prostaglandins, which scientists believe encourage the cervix to soften and the uterus to contract [2]. Surges of prostaglandin are also a regular part of menstruation, helping the uterus contract and release the uterine lining (endometrium) in the form of a bleed during your period. In both menstruation and pregnancy, prostaglandins can have a parallel effect on your bowel movements and cause diarrhea for some women [3].

While prostaglandin plays an important role in labor, and can even be used to artificially induce labor, diarrhea is an unreliable predictor of when labor is beginning or how quickly it will proceed [2]. For that reason, while it’s common to have diarrhea before labor, it shouldn’t be considered an early labor sign nor an indication that labor is going to start soon.

Pelvic pain

You might, unfortunately, already be familiar with pelvic pain, or pelvic girdle pain, which can get stronger at the end of your pregnancy. As your baby gets into the birthing position, they press down on your pelvis, which can lead to worsening pain in your pubic region, lower back, hips, groin, thighs, or even knees [4]. This can make moving, walking, sleeping, or doing everyday activities painful and difficult.

Try to remember to maintain good posture, with a neutral spine and bottom tucked slightly under you, when sitting and standing. Poor posture can make pelvic pain worse. Light exercise (if safe to do in your pregnancy), rest, not staying in any position too long, and using a pillow between your knees when resting or sleeping can all help with pelvic pain [4]. If your pain is becoming worse or affecting your ability to go about your day-to-day life, contact your healthcare provider to see if physiotherapy or other therapeutics might be right for you.

You might be wondering how pelvic pain will affect labor and birth. In most cases, women who suffer from pelvic pain in pregnancy can still have a vaginal birth [4]. However, make sure that your midwife and/or doctor are aware of your pelvic pain so they can help you find a comfortable position during labor and childbirth.

Changes to your cervix

In your final checkups before birth, your nurse, midwife or doctor might examine your cervix to see whether it has begun “ripening” or effacement, which are words that both mean getting ready for labor. When this happens, your cervix will soften, and get thinner and/or shorter. If this is your first birth, your cervix will also start to open, or dilate, after effacement begins [5].

While these changes show that your body is getting ready, they cannot actually predict when labor will begin. Some women experience symptoms of effacement weeks before they give birth. Similarly, labor can proceed so quickly that sometimes your doctor or healthcare provider won’t notice changes to your cervix before your water breaks or you begin having contractions.

Your baby’s development at 39 weeks

At 39 weeks, your baby is fully developed and is still gaining weight! This extra fat will help them regulate their body temperature and stay warm outside the cozy uterus [6]. At term, your baby can have a firm grasp, so they will be able to hold your finger. They can also turn their head and face you, or a sound. But their eyesight is still developing — at birth, full term newborns can only see about 6-10 inches (15-25 cm) in front of their face.

This week, your baby likely weighs between 6.5 and 8 lbs (2.9 to 3.6 kilograms) and is around 18 to 20.5 inches (45.7 to 52 cm) long [7]!

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Signs of labor at 39 weeks

There are three main signs of labor: contractions, the release of the mucus inside your cervix, and your water breaking.

Labor contractions will come at regular intervals that you can time with a watch, and they will get stronger and closer together as labor progresses. These are different from Braxton Hicks contractions, which can come randomly and go away completely.
Discharging your mucus plug, which is also known as a “show” or “bloody show”, might be different from the discharge you have been experiencing. It’s usually thick, clear, and can have blood in it [8]. You might not even notice if you lose your mucus plug or you might not lose it until you’re already in labor.
Water breaking, which is also called the rupture of membranes, is when the amniotic sack that has been holding the baby opens and the amniotic fluid comes out of your vagina. This can happen in a large rush, or it can leak out slowly.

You might be wondering, can you be in labor without having contractions or experiencing your water breaking? Despite what you might have seen in movies or on TV, most women won’t experience their water breaking at the very start of labor. In fact, it’s the first sign of labor for only 8-12% of women [9,10]. Contractions, on the other hand, are felt by everyone during labor. Keep track of the frequency of your contractions and follow the guidelines of your hospital or birthing center to know when to contact your midwife or doctor and go to the hospital. Labor can progress unexpectedly, so it’s advisable to be ready to go to the hospital as soon as you begin having regular contractions.

If your water breaks or you suspect you’re leaking amniotic fluid, even if you aren’t experiencing contractions, you need to contact your hospital or maternity clinic immediately. You should also contact them if you experience bleeding of any kind.

Tips in week 39

Take it easy: first and foremost, try to rest and relax as much as you can this week. Whether you’re giving birth to your first child, or your tenth, your life will be changing a lot as soon as your baby is born. Try to take as much time for yourself, for you and your partner, and for you and your family as possible.
Stock up on entertainment: being prepared with reading materials, like books or magazines, or having some shows or podcasts downloaded and ready on your phone or tablet can help you relax leading up to and through the early stages of labor, which can sometimes take a long time!
Consider taking a trip to the pool: at 39 weeks, you might be feeling very large, heavy, and uncomfortable. Not to mention hot! Why not consider a trip to the local pool? If it’s safe to do in your pregnancy, floating, light swimming, or water walking can help take some pressure off your joints and provide some relief for pregnancy aches and pains.
Prepare for postpartum: labor is hard work, and your body will take time to heal and recover afterward. Whether you have a vaginal birth or caesarian section, you will likely need some extra supplies after giving birth, like maxi pads, postpartum underwear, and peri bottles to help make you as comfortable as possible. Though unpleasant, hemorrhoids are also very common after giving birth, so have some medication or remedies ready just in case.
Schedule your week 40 checkup: you will most likely see your doctor or midwife at week 40. That appointment is a great time to ask any last-minute questions about labor and birth, so if you haven’t already done so, read up on the delivery process. You can also ask about what happens if your pregnancy goes past week 40 and find out more about induction.

Support through your pregnancy and postpartum with Natural Cycles

You might know Natural Cycles as the first FDA Cleared birth control app, but did you know that Natural Cycles can support your fertility health through pregnancy and postpartum? During your pregnancy, NC° Follow Pregnancy offers weekly guides that keep you updated on the progress of your pregnancy and baby’s development. After you give birth, switch to NC° Postpartum for extra support as you recover from childbirth and transition to life postpartum. The app also has articles and guides to support your sexual, mental, and physical health throughout pregnancy and postpartum. Finally, you can use NC° Birth Control as a non-invasive, hormone-free birth control method after giving birth.

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There are several reasons people may choose to use abstinence and outercourse, whether it’s as an alternative to birth control, for religious reasons, or maybe just a personal preference when it comes to intimacy. In this article, we’re going to take a look at everything you need to know about abstinence and outercourse as pregnancy prevention methods, including how abstinence and outercourse work, the benefits (and drawbacks) of outercourse and abstinence, and how to talk about it with your partner.

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Key takeaways

Abstinence means refraining from any form of sexual activities for various reasons such as health, religion, or spirituality
Outercourse is an umbrella term used to describe a variety of sexual activities outside vaginal intercourse, such as oral sex, kissing, cuddling and dry humping
Both abstinence and outercourse can be used as effective non-hormonal birth control methods to prevent pregnancy

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What is abstinence?

Generally, sexual abstinence is defined as refraining from various sexual activities, such as oral, vaginal, or anal sex with a partner. Some people may abstain from all sexual activities, including solo masturbation, while others may choose to engage in self-pleasure and only abstain from partnered sex.

There are many reasons people choose to use abstinence. Some people might be abstinent for short periods of time throughout their lives, whereas others may choose long periods of abstinence or, in some cases, lifelong abstinence.

Abstinence is an individual choice, and for some people, it’s a great option – but as with all individual choices, it doesn’t mean it’s right for everyone!

How does abstinence work?

People use abstinence for various reasons (more on that below), but when it comes to using abstinence to prevent pregnancy, the method works by keeping sperm cells away from a female egg cell. Without vaginal intercourse, there's no way for the sperm to fertilize the egg, which is how pregnancy occurs [1].

Abstinence can also be used as part of natural family planning as a means to prevent pregnancy. Natural family planning works by finding the fertile days when you are at risk of pregnancy. During this fertile window, it’s important not to have unprotected penetrative sex. For some people, this means using condoms, and for other people, this means abstaining from penetrative sex.

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Natural Cycles and abstinence

The FDA Cleared birth control app, Natural Cycles uses temperature data to calculate your fertile days. The app gives you a daily fertility status, and on days when you’re fertile, you can choose to either use a condom or abstain from penetrative intercourse.

What are the different types of abstinence?

There are two different abstinence types. Sexual abstinence may be primary, meaning that you have never engaged in intercourse before, or secondary, when you have had sex with a partner before but are choosing not to engage in any sexual activities anymore [2].

While some people may want to use abstinence to prevent pregnancy, they may still want to find ways to be sexual with their partners. So, people may choose to engage in other activities such as oral sex, kissing, or touching. This is often referred to as outercourse.

What is outercourse?

Outercourse is a term that’s sometimes used to describe any form of sexual activity that doesn't involve penetration or intercourse. What sort of activities counts as outercourse varies from person to person but may generally include things like:

Kissing
Cuddling
Massage
Sexual rubbing
Sharing sexual fantasies
Phone sex
Mutual masturbation
Oral sex
Anal sex
Fingering [3]

Abstinence vs. outercourse

Abstinence and outercourse are terms often used interchangeably, though they're not actually the same thing. Personal definitions of abstinence can vary. Some people consider outercourse to be a form of abstinence, and that works great for them. However, in many cases, abstinence means not engaging in sexual activities at all, while outercourse encompasses all the sexual activities that don't involve intercourse or penetration.

Abstinence and outercourse are different not only by definition but also by intention. Abstinence may be voluntary when someone actively chooses not to have sex due to health or religious reasons. Or it may be involuntarily, when someone isn’t sexually active or may not be able to have sex due to aging, medical conditions, or even psychological reasons [2].

Outercourse, on the other hand, is something that people often choose due to various reasons. For example, we may want to engage in non-penetrative activities to avoid pregnancy, increase pleasure, or add novelty to our sex life.

Pros & cons of abstinence

What are the benefits and risks of practicing sexual abstinence? Well, there are quite a few compelling pros and cons:

Pros:

Prevents STIs: Abstaining from any form of sexual activity is one way to prevent contracting an STI.
Prevents pregnancy: When practiced consistently, abstinence can be extremely effective at preventing pregnancy. No sexual activity means there are no chances of sperm getting anywhere close to the female egg cell.

Cons:

Hard to practice: Abstinence is only effective in preventing pregnancy and protecting against STIs if it's practiced consistently. That may be harder to do than we think because choosing to be abstinent doesn't make sexual desire and attraction to our partners disappear. It requires 24/7 mindfulness, dedication, and will, which can be hard for some.
May lead to poor relationship with sex: In some countries, it’s common to teach an abstinence-first approach to sex education. However, we know that this method is only one of a number of different approaches and won’t work for everyone. Research shows that receiving abstinence-first sex education doesn't delay the age of first-time sexual intercourse [4].
May negatively impact mental health: Sex and orgasms have a multitude of health benefits [5], and abstaining from any sexual activity may have adverse mental health effects. Recent research shows that during lockdown, people who were sexually active had lower anxiety and depression scores compared to people who weren't [6].

Abstinence and fertility

There’s a lot of stigma and misinformation about the relationship between fertility and abstinence. One of the common beliefs is that to increase your chances of conceiving, it’s a good idea to abstain from sex, so it gives more time for the sperm to “accumulate.” Let’s see what the science says.

For men who are trying to conceive and are looking for ways to boost fertility, abstinence may be a way to improve sperm quality. However, it only applies to short-term abstinence of 24 hours – one study found that after abstaining from ejaculation for a day, men's sperm showed increased motility, oxidative activity, and sperm function [7].

That same study found that after longer periods of delaying ejaculation, the sperm quantity increased, but the quality started to decline. So, the evidence suggests not having sex for long periods of time doesn’t improve fertility.

Pros & cons of outercourse

What are the benefits and risks of engaging in outercourse? Here are some pros and cons:

Pros:

Adds variety to your sex life: Novelty is key to keeping passion alive in long-term relationships, and couples who try new things together (outside and inside the bedroom) tend to report higher relationship satisfaction [8]. Outercourse may be a great and easy way to add variety and try something different with your partner.
Minimizes risk of pregnancy: While outercourse activities are not 100% pregnancy-risk-free, most can be if you're diligent about the way you engage in outercourse. For example, activities like kissing, cuddling, dry humping, and even mutual masturbation are safe and can greatly reduce the chances of pregnancy [3].
Gives an alternative way to enjoy pleasure: Some people have trouble enjoying intercourse due to pain or discomfort. Engaging in non-penetrative sex-focused activities like oral sex, mutual masturbation, or dry humping may be a great way to enjoy sex and have an easier time achieving orgasms.

Cons:

May still lead to pregnancy: Just because the penis doesn’t enter the vagina, it doesn’t mean outercourse activities can’t lead to pregnancy. If the ejaculate gets close to the vagina, there’s a chance that the sperm may fertilize the egg.
May not be for everyone: Some people may require intercourse to take place during intimate moments for them to feel sexually satisfied and close with their partners. Because sex is an individual experience, outercourse may simply not be the right form of sex for some.

How effective are abstinence and outercourse?

If you want to use abstinence or outercourse as a birth control method, you might be curious to find out how effective they are at preventing pregnancies.

How effective is abstinence?

When it comes to preventing pregnancy, abstinence is effective if practiced consistently. Meaning: if you avoid any and all sorts of sexual activities at all times, you won’t get pregnant. However, sexual abstinence can be difficult to practice, and, as we already touched on, it’s really up to an individual whether or not abstinence suits their lifestyle and values.

While no birth control method is 100% effective at preventing pregnancy, it’s good to consider an option that you are willing to use and will suit you. In short, abstinence works if you can stick to it, but if it’s not for you, you might want to consider another birth control option.

How effective is outercourse?

When it comes to preventing pregnancy, outercourse can be an effective method. If you engage in outercourse activities such as kissing, cuddling, dry humping with clothing, or mutual masturbation, then your chances of pregnancy are extremely low.

However, other forms of outercourse may have a higher chance of pregnancy. Keep in mind that pregnancy can happen if any sperm cells get into the vagina. It doesn’t have to just be through penetrative sex. So it’s really important to wash hands and sex toys if they get ejaculate on them before putting them in the vagina to avoid the risk of pregnancy.

Can you get pregnant from dry humping?

Dry humping is a form of outercourse when you rub and grind against your partner for sexual pleasure. You may choose to dry hump with your clothes on or naked. Either way, dry humping can be pleasurable and lead to an orgasm.

Generally, dry humping is considered to be a low-risk sexual activity, but the chances of getting pregnant depend on how you choose to engage in this activity – if you're dry humping while fully clothed, the chances of pregnancy are non-existent [9].

However, if you choose to dry hump naked, and involve genital rubbing and ejaculation occurs, some of the sperm may get inside the vaginal canal, increasing your chances of getting pregnant [3]. Though, the chances of this happening are low.

Do abstinence and outercourse protect against STIs?

When practiced properly, sexual abstinence can be very effective at protecting us against contracting STIs. The science is simple – no sexual activity, the risk of STIs is almost zero.

Outercourse is a different matter, though. When it comes to preventing STIs, engaging in certain outercourse activities like anal sex or oral sex without protection with partners whose sexual history you don't know may put you at an even higher risk of contracting an STI [3]. So, the effectiveness of outercourse in preventing STIs will greatly vary from person to person.

How do I talk to my partner about not having sex?

Open, non-judgmental sexual communication is key to a satisfying sex life and relationship. If you're considering practicing abstinence and you're in a relationship, it's important to communicate your desires to your partner so you can both be on the same page.

We get it – talking about sex can be intimidating. Here are a few tips that may help you overcome the discomfort when talking about sex and your needs:

Be honest: If you want to stop having sex for whatever reason, be honest and straightforward with your partner. Share your thoughts, feelings, and reasons for wanting to abstain from sex so they can better understand how you’re feeling. Tell them exactly how you want them to support you so they know what to do and are not left trying to read your mind or guessing.
Be upfront: If you're just entering a new relationship, be upfront about your desire to practice abstinence as soon as possible. Don't wait until you're about to have sex to drop this piece of information – have a conversation beforehand so your partner knows what's happening.
Set boundaries: If you choose to practice abstinence, it's your right to set boundaries around what forms of intimacy you feel comfortable with and which are off-limits. Your partner should always respect those boundaries and be supportive of them.

Every one of us is different and may have a different view of sexuality and sex. We all have different sexual desires and sex drives. So, keep that in mind and be patient with your partner as you navigate these complex conversations.

How do I talk to my partner about outercourse?

Talking about sex when you're happy with your sex life but want to try something new can be equally as complicated. Don't worry – you're not alone. Many couples feel apprehensive when it comes to talking about sex.

The good news is, expressing your sexual desires is easier than you think, as long as you approach the conversation about trying outercourse from the right angle:

Avoid criticism: When communicating your desire to try something new with your partner, always try to frame it from a positive angle, rather than criticizing your current sex life. Instead of saying, \"Our sex life is boring, I want to try something new to shake things up,\" try something like: \"Babe, I love having sex with you. How do you feel about trying [X, Y, Z...] together?\"
Make a \"Yes/No/Maybe\" list: If talking about it is hard, why not put things on the paper? On your next date night, make a \"Yes/No/Maybe\" list with your partner. Each of you writes down outercourse activities you want to try in the \"Yes\" column, activities that are off-limits in the \"No,\" and activities you're curious about in the \"Maybe\" column. Swap your lists, find activities in the \"Yes\" and \"Maybe\" columns that overlap, and start exploring.
Respect is key: Always respect your partner’s desires and boundaries when it comes to trying new things together. They may be hesitant when you first introduce the idea – give them time and space to think about it. Talk about ways to make it more comfortable for them, and be patient.

Searching for a hormone-free way to prevent pregnancy?

Thanks for reading up on abstinence and outercourse. At Natural Cycles, we’re passionate about birth control choices and believe everyone should have the tools and the knowledge to make informed decisions about their health.

If you’re thinking about coming off hormonal birth control, or are already practicing abstinence or outercourse as a means to prevent pregnancy, then Natural Cycles could be a good fit for you. In 2018, Natural Cycles became the first FDA-cleared birth control app. It’s 93% effective with typical use and 98% effective at perfect use. Users log their temperature each day in the app and get a daily fertility status. With this information, they can then choose to use protection or abstain from sex on fertile days. Why not find out if Natural Cycles could work for you?

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Website, N. (2024, November 14). Trying to get pregnant. nhs.uk. https://www.nhs.uk/pregnancy/trying-for-a-baby/trying-to-get-pregnant/
Irfan, M., Hussain, N. H. N., Noor, N. M., Mohamed, M., & Ismail, S. B. (2020). Sexual Abstinence and Associated Factors Among Young and Middle-Aged Men: A Systematic review. The Journal of Sexual Medicine, 17(3), 412–430. https://doi.org/10.1016/j.jsxm.2019.12.003
Baxter, R. (n.d.). Outercourse. SMSNA. https://www.smsna.org/patients/did-you-know/outercourse
Santelli, J. S., Kantor, L. M., Grilo, S. A., Speizer, I. S., Lindberg, L. D., Heitel, J., Schalet, A. T., Lyon, M. E., Mason-Jones, A. J., McGovern, T., Heck, C. J., Rogers, J., & Ott, M. A. (2017). Abstinence-Only-Until-Marriage: An Updated review of U.S. policies and programs and their impact. Journal of Adolescent Health, 61(3), 273–280. https://doi.org/10.1016/j.jadohealth.2017.05.031
The Benefits of a Healthy Sex Life | Center for Women’s Health | OHSU. (n.d.). https://www.ohsu.edu/womens-health/benefits-healthy-sex-life
Mollaioli, D., Sansone, A., Ciocca, G., Limoncin, E., Colonnello, E., Di Lorenzo, G., & Jannini, E. A. (2020). Benefits of sexual activity on psychological, relational, and sexual health during the COVID-19 breakout. The Journal of Sexual Medicine, 18(1), 35–49. https://doi.org/10.1016/j.jsxm.2020.10.008
Okada, F. K., Andretta, R. R., & Spaine, D. M. (2020). One day is better than four days of ejaculatory abstinence for sperm function. Reproduction and Fertility, 1(1), 1–10. https://doi.org/10.1530/raf-20-0018
Rosa, M. N., Matthews, S. A., Giuliano, T. A., Thomas, K. H., Swift, B. A., & Mills, M. M. (2019). Encouraging erotic variety: Identifying correlates of, and strategies for promoting, sexual novelty in romantic relationships. Personality and Individual Differences, 146, 158–169. https://doi.org/10.1016/j.paid.2019.04.009
If I had dry sex, am I still a virgin? (2024, February 7). Planned Parenthood. https://www.plannedparenthood.org/blog/if-i-had-dry-sex-am-i-still-a-virgin

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March is endometriosis awareness/action month — a time to raise awareness and take actionable steps toward improving the depth and breadth of our understanding on the common condition that is endometriosis. If you suspect you may have endometriosis or know someone who does, you may be wondering what endometriosis is, what causes it, and how one can manage it.

","

Endometriosis is common but complex — it affects 1 in 10 women, causes chronic pain, and can impact fertility, yet diagnosis and treatment remain challenging
Diagnosis and treatment vary and range from surgery to imaging and hormonal therapy to pain management, depending on your symptoms and their severity
Tracking your cycle can help you understand menstrual patterns, manage symptoms, and help you have more informed discussions with your doctor

","

What is endometriosis?

Endometriosis is a chronic inflammatory condition, which means that it is long-lasting and can impact people for much of their lives. It affects an estimated 1 in 10 women of reproductive age [1]. For context, this is as common as diabetes in the United Kingdom. The condition itself is characterized by the growth of tissue similar to the lining of the uterus (womb) outside of this area [2]. Although this tissue is most commonly found around the pelvis on the bowels, bladder, or rectum in women with endometriosis, it can be found all over the body and, in rare cases, in locations such as the lungs [3].

The endometriosis lesions (tissue) respond to hormonal changes throughout the menstrual cycle similarly to the womb lining, which cause the tissue to grow [4]. Now you know what endometriosis is, you might be wondering, what causes this complex condition?

What causes endometriosis?

Whilst there isn’t a single cause of endometriosis, there are some theories as to what causes the condition, such as:

Retrograde menstruation: During your period, some of the womb lining that would typically leave the body through the vagina actually flows backward, through the fallopian tubes, and into the abdomen. This tissue then implants around the abdomen and continues to respond to hormones in this area. This theory doesn’t explain certain cases of endometriosis, however, and most people who menstruate will, at some point, experience retrograde menstruation and not develop endometriosis [5].
Genetics: Research suggests that there is a significant genetic component to endometriosis, meaning that if a close relative has endometriosis, you may be more likely to have it [6].
Immune system dysfunction: It is believed that for some, the immune system may not be strong enough to “fight off” endometriosis. However, it isn’t clear whether this contributes to the development of endometriosis or occurs as a result of having the condition [7].

What are the risk factors for endometriosis?

There isn’t anything that can prevent endometriosis, but there are some factors which may increase the risk of developing the condition.

Early onset of menstruation (i.e., menarche, when you first get your period)
Short menstrual cycles
Long and heavy periods
Reproductive tract abnormalities [8]

How is endometriosis diagnosed?

Traditionally, getting a diagnosis of endometriosis has been a lengthy and invasive process, and there are a few routes to diagnosing the condition, including:

Surgery: Laparoscopic, aka ‘key-hole”, surgery has long been the “gold standard” for endometriosis diagnosis. The surgery involves a small incision being made in the abdomen. A small tube and a camera will be inserted into the pelvis to investigate and visualize any disease [5].
Imaging: There have been some exciting developments on the use of imaging (i.e. MRI and transvaginal ultrasound) to diagnose endometriosis. As a non-invasive method, imaging can be used to diagnose endometriosis but is most effective for deep infiltrating endometriosis. It is important to note that even if an imaging test comes back negative for endometriosis, it is still possible that there is some disease that wasn’t picked up, especially if it is within the abdominal cavity [9].

For some, being diagnosed with endometriosis can provide a feeling of ‘relief’, especially if you have been suffering for years without a diagnosis. If you have surgery to diagnose endometriosis and doctors don’t find signs of disease, it’s important to know that your symptoms and your experience are still valid. You deserve to have your experience taken seriously and your symptoms managed, with a diagnosis of endometriosis or not.

What are the symptoms of endometriosis?

Endometriosis is a complex condition. There are many possible symptoms that could impact someone with an endometriosis diagnosis [2]. Some of the most common symptoms associated with endometriosis are pain and fertility challenges. It is important, however, to note that not everyone who has endometriosis will experience these symptoms, and it’s estimated that up to 25% of those with endometriosis will be asymptomatic (have no symptoms at all) [10]. Additionally, the amount of endometriosis disease found in the body does not correspond to the severity of symptoms experienced. Let’s take a closer look at some of the different kinds of symptoms.

Pain-related symptoms

Some of the most common symptoms associated with endometriosis are pain-related. This can include (but is not limited to):

Pain during your period (dysmenorrhea)
Chronic pelvic pain
Pain during sex (dyspareunia)
Pain when you poo or pee
Pain outside of the pelvis [2]

Those with endometriosis can also experience endometriosis-related ovulation pain. Ovulation is the time during a menstrual cycle when the egg is released from an ovary. Women who ovulate can experience some pain or discomfort during this time of the menstrual cycle, however, those with endometriosis may be more likely to experience more severe pain due, in part, to the location inflammation caused by hormonal changes during this time [11].

Endometriosis is also considered a chronic overlapping pain condition — a cluster of pain conditions that commonly happen at the same time — such as irritable bowel syndrome, fibromyalgia, migraine, and low back pain, to name a few [12]. Being diagnosed with one of these pain conditions increases the likelihood of being diagnosed with one of the others. If your day-to-day life is impacted by pain, with an endometriosis diagnosis or not, it's important to seek support from your healthcare provider. Though pain is very common, especially among women, it's not normal and should be investigated by a healthcare provider.

Impact on fertility

It is estimated that 30-50% of women with endometriosis will experience infertility [10]. There are many factors which may contribute to this infertility, some of which include:

Changes to pelvic anatomy caused by endometriosis lesions
Hormonal and cellular-level changes in the womb lining
Abnormalities in the endocrine system or ovulation

Though infertility is common in those with endometriosis and depends on the severity of the condition, most women will be able to conceive naturally, without additional medical intervention [13]. If you have concerns about conceiving with an endometriosis diagnosis, we recommend seeking support from a healthcare provider.

Other symptoms

There are a number of other symptoms associated with endometriosis that can’t be categorized as relating to pain or fertility. These include;

Heavy bleeding during your periods: If you need to change your pad or tampon every 1 to 2 hours or find that you are bleeding through your clothes, this is a sign that your periods are heavy [14]

Mental health challenges: those with an endometriosis diagnosis are more likely to experience mental health challenges and have diagnoses of conditions like anxiety and depression [15]. If you are struggling with your mental health because of your endometriosis or the symptoms you experience because of it, you’re not alone.

Support for endometriosis

Endometriosis, though common, can be an isolating experience. It is important to know that there is support available. Below we’ve suggested some helpful people and resources to look into if you’re struggling with endometriosis.

Healthcare provider: Reach out to your doctor for help with managing the condition, whether through pain medication, talking therapy, or simply by getting a diagnosis
Community support groups: Talking to others who share similar experiences can be a helpful way to feel connected
Friends and loved ones: Talk to your nearest and dearest about the condition and discuss ways in which they can support you
Online forums and groups: Creating a network of online support can be another useful way to reach others who are in a similar situation

If you suspect you have endometriosis or have any/some of the symptoms listed above, we recommend you contact your healthcare provider as a first step to discuss these in more detail.

Treatment for endometriosis

As endometriosis is a chronic condition, there is no cure. However, there are some treatment options available that can help to manage the disease and its associated symptoms. Since endometriosis can present very differently for individuals, there is no one-size-fits-all treatment approach, and a process of trial and error or a combination of treatment options may be best suited to your needs. To determine the best treatment plan for you and your endometriosis, you should consult with your endometriosis specialist or healthcare provider. Here are a few options to be aware of:

Hormonal treatment: Often the first line treatment for endometriosis, hormonal contraception is prescribed to reduce estrogen levels and slow the growth of endometriosis tissue. These hormones can suppress ovulation and can stop your periods or make periods lighter. There are many different hormones that could be prescribed; your doctor will be able to advise on the best option for you [16].
Surgery: In some cases, you and your healthcare provider may decide that surgery is a suitable treatment option. Surgery may sound like a scary option, so we encourage you to ask any questions about the procedure and why this option is best in your consultations [17].
Pain medications: Over the counter pain medications, like ibuprofen, may help to relieve your pain. If these options are ineffective, your doctor may be able to prescribe a stronger pain management option [16].
Non-hormonal treatment options: In consultation with your healthcare provider, you may wish to explore non-hormonal treatment options. This could include pelvic physiotherapy, a TENS machine [18], or soothing heat packs.

When should I see a doctor about endometriosis?

Although many of us are used to living life in pain, it’s not normal, and you deserve to have your concerns taken seriously by your healthcare provider. If you experience any of the following, we recommend speaking with a healthcare provider to get the support you need:

You are experiencing bothersome symptoms that prevent you from doing day-to-day activities in a way you’d want to
You suspect you may have endometriosis
You have a diagnosis of endometriosis, and you’ve noticed changes in your symptoms

Know your body better with Natural Cycles

We hope you’ve learned something about endometriosis and how it can affect your reproductive health! Knowing your menstrual cycle can help you to recognize any changes or patterns across your menstrual cycle that may indicate something isn’t right. Natural Cycles, the first FDA Cleared birth control app is a hormone-free way to prevent pregnancy and also makes it easy to track changes and notice patterns across your menstrual cycles. The app even includes a downloadable cycle report that you can share directly with your doctor, making it easy to document and discuss symptoms.

If you’re interested in finding out more about your cycle, why not try Natural Cycles? It’s FDA Cleared, 100% hormone-free, and personalized to your unique cycle.

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World Health Organization. Endometriosis [Internet]. World Health Organization. World Health Organization; 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/endometriosis
Endometriosis UK. What is endometriosis? | Endometriosis UK [Internet]. Endometriosis-uk.org. 2022. Available from: https://www.endometriosis-uk.org/what-is-endometriosis
What is thoracic endometriosis? | The Endo Foundation [Internet]. The Endo Foundation. 2024. Available from: https://www.theendometriosisfoundation.org/what-is-thoracic-endometriosis
Chantalat E, Valera MC, Vaysse C, Noirrit E, Rusidze M, Weyl A, et al. Estrogen Receptors and Endometriosis. International Journal of Molecular Sciences [Internet]. 2020 Apr 17;21(8). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215544/
Allaire C, Bedaiwy MA, Yong PJ. Diagnosis and management of endometriosis. Canadian Medical Association Journal [Internet]. 2023 Mar 14;195(10):E363–71. Available from: https://www.cmaj.ca/content/195/10/E363#sec-6
Hansen KA, Eyster KM. Genetics and Genomics of Endometriosis. Clinical Obstetrics and Gynecology [Internet]. 2010 Jun;53(2):403–12. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4346178/
Abramiuk M, Grywalska E, Małkowska P, Sierawska O, Hrynkiewicz R, Niedźwiedzka-Rystwej P. The Role of the Immune System in the Development of Endometriosis. Cells [Internet]. 2022 Jan 1;11(13):2028. Available from: https://www.mdpi.com/2073-4409/11/13/2028/htm
Bhamidipaty-Pelosi S, Kyei-Barffour I, Volpert M, O’Neill N, Grimshaw A, Eriksson L, et al. Müllerian anomalies and endometriosis: associations and phenotypic variations. Reproductive Biology and Endocrinology. 2024 Dec 19;22(1).
Avery J, Deslandes A, Freger SM, Leonardi M, Lo G, Carneiro G, et al. Non-invasive Diagnostic Imaging for Endometriosis Part 1: A Systematic review of recent developments in Ultrasound, Combination Imaging and Artificial Intelligence. Fertility and Sterility. 2023 Dec 1;
Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. Journal of Assisted Reproduction and Genetics. 2010 Jun 25;27(8):441–7.
Maddern J, Grundy L, Castro J, Brierley SM. Pain in Endometriosis. Frontiers in Cellular Neuroscience. 2020 Oct 6;14(14).
Bartley EJ, Alappattu MJ, Manko K, Lewis H, Vasilopoulos T, Lamvu G. Presence of endometriosis and chronic overlapping pain conditions negatively impacts the pain experience in women with chronic pelvic–abdominal pain: A cross-sectional survey. Women’s health. 2024 Jan 1;20.
Endometriosis UK. Endometriosis, Fertility and Pregnancy [Internet]. Available from: https://www.endometriosis-uk.org/sites/default/files/2022-08/fertility.pdf
NHS. Endometriosis [Internet]. NHS. 2022. Available from: https://www.nhs.uk/conditions/endometriosis/
Anna Lena Zippl, Reiser E, Seeber B. Endometriosis and Mental Health Disorders: identification and treatment as part of a multimodal approach. Fertility and sterility. 2023 Dec 1;121(3).
Becker CM, Bokor A, Heikinheimo O, Horne A, Jansen F, Kiesel L, et al. ESHRE guideline: endometriosis. Human Reproduction Open. 2022 Feb 26;2022(2).
Zanelotti A, DeCherney AH. Surgery and Endometriosis. Clinical obstetrics and gynecology [Internet]. 2017 Sep 1;60(3):477–84. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635831/
NHS. TENS (transcutaneous electrical nerve stimulation) [Internet]. NHS. 2022. Available from: https://www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/

",{"_298":7377,"_438":7378,"_1695":7379,"_1697":-5,"_1699":7279,"_1701":7380,"_1703":7381,"_1705":7382,"_1707":7383,"_1709":-5,"_1710":7384,"_408":7385,"_410":7386,"_1810":7387,"_1880":7430,"_342":7431,"_1891":1892,"_1893":7437,"_1908":1909,"_1910":-5,"_1923":2845,"_1925":-5,"_1929":-5},"148819503","How is my data protected?","how-is-my-data-protected","2023-05-30T11:00:25+01:00","

People are more concerned than ever about how their most sensitive information is handled. At Natural Cycles, keeping your data safe is at the heart of everything we do. The world is ever-changing, but we stay focused on protecting what matters — your data. That’s why we continuously monitor and update our security measures. In this article, we’ll unpack our security protocols so you know just how your data is processed and how you are protected.

","

Key takeaways

Because we charge a subscription, we don’t need to profit from your data like “free” apps do — every subscription includes our advanced data protection program, NC° Secure
Natural Cycles follows strict regulations, including FDA cybersecurity standards, with regular audits to ensure compliance, and offers additional protection to safeguard your identity
Your NC° data belongs to you, and participation in research is always optional — you control your data and privacy preferences

","

As a regulated medical device and certified birth control method, we have to follow a strict set of standards when handling our users’ data. Regular audits are just one way we ensure that we follow the required protocol, and we take that responsibility seriously.

Natural Cycles is a Swedish company, which means we are built under GDPR law and committed to protecting your data no matter where you live. We’ll go into just what that means later.

While these existing measures go a long way in protecting our users, regulations alone aren’t enough. People everywhere face real concerns about the security of their most sensitive data. That’s why we took extra steps and created NC° Secure, an added layer of protection designed with you in mind.

What is NC° Secure?

This is our comprehensive data privacy protection program designed to keep your information safe. NC° Secure goes beyond a single security measure to include a set of approaches, each one put in place to take into account all types of fertility journeys — it's privacy protection you can trust.

NC° Secure includes:

Advanced data protection: Our Data Protection Officer and Data Protection Team employ top security protocols, including encryption and pseudonymization. We continue to evaluate new risks and adapt our security measures to protect your data accordingly.

Identity protection: When privacy matters most, an extra level of security is available. Go Anonymous lets you use the Natural Cycles app without sharing personal, identifiable information by separating your identity from your fertility data — and this means even we won’t be able to link you to your NC° data.

You can switch to this in-app feature anytime. Just know that if you Go Anonymous, it may limit your NC° app experience, so it’s best for situations where your data could be at higher risk. Learn more on our NC° Secure web page.

Third party validation: As a certified and regulated medical device, the NC° app is designed to comply with FDA cybersecurity requirements. Our data privacy measures also earned us a commendable mention from Mozilla in 2022.

What is GDPR?

GDPR stands for General Data Protection Regulation. This piece of legislation came into effect in 2018 and those who violate its security and privacy standards can face fines up to tens of millions of dollars.

As a Swedish company, we operate under GDPR standards. No matter where you live, we are committed to protecting your information with state-of-the-art security and high measures.

Don’t just take our word for it

We’re proud of the work we’ve put into protecting our users' data, but we’re not the only ones talking about our data protection. Our security standards have been independently reviewed by Mozilla in their Independent Buyer’s Guide, where we earned a commendable mention.

As part of our certification as a contraceptive app, we must also take part in yearly audits where an independent auditor assesses many parts of our app, including our data privacy protocols. We have an entire team of experts in place who are responsible for ensuring Natural Cycles maintains this level of data protection every day.

How is my data used for research?

At Natural Cycles, we’re passionate about advancing women’s health and are so grateful to our users for helping us do this. We often analyze what’s called “aggregate data.” This refers to a very large amount of data, meaning we don't single out individual users when doing this type of analysis but rather look at hundreds or thousands of cycles together.

We want you to know that your involvement in our studies is always optional. We ask every user when they join Natural Cycles if they want to take part in this type of research. If you want to opt in (or out) of this at any time, you can do so by visiting settings in the app and choosing “consent and permissions.”

Curious to learn more about the types of studies we’ve been working on? Head over to our Research Library to learn more.

The only certified birth control app

Natural Cycles is an FDA Cleared and CE marked birth control app, it’s not the same as a fertility app or period tracker. Keep in mind that not all apps have the same level of security as we do. Because we charge a subscription, we don’t need to profit from your data like some “free” apps do. An NC° subscription also helps fund ongoing development, so we can continue offering a hormone-free alternative while keeping your data protected. No matter what the future brings, you can feel confident knowing you are in safe hands with NC° Secure.

",[],{"_39":4627,"_1695":4628},{"_438":6903,"_1805":248,"_1807":6904,"_1809":6905},[7388,7390,7392,7394,7397,7399,7401,7404,7406,7408,7411,7413,7415,7417,7419,7421,7424,7426,7428],{"_1813":-5,"_1707":7389,"_1815":438},"How is my Natural Cycles Data Protected? ",{"_1813":7391,"_1707":-5,"_1815":1820},{"_1818":1819,"_1707":7389},{"_1813":7393,"_1707":-5,"_1815":1820},{"_39":1823,"_1707":7389},{"_1813":7395,"_1707":-5,"_1815":1820},{"_39":1826,"_1707":7396},"Discover our security protocols to learn how your data is processed and how you are protected. Learn more with Natural Cycles today.",{"_1813":7398,"_1707":-5,"_1815":1820},{"_1818":1830,"_1707":7396},{"_1813":7400,"_1707":-5,"_1815":1820},{"_39":1833,"_1707":7396},{"_1813":7402,"_1707":-5,"_1815":1820},{"_1818":1836,"_1707":7403},"https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?auto=format&fit=max&w=1200",{"_1813":7405,"_1707":-5,"_1815":1820},{"_1818":1840,"_1707":1841},{"_1813":7407,"_1707":-5,"_1815":1820},{"_1818":1844,"_1707":6718},{"_1813":7409,"_1707":-5,"_1815":1820},{"_1818":1848,"_1707":7410},"Person looking at their phone",{"_1813":7412,"_1707":-5,"_1815":1820},{"_39":1852,"_1707":7403},{"_1813":7414,"_1707":-5,"_1815":1820},{"_39":1855,"_1707":7410},{"_1813":7416,"_1707":-5,"_1815":1820},{"_1818":1858,"_1707":44},{"_1813":7418,"_1707":-5,"_1815":1820},{"_1818":1861,"_1707":1862},{"_1813":7420,"_1707":-5,"_1815":1820},{"_1818":1865,"_1707":222},{"_1813":7422,"_1707":-5,"_1815":1820},{"_1818":1868,"_1707":7423},"2025-03-24T11:23:04Z",{"_1813":7425,"_1707":-5,"_1815":1820},{"_1818":1872,"_1707":1873},{"_1813":7427,"_1707":-5,"_1815":1820},{"_39":1876,"_1707":1588},{"_1813":7429,"_1707":-5,"_1815":1820},{"_39":1879,"_1707":1584},{"_1826":7396,"_1697":1698,"_438":7389,"_1587":1588},{"_345":7410,"_41":7432,"_422":7433},"https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg",{"_424":7434,"_426":7435,"_428":1887,"_430":7436,"_432":1889,"_434":1890,"_436":6748,"_345":7410,"_438":7410},"https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?dpr=0.25&w=900 225w,https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?dpr=0.5&w=900 450w,https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?dpr=0.75&w=900 675w,https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?w=900 900w,https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?dpr=1.5&w=900 1350w","https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?dpr=0.25&fm=webp&w=900 225w,https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?dpr=0.5&fm=webp&w=900 450w,https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?dpr=0.75&fm=webp&w=900 675w,https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?fm=webp&w=900 900w,https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?dpr=1.5&fm=webp&w=900 1350w","https://www.datocms-assets.com/21281/1742559653-data-privacy_hero_0325.jpg?w=900",{"_39":7438,"_1896":7439,"_1898":7440},"Cara Sumner","Cara Sumner is an accomplished writer with more than ten years of experience writing on subjects including skincare, sustainability, health, and wellness. Now, she’s dedicating her days to bringing more awareness and education to female reproductive health in her role at Natural Cycles. Cara holds a Master's Degree in Social Anthropology from Stockholm University and Minored in Female Studies/English Literature while getting her Bachelor of Arts Degree from Radford University in the States. On the weekends, you'll find her forest bathing in the woods around Stockholm.",{"_41":7441,"_422":7442,"_345":7446},"https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg",{"_424":7443,"_426":7444,"_428":2290,"_430":7445,"_432":2292,"_434":1906,"_436":2293,"_345":7446,"_438":-5},"https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?dpr=0.75&h=100&w=100 56w,https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?h=100&w=100 75w,https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?dpr=1.5&h=100&w=100 112w,https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?dpr=2&h=100&w=100 150w,https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?dpr=3&h=100&w=100 225w,https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?dpr=4&h=100&w=100 300w","https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?dpr=0.75&fm=webp&h=100&w=100 56w,https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?fm=webp&h=100&w=100 75w,https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?dpr=1.5&fm=webp&h=100&w=100 112w,https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?dpr=2&fm=webp&h=100&w=100 150w,https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?dpr=3&fm=webp&h=100&w=100 225w,https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?dpr=4&fm=webp&h=100&w=100 300w","https://www.datocms-assets.com/21281/1696584092-9da4a833-7931-4d7f-abad-a9f999b7f264-1.jpg?h=100&w=100","Cara",{"_298":7448,"_438":7449,"_1695":7450,"_1697":1698,"_1699":7279,"_1701":7451,"_1703":7452,"_1705":7453,"_1707":7454,"_1709":-5,"_1710":7455,"_408":7488,"_410":7489,"_1810":7490,"_1880":7533,"_342":7534,"_1891":1892,"_1893":7540,"_1908":1909,"_1910":7543,"_1923":1924,"_1925":7546,"_1929":7547},"RWvv-DxdQMeUChN79LIt6g","38 Weeks pregnant: Baby development, symptoms and signs","38-weeks-pregnant","2025-03-21T11:44:36+00:00","

Welcome to week 38 of your pregnancy! In this week’s article, we’ll talk about what’s going on in your body and offer suggestions on how to ease the discomforts of swelling and sleep troubles. We’ll also check in with your baby, who’s continuing to gain weight as they get ready to meet you. Since labor can begin at any time, we will review the early labor signs and cover what you can expect at your checkup this week. Finally, we’ll go over some tips on ways to help you physically and mentally prepare for your baby’s arrival!

","

Key takeaways

It’s normal to have swollen ankles and feet in the final weeks of pregnancy, but be on the lookout for any sudden, severe swelling in your hands, face, or feet as this can be a sign of preeclampsia [1,3]
Getting enough rest is a top priority, as insomnia can affect your mental health, important relationships with partners, and even labor and delivery
Contractions, discharging your mucus plug, and rupture of membranes (water breaking) are all signs that labor has begun

","

Your body at week 38

Swollen ankles and feet

Some swelling in the feet and ankles, which can get worse in the final weeks of pregnancy, is considered normal and doesn’t pose any medical risk to you or your baby [1]. It’s usually caused by your body retaining more water when pregnant and the extra pressure of your uterus, which affects blood flow to your extremities. Because of gravity, swelling tends to be the worst in your ankles and feet.

Resting with your feet and legs elevated, wearing comfortable shoes, and light exercise like walking or foot stretches can all help to relieve swelling and discomfort [1].

However, if you experience sudden swelling in your hands, face, or feet, contact your primary healthcare provider immediately as this might be a sign of preeclampsia [1]. Preeclampsia is a hypertensive disorder (relating to high blood pressure) that is estimated to occur in approximately 2-10% of pregnancies worldwide [2]. Though many cases are mild, it’s important to seek medical attention immediately because unmonitored, untreated preeclampsia can lead to serious complications for you and your baby [3].

Trouble sleeping

The majority of pregnant women suffer sleep disruptions in the third trimester, with over 98% reportedly not being able to sleep through the night [4]. There’s lots going on in your body that can affect your sleep — discomfort in your legs, not being able to find a comfortable sleep position, needing to go to the bathroom frequently, fetal movements, and general stress and anxiety. Insomnia, which affects up to 80% of pregnant women, is also worse in the third trimester [4]. With a baby on the way, you might feel pressure to get some extra sleep while you can, and not being able to can feel frustrating and stressful!

During the day, insomnia can cause fatigue and mood changes, affecting relationships you have with a partner and close family and friends. Third-trimester sleep disturbances have also been tied to an increased perception of pain in labor, longer labor, and more assisted deliveries and cesarean sections [4]. For these reasons, it’s important to take insomnia and sleep disturbances seriously and contact your healthcare provider for help if needed. Try to prioritize rest when you can — even if it’s just lying down or closing your eyes for a bit during the day.

To ease the physical discomforts associated with pregnancy insomnia, you can try:

Regular, gentle exercise: walking, prenatal pilates, and yoga can be great options if considered safe during your pregnancy
Get some fresh air: time outside can relieve both physical and mental strain
Cool off: you might have also noticed you tend to get warm or hot, particularly in the evenings, so switching to lighter sleep clothes or bedding can help
Load up on pillows: using extra pillows, or a pregnancy pillow, to support your belly or legs can make it easier to find a comfortable sleeping position.
Talk to someone: if you suspect stress or anxiety about labor, birth, or welcoming a newborn is the culprit of your insomnia, talk to your midwife, nurse, or OB-GYN to see if counseling or a support group is available [5].

Braxton Hicks contractions

In Week 38, you’re likely on alert for any contractions that indicate that labor has begun. Braxton Hicks contractions, commonly referred to as practice contractions, can be easily confused with labor contractions and there are some key differences to remember. Braxton Hicks contractions, which are more common in the third trimester, are irregular and don’t get closer together over time [6]. In contrast, labor contractions will get stronger and come more frequently at regular intervals. Braxton Hicks contractions can also go away completely and come back hours later. Once labor contractions begin, they won’t stop until you give birth.

Your baby’s development at 38 weeks

At 38 weeks, you are nine months pregnant and your baby is considered term, even though your due date is not for another couple of weeks. Your baby is still growing and gaining weight, but the major organs are all fully functional.

You might be wondering what your baby will look like — what color will their eyes and hair be? While this is exciting to think about and imagine, you likely won’t know the answer even when your baby is born! Eye color, in particular, tends to settle around six to nine months, while research has shown that hair color and texture can change during the first few years of your baby’s life [7, 8]. It is good to also remember that some newborns are born with lots of hair, and some might be almost bald, or have very fine hair.

At 38 weeks, your baby weighs around 6.25 to 7.5 pounds (2.8 to 3.4 kg) and is likely 17 to 20 inches (43.2 to 50.8 cm) long [9].

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Signs of labor at 38 weeks

Because most low-risk, “normal” births happen between weeks 38 and 40, now is a good time to familiarize yourself with the early signs of labor.

The earliest signs of labor are contractions, when the mucus that has been in your cervix throughout the pregnancy is discharged (sometimes referred to as a “show” or “bloody show”), and your water breaking [10]. You might also experience a backache, or heavy aching feeling in your back, and the need to go to the bathroom.

Contractions are tightenings of your uterine muscles that push the baby further into birthing position and dilate, or open, the cervix in preparation for delivery
A “show” can be primarily mucus of a jelly-like consistency and but can also have some blood mixed in causing it to be pink or reddish in color [10]
When your water breaks, also called the “rupture of membranes” in medical-speak, the amniotic sack holding the baby opens and amniotic fluid will come out of your vagina. This can happen all at once, like a rush of water, or it can trickle out more slowly. While a common sign of oncoming labor in movies and on TV, it’s important to remember that only about 8-12% of women actually experience water breaking as a first sign of going into labor [11,12].

The first stage of labor, when your cervix begins to dilate to 10 cm, can often take many hours, but it’s important to remember that labor can progress unexpectedly. Be sure to follow the medical advice of your healthcare team and monitor the progress of your contractions by taking note of the duration of the contractions and how frequent they come.

You should contact your midwife or maternity unit urgently if your water breaks, you experience any vaginal bleeding, and if you believe your baby is moving less than normal [10]. Similarly, contact your healthcare provider if you experience any severe pain in your belly, nausea and throwing up, trouble breathing, severe headache, blurred vision or changes to your vision, or dizziness [13].

Your 38-week checkup

At the end of your pregnancy, you’re likely seeing your doctor, midwife, or nurse frequently. If you have an appointment this week, you can expect that your healthcare provider will use a tape measure to measure your belly, take your blood pressure, test your urine for protein, check the baby’s position, and ask about your baby’s movements. If you have a low-risk, “normal” pregnancy with no underlying health conditions, you might not have an ultrasound.

Your healthcare provider might also discuss birthing options with you. While your baby is fully developed and term at 38 weeks, your medical team will most likely recommend letting your body naturally go into labor [14]. However, if your examination or test results suggest that you or your baby are having a health problem, or if you have certain pre-existing conditions like diabetes or high blood pressure, your healthcare provider might suggest artificially inducing labor rather than waiting for labor to proceed naturally [15].

Tips in week 38

Getting to the hospital: if you plan to give birth at a maternity center or hospital, make sure you have a plan for getting there! Remember that you can go into labor at any time of day, and it’s not advised to drive yourself to the hospital for safety reasons. Making a transportation plan can help you stay calm when labor begins.
Research baby feeding: whether you intend to breastfeed your newborn or know you will use formula, it’s good research ahead of time the various options, bottle-feeding basics, and tips for breastfeeding. Like birth plans, it’s important to try and be flexible in your approach and expect the unexpected. Familiarizing yourself with the basics of different feeding methods can help you feel more prepared and comfortable adjusting to your baby’s needs.
Remember those pelvic floor exercises: gentle exercises to help strengthen the pelvic floor can help you manage pelvic discomfort and urinary incontinence in the final weeks of your pregnancy. The pelvic floor muscles also come under heavy pressure during childbirth, and studies have shown that exercises that strengthen these muscles can help during delivery and postpartum recovery [16].
Learn about newborn screenings: after your baby is born, they will likely be seen by a nurse or doctor frequently in their first six months to receive important screenings, vaccinations, and well-being checkups. Familiarizing yourself with the recommended timeline and schedule of these appointments will help you know what to expect, and when.
Safety and first aid courses: consider taking an in-person or online infant CPR or first aid course. Knowing what to do in case of an emergency can help you feel more comfortable when you bring your newborn baby home from the hospital.

Feel supported during your pregnancy and postpartum with Natural Cycles

Natural Cycles is the first FDA Cleared birth control app for contraception and fertility tracking. But did you know it can also support you during your pregnancy and postpartum journey? NC° Follow Pregnancy gives you weekly updates and offers helpful guides, such as how to prepare for childbirth. There is also easy-to-use curated content about your sexual, reproductive, and pregnancy health. After you give birth, you can immediately switch to NC° Postpartum to help support your recovery through personalized trackers, community insights, and expert guidance. Natural Cycles is also a great option for those looking for hormone-free, non-invasive birth control postpartum, and beyond.

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Khan B, Allah Yar R, Khakwani AK, Karim S, Arslan Ali H. Preeclampsia Incidence and Its Maternal and Neonatal Outcomes With Associated Risk Factors. Cureus. 2022 Nov 6;14(11):e31143. doi: 10.7759/cureus.31143. PMID: 36483900; PMCID: PMC9723483.
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Hashmi AM, Bhatia SK, Bhatia SK, Khawaja IS. Insomnia during pregnancy: Diagnosis and Rational Interventions. Pak J Med Sci. 2016 Jul-Aug;32(4):1030-7. doi: 10.12669/pjms.324.10421. PMID: 27648062; PMCID: PMC5017073.
NCT. How to sleep better in pregnancy: 10 tips | NCT [Internet]. NCT (National Childbirth Trust). 2024 [Cited 2025 Mar 18]. Available from: https://www.nct.org.uk/information/pregnancy/wellbeing-and-lifestyle-pregnancy/how-sleep-better-pregnancy-10-tips
Raines DA, Cooper DB. Braxton Hicks Contractions. [Updated 2023 Aug 8, Cited 2025 Mar 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470546/.
Glenn N. When do a baby’s eyes change color? [Internet]. DMEI | Dean McGee Eye Institute. 2023 [Cited 2025 Mar 18]. Available from: https://dmei.org/blog/when-do-a-babys-eyes-change-color/#:~:text=As%20more%20melanin%20develops%2C%20the,months%20of%20age%2C%E2%80%9D%20Dr.
Change in hair pigmentation in children from birth to 5 years in a Central European population (Longitudinal Study) | Office of Justice Programs [Internet]. [Cited 2025 Mar 20]. Available from: https://www.ojp.gov/ncjrs/virtual-library/abstracts/change-hair-pigmentation-children-birth-5-years-central-european
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Majority of women can still give birth naturally if their water breaks early [Internet]. University of Michigan News. 2021 [Cited 2025 Mar 21]. Available from: https://news.umich.edu/majority-of-women-can-still-give-birth-naturally-if-their-water-breaks-early/
Middleton P, Shepherd E, Flenady V, McBain RD, Crowther CA. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD005302. DOI: 10.1002/14651858.CD005302.pub3. Accessed 06 March 2025.
Signs and symptoms of urgent maternal warnings Signs [Internet]. HEAR HER Campaign. 2024 [Cited 2025 Mar 18]. Available from: https://www.cdc.gov/hearher/maternal-warning-signs/index.html
Amis D. Healthy Birth Practice #1: Let Labor Begin on Its Own. J Perinat Educ. 2019 Apr 1;28(2):68-80. doi: 10.1891/1058-1243.28.2.68. PMID: 31118543; PMCID: PMC6503903.
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Pelvic floor muscle exercises [Internet]. HSE.ie. [Cited 2025 Mar 18]. Available from: https://www2.hse.ie/pregnancy-birth/keeping-well/exercises/

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If you or your partner is curious about a vasectomy as a form of birth control, in this article, you'll learn about what a vasectomy procedure entails, vasectomy recovery information, and some pros and cons of this contraceptive choice.

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Key takeaways

Vasectomies are safe, effective, non-hormonal birth control procedures
They are performed as an outpatient procedure, and recovery time is typically quick with limited discomfort
Vasectomies do not protect against sexually transmitted infections as barrier methods like condoms do

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Vasectomy is one of the most common forms of male birth control in developed nations. It accounts for 10.8% of contraceptive methods as reported by women in the United States, 21.7% in Canada, 21% in the UK, and 16.4% in Western Europe [1]. Let’s dive in and explore why this procedure is being chosen.

What is a vasectomy?

A vasectomy is a simple surgical procedure that is also referred to as “male sterilization.” Vasectomies are generally considered safe with minimal risk for the patient. Most of the time, the procedure is quite quick with patients able to go home the same day [4].

The procedure involves cutting or blocking the vas deferens — the small tubes in the scrotum that carry sperm cells from the testicles to the ejaculatory duct, where it mixes with other liquids to become semen that is ejaculated from the penis [4]. Closing off these tubes prevents sperm from mixing with semen, leaving the body, and fertilizing a female egg cell during sex, thus effectively preventing pregnancy [3].

Patients are still able to ejaculate post-operation, and there will be barely any difference in the semen (sperm only make up about 5% of semen fluid) [3]. The body still produces male sex hormones and sperm as well — the sperm cells will just be safely reabsorbed into the body rather than transferred to the female egg cell [4].

It’s important to note that vasectomies do not prevent sexually transmitted infections or diseases as condoms do, but they are a highly effective birth control method otherwise [3].

How effective is a vasectomy?

Vasectomy procedures are among the most effective methods of birth control to prevent pregnancy [5]. While no form of contraception can guarantee 100% effectiveness, the risk of pregnancy is extremely low with vasectomies. They are more than 99% effective at preventing pregnancy as long as post-operative instructions are followed [5].

Keep in mind that vasectomies are only effective after the sperm count in your partner’s semen is non-moving and near zero [6]. Your doctor will perform follow-up tests in the months following the vasectomy to measure your sperm count, usually about two to four months after the procedure [6]. This buffer period is needed to make sure all existing sperm (created and dispersed before the procedure) has time to clear. As a couple, you’ll need to use another form of birth control to prevent pregnancy until your doctor can confirm your ejaculate is free of sperm [3].

There is no evidence that vasectomies cause erectile dysfunction, reduce orgasms, decrease sexual interest, or diminish pleasure [6]. Instead, studies have actually seen an increase in intercourse frequency or improvement in sexual satisfaction for most men (and female partners) after a vasectomy [2].

Vasectomy procedure explained

Now that we’ve gone over the basics, let’s dive into the details of the vasectomy procedure:

What happens before a vasectomy?

Before the procedure, the doctor will do a consultation going over medical history, logistics, benefits, risks, interactions with any medications the patient is currently taking, along with post-operative care [6].

On the day of the vasectomy, the area will be shaved and washed with an antiseptic. The patient will receive local anesthesia, and possibly general anesthesia or an oral sedative depending on what the doctor prescribes [6]. The anesthesia will numb any sharp pain, but the patient may still feel some sensation like touch, tension, or tugging [4].

How is the vasectomy procedure done?

Vasectomies are out-patient procedures typically done by a surgeon or urologist. There are two main techniques for vasectomies: incision (also called “conventional” vasectomy or CV) and no-cut (also called “no-scalpel” vasectomy, which is an example of “minimally invasive” vasectomy or MIV) [4, 6]. Let’s go through each type, as they’re performed a bit differently:

What happens during an incision vasectomy?

During a conventional or incision vasectomy, one or two small cuts are made to open the skin of the scrotum. From that opening, one of the vas deferens tubes is pulled through until it forms a loop. Then, a small section of the tube is cut out, and the two ends are tied. They may also be sealed with heat, which causes scar tissue to form over time and further block the tubes. This process is repeated for the other tube, and then each is put back in place. The cut skin may be closed with dissolvable stitches or allowed to heal and close on their own depending on the case. [3, 4].

What happens during a no-scalpel vasectomy?

The no-cut or no-scalpel vasectomy technique was developed more recently in the 1970s. This procedure still involves blocking the tubes, but no incisions are made on the skin. Instead, the vas deferens is first located and held into place with a clamp through the skin before a special tool is used to puncture the scrotum in one place. The tubes are then gently pulled up through the small hole, blocked, and put back into place. This means that no stitches are needed, and there tends to be less post-operative pain along with shorter recovery time [3, 4].

Does getting a vasectomy hurt?

It’s normal to experience some mild pain or slight discomfort over the first few hours/days after the procedure, but chronic, ongoing pain is extremely rare, affecting only about one to two percent of patients [6]. Light over-the-counter pain medication should help with the discomfort after the procedure [4].

A benign lump called a granuloma may also appear in the days following the vasectomy. This happens because sperm may leak from the cut end of one of the tubes into the scrotal tissues. It may be a bit painful or sensitive to touch, but it isn't harmful and will likely subside with time [4].

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Vasectomy recovery: what you need to know

There are quite a few things to keep in mind post-op which we’ll go over on a high level below. Remember that the doctor will cover specific, personalized vasectomy recovery information related to each case, including guidance on what medications to take, or what to do in the case of certain health conditions.

What happens after you have a vasectomy?

After the vasectomy, post-op care instructions usually include lots of rest following the procedure. Your doctor may also suggest an ice pack for swelling or pain, along with compression underwear or a jockstrap to aid with recovery. Following the instructions as closely as possible is recommended for the quickest, healthiest recovery. [4]

How long does it take to recover after a vasectomy?

While the patient is usually able to go home the same day of the vasectomy procedure, they’ll still need to rest for at least one day. Most people are able to return to their job as early as the next day if they do sedentary desk work, and within the following week otherwise [4].

When is it safe to have sex after a vasectomy?

It’s best to avoid sex or ejaculation for three to seven days during vasectomy recovery. Any other activities that involve a lot of strength or endurance should also be avoided if possible [4].

When can you stop other forms of birth control?

As we mentioned earlier, sperm cells can remain in the vas deferens tubes for weeks or months after the vasectomy, so you and your partner will need to use another form of birth control until your doctor confirms that there are no motile sperm left in the semen [6].

Can I have a vasectomy reversed later if I choose?

While the procedure can be reversed in some cases, it’s never guaranteed and the success rate of reversal is dependent on a number of variables you can discuss with your doctor. Vasectomy reversals may also be expensive and not covered by insurance [7].

With that in mind, make sure you and your partner discuss if you want to have any (or more) children before getting a vasectomy. If you’re not settled on that point but you still want to have the procedure done, you might want to consider freezing a sperm sample before the vasectomy [3]. There are a few procedures, aside from vasectomy reversal, that may still allow you to get pregnant with a sperm sample. These include in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Again, keep in mind that these procedures can be expensive and the success rate is about one in every two couples who try these techniques [6].

It’s worth noting that across a large number of studies, only about one to two percent of men expressed regret or dissatisfaction about having undergone vasectomies, while the great majority would recommend it to others [6].

Pros and cons of vasectomy procedures

Let’s recap what we’ve learned so far with some pros and cons:

Pros of a Vasectomy:

You don’t need to think about this birth control method every day or every time you have sex
Vasectomies are more than 99% effective at preventing pregnancy
It’s a quick outpatient procedure with minimal downtime
It’s often more affordable, effective, and safe than the female sterilization alternative, tubal ligation (even so, tubal ligation remains more common than vasectomy in the U.S., even among married couples who are looking for permanent sterilization [6])

Cons of a vasectomy:

Mild pain and discomfort post-procedure
Does not protect against sexually transmitted infections
Invasive birth control method (surgery is required)
Very slight risk of complications like infection or swelling

When to speak with a doctor

It’s best for you and your partner to speak with your healthcare provider about your specific case if you’re curious about getting a vasectomy to make sure it’s the best option for you. They’ll go over the risks, benefits, and what you can expect from the procedure if you decide to move forward.

Post-operation, contact your doctor as soon as possible if you notice:

Scrotum is enlarged
Scrotum is red or sore
Fever
Continued pain [4]

Take control of your reproductive journey with Natural Cycles

At Natural Cycles, we’re passionate about birth control choice and want you to have an awareness of all your options, including more permanent methods like sterilization. We also believe that contraception is a shared responsibility among couples. Dr. Brian Nguyen, member of the Natural Cycles Medical Advisory Board, shared his perspective with us.

“While pregnancy prevention is commonly thought of as a woman’s responsibility, prior to the development of female hormonal contraception, men were primarily responsible via their use of condoms and/or withdrawal for contraception. The shift towards female responsibility is thus rather recent, though so widespread that men’s involvement seems so limited today. However, decisions to plan and prevent pregnancy are a couple’s issue that warrants communication between partners about their expectations for family planning,” he said.

If you’re looking for a hormone-free contraceptive method, why not find out if Natural Cycles could work for you? It’s the first FDA Cleared non-hormonal birth control app and uses the science of body temperature to predict ovulation, giving you a deeper understanding of your fertility. No hormones. No Side effects. Just science. Try Natural Cycles today.

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https://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf
Engl T, Hallmen S, Beecken WD, Rubenwolf P, Gerharz EW, Vallo S. Impact of vasectomy on the sexual satisfaction of couples: experience from a specialized clinic [Internet]. 2017 [cited 2025 March 11]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5656365/
American College of Obstetricians and Gynecologists (ACOG). Sterilization for Women and Men [Internet]. 2022 [cited 2025 March 11]. Available from: https://www.acog.org/womens-health/faqs/sterilization-for-women-and-men
American Urological Association. What is a Vasectomy? [Internet]. 2020 [cited 2025 March 11]. Available from: https://www.urologyhealth.org/urology-a-z/v/vasectomy
Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception and the percentage continuing use at the end of the first year. [Internet]. [cited 2025 March 11]. Available from: https://www.datocms-assets.com/21281/1662539230-contraceptive-technologies_failure-rates-table-2018.pdf
Sharlip ID, Belker AM, Honig S et al. Vasectomy: AUA guideline [Internet]. 2015 [cited 2025 March 11]. Available from: https://www.auanet.org/guidelines-and-quality/guidelines/vasectomy-guideline
American Urological Association. What is a Vasectomy Reversal? [Internet]. [cited 2025 March 18]. Available from: https://www.urologyhealth.org/urology-a-z/v/vasectomy-reversal

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It’s no secret that our fertility decreases as we get older. But despite that, more women than ever are having children later in life — many in their late 30s [1]. So, this begs the question: what are the chances of getting pregnant at different ages? In this article, we’ll answer that question and dive into why our fertility decreases as we get older, how age affects men’s fertility, plus we’ll take a look at whether there are ways of prolonging our fertile years, tips for improving your chances of conceiving, and when to reach out to a doctor for help.

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Key takeaways:

We are the most fertile in our twenties and early thirties, and fertility starts declining more rapidly in our mid-thirties due to our ovarian reserve decreasing
The majority of couples without fertility issues conceive within a year of trying, but the likelihood of getting pregnant decreases with age
Options for fertility treatments to help get pregnant later in life include IVF, egg donation, and egg freezing

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What are the chances of getting pregnant at different ages?

This question doesn’t have a straightforward answer and the truth is that everyone has their own personal fertility journey. Some might get their positive test already in the first month of trying, while others need to wait longer — and it’s completely normal that it takes some time. Age aside, fertility can also be affected by many factors related to health and lifestyle, as well as conditions like PCOS and endometriosis. However, most couples who are actively trying to conceive and don’t have any issues with fertility do so within a year [2].

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In a study on Natural Cycles users, we found that the median time to conceive for those who used NC° Plan Pregnancy was four cycles [3]. Those under the age of 35 with regular cycles and no fertility issues had a median time to conceive of only two cycles.

One way of looking at the average time to get pregnant at different ages is by counting how many women in certain age groups become pregnant within a set period of time. Different studies will show slightly different estimates, but the main take-home messages are very similar, so we’ll focus on the findings from one study of 2,962 participants to keep things simple [4]. In the graph below, you can see the percentage of women with no known fertility issues who got pregnant within six and twelve cycles:

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From the graph, we can clearly see that age impacts the likelihood of getting pregnant, with higher percentages during the twenties and early thirties and lower in the late thirties and forties. Now that you’ve got a clear idea of how age impacts female fertility, let’s dig into the specifics!

Chances of getting pregnant in your 20s

Our twenties are generally when we’re the most fertile. According to the American College of Obstetricians and Gynecologists (ACOG), the odds of getting pregnant are roughly 25% in each individual menstrual cycle during our twenties [5].

The research shows that in the early twenties (21-24 years), almost 57% of women got pregnant within six menstrual cycles, while 71% conceived within 12 cycles of trying [4]. These numbers even increased a bit during the mid to late twenties. Women between 25 and 27 had the highest chances of conceiving within twelve months (79%) and the age group 28 to 30 were the most likely to get pregnant within six cycles (62%).

To summarize, we have a good chance of getting pregnant during our twenties and this is the age when the average time to get pregnant is the shortest, statistically. But again, everyone is different, so try not to worry if it doesn’t happen right away.

Chances of getting pregnant in your 30s

In our thirties, and especially in the early thirties, the chance of getting pregnant remains high and is quite similar to how it is in our twenties — although it starts to decline a little. This then picks up in our mid-thirties [5].

The study found that between the ages of 31 and 33, 61% of women got pregnant within six cycles and 77% did so within twelve cycles [4]. These numbers were slightly lower for the group aged 34 to 36, where 56% got pregnant within six cycles and 75% conceived within twelve cycles.

A more significant drop in the likelihood of pregnancy happened during the late thirties. Between the ages of 37 and 39, 46% got pregnant within six cycles and 67% within twelve cycles [4].

All in all, it can take a little longer to conceive in our thirties compared to our twenties (especially in the later part of this decade), but chances are still good that you’ll get pregnant within a year. However, if you’re in your late thirties, have any known fertility issues, or have tried for over a year without success, it’s a good idea to speak with your doctor — there are options available that can help.

Chances of getting pregnant in your 40s

Fertility rates decrease even further in our forties. It’s estimated that the odds of conceiving in any individual menstrual cycle have decreased to 5-10% by the time we’re forty (compared to 25% in our twenties) [6, 7].

Those numbers may sound worrying, but many are still able to become pregnant at this age. Coming back to the research, about 28% of women between 40 and 45 become pregnant within six cycles of trying, while almost 56% become pregnant within twelve cycles [4]. However, it’s important to note that this study only looked at women who didn’t have any issues with their fertility — and as we get older, conditions like fibroids that can affect fertility become more common [5].

If you’re over 40 and looking to get pregnant, it’s a good idea to reach out to your healthcare provider to make sure you get help right away if needed.

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Age and pregnancy loss

The chance of becoming pregnant is not the only thing that’s affected by age — we also have a higher risk of miscarriage as we get older. One large Norwegian study which included over 420,000 pregnancies found that women in their twenties have around a 10% risk of miscarriage [8]. This number then increases starting in the early thirties, and by the age of 45, the risk is over 50%.

Pregnancy loss is a sensitive topic surrounded by stigma, but we think it’s an important one to talk about openly. If you’ve gone through a pregnancy loss, know that you’re not alone however you choose to process it. Your healthcare provider can also help with resources if you have questions or are worried about pregnancy loss.

Why does fertility decrease as we get older?

The menstrual cycle, and more specifically ovulation, lies at the core of female fertility. During ovulation, an egg cell is released from the ovaries and travels down the fallopian tubes where it can be fertilized by sperm, resulting in pregnancy. We enter our “fertile years” when we start ovulating during puberty, and we stop being fertile entirely when we reach menopause.

So, our fertility is closely linked to our eggs — both how many we have and their quality. It’s worth mentioning here that it takes two to get pregnant, and also for men, both age and lifestyle factors can impact their ability to conceive [9]

The ovarian reserve

Did you know that you’re born with all your eggs? The exact number of eggs we have to begin with varies widely from person to person, but a common estimate is that we’re born with between one and two million eggs [10]. This is called the ovarian reserve, or more simply put, the egg reserve.

By the time we reach puberty, the ovarian reserve has already dropped to around 3-500,000 eggs and from that point, it continues to decrease by about 1,000 eggs per month [11, 10]. It may sound a bit alarming to hear that we “lose” 1,000 eggs each month, but this is a completely natural process in our bodies.

During a typical cycle, only one egg cell matures enough to actually be released during ovulation [12]. The rest of the eggs that have been in the process of maturing at the same time, but don’t get “selected” for ovulation, are reabsorbed by the body and lost in the process. Hyperovulation (when more than one egg is released) can also happen occasionally, resulting in fraternal twins if they’re fertilized.

The rate at which the eggs are lost increases in our mid-thirties, which is one of the main reasons why our fertility declines more rapidly at this age. At age 37, we’re estimated to have around 25,000 eggs left and by the time we reach menopause, only 1,000 eggs remain [11].

The quality of the egg cells

It’s not just the number of eggs that affects fertility, it’s also the quality. After all, we only ovulate about 450 times in our lifetime even though we have several hundred thousand eggs when we reach puberty [13].

Not all eggs have the potential to be fertilized. As we get older, we also have fewer high-quality eggs left, which is why older women have a higher risk of chromosomal abnormalities and miscarriages [5, 14]. We’re also more likely to have complications during pregnancy, such as preeclampsia, which is likely because we tend to have more health issues in general as we age [5].

We know this can be a scary subject, but it’s not all doom and gloom. More and more people are able to have healthy pregnancies in their late thirties and forties — all that’s needed is for one sperm to reach a healthy egg cell for pregnancy to happen. Advances in fertility treatments and technology also help us become pregnant later in life than what’s been possible historically.

How age affects men’s fertility

When it comes to fertility and age, there’s a lot of focus on how women’s fertility decreases as we get older. Men, on the other hand, have the ability to impregnate women well into their advanced years — there’s no hard limit and there are men who father children into their 70s and above [6].

However, it’s estimated that in around one-third of cases where a couple has trouble conceiving, it’s the man who has some fertility issue (while in one-third of cases, the issue lies with the woman and one-third are due to unknown reasons or a combination of both) [15].

Age does affect men’s fertility as well, but not as much compared to women and it’s less clear exactly at what age these effects become apparent. Studies have found that the quality of sperm decreases as men get older, including how many sperm cells are in ejaculate, the sperm’s ability to move, and their shape [16]. While older men are often still fertile, the age of the male partner does impact the female partner’s chances of getting pregnant and it can take longer to conceive if the man is older.

It’s also important to note that other lifestyle factors like smoking, drinking, diet, and exercise can also affect sperm quality [9].

At what age are you most fertile?

Statistically, we’re the most fertile in our twenties and early thirties [5]. At this age, we still have a lot of eggs in our ovarian reserve and a large percentage of them are healthy. A majority of women become pregnant within a year of trying at this age [4].

Not everyone is ready to be a parent in their twenties, so even though this might be the age when we’re physically primed to start having kids, there are plenty of reasons people might choose to wait. However, it’s still good to be aware of what to expect when trying to get pregnant at different ages, so that you can plan accordingly if you know that you want children.

When does fertility start to decline?

Our fertility begins to decline in our thirties, around the age of 32, though it’s slow at first [11]. Around the age of 35, we start to lose our egg reserve more rapidly.

However, even though our egg reserve becomes lower in our late thirties, you can still become pregnant as long as you’re ovulating. Plenty of people have kids after the age of 35 — it might just take a little longer. There are also options to help if you’re struggling with getting pregnant (more on that below), so make sure you reach out to your healthcare provider to see what your alternatives are.

Can you increase your fertility at any age?

There’s no way of really counteracting the effects of age on fertility — we can’t stop our eggs from becoming fewer over time. Our chances of conceiving will naturally decrease as we get older regardless of how healthy we are overall. However, there are some options available that can help you get pregnant:

In-vitro fertilization (IVF): During IVF, you’re given hormones to stimulate your ovaries so that more eggs mature than what’s typical during a normal menstrual cycle. The eggs are then extracted and fertilized in a lab, and the embryos are later implanted into your uterus. IVF can be an effective treatment with high success rates (roughly 39% for women under 35) [17]. However, one common misconception is that IVF can completely counteract aging, so it’s good to be aware that the success rate of IVF also decreases with age.
Egg donation: IVF with donated eggs can be an option if you’re not able to use your own for any reason, and using donated eggs from a younger woman can increase the chances of a successful pregnancy during IVF [6]. During an egg donation, eggs from the donor are extracted and fertilized (in the same way as in the normal IVF process), and the recipient takes hormones to prepare the uterus for the embryo transfer.
Egg freezing: This has become an increasingly popular way of extending the fertile years, and it’s sometimes referred to as “social egg freezing” [18]. During an egg freezing cycle, you’re given hormones to stimulate your ovaries so that more eggs than usual mature, and the eggs are then extracted so that they can be frozen and stored until you’re ready to use them. Egg freezing can be costly and there are some risks involved with taking hormones to stimulate the ovaries, so it’s not an option for everyone.

Which treatment options are available to you will vary depending on your individual needs, so make sure to reach out to your healthcare provider if you have questions about your fertility or any of the treatments listed here, so that you can get the right help.

Can you improve your chances of getting pregnant naturally?

“You can’t change your age or go back in time, but it is not the only thing impacting our fertility. I always like to say that all of our cells age together — we get wrinkles and back pain and our eggs get older too. The same factors that keep you healthy also can help improve your egg quality. Similarly, the factors that cause inflammation are toxic and lead to an increased rate of cellular damage inside our eggs. This is why I always recommend you control the factors you can to limit inflammation and improve your egg quality in the ways that you can: diet, exercise, sleep, stress management, and limiting toxins,” says Natural Cycles’ Medical Advisory Board Member Dr. Natalie Crawford.

Let’s dive into some ways you can optimize your chances of becoming pregnant:

Diet & exercise: Though research in this area is limited, maintaining a healthy lifestyle and weight through diet and exercise may have a positive impact on our fertility [9]. Focus on nutrient-rich food with a balance of carbs, healthy fats, protein, and fiber, and try to exercise regularly in a way you enjoy.

Limit alcohol: Research has found that drinking large amounts of alcohol can have a negative impact on fertility. Though this topic hasn’t been studied enough to say exactly at what doses this happens, studies have found that drinking enough to become hungover can lower the chances of becoming pregnant [9]. Everyone is different, and while you can most likely still enjoy a drink here and there, it’s a good idea to limit your alcohol intake while you’re trying to get pregnant.

Don’t smoke: Smoking has been linked with lower fertility in general, and some research has found that it can lead to a faster decline in the ovarian reserve [9].

Manage stress: There is some research that suggests that stress can have a negative impact on our fertility [9], so reducing your stress levels may help increase your chances. We know this isn’t always easy, and trying to conceive can be stressful in and of itself, but try to be kind to yourself and find ways of recharging that work for you — whether it’s going for a walk in nature or just taking a few minutes to focus on your breathing.

Get to know your menstrual cycle: Did you know you’re not fertile 24/7? In fact, you can only get pregnant during a six-day-long fertile window in each cycle — the five days before ovulation and on ovulation day — so timing intercourse during those fertile days is crucial when trying to conceive. Getting to know your own cycle through tracking your period and other fertility signs, like cervical mucus, cervix position, luteinizing hormone (LH), or basal body temperature, can help you understand when you’re fertile so that you can plan sex accordingly.

Use Natural Cycles: Our temperature-based algorithm does the hard work for you, identifying your fertile window so you know which days you have the highest chance of conceiving in each individual menstrual cycle. Simply measure your temperature with one of our integrated devices, add your period dates and optional ovulation tests, and the NC° app does the rest! Our research has found that couples who use NC° Plan Pregnancy to conceive take three cycles to get pregnant on average [19].

With all of these tips in mind, we also recognize that the path to pregnancy looks different for everyone. We know that it’s easy to start worrying if it doesn’t happen right away, but it’s normal that it takes some time to become pregnant even if you’re following all the guidelines. If you feel worried for any reason, don’t hesitate to reach out to your doctor who can give you personalized advice, and though it’s easier said than done, try not to stress too much.

When to get help from your doctor

So, given that it’s natural for it to take a while to get pregnant, when should you reach out to your doctor? The guidelines differ a bit depending on age and where you live. If you’re under the age of 35 and don’t have any known fertility issues, you’re usually recommended to try on your own for a year before contacting your healthcare provider [7]. If you’re over 35, you’re recommended to try for six months.

However, there are also some exceptions where you should reach out to your healthcare provider sooner [11]. If you’re over the age of 40, or if you have any condition that might impact fertility (such as PCOS or endometriosis), you should reach out right away when to start trying to make sure you get the right support as soon as possible.

Get pregnant faster with Natural Cycles

With the amount of information and advice out there around planning a pregnancy, it’s easy to get overwhelmed by looking at different guidelines, statistics, and pregnancy success rates. Here at Natural Cycles, we believe that everyone should have the information they need to take control of their own fertility journey. NC° Plan Pregnancy can help you do just that by showing you which days you have the highest chances of conceiving in each cycle based on your individual cycle information. We’ve helped over 160,000 couples get pregnant — why not see if Natural Cycles could be right for you?

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Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: final data for 2022. Natl Vital Stat Rep. 2024;73(2). Available from: https://dx.doi.org/10.15620/cdc:145588
NHS. How long does it usually take to get pregnant? [Internet]. 2022 [cited 2025 Mar 13]. Available from: https://www.nhs.uk/pregnancy/trying-for-a-baby/how-long-it-takes-to-get-pregnant/
Favaro C, Pearson JT, Rowland SP, Jukic AM, Chelstowska M, Berglund Scherwitzl E, et al. Time to pregnancy for women using a fertility awareness-based mobile application to plan a pregnancy. J Womens Health. 2021;30(11):1538–45. Available from: https://doi.org/10.1089/jwh.2021.0026
Wesselink AK, Rothman KJ, Hatch EE, Mikkelsen EM, Sørensen HT, Wise LA. Age and fecundability in a North American preconception cohort study. Am J Obstet Gynecol. 2017;217(6):667.e1–667.e8. Available from: https://doi.org/10.1016/j.ajog.2017.09.002
ACOG. Having a Baby After Age 35: How Aging Affects Fertility and Pregnancy. [Internet]. 2023 [cited 2025 Mar 3]. Available from: https://www.acog.org/womens-health/faqs/having-a-baby-after-age-35-how-aging-affects-fertility-and-pregnancy
American Society for Reproductive Medicine. Age and fertility: a guide for patients [Internet]. 2012 [cited 2025 Mar 6]. Available from: https://www.reproductivefacts.org/news-and-publications/fact-sheets-and-infographics/age-and-fertility-booklet
ACOG. Evaluating infertility [Internet]. 2020 [cited 2025 Mar 6]. Available from: https://www.acog.org/womens-health/faqs/evaluating-infertility
Magnus MC, Wilcox AJ, Morken N-H, Weinberg CR, Håberg SE. Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study. BMJ. 2019;364:l869. Available from: https://www.bmj.com/content/364/bmj.l869
Sharma R, Biedenharn KR, Fedor JM, Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reprod Biol Endocrinol. 2013;11:66. Available from: https://doi.org/10.1186/1477-7827-11-66
Cox E, Takov V. Embryology, ovarian follicle development [Internet]. StatPearls - NCBI Bookshelf. 2023 [cited 2025 Mar 3]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532300/
American College of Obstetricians and Gynecologists Committee on Gynecologic Practice, The Practice Committee of the American Society for Reproductive Medicine. Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril. 2014;101(3):633-634. Available from: https://doi.org/10.1016/j.fertnstert.2013.12.032
Erickson GF. Follicle growth and development. In: The Global Library of Women's Medicine [Internet]. 2008 [cited 2025 Mar 6]. Available from: https://www.glowm.com/section-view/heading/follicle-growth-and-development/item/288
Wallace WHB, Kelsey TW. Human ovarian reserve from conception to the menopause. PLoS One. 2010;5(1):e8772. Available from: https://doi.org/10.1371/journal.pone.0008772
Franasiak JM, Forman EJ, Hong KH, Werner MD, Upham KM, Treff NR, Scott RT Jr. The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening. Fertil Steril. 2014;101(3):656–663.e1. Available from: https://doi.org/10.1016/j.fertnstert.2013.11.004
Eunice Kennedy Shriver National Institute of Child Health and Human Development. How common is infertility? [Internet]. 2018 [cited 2025 Mar 10]. Available from: https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common
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Condoms are one of the most common barrier birth control methods. You may be familiar with external condoms designed to fit over a penis (think: the “practice banana” day in sex ed class). Condoms come in many different sizes and styles, but did you know that there are also internal condoms available for use inside the vagina or anus? In this article, we’ll do a deep dive into the lesser-known internal condom, also called the female condom. We’ll answer questions like, “how does a female condom work?” along with how you can use them, and how effective they are at preventing pregnancy and STIs.

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Key takeaways:

Internal condoms, also called female condoms, are placed inside the body to be used as a non-hormonal barrier birth control method
They help prevent pregnancy and protect against sexually transmitted infections (STIs)
They’re 95% effective at preventing pregnancy with perfect use, and 79% effective with typical use

","

What is a female condom?

The internal condom is a soft pouch usually made of nitrile (a soft plastic material) with two rings on either end. One of these rings is smaller and enclosed in the pouch — it goes inside of your body to secure the condom in place. The other larger ring stays outside your body.

With this setup, the pouch securely lines the entire internal area while allowing for penetration through the larger ring by fingers, toys, or a penis. The condom prevents pregnancy by blocking sperm cells from reaching an egg cell during vaginal sex, and also helps prevent the spread of STIs from either vaginal or anal sex [1,2].

Who can use internal condoms?

Internal condoms are sometimes called the “female condom” because it’s worn inside the body rather than externally on a penis. However, this gendered language isn’t necessarily accurate — as anyone can wear internal condoms to prevent pregnancy or help protect against the risk of STIs [2].

How do I use a female condom?

To use an internal condom, carefully open the packaging and remove the condom first. Then locate the thicker, inner ring — this will go inside your body. By pinching the sides of this ring with your thumb and index finger, you’ll be able to gently insert it. Then, using your pointer finger, push the inner ring as far up as it will go towards your cervix while keeping the outer ring in place outside the body. The internal ring will naturally expand into place (you may not even feel it!) [2,3].

You can insert the internal condom up to eight hours before intercourse. After intercourse, gently twist the outer ring and pull down to remove the condom. The CDC has a few helpful diagrams of this process available here [2,3].

Now that we’ve gone over how female condoms work, let’s go over a few things you’ll want to keep in mind if you decide to use them:

Dos:

Make sure the condom is not past its expiration date (this should be located on the outside of the packaging)
Check the condom for any tears or defects before you insert it
Read the packet insert and follow the instructions
Keep the condom on during sex from start to finish
If desired, use a water or silicone-based lubricant to keep the condom from moving and potentially tearing during sex
Store internal condoms in a cool, dry place [2]

Don’ts:

Don’t reuse internal condoms — they are single-use only
Don’t flush used condoms down the toilet, as they may cause clogs
Don’t use a male (external) condom at the same time as a female (internal) condom — they’re each designed to be used on their own and combining both can lead to tearing [2]

How effective is the female condom?

If you use the internal condom perfectly every single time you have sex, it’s 95% effective at preventing pregnancy. However, with typical use that accounts for real-world user behavior including human errors, they’re actually 79% effective. This means that about 21 out of every 100 people who use female condoms as their primary birth control method will still get pregnant each year [1].

You can always use the internal condom in addition to another birth control method like the pill to layer pregnancy prevention (just be sure not to use two condoms at once, as we mentioned earlier).

Do internal condoms help protect against STDs?

Yes — STDs and STIs are typically spread by direct contact with semen, pre-cum, or skin. Since internal condoms line and protect the area of penetration, this decreases your chances of contact, thus helping to protect against STIs. In fact, condoms are the only methods of birth control that help prevent the spread of sexually transmitted infections like HIV, chlamydia, and gonorrhea. You can always use condoms for this protection, even if you're already on another type of birth control [1].

Just remember that more research is needed to confirm whether or not internal condoms provide the same amount of protection against STIs that external condoms do. The data collected up to now suggests it, but no study has been able to confirm it [4].

Pros and cons of female condoms

Let’s go through a few pros and cons of internal condoms to help you make the best decision for your body:

Pros:

They are an effective non-hormonal birth control method
Internal condoms are available at some pharmacies or online to purchase without a prescription
You get both pregnancy prevention and STD protection from this method
They’re usually latex-free unlike external condoms (if you’re allergic, be sure to check the ingredients on the packaging)
Internal condoms may provide you with a sense of empowerment — even if your partner doesn’t want to wear a condom, you can stay in control of your sexual health
If you want to plan pregnancy in the near future, it is easy to just stop using the method when you want to conceive
They’re safe to use while breastfeeding [1,5]

Cons:

They’re typically more expensive than external condoms
There is a bit of a learning curve with the technique to insert an internal condom when you first start using them, but with time and practice, it becomes easier
You may find the process of inserting the condom to be a bit disruptive when you’re in the mood — some couples integrate the insertion into foreplay to prevent this
You may experience irritation or extra friction during sex with an internal condom (using a water or silicone-based lubricant may help)
You’ll need to use an internal condom every time you have sex
There are other more effective birth control methods out there, including long-acting methods like IUDs and implants [4,5]

Get to know your body better with Natural Cycles

Birth control comes in many different forms. With all of this in mind regarding internal condoms, along with advice from your healthcare provider, you can make the best choice for your sexual health. If you’re thinking about switching to a hormone-free method, why not consider the first FDA Cleared birth control app? See if Natural Cycles can contribute to your birth control plan today.

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CDC. How to Use an Internal Condom [Internet]. 2024 [cited 6 March 2025]. Available from: https://www.cdc.gov/condom-use/resources/internal.html
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Gallo M F, Kilbourne-Brook M, Coffey P S. A review of the effectiveness and acceptability of the female condom for dual protection [Internet]. 2012 [cited 12 March 2025]. Available from: https://pubmed.ncbi.nlm.nih.gov/22348629/
ColumbiaDoctors. Female Condoms [Internet]. [cited 7 March 2025]. Available from: https://www.columbiadoctors.org/health-library/article/female-condoms/

",{"_298":7867,"_438":7868,"_1695":7869,"_1697":1698,"_1699":7870,"_1701":7871,"_1703":7872,"_1705":7873,"_1707":7874,"_1709":-5,"_1710":7875,"_408":7908,"_410":7909,"_1810":7910,"_1880":7952,"_342":7953,"_1891":1892,"_1893":7958,"_1908":1909,"_1910":7961,"_1923":1924,"_1925":7964,"_1929":7965},"Qz4Yc_0STw-HFYj6psUzfA","Perimenopause & long periods: What’s normal & how to cope","long-period-during-perimenopause","2025-03-10","2025-03-10T13:51:17+00:00","

Perimenopause and long periods may go hand in hand for some people [1]. Irregular periods or unexpected bleeding are only one of the many symptoms that we might be going through during this transitional period.

","

Key takeaways:

It's normal for our periods to become longer or shorter when we go through perimenopause
Flow length may change during perimenopause due to hormonal fluctuations because our ovaries start producing less estrogen and may or may not release an egg every month [1]
There are many ways to help you cope with long and heavy periods during perimenopause, including lifestyle changes and medical intervention

","

Perimenopause is a normal and natural part of our lives that comes with many changes that are unfortunately not widely understood. A lack of understanding of what happens in our bodies during this time, and why, may lead to confusion and even anxiety. Especially if our periods suddenly change and become longer.

If you notice your periods becoming irregular, heavier, and longer as you go through perimenopause, keep in mind that it's a normal part of the process, and you're not alone going through this. In this article, we'll dive into everything you need to know about perimenopause and long periods and how to navigate these changes.

Is it normal to have longer and heavier periods during perimenopause?

Experiencing a change in our menstrual cycles as we enter perimenopause is very normal. So yes, our periods can become longer and heavier, and in many cases, this won't be a cause for concern. Flow changes are one of many perimenopause symptoms, such as mood swings, hot flashes, and perimenopause fatigue, to name a few [2].

How long is a normal period?

A menstrual cycle starts on the first day of our period and ends a day before the next bleeding occurs. Technically, there's no such thing as a \"normal period\" because our bodies are different, and each cycle is individual to each person. However, generally, a menstrual cycle is typically between 24 and 38 days [1].

Just like the length of our cycles, how long our flow lasts is highly individual and will vary from person to person. But on average, a period may last between two and eight days [3].

Our cycles may be irregular when we are younger during the years of puberty, but they often regulate by the time we reach adulthood before once again potentially becoming irregular when we reach perimenopause years [4].

What causes longer periods during perimenopause?

During our reproductive years, the levels of sex hormones estrogen and progesterone rise and drop throughout our menstrual cycles in regular patterns. Estrogen peaks at ovulation, which happens in the middle of the cycle, and then starts to drop as progesterone rises up until our period starts (if fertilization of the egg didn't happen) [1].

Now, once we reach perimenopause years, these regular patterns can change and become irregular. That happens because our ovaries start to produce less estrogen, and they might not release an egg every month [1]. This is known as an anovulatory cycle.

These wild hormonal fluctuations may make periods longer, shorter, heavier, lighter, or become intermittent. After one year of absent periods, we officially transition from perimenopause to menopause [1].

How long is too long for a period during perimenopause?

Generally, a period that lasts for longer than eight days is considered a heavy period and may be cause for concern [5]. However, a study that looked at over 50,000 menstrual cycles of over 1,000 midlife women found that 77% of perimenopausal women experienced 10+ days of bleeding on more than three occasions over a more than 10 year observation period [6].

What does this data tell us? Well, as with everything health-related, period length during perimenopause is very individual and what may be normal for some people may be a cause of concern for others.

You may want to contact your healthcare provider if your period is heavier or longer than usual or you experience abnormal bleeding such as [1]:

Bleeding and spotting between periods
Bleeding or spotting after sex
Bleeding after menopause

Other period changes during perimenopause

Aside from experiencing long periods during perimenopause, you may notice other ways your flow changes:

Periods may be heavier or lighter

As we already briefly touched on before, during perimenopause, your periods may become heavier. You will know if you have a heavy period, called menorrhagia if you bleed for longer than seven days at a time and have to change your tampon or pad every two hours [7].

On the other hand, you might experience lighter periods than before. That may be due to ovulation not happening because of hormonal fluctuations [1].

Periods may become irregular

You may also notice your cycle becoming irregular during perimenopause. Because ovulation may not happen every month due to a natural reduction in estrogen production, the timing when your period shows up can vary greatly from month to month [1].

You may experience spotting

Spotting during perimenopause is something that many women experience – 66.8% of midlife women report experiencing six or more days of spotting at least three times over the 10.5 years of data collection [7].

“Light spotting is common, but any significant or prolonged spotting should be checked by a doctor. Especially when it lasts longer than 3 months,” says Natural Cycle’s Medical Advisory Board Member Dr. Jessica Shepherd.

How to cope with extended perimenopause periods

Just because it's normal to experience irregular periods during perimenopause, it doesn't mean you have to suffer through them. There are remedies that may help manage perimenopausal symptoms.

Some ways to cope are lifestyle-related, while others are medical and will require a visit to a healthcare professional:

Contraception pills: Combined hormonal contraceptives can help manage perimenopause symptoms, including period length, flow, and even period pains [8].
Hormone replacement therapy: Hormone replacement therapy (HRT) is a medical treatment that's prescribed to help alleviate perimenopause symptoms by supplementing key hormones we might be missing, most often estrogen and progesterone [9]. Depending on how severe your overall perimenopause symptoms are, it might be a great way to help alleviate long and heavy periods and improve your well-being.
Leading a healthy lifestyle: Regular exercise, good sleep, and relaxing activities like yoga promote overall health and well-being, which may also help you feel better during perimenopause [10].
Reduce alcohol intake: Research suggests there’s a link between increased alcohol consumption and increased estrogen levels in women. Alcohol consumption may also be linked to vasomotor symptoms (hot flashes ) [11], so cutting down on alcohol may reduce these symptoms.
Maintain a healthy weight: Obese women tend to experience perimenopausal symptoms much more severely compared to nonobese women, and losing weight tends to improve those symptoms [12], so maintaining a healthy weight can be helpful.
Track your symptoms: Tracking and recording your perimenopause symptoms, like irregular periods, with Natural Cycles can help you understand all the changes happening in your body during perimenopause, which may help reduce anxiety and stress. Also, having a record of your health patterns may come in handy when speaking with a medical advisor because having this data can help them find the best treatment for you.

It's also a good idea to always be prepared for the unexpected. So, the best way to cope with irregular periods is to ensure you always have tampons and pads on hand, as well as over-the-counter medication for period pain if you experience it.

What if your perimenopausal bleeding won’t stop?

While it's normal to experience bleeding for longer periods of time, shorter periods, or spotting during perimenopause, if any of the symptoms become hard to deal with or cause pain and discomfort, it's a good idea to contact a healthcare provider:

If you're bleeding for longer than seven days
If you experience heavy bleeding where you bleed through a tampon or a pad every few hours
If you notice blood clots larger than a bottle cap

There may also be other reasons aside from perimenopause that could be causing heavy and long periods [13]:

Thyroid disorders
Hyperprolactinemia (high levels of the hormone prolactin)
Polyps
Fibroids
Infections
Adenomyosis (a problem with the lining of the uterus)

It's important to seek help from a medical advisor so they can run tests and rule out any of the other possible conditions that could be causing abnormal bleeding.

Be in tune with your body with Natural Cycles

Perimenopause brings new challenges and unexpected changes to our bodies, and learning to navigate this new part of life can take time. Keeping track of your perimenopause symptoms and period changes allows you to be empowered throughout this transition, and Natural Cycles is here to support you on this journey. Why not find out how NC° can support you during your fertility journey and beyond?

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Perimenopausal bleeding and bleeding after menopause. (n.d.). ACOG. https://www.acog.org/womens-health/faqs/perimenopausal-bleeding-and-bleeding-after-menopause
Website, N. (2024, September 19). Symptoms. nhs.uk. https://www.nhs.uk/conditions/menopause/symptoms/
Reed, B. G., & Carr, B. R. (2018, August 5). The normal menstrual cycle and the control of ovulation. Endotext - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK279054/
Menstruation in girls and Adolescents: Using the menstrual cycle as a vital sign. (n.d.). ACOG. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/12/menstruation-in-girls-and-adolescents-using-the-menstrual-cycle-as-a-vital-sign
Website, N. (2025, January 15). Heavy periods. nhs.uk. https://www.nhs.uk/conditions/heavy-periods/
Paramsothy, P., Harlow, S., Greendale, G., Gold, E., Crawford, S., Elliott, Lisabeth, L., & Randolph, J. (2014). Bleeding patterns during the menopausal transition in the multi‐ethnic Study of Women’s Health Across the Nation (SWAN): a prospective cohort study. BJOG an International Journal of Obstetrics & Gynaecology, 121(12), 1564–1573. https://doi.org/10.1111/1471-0528.12768
About heavy menstrual bleeding. (2024, May 15). Bleeding Disorders in Women. https://www.cdc.gov/female-blood-disorders/about/heavy-menstrual-bleeding.html?CDC_AAref_Val=https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html
Grandi, G., Di Vinci, P., Sgandurra, A., Feliciello, L., Monari, F., & Facchinetti, F. (2022). Contraception during Perimenopause: Practical guidance. International Journal of Women S Health, Volume 14, 913–929. https://doi.org/10.2147/ijwh.s288070
Hormone therapy for menopause. (n.d.). ACOG. https://www.acog.org/womens-health/faqs/hormone-therapy-for-menopause
Website, N. (2022, May 24). Things you can do. nhs.uk. https://www.nhs.uk/conditions/menopause/things-you-can-do/
Erol, A., Ho, A. M., Winham, S. J., & Karpyak, V. M. (2017). Sex hormones in alcohol consumption: a systematic review of evidence. Addiction Biology, 24(2), 157–169. https://doi.org/10.1111/adb.12589
Chopra, S., Sharma, K. A., Ranjan, P., Malhotra, A., Vikram, N. K., & Kumari, A. (2019). Weight management module for perimenopausal women: A practical guide for gynecologists. Journal of Mid-life Health, 10(4), 165. https://doi.org/10.4103/jmh.jmh_155_19
My periods have changed. Is menopause around the corner? (n.d.). ACOG. https://www.acog.org/womens-health/experts-and-stories/the-latest/my-periods-have-changed-is-menopause-around-the-corner

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Congratulations, you have reached week 37 and your baby is now at term! Though you likely have a few weeks left to go before you meet your little one, it is important to remember that labor can begin at any time. In this article, we will chat about what you might be experiencing in your body this week, from stretch marks to heartburn and leaky breasts. We will also check in on the baby, who is still moving as much as ever. Finally, we will discuss what to expect when labor begins and talk about the stages of giving birth, along with some tips for things you can do this week to help you get ready for your baby’s arrival.

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Key takeaways

Whether your breasts are leaking or not, your body is still readying itself to produce breast milk for the baby
By week 37, your baby’s heart, blood vessels, muscles, and bones are all complete and developed
There are several signs of labor to watch out for — getting familiar with these now can help you prepare for birth

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Your Body at Week 37

Stretch marks

Stretch marks, which are common even amongst non-pregnant people, can continue to appear especially in the final weeks of your pregnancy. Depending on your skin’s natural pigmentation and texture, stretch marks can be narrow or thick, and be pink, red, brown, purple, or white in color [1]. Stretch marks occur when the middle layer of skin is stretched and becomes broken. What you see as stretch marks are actually scars. This often happens during periods of weight gain, like growing a pregnant belly, and can also be affected by hormonal changes like those that occur during puberty and pregnancy [1].

During pregnancy, stretch marks usually appear on the belly and breasts as well as on the upper thighs. Though they can be itchy, they are not associated with any other medical conditions, and there is not a specific or recommended treatment for them [1]. After your baby is born, the marks will probably fade and become less noticeable, but as they are scars, they likely will never disappear entirely.

Unfortunately, there is no known single treatment or product that can prevent or treat stretch marks [1]. There are some treatments like prescription retinoids, chemical peels and laser treatments that are often not advised during pregnancy [2]. However, there are skin creams, gels, lotions, and oils marketed to treat or prevent pregnancy stretch marks, as well as commonly used home remedies like almond oil, cocoa butter, olive oil or vitamin E [2]. While there is limited scientific evidence surrounding the efficacy of creams, oils, and gels, dermatologists generally recommend that beginning any treatment early, taking time to massage the product into stretched skin, and using the product daily for many weeks is the best way to maximize its effectiveness [2].

Moisturizing can also be a valuable part of your self-care routine during the final weeks of pregnancy, for example using oils or creams after a shower or before bed. If you have questions about any products, or treatments, consult your doctor or dermatologist.

Feeling movement

Babies commonly will move more and more in the uterus until about the 32nd week of pregnancy, after which the frequency of their movements will remain the same for the remainder of the pregnancy [3]. While babies can move any time during the day or night, they tend to be the most active in the afternoons and evenings. When they are asleep, which can last anywhere from 20 minutes to an hour and a half, you might not be able to feel them moving [3].

You might still be counting kicks, as we discussed in Week 28 of pregnancy, or you might be feeling the movements so strongly that you no longer feel the need to. You should be able to feel movements all the way up until, and through, labor [3]. If you notice any changes or reductions in your baby’s movements, contact your midwife or maternity unit.

Leaking breasts

Some women experience leaking milk, or colostrum (the first milk you will produce for your baby), in the second half of pregnancy. This is completely normal and is even more common in the weeks prior to giving birth [4]. You can start using breast pads, also known as nursing pads, to help stay dry and comfortable. If you breastfeed after your baby is born, leaking will likely continue until you stop breastfeeding.

While leaking is common, if you are not leaking, there is no cause for concern. There is no known link between leaking colostrum during pregnancy and your milk supply after birth [5]. However, if there is blood in the leaking milk that makes it red or brown in color, contact your nurse, doctor or midwife.

Heartburn

Heartburn, or acid reflux, is common in pregnancy particularly in the third trimester [6]. Heartburn is a type of indigestion that presents as a burning sensation in the chest or throat. When experiencing heartburn, you might also burp more frequently, feel sick to your stomach, or even throw up. While doctors are not sure why heartburn is so common in pregnancy, it is believed to be linked to hormonal changes that relax certain muscles and slow the digestive tract, alongside the internal pressure of the growing uterus on other organs [7].

Sometimes changing your diet and lifestyle can help control heartburn symptoms. Spicy and greasy foods are known to make heartburn worse, while foods that are easier to digest can ease symptoms [7]. Large meals, overeating, and eating right before sleeping or napping can also worsen heartburn symptoms [7]. Many over the counter medications, like chewable tablets or liquid antacids can be safe to use during pregnancy, but check with your doctor or pharmacist.

Your baby’s development at 37 weeks

At 37 weeks, your baby is considered term, which means if they were born this week they would no longer be considered premature. Your baby’s heart, blood vessels, muscles and bones are complete and fully developed [8]. However, unless there is a medical risk to you or your baby’s health, it is usually recommended that your baby stay inside your uterus until you naturally go into labor [9].

By 37 weeks, your baby likely weighs between 6 and 7 lbs (2.7 to 3.2 kg) and is around 18 to 19 inches (45.7 to 49 cm) long [9]. This is approximately the size of a head of romaine lettuce!

Signs and Stages of Labor

While you probably have some weeks left to go, your baby can really come at any time now. According to 2022 statistics from the Center for Disease Control (USA), nearly 30% of all births occurred between 37 and 38 weeks, while around 55% occurred between weeks 39-40 [10]. Recognizing signs of labor can help you remain calm and know what to do when the time comes.

The earliest signs of labor include discharging mucus from your cervix (also known as a “show” or “bloody show”), water breaking, lower back pain, and contractions that come at regular intervals and with increasing intensity. Contrary to what you might have seen on television or in movies, only an estimated 8-12% of women experience their water breaking, or the rupture of the amniotic sac, prior to going into labor [11,12]. Most women will experience other signs of labor, or even be in labor, before the water breaks.

In most cases, the hospital or maternity unit where you give birth will have guidelines and suggestions of when to contact the hospital or when you will likely be admitted if you have gone into labor. It is good to familiarize yourself with their guidelines so you know how best to monitor your labor. The guidelines will usually advise you to take note of the length and frequency of your contractions. However, if your water breaks, you experience bleeding, severe or persistent pain, or changes in fetal movement, you should always contact your hospital or maternity unit [13].

While every labor is different, doctors tend to divide labor into stages. The first stage, sometimes called the dilation stage, tends to take the longest. In this stage, the cervix starts to soften and you start experiencing contractions that get stronger and more frequent [14]. This stage lasts until your cervix has opened enough to begin pushing. The second stage of labor is when you give birth. Your cervix has completely dilated, or opened, to approximately 10cm and you will likely be encouraged to push when you have contractions, or feel the urge to push yourself [14]. After you give birth, the third stage of labor is when your uterus contracts and the placenta comes out of your vagina.

Tips in week 37

Install your car seat: if you have not yet purchased and installed your infant car seat, it is time! You most likely will need a car seat to bring your newborn home from the hospital. Check that it is installed correctly in your vehicle, or make sure you know how to secure it safely in a taxi, family’s, or friend’s vehicle. Installation can be tricky, so be sure to consult the manufacturer’s safety manual and even consult your local fire station or police department for assistance.
Check your hospital or maternity unit’s guidelines: review the guidelines and suggestions offered by your hospital or maternity unit. These can have useful tips on things to make sure you pack for your stay. In most cases, they will also have advice on how to monitor your labor at home and when it is advised to come to the hospital.
Hospital and maternity unit phone numbers: most hospitals or maternity units will have special phone numbers to call when you go into labor. Be sure to save those numbers ahead of time in your phone and write them in a visible place in your home so that a friend, family member, or partner can call the right number when you go into labor.
Keep hydrated: keep drinking plenty of water! Though you might be constantly going to the bathroom, staying hydrated can help fend off heartburn, indigestion, dehydration, headaches, and even Braxton Hicks contractions.
Check the smoke and carbon monoxide detectors in your home: carrying out routine safety tasks now, will save you time in the future when you care for your little one. Make sure your carbon monoxide and smoke detectors are working properly before bringing home your new baby.
Set up a safe bed for your newborn: whether you are using a bassinet, crib, or other sleeping space, now is a good time to get it assembled and set up safely.

Using Natural Cycles during your pregnancy

Natural Cycles can support you from conception through to postpartum and beyond. As the first FDA Cleared birth control app, Natural Cycles offers a hormone-free, non-invasive method of contraception and fertility tracking. NC° Follow Pregnancy offers weekly guides that update you on the baby’s development and changes you might be experiencing in your body. You can also use the app to track important pregnancy symptoms and monitor your own health. After giving birth, NC° Postpartum can provide additional health tips and support as you recover from childbirth. Why not find out how Natural Cycles can support you?

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National Health Service. Stretch marks in pregnancy [Internet]. nhs.uk. 2024 [Cited 2025 Mar 6]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/stretch-marks/
Stretch marks: Why they appear and how to get rid of them [Internet]. [Cited 2025 Mar 6]. Available from: https://www.aad.org/public/cosmetic/scars-stretch-marks/stretch-marks-why-appear
National Childbirth Trust. Baby movements in the womb before birth | NCT [Internet]. NCT (National Childbirth Trust). 2025 [Cited 2025 Mar 6]. Available from: https://www.nct.org.uk/information/pregnancy/body-pregnancy/baby-movements-womb-birth
National Health Service. Leaking from your nipples [Internet]. nhs.uk. 2024 [Cited 2025 Mar 6]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/leaking-nipples/
Breast changes during pregnancy [Internet]. HSE.ie. [Cited 2025 Mar 6]. Available from: https://www2.hse.ie/pregnancy-birth/baby-development-pregnancy-stages/stages/breast-changes/
Indigestion and heartburn in pregnancy [Internet]. HSE.ie. [Cited 2025 Mar 6]. Available from: https://www2.hse.ie/conditions/heartburn-indigestion-pregnancy/
Pregnancy and heartburn [Internet]. Stanford Medicine Children’s Health. [Cited 2025 Mar 6]. Available from: https://www.stanfordchildrens.org/en/topic/default?id=pregnancy-and-heartburn-134-10
Fetal development [Internet]. Mount Sinai Health System. [Cited 2025 Mar 6]. Available from: https://www.mountsinai.org/health-library/special-topic/fetal-development
American Pregnancy Association. 37 weeks pregnant [Internet]. American Pregnancy Association. 2023 [Cited 2025 Mar 5]. Available from: https://americanpregnancy.org/healthy-pregnancy/week-by-week/37-weeks-pregnant/
Osterman, M. J. K., Hamilton, B. E., Martin, J. A., Driscoll, A. K., & Valenzuela, C. P. (2024). Births: Final Data for 2022. National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 73(2), 1–56.
Majority of women can still give birth naturally if their water breaks early [Internet]. University of Michigan News. 2021 [Cited 2025 Mar 6]. Available from: https://news.umich.edu/majority-of-women-can-still-give-birth-naturally-if-their-water-breaks-early/
Middleton P, Shepherd E, Flenady V, McBain RD, Crowther CA. Planned early birth versus expectant management (waiting) for prelabour rupture of membranes at term (37 weeks or more). Cochrane Database of Systematic Reviews 2017, Issue 1. Art. No.: CD005302. DOI: 10.1002/14651858.CD005302.pub3. Accessed 06 March 2025.
National Health Service. Signs that labour has begun [Internet]. nhs.uk. 2024 [Cited 2025 Mar 6]. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/signs-of-labour/signs-that-labour-has-begun/
National Health Service. The stages of labour and birth [Internet]. nhs.uk. 2024 [Cited 2025 Mar 6]. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/the-stages-of-labour-and-birth/

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If you’re wondering if conception is possible without having sexual intercourse, the simple answer is… yes! But it’s a bit more complicated than that. You’ve probably heard rumors about people getting pregnant after someone ejaculated in a hot tub or from having oral or anal sex. While it’s extremely unlikely or even impossible to get pregnant in many of these scenarios, there are a couple of instances when you can get pregnant without having sexual intercourse. In this article, we’ll dive into exactly how pregnancy happens, how you can get pregnant without having sex, and what you can do to protect yourself.

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Key takeaways:

In most cases, pregnancy occurs when a penis ejaculates inside a vagina
It’s possible to get pregnant if semen gets on fingers or sex toys that then penetrate the vagina, but it’s rare that pregnancy happens this way
Sperm can’t live for long outside the human body or in water so it’s very unlikely to get pregnant from sharing a hot tub or swimming pool
Fertility techniques like IVF make conception possible without having penetrative vaginal sex
Knowing when you’re fertile can be a helpful tool in preventing pregnancy, as you can choose to use condoms or abstain from sex only on fertile days

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How does pregnancy happen?

Before we go into the likelihood of getting pregnant without having sex, let’s back up a second and take a refresher into the ins and outs of how pregnancy happens in the first place. Are you ready to go back to biology class?

Typically, during the menstrual cycle, our ovaries release a female egg cell in a process called ovulation. This egg cell travels down the fallopian tubes and can survive for between 12-24 hours before it starts to deteriorate in the uterus [1]. If the egg cell isn’t fertilized by a sperm cell, then this is exactly what happens. The uterine lining then sheds (in the form of your period) and the cycle begins again. However, if sperm cells are present and they fertilize the egg cell, this can lead to pregnancy.

It’s useful to know that we’re only fertile during six days per cycle, known as the fertile window, which consists of the five days before ovulation and ovulation day. Sperm cells can survive in the female reproductive tract for up to five days under the right conditions. [1] For pregnancy to happen, sperm needs to enter the female reproductive tract in the days before ovulation happens or during the 24-hour window while the egg cell can be fertilized.

How is it possible to get pregnant without having sex?

You might be wondering how sperm can end up in the vagina if a penis hasn’t been there. Well… There are a few ways you can get pregnant without having penetrative sex, as all that’s needed for conception to occur is for live sperm to get to the fallopian tubes through the vagina around the time of ovulation. This can happen if your partner ejaculates very close to your vagina or on fingers, sex toys, or any objects that then go inside the vagina [2]. This is sometimes called a “splash pregnancy”.

Did you know it’s also possible to get pregnant from pre-cum or pre-ejaculate if that gets in the vagina? While there are typically reduced levels of sperm in pre-ejaculate, if your vagina comes into contact with any semen this puts you at risk of pregnancy as it only takes one single sperm to reach the egg cell to get pregnant [3].

The best way to protect yourself from a splash pregnancy is to regularly wash your hands, toys, or anything else that goes inside the vagina. You can also use condoms, while engaging in non-penetrative sex or with sex toys — this can add an extra barrier and also protect against sexually transmitted infections (STIs).

How long can sperm live outside the body?

Now you know it’s possible for sperm to get into the vagina in other ways than intercourse, you may be wondering how long sperm can survive on fingers or sex toys. The good news is that once sperm is outside the warm and protective conditions of the human body, it can’t survive for very long on its own.

What about that rumor about someone getting pregnant after sharing a hot tub? While it’s possible to get pregnant if you have sex in water, it’s extremely unlikely just from sharing the same water as someone else. Not only will sperm disperse in water and become separated from the fluids that protect them, but any soap or chemicals in the water will kill off sperm pretty quickly.

How deep does sperm need to go for you to get pregnant?

So if you’re worried about sperm getting into the vagina unexpectedly, you might also be curious to know how deep does it actually need to go into the vagina for you to get pregnant? The answer is not very straightforward. While you might have heard about some sex positions that are more likely to help you conceive, the science in this area is extremely murky. There is no evidence to suggest that any particular sex position can improve your chances of getting pregnant [4].

Remember that only one healthy sperm needs to get to the vagina for conception to occur. Sperm are equipped with a tail and are built for swimming, so provided they are deposited in the vagina they are able to make their own way towards the egg cell in the fallopian tubes — an epic journey of about 7 inches or 19cm [5].

What other ways can you get pregnant without having sex?

Aside from a splash pregnancy, it’s also possible to get pregnant without having sexual intercourse if you use artificial insemination to conceive or assisted reproductive technology (ART). [6] This involves techniques such as in vitro fertilization (IVF) where fertilization happens outside the body and the fertilized embryo is transferred to the uterus. Assisted reproductive technology can be a useful tool for those who’ve had difficulty getting pregnant or who can’t conceive through sexual intercourse. Getting pregnant through IVF or another fertility treatment is now fairly common with 42% of adults in the US stating that they have either used fertility treatments themselves or know someone who has [7].

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What do we mean when we talk about “sex”?

Intimacy means many different things to different people and it’s important to note that not all sex is penetrative vaginal sex. Sex can also include touching, kissing, oral activities, or any act that you find erotic. Check out our article on the different types of sex to learn more.

Can I get pregnant if…

If you’re reading this article, you’ve probably got some unanswered questions about when and how it’s possible to get pregnant. Well, there’s a lot of misinformation floating around when it comes to the topic of unintended pregnancy! At Natural Cycles, we’re all about busting these unhelpful myths, so let’s take a look at some scenarios and answer whether or not it’s possible to get pregnant from them.

Can I get pregnant if I have sex on my period?

This is a complicated one. The short answer is yes, although it’s highly unlikely. Most people aren’t fertile during their period, but if you have a very short cycle, long menstruation and/or ovulate early, it’s technically possible to get pregnant as sperm can survive in the female reproductive tract for up to five days [7]. If you have sex on your period and then ovulate soon afterward, it’s possible to get pregnant if any sperm have survived to fertilize the egg.

However, most people won’t be fertile until after their period ends — to learn more about your body and track your ovulation, why not try the Natural Cycles app?

Can I get pregnant if my partner ejaculated right outside of my vagina?

Yes. There are potentially hundreds of millions of sperm in each ejaculation and these are too small to see with the naked eye [8]. Even if only a small amount of semen manages to get inside the vagina, there is still a risk of pregnancy. If you’re trying to prevent pregnancy, it’s best to avoid getting ejaculate or pre-cum anywhere near the vagina during the fertile window (this includes the day of ovulation and five days prior when sperm can survive in the female body).

Can I get pregnant from oral sex?

You can’t technically get pregnant from oral sex, although we’ve all heard THAT rumor… Keep in mind though, that if any ejaculate or pre-cum gets near the vagina during activities like foreplay, then pregnancy is possible. Using a condom during oral sex can add another layer of protection against both pregnancy and STIs.

Can I get pregnant from fingering or giving a hand job?

Again, for pregnancy to happen, sperm has to get inside the vagina. You can’t technically get pregnant from touching someone’s genitals or touching your own, but if semen gets on your fingers and then those go inside the vagina, then pregnancy is possible. Washing your hands if they get pre-cum or ejaculate on them can help protect you from pregnancy in these situations.

Can I get pregnant from anal sex?

While there isn’t a risk of pregnancy directly from anal sex, if any semen is deposited in the general genital area it’s possible for it to leak into the vagina and cause pregnancy. Using a condom offers extra protection if you’re worried about ejaculate or pre-cum getting into the vagina after anal sex. Always wash fingers, penises, and sex toys before putting them in the vagina if you’re engaging in anal sex. It’s also advised to change condoms between anal and vaginal sex. This not only reduces your risk of infection but can wash off any lingering semen.

Can I get pregnant if my partner pulls out?

Yes. The pull out method or withdrawal method is not a reliable form of contraception for a couple of reasons. Sperm is still present in pre-cum and it only takes one sperm cell to fertilize an egg cell [3]. It can also be difficult to get the timing right, and it’s possible your partner won’t pull out in time. With typical use, the withdrawal method is only 80% effective, so we wouldn’t recommend it to anyone who’s actively trying to avoid pregnancy [9]. There are plenty of options out there when it comes to switching birth control, including long-acting methods like IUDs and other non-hormonal birth control options.

Know when you’re fertile and prevent pregnancy naturally

So, returning to the question “Can you get pregnant without having penetrative sex?”, the answer is yes! Whether that’s from semen getting in the vagina accidentally, or from fertility treatments like IVF, there are a number of ways it’s possible to get pregnant without a penis physically going into a vagina.

If you’re looking for a natural way to prevent pregnancy that’s also free from side effects, why not consider Natural Cycles, the first and only FDA Cleared birth control app? It’s hormone-free, non-invasive, and available to download now. The app uses the science of how your body temperature changes during your menstrual cycle to identify your fertile days so you know when you can and can’t get pregnant. With this information, you can then either abstain from sex on fertile days or use protection. Natural Cycles is 93% effective with typical use and 98% with perfect use.

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Trying to get pregnant? Here’s when to have sex. [Internet]. ACOG. Available from: https://www.acog.org/womens-health/experts-and-stories/the-latest/trying-to-get-pregnant-heres-when-to-have-sex [cited 5 March 2025]
Website N. Periods and fertility in the menstrual cycle [Internet]. nhs.uk. 2024. Available from: https://www.nhs.uk/conditions/periods/fertility-in-the-menstrual-cycle/ [cited 5 March 2025]
Killick SR, Leary C, Trussell J, Guthrie KA. Sperm content of pre-ejaculatory fluid. Hum Fertil (Camb) 2011 Mar;14(1):48-52. Available from: https://doi.org/10.3109/14647273.2010.520798
Sex when trying to get pregnant [Internet]. HSE.ie. Available from: https://www2.hse.ie/pregnancy-birth/trying-for-a-baby/your-fertility/sex-when-trying [cited 5 March 2025]
Rate of transport of spermia in human uterus and tubes, Brown, Royal L. American Journal of Obstetrics & Gynecology, Volume 47, Issue 3, 407 - 411
Website N. Infertility [Internet]. nhs.uk. 2023. Available from: https://www.nhs.uk/conditions/infertility/ [cited 5 March 2025]
Website N. Periods and fertility in the menstrual cycle [Internet]. nhs.uk. 2024. Available from: https://www.nhs.uk/conditions/periods/fertility-in-the-menstrual-cycle [cited 5 March 2025]
World Health Organization. WHO laboratory manual for the Examination and processing of human semen. 2010 https://iris.who.int/bitstream/handle/10665/44261/9789241547789_eng.pdf?sequence=1
Contraceptive Technologies. Contraceptive failure rates table [Internet]. 2018 [March 6 2025]. Available from: https://www.datocms-assets.com/21281/1662539230-contraceptive-technologies_failure-rates-table-2018.pdf

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The journey to pregnancy looks different for everyone, and it can be both exciting and scary. If you’re just starting to think about trying to conceive, you might be asking yourself: “When is the best time to have sex to get pregnant?” In this article, we’ll dive into what the fertile days of the menstrual cycle are and how to find them, and we’ll also cover how often you should have sex to get pregnant, tips for optimizing your chances, and when it’s time to reach out to a doctor for help.

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Key takeaways:

The fertile window, the days in each menstrual cycle when we can get pregnant, is only six days long and consists of the five days before ovulation and ovulation day itself
You have the highest chance of conceiving if you have sex on the two days leading up to ovulation and on ovulation day
Having sex every day or every other day during the fertile window gives the highest chances of conception when trying to get pregnant

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When in the menstrual cycle can you get pregnant?

Did you know that we’re actually only fertile for a maximum of six days in each menstrual cycle? This is called the fertile window, and it consists of the five days leading up to ovulation and ovulation day itself [1].

The length of the fertile window is determined by how long sperm can survive in the female reproductive system and how long the egg cell can survive once it’s released [2]. Sperm can survive for five days at most (under the right conditions), but the egg cell’s lifespan is shorter — it only lives for 12-24 hours after it’s released on ovulation day [3].

So, all in all, the fertile window lasts a total of six days, and you’ll have the best chance of getting pregnant if you’ve already had sex in the days right before ovulation so that sperm is waiting for the egg when it’s released on ovulation day.

What are the chances of getting pregnant on the fertile days?

It’s only during those six days that intercourse can lead to a pregnancy, so timing is important. In fact, chances even vary on the days in the fertile window itself. The days right at the start of the window, furthest from ovulation, have a lower chance of pregnancy, while the two days right before and on ovulation day give you the highest chance of conception [1].

However, even when timing sex perfectly, pregnancy isn’t a given. On the most fertile day in the menstrual cycle (the day before ovulation), the chance of getting pregnant from intercourse is roughly 30% [1].

Our chances of getting pregnant at any given time also depend on other factors. Age is one of the most important ones — it’s well-established that our fertility decreases with age. In general, we’re the most fertile in our twenties and early thirties, and then fertility rates decrease more rapidly in our mid-thirties and onward [4]. Other lifestyle factors that can affect fertility are diet, weight, stress, smoking, and excessive alcohol use [5]. It’s also important to remember that we’re all individuals, and some people will have an easier time getting pregnant than others.

How often should you have sex to get pregnant?

So, now that we’ve established when to have sex, you might be wondering how often you should have sex during those fertile days to have the best chances. Research has found that theoretically having sex every day or every other day during the fertile window leads to the highest probability of conceiving [2].

For some, it may feel like having sex this often — especially when also trying to time it during the most fertile days — creates a lot of pressure. This can make the experience less enjoyable or even downright stressful. While it can certainly feel like there’s only a small window of opportunity in each cycle, it’s also important to keep in mind that it only takes one sperm to fertilize an egg, while there are normally hundreds of millions of sperm in each ejaculation [6]. Most couples do become pregnant on their own within a year of trying [7]. So, try to not stress too much and enjoy each others’ company. If you need it, there’s also help available (more on that later).

Should you only have sex on the fertile days when trying to conceive?

It’s only during the fertile days that sex can lead to pregnancy. However, there’s no need to “save up” and only have sex during the fertile window if you want to do it more often. There’s even research to suggest that the quality of sperm may be affected when abstaining from sex — well, from ejaculating — for longer periods of time (more than 10 days for men with normal sperm quality) [8]. That said, not all sex needs to involve penetration. If you want to have sex outside the fertile days but aren’t feeling like having vaginal sex, there are lots of ways to be intimate, and masturbation is another option if one of you is feeling it and the other isn’t.

Again, it can feel like there’s a lot of pressure to perform for couples trying to conceive and sex should feel enjoyable for both parties. At the end of the day, it’s always up to you how often you want to have sex. If you’re not feeling like doing the deed that often, you can focus on the fertile window when you’re trying to conceive.

How to predict ovulation and the fertile days

Understanding when you ovulate is crucial to identifying those fertile days, but how do you actually go about predicting when you’re going to ovulate? Let’s go through some ways that you can understand when you’re ovulating during your menstrual cycle:

Using ovulation tests: Ovulation tests (sometimes called LH tests) measure the amount of luteinizing hormone (LH) in urine. LH levels peak roughly 1-2 days before you ovulate, so a positive ovulation test is a good indication that you will ovulate soon [9]. However, it doesn’t confirm that ovulation has or will happen.
Tracking cervical mucus: Your cervical mucus changes throughout your menstrual cycle and tracking it can help you find your most fertile days [10]. During the fertile window, the cervical mucus becomes clear and stretchy — with a consistency and color that resembles raw egg whites — and this helps the sperm swim and stay alive in the female reproductive system.
Tracking your periods: For most, ovulation happens roughly two weeks before the next period starts [11]. Keeping track of your periods, for example with a cycle tracking app or using a regular calendar to mark the days, can be a helpful tool to find your fertile days during your menstrual cycle. However, there are now more sophisticated ways to learn the pattern of your cycle and it’s important to know that if your cycles are irregular, it can be tricky to predict ovulation this way since it will change from one cycle to the next, so you might want to combine it with other methods too.
Measuring your basal body temperature (BBT): Your BBT, the body’s resting temperature, increases after ovulation due to an increase in progesterone levels [12]. By tracking your BBT throughout your cycle, you can understand when you usually ovulate and plan intercourse accordingly. However, it’s good to keep in mind that BBT tracking can only show ovulation after it’s already happened, i.e. after the fertile window has closed.
Using Natural Cycles: When using NC° Plan Pregnancy, the FDA Cleared app can identify which days you’re most likely to be fertile in each cycle, helping you get pregnant faster. The algorithm behind the app learns your unique cycle by analyzing your biometric data — temperature data, period data, and optional ovulation tests — and your previous cycles to predict when you will ovulate, giving you a daily fertility status. Research shows that Natural Cycles finds fertile days more accurately than calendar-based methods [13].

What else can you do to increase your chances of getting pregnant?

Aside from timing sex during the fertile days, are there any other ways of increasing the chances of getting pregnant? Here, we’ve listed a few things you can do on your own:

Eat a balanced diet: While there’s limited evidence to support any specific dietary practices linked to higher fertility rates, eating a nutrient-rich diet with a good balance of carbs, protein, healthy fats, and fiber is good for promoting general health and may help the body ovulate regularly [5].
Exercise regularly: Exercising regularly is good for our overall health, and moderate exercise has been suggested to help promote fertility [5]. However, excessive training while not eating enough food can have the opposite effect, so it’s important to build up your exercise routine and maintain a healthy balance with plenty of rest and proper nutrition.
Maintain a healthy weight: Our weight can impact our hormones, and both obesity and being underweight have been linked with couples taking longer to get pregnant [6]. A very high or low weight can lead to cycle irregularities and lower ovulation rates, which, in turn, may make it more difficult to get pregnant [5, 14]. If you have questions about your weight when trying to get pregnant, it’s a good idea to speak with your healthcare provider.
Take supplements: Women who are looking to get pregnant are generally recommended to take folic acid supplements (folic acid is important for the development of the brain and spine in early pregnancy) [15]. You can also consider taking prenatal vitamins that contain iron, vitamin D, and calcium — make sure you check with your healthcare provider what they recommend for you before taking any new supplements.
Don’t smoke: Smoking has been linked with higher rates of infertility in both men and women [5], so it’s best to cut out smoking completely if you’re trying to conceive.
Limit alcohol: An excessive use of alcohol may reduce your chances of conceiving [5]. While it’s fine to have a glass of wine or beer here and there, it’s recommended to limit your alcohol intake if you’re trying to get pregnant.
Limit caffeine: When consumed in very large amounts (five cups per day or more), caffeine has been linked to it taking to conceive [5]. There’s most likely no need to skip your morning coffee or tea, but it can be a good idea to limit your caffeine intake if you usually consume a lot.

Trying to get pregnant can feel daunting at times — with many dos and don’ts all over the internet (and maybe you’re even getting advice from people around you that you didn’t ask for!). It’s important to know that everyone’s journey to pregnancy looks different, and even if you do everything by the book, it’s normal that this process takes some time. We know it’s easier said than done, but try to be kind to yourself and not stress too much.

Are certain sex positions better for conceiving?

Speaking of enjoying the process, there’s no evidence to support that any specific sexual positions are better than others when it comes to trying to conceive (as long as you’re having vaginal intercourse) [6]. In short, as long as sperm enters the vagina, you’re good to go.

While we’re busting myths, there’s also no need to lie down with your legs elevated after sex to increase your chances [6]. Sperm are fast swimmers and reach the cervical canal within a few seconds after ejaculation, so while it won’t hurt to lie down for a while afterward, you won’t hurt your chances if you move around or go to the bathroom.

How long does it take to get pregnant?

Everyone has their own personal fertility journey, and how long it takes to get pregnant can vary greatly from one person to the next — for some, it takes only a couple of months while for others, it may take years. However, the majority of couples who don’t have any fertility issues get pregnant within a year of trying [7].

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Our study on how long it takes for Cyclers using NC° Plan Pregnancy to conceive showed that the median time to conceive was four cycles [16]. For women under the age of 35 with regular cycles and no fertility issues, the median time to get pregnant was only two cycles.

It’s common to feel impatient when pregnancy doesn’t happen right away, and for many, it can trigger fears that something is wrong. However, it’s completely normal that it can take some time to become pregnant, even when you’re fertile, healthy, and following all the guidance.

When to talk to a doctor

If you’re female and under 35 with no known fertility issues you will be generally recommended to try on your own for a year before seeking help from a medical professional [17]. If you’re older than 35, you should reach out to your healthcare professional after six months of trying, and if you’re above 40 or have medical conditions that may affect your fertility (like PCOS or endometriosis), you may want to seek help even sooner [18].

While the recommendations around when to reach out to a doctor largely depend on the woman’s age, trouble conceiving isn’t always down to the woman. In fact, the issue lies with the man in around one-third of cases [19]. One-third is due to the woman, and finally, in the last one-third of cases, the cause of the problem is unknown or due to a combination of fertility issues for both parties.

If you’re not succeeding in becoming pregnant despite trying for the recommended duration of time for your age, it’s important to talk to your healthcare provider so that you can get the right help. There are many options to help couples who struggle to get pregnant on their own, ranging from medication to trigger ovulation to IVF, so the key is to find the right option for you.

Plan your pregnancy with Natural Cycles

There are so many aspects of fertility, but knowing when you ovulate is key to understanding when to time sexual intercourse to optimize your chances of getting pregnant. That’s where Natural Cycles comes in — NC° Plan Pregnancy takes the guesswork out of the equation by helping you identify which days you have the highest chances to conceive, giving you individualized insights into your fertility.

During your pregnancy, you can track your baby’s development and your body’s changes with NC° Follow Pregnancy, and then seamlessly switch to NC° Postpartum once you give birth for additional support while you recover. Why not see if Natural Cycles could be right for you today?

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Dunson DB, Baird DD, Wilcox AJ, Weinberg CR. Day-specific probabilities of clinical pregnancy based on two studies with imperfect measures of ovulation. Hum Reprod. 1999 Jul;14(7):1835-9. Available from: https://doi.org/10.1093/humrep/14.7.1835
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ACOG. Trying to get pregnant? Here’s when to have sex [Internet]. 2023 [cited 2025 Mar 7]. Available from: https://www.acog.org/womens-health/experts-and-stories/the-latest/trying-to-get-pregnant-heres-when-to-have-sex
Dunson DB, Colombo B, Baird DD. Changes with age in the level and duration of fertility in the menstrual cycle. Hum Reprod. 2002 May;17(5):1399-1403. Available from: https://doi.org/10.1093/humrep/17.5.1399
Sharma R, Biedenharn KR, Fedor JM, Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reprod Biol Endocrinol. 2013;11:66. Available from: https://doi.org/10.1186/1477-7827-11-66
Practice Committee of the American Society for Reproductive Medicine. Optimizing natural fertility: a committee opinion. Fertil Steril. 2013 Aug;100(3):631-637. Available from: https://doi.org/10.1016/j.fertnstert.2013.07.011
Wesselink AK, Rothman KJ, Hatch EE, Mikkelsen EM, Sørensen HT, Wise LA. Age and fecundability in a North American preconception cohort study. Am J Obstet Gynecol. 2017;217(6):667.e1-667.e8. Available from: https://doi.org/10.1016/j.ajog.2017.09.002
Levitas E, Lunenfeld E, Weiss N, Friger M, Har-Vardi I, Koifman A, et al. Relationship between the duration of sexual abstinence and semen quality: analysis of 9,489 semen samples. Fertil Steril. 2005 Jun;83(6):1680–6. Available from: https://doi.org/10.1016/j.fertnstert.2004.12.045
Miller PB, Soules MR. The usefulness of a urinary LH kit for ovulation prediction during menstrual cycles of normal women. Obstet Gynecol. 1996;87(1):13-17. Available from: https://doi.org/10.1016/0029-7844(95)00352-5
Su W, Yi C, Wei Y, Chang C, Cheng M. Detection of ovulation: a review of currently available methods. Bioeng Transl Med. 2017;2(3):238-246. Available from: https://doi.org/10.1002/btm2.10058
Bull JR, Rowland SP, Scherwitzl EB, Scherwitzl R, Danielsson KG, Harper J. Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles. NPJ Digit Med. 2019;2:83. Available from: https://doi.org/10.1038/s41746-019-0152-7
Ecochard R, Boehringer H, Rabilloud M, Marret H. Chronological aspects of ultrasonic, hormonal, and other indirect indices of ovulation. BJOG. 2001;108(8):822-829. Available from: https://doi.org/10.1111/j.1471-0528.2001.00194.x
Kleinschmidt TK, Bull JR, Lavorini V, Rowland SP, Pearson JT, Scherwitzl EB, et al. Advantages of determining the fertile window with the individualised Natural Cycles algorithm over calendar-based methods. Eur J Contracept Reprod Health Care. 2019;24(6):457-463. Available from: https://doi.org/10.1080/13625187.2019.1682544
Giviziez CR, Sanchez EG, Approbato MS, Maia MC, Fleury EA, Sasaki RS. Obesity and anovulatory infertility: a review. JBRA Assist Reprod. 2016;20(4):240-245. Available from: https://doi.org/10.5935/1518-0557.20160046
ACOG. Nutrition During Pregnancy [Internet]. 2023 [cited 2025 Mar 7]. Available from: https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy
Favaro C, Pearson JT, Rowland SP, Jukic AM, Chelstowska M, Berglund Scherwitzl E, et al. Time to pregnancy for women using a fertility awareness based mobile application to plan a pregnancy. J Womens Health. 2021;30(11):1538-1545. Available from: https://doi.org/10.1089/jwh.2021.0026
ACOG. Evaluating infertility [Internet]. 2020 [cited 2025 Mar 7]. Available from: https://www.acog.org/womens-health/faqs/evaluating-infertility
American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril. 2014;101(3):633-634. Available from: https://doi.org/10.1016/j.fertnstert.2013.12.032
Eunice Kennedy Shriver National Institute of Child Health and Human Development. How common is infertility? [Internet]. 2018 [cited 2025 Mar 7]. Available from: https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common

",{"_298":8271,"_438":8272,"_1695":8273,"_1697":1698,"_1699":8274,"_1701":8275,"_1703":8276,"_1705":42,"_1707":8277,"_1709":-5,"_1710":8278,"_408":8311,"_410":8314,"_1810":8315,"_1880":8360,"_342":8361,"_1891":1892,"_1893":8368,"_1908":1909,"_1910":-5,"_1923":2845,"_1925":-5,"_1929":-5},"71855219","My honest review of Natural Cycles","review-of-natural-cycles","2025-03-05","2021-11-10T09:47:02+00:00","Six months ago, I had “the talk” with my partner. We had been dating for seven months and things were going beyond good. I didn’t want to rock the boat with my proposal. As a Libra Sun and a “nine” on the Enneagram, rocking the boat is not my forte. I would much prefer to keep sailing that boat as closely to whomever I’m sailing with, making cocktails and margaritas for everyone...","

Disclaimer: This is one Natural Cycles user’s experience coming off hormonal birth control. Everyone's experience is different and we encourage you to talk to your healthcare provider when considering switching birth control.

My proposal had to do with going off the pill to use an alternative birth control method. There was a convergence of circumstance, situation, and serendipity that led me to this decision. It started with gnarly menstrual cramps, which I’ve had for a few years, but had gotten especially bad the past few months.

It didn’t occur to me that there was anything I could do about it until a friend recommended a book, Love your Lady Landscape by Lisa Lister. In it, the author talks about her own painful struggles with her nether-regions and how she discovered it was her body trying to communicate with her. How the pain was trying to wake her up to the innate power we have as women. She recommends the forgotten ancient practice of speaking with your womb on a regular basis to stay connected with your own “SHE” power.

Talking to your womb may sound weird, but having effectively talked to my anxiety blob to understand the roots of my anxiety when I was in Somatic Psychotherapy, I’ve learned to go with the flow and try this stuff out. And so a couple of weeks later, as I laid in bed writhing in PMS pain, I had a chat with my uterus. I asked her, “Uterus, what’s going on with you?” In my mind’s eye, my uterus was laying next to me in bed, and she was pissed and sad at the same time. She screamed, “Why don’t you listen to me? I want to ovulate!” Her little uterus head banged on the pillow and her fallopian tubes flailed about as she sobbed.

Why I needed to rethink the pill

She (my uterus) was referring to the pill. It’s funny because, it’s like — I know how the pill works. But when I first made the decision to go on the pill at 18 years old, I never fully processed it. Basically, the pill works through using synthetic estrogen and progesterone to trick the body into thinking it’s already pregnant, which prevents an egg from being released, which prevents ovulation from occurring. As mentioned in Love your Lady Landscape, the period you’re having on the pill isn’t a real period, but something called “withdrawal bleeding” caused by the drop in hormone levels when taking the placebo pills. Our “cycle” during the pill isn’t a real menstrual cycle.

Here’s the thing. When you’re 18 years old and don’t want to get preggers, that sounds great! Of course it’s effective — an egg doesn’t release, so no bun in the oven. It’s exactly what I need. As a 41 year-old woman on a journey to understand what it means to be a woman and who just decided that I do want kids after all—it made me uneasy. To think that in the last 23 years of my life, I’ve only allowed myself to have the beautiful miracle of my womanhood — a natural menstrual cycle — only a handful of times? That didn’t feel right.

It also brought up concerns about my fertility. When I looked it up, I read article after article saying not to worry. the pill is safe and most women begin to ovulate soon after stopping, even if you’ve used the pill for years.

Still, I was concerned and had this gut feeling that my body wanted me off the pill for a reason. That night, I searched for non-hormonal birth control methods. My partner and I were not ready to have kids yet. I know, one can ever be ready to be a parent, yada, yada, yada, but seriously, we weren’t. We had only been dating for about seven months and weren’t even living together at the time. Even though we had talked about it, neither of us have a spontaneous bone in our bodies, so throwing all caution to the wind and just having a baby already? Not gonna happen.

This was when I began googling. What popped up was Natural Cycles, an FDA cleared non-hormonal birth control method that involves measuring your basal temperature daily to track ovulation through an app. Every day you enter your temperature into the app, and it tells you when you are at risk of getting pregnant. During this period, it recommends that you abstain or use a condom to prevent pregnancy. It boasts a 93% efficacy rate (98% when used perfectly).

The only other non-hormonal methods with above 90% typical efficacy rates were copper IUDs that are for long-term birth control. Planning ahead, if all goes well with my partner, we’d likely want to try to get pregnant in the next year or two. It seems like using Natural Cycles is a great way for me to clear my body of hormones, and get a glimpse into my fertility to boot.

Because, let’s face it. I am concerned about my fertility. I’m 41 years old, and we’ve all heard the stories around the chances of getting pregnant the older we get. Non-ovulation is a huge cause for fertility issues. If Natural Cycles can tell me whether I ovulate or not, it would give me a lot of peace of mind as I move towards the pregnancy journey.

I figured, whether what my uterus said was real or imagined, I had nothing to lose. Why not try and see if getting back on my natural cycle improves my cramping? At the same time, if Natural Cycles sucks as a birth control method, and I get pregnant, then the Universe is pushing me towards motherhood, and I don’t have to worry if I can or can’t get pregnant.

“Will you NOT take the pill with me?”

When I went to talk to my partner, I was nervous. For one, I’m proposing to a man, a new birth control method that suggests that for parts of the month we must abstain or use a condom, whereas before, we could have sex freely whenever we wanted! I know my partner isn’t that type of guy, but deep down, I want to be a dutiful girlfriend. The one who wants to keep her man happy, and satisfied, which is so not okay to admit to in these modern “feminist” times.

For second, I am proposing an alternative birth control method — ”alternative” being the keyword here. We may be a liberal, spiritual couple who discusses hippy-dippy topics, such as talking to and communing with trees. As far out as we are, alternative just isn’t what it used to be. In the 90s, alternative was like Nirvana and MTV—it was about rebellion and sticking it to The Man. Now? Alternative is associated with conspiracy theories and alternative facts, and people believing that the Earth is flat.

My partner was predictably apprehensive, “You want to use an app as birth control?” He may be in seminary school learning to be one with the infinite divine, but he’s also a lawyer and a physics major. So he was, of course, going to question it. I didn’t take offense. As a former researcher, I had researched the hell out of it as well.

In fact, having been a research analyst, Natural Cycles appealed to that data-loving side of me. The idea of inputting my own personal database, paired with a mathematical algorithm to safely and effectively prevent pregnancy (or use it to get pregnant, in the future) made me have hope that data can be used for good! Data is not only for targeting people to get them to buy stuff, as my former life would lead me to believe.

After explaining all the science behind it, and how it works, (including the part about how we may have to abstain from sex at times), and all my reasons for wanting to go off the pill, in the end, he said what every woman wants to hear in this situation, “I support you in whatever decision you make for your body.” Ah, choice—now that’s feminism!

What it’s really been like to use an alternative birth control method

Now that I’ve completed five cycles on Natural Cycles, I can safely say, I’m a fan! That’s not to say there weren’t some sketchy moments those first couple of months when I wondered if I had made a terrible mistake. Natural Cycles is not for the impatient, that’s for sure.

Here’s how Natural Cycle works. Every day, you measure your basal temperature and input it into their app every morning. The goal is for the app to detect ovulation when there’s an increase in body temperature due to the release of luteinizing hormones that kicks off ovulation.

Once you ovulate and enter the luteal phase of your cycle, your temperature stays at that higher range until your period. Because sperm can survive in the womb for up to five days, the trick for the app is to predict ovulation day in your individual cycles. The key is to not have those little guys swimming around in there for the days leading up to ovulation (hence abstain or use a condom). And because that timing varies from woman to woman, the more data entered, the more precise the prediction for your own personal fertile window.

All this means that when you first start using Natural Cycles, it takes a few months for it to get to know your cycle. Considering an oopsie in a birth control method is kinda a big deal, the app errs on the conservative side, giving you mostly “red days” (days when you should abstain or use a condom) the first few months of the cycle.

After throwing away my pill packs to begin my exciting adventure with Natural Cycles, I was disappointed to see only one week of “green days” (aka no condom days). Forget wanting to please my man, I wanted sexual freedom for more than one week out of the month! But I stuck with it, and now that I’ve entered enough data for a more accurate prediction, 68% of my cycle is green days.

And by the way, “the red days” (when we have to abstain) have actually been quite a plus in our relationship. For one, using the Natural Cycles method means having to communicate openly with my partner as to where I am in my cycle. This has cultivated a deeper sense of trust and intimacy, by me vocalizing what’s going on with my body, and for him to demonstrate his respect for my choice by abstaining.

Beyond this, we’ve also taken the opportunity to be very creative during “the red zone” as we call it! There are other ways to entertain ourselves without going to fourth base! “The red zone” has become an exciting little corner in our sex life, and gives both zones its own unique pleasures.

Another cause for concern those early days was when ovulation was not detected the first month. My temperatures stayed too flat for the app to confirm that ovulation had occurred. I feared the worst. “What if I can’t ovulate?” I worried. I tried to reason with myself. This was my first month off the pIll, so it may take some time to clear the hormones from my system.

By month two, my basal temperature began to map precisely to the app’s prediction. And when, on day fifteen of my cycle, my temperature raised just as the prediction line showed, I was amazed. “I think I ovulated!!!” I yelped. The days after that, the temperature stayed high as predicted, and ovulation was officially detected by the app a few days later. I cheered on for my body and for science—“I did it, I did it! I ovulated! I ovulated!” I was in awe of my biology, and what my body is able to do. I ovulated, even though I didn’t ask it to. Even though I had been ignoring my own cycle for so long. Apparently, my body doesn’t forget how to.

The unexpected side effects of using Natural Cycles

This discovery has brought me a sense of equanimity, not only because it’s given me a glimpse into my own fertility, but also a newfound connection to my body that I’ve never experienced before. For most of my life, I hated my body. Partially, that hatred was the typical body image issues all girls unfortunately experience. But more than that, I didn’t like being in my body. I invalidated its limitations, and hated having to feel the feelings that arise when we’re anxious or angry. I was always trying to escape my body by focusing on my mind. As an 18-year-old who hated my body, going on the pill to control my body was convenient — out of sight, out of mind.

Society gives us a lot of mixed messages on the body. On the one hand, we’re told to eat healthy and exercise. On the other hand, when we’re tired, we’re told to drink coffee and keep pushing on. Being healthy is only good so long as it doesn’t cut into our productivity. When we’re tired and the body is trying to give us a message, we don’t listen. In this experiment in working with my body, rather than against it, it was clear that I had stopped listening to my body long ago. My screaming cramps were a wake-up call. Like a cranky toddler that feels unheard, it had a tantrum loud enough to make me listen.

Day after day, I took my body’s temperature, recorded it, and reported on my period. I gave my body attention it had never received before. With just that little three-minute ritual each morning, I was setting aside that time to tell my body that it mattered. A seemingly small validation of its existence opened my eyes to what my body needed. I began to notice the little nudges my body would communicate to me.

Being in lockdown, I was also able to give into its whims. I napped when I was tired, took a walk when I felt like I needed to stretch my legs. The day before my vaccination, I craved avocados. Later, I found out that avocados are high in antioxidants which are helpful in lessening the symptoms of the vaccine.

Our body knows what it needs. We typically only notice our body when it’s not working well. We invalidate it, and can be hard on ourselves when something goes wrong and build a distrust of the body, instead of cultivating a direct relationship with its needs.

Update March 2025:

3 years have passed since I wrote this article reviewing Natural Cycles and documenting my transition off of hormonal birth control. I still use Natural Cycles today, and I’ve continued to see other benefits after coming off the pill; I now have much less cramping for one! When it comes to my relationship status…There have been some changes, I’m now happily married to my partner! We’re still using Natural Cycles to track my ovulation, but have recently made the switch to NC° Plan Pregnancy and are looking forward to using the app to grow our family. Watch this space to find out what happens next...

Huge thanks (and congratulations!!!) to Bonnie and her partner for sharing their story and keeping us up-to-date. We wish them all the best for the future. If you're thinking of going hormone-free, why not find out if Natural Cycles could work for you? Now available with a range of measuring devices, going hormone-free with NC° has never been easier.

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Cervical effacement describes the process of the cervix thinning in preparation for labor. Let’s find out everything you need to know, including how effacement is measured, signs of effacement, and more.

","

Key takeaways:

Effacement is the thinning of the cervix in preparation for labor
It’s measured in percentages, from 0% (no effacement) to 100% (fully effaced)
It’s different from dilation, but the two go hand in hand — although they don’t always happen simultaneously

","

What is effacement in pregnancy?

Before we dive into the main question of “what does effaced mean in pregnancy”, it can be helpful to understand the different stages of labor.

The latent phase of labor is when your cervix starts to prepare for labor — sometimes called “cervical ripening”. During this process, there is increased blood flow to the cervix and release of chemicals called prostaglandins that lead to both effacement and some dilation of the cervix. You may feel some contractions during this stage, but they can be irregular. It’s usually the longest stage of labor.

The latent phase is technically part of the first stage of labor, but it’s often separated into its own sub-division, as we’ve done here. The three stages of labor are:

The first stage of labor includes both the early/latent phase of labor (0-6cm dilation) and active phases of labor (6-10cm dilation).
The second stage of labor lasts from when your cervix is fully dilated, until your baby is born.
The third stage happens when the placenta is delivered, after your baby is born [1].

Cervical effacement begins during the latent phase of labor. It describes the thinning of the cervix that happens before and during labor. During early pregnancy in the first and second trimesters, the cervix is long, firm, and closed. During the latent phase of labor, the muscles of the uterus contract. The fetal head presses into the cervix during a contraction, which causes the cervix to thin and then dilate. The mucus plug is sometimes lost during this latent phase of labor, but it’s important to note that this doesn’t necessarily mean that active labor is near — at least, not without other signs of labor, like the water breaking and regular, painful contractions.

In many first-time mothers, the cervix often thins before it opens up (meaning that effacement occurs before dilation), while it’s often the case that dilation can happen before effacement in women who’ve had children before. That’s because the cervix has previously been opened up or “stretched out”.

While this is a natural process, it can also happen in a hospital setting for those who have an induced labor. Healthcare providers use medications like prostaglandins (which are also released during natural latent labor) or special catheters known as Foley balloons to “ripen” the cervix, simulating the early stage of labor.

How is effacement measured?

Effacement is described in percentages. So if your cervix hasn’t thinned at all, it’s 0% effaced, while if it’s thinned completely, then it’s 100% effaced [2].

It can be measured by your healthcare provider or OB-GYN. Depending on where you live, they may start checking towards the end of the third term, although exactly when varies depending on your healthcare provider. In other locations, they may not perform any checks until you’re past your due date.

If you do have these cervical checks, they can tell you both how effaced and how dilated you are. They’ll check effacement by inserting a gloved hand into your vagina and feeling how thick your cervix is — it’s not an exact science, but it can help to give both them and you an indication of where you are in the labor process.

The Bishop score is based on changes in your cervix (including dilation and effacement) and the position of your baby’s head. It’s often used when determining whether labor should be induced and how successful induction might be, based on the cervical conditions — but this will typically only be done when you reach 40 weeks [3].

Does effacement mean you’re close to labor?

Once your cervix starts to efface and dilate, it can mean that active labor is on its way. However, just how close you are to labor varies from person to person. You need to be 100% effaced and 10cm dilated before a vaginal delivery — and that can take some time to happen, especially for first-time mothers.

The latent phase — when your cervix starts to efface and dilate — typically lasts between 4 and 24 hours. However, it can last for several days or even weeks for some people, particularly for those who haven’t given birth before [4].

It’s likely you’ll experience some contractions during the latent phase of labor, but when you’re in the active phase, your contractions will become more regular, continuing until you give birth.

It’s not always easy to tell when the active phase of labor starts, so some people will want to see their healthcare provider or go to hospital for assessment. If you’re still in the latent phase (which is determined by being less than 6cm dilated and not yet very effaced), you’ll typically be advised to return home until your contractions are longer, stronger, and closer together [4].

Dilation vs. effacement

Dilation and effacement shouldn’t be conflated — but they do go hand in hand.

While effacement refers to the thinning of the cervix, dilation is the opening or widening of the opening of the cervix.

Effacement and dilation both start to happen during the latent phase of labor, with the cervix becoming increasingly dilated throughout the first stage of labor until it’s fully dilated and ready for birth.

The contractions you experience during this stage help your cervix to dilate and efface, letting your baby move lower into your pelvis [5].

The cervix needs to be open to around 10cm to let the baby pass through it — and being 10cm dilated is usually called “being fully dilated” [6]. This also happens to be the typical size of a newborn baby’s head — which means that, when you reach this stage, your healthcare provider won’t be able to feel any cervix remaining around the head.

So while dilation and effacement are different, they are closely related. Research has found that the more effaced the cervix is before and during labor, the faster the process of dilation may be [7].

Once your cervix is 100% effaced and 10cm dilated, you’re ready to start pushing your baby out for a vaginal delivery. Effacement and dilation aren’t directly relevant to those having a cesarean section, but some obstetricians may dilate the cervix manually during the operation, to help the postpartum blood more easily leave the uterus [8].

Can you be effaced but not dilated?

While effacement and dilation are related, they don’t always happen at exactly the same time — which means that it’s entirely possible to be effaced but not dilated. This is especially true for first time mothers, who often experience effacement before dilation.

It’s also possible to be dilated but not effaced, which is typically more common in second-time mothers.

What are signs of effacement?

You might not feel anything as your cervix starts to efface, although you may start to feel irregular contractions. The contractions may feel uncomfortable, or they could be quite painful — it’s different for everyone, and there’s no set pattern to how many contractions you’ll get during the latent phase or how long they’ll last [5].

As you get closer to active labor, you may experience other symptoms, such as:

Feeling your baby drop: Also known as lightening, this is when the baby’s head lowers farther down into your pelvis.
Loss of the mucus plug: This is when the blood-tinged mucus plug that blocks your cervix during pregnancy comes away as the cervix starts to dilate, which may result in red, pink, or brown discharge.
Your water breaking (which is when the amniotic sac around the baby breaks). This doesn’t always feel like a gush of fluid but is sometimes more like a trickle.
Increasing contractions: As you get closer to active labor, your contractions become longer, stronger and closer together, following a more regular pattern [9].

$\"Diagram$

Stages of effacement

You might hear your doctor talk about \"stages of effacement”. This is measured in percentages, with the percentage increasing as birth approaches and the cervix thins.

Pre-labor, your cervix isn’t effaced, which is also described as 0% effacement. That means your cervix is the normal length (usually about 4cm) and thickness, before the process of labor begins.

Your cervix becomes increasingly effaced as you move through the stages of labor. At 50% effaced, your cervix has thinned to half of its normal thickness.

At 100% effaced, your cervix has fully thinned out, so it feels paper thin. Complete effacement is needed for a vaginal delivery — but you also need to be dilated to 10cm to allow the baby to safely pass through the birth canal.

Are there any complications to effacement?

Usually, effacement is a normal part of pregnancy — and it’s often an exciting development, as it can mean that active labor may come fairly soon. However, if effacement doesn’t progress as expected, it’s possible that it could be a sign of a complication. Complications related to effacement include:

Early effacement or insufficient cervix

During pregnancy, the cervix usually stays closed until late in the third trimester and effacement usually happens during the last few weeks of pregnancy. But if effacement happens too early, it’s known as cervical insufficiency. This can lead to situations including:

Second trimester miscarriage
Preterm labor
Preterm premature rupture of membranes (PPROM)
Premature delivery [10]

Treatments for these conditions depend on what stage of pregnancy you’re in, how long your cervix is, and whether there is a presence or absence of broken water or an infection. Your healthcare provider will be able to recommend the best course of action for you. Statistics vary, but cervical insufficiency isn’t a very common condition [11]. You should always see your healthcare provider if you have any symptoms like abnormal spotting or bleeding, or cramps in your abdomen or pelvis during the second and early third trimester [10].

When to see a doctor

Effacement itself isn’t necessarily a reason to see a doctor. It’s a normal part of late pregnancy and is one of the first steps towards active labor. However, the timing and context of effacement matters. Effacement is normal in any of the stages of labor, but effacement before 37 weeks could be a sign of preterm labor.

It’s important to call your healthcare provider if you think you could be in labor, as well as if you have any other symptoms, such as:

Your water breaks
You have vaginal bleeding
Your baby is moving less than usual
You're less than 37 weeks pregnant and are experiencing regular contractions
Any of your contractions last longer than 2 minutes
You're having 6 or more contractions every 10 minutes [12]

Follow your pregnancy with Natural Cycles

Cervical effacement is a crucial step in the process of labor. Along with the dilation of the cervix, effacement gets your body ready for childbirth. The experience can vary widely (especially between first and second-time mothers), but understanding the process can help you to better understand your labor journey.

Natural Cycles can also help you to better understand your full pregnancy journey with NC° Follow Pregnancy. There’s a lot going on during pregnancy, which is why we’ve added trackers for baby movements, morning sickness, emotions, and other symptoms. We’ll be with every step of the way as you get to know your pregnancy — and your baby — better. After birth, we’ll also be there to help you on your journey to recovery with NC° Postpartum, where you’ll find articles, guides, baby feeding tracking, emotional support, and more tailored resources to support you. Learn how Natural Cycles can help you throughout your fertility journey and beyond.

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University Hospitals Bristol and Weston NHS Foundation Trust. Latent phase of labour: Ideas to help you [Internet]. 2021 [cited 2025 Feb 26]. Available from: https://www.uhbw.nhs.uk/assets/1/23-001_latent_phase_of_labour__ideas_to_help_you_dec21_dms_d_redacted.pdf
Cervical Effacement and Dilatation | University of Michigan Health [Internet]. [cited 2025 Feb 26] Available from: https://www.uofmhealth.org/health-library/zx3441/
Salisbury NHS Foundation Trust. Patient information leaflet: Membrane sweeps [Internet]. [cited 2025 Feb 26]. Available from: https://salisbury.nhs.uk/FOIdocs/FOI_5272/QuestionNo2/Patient%20information%20leaflet%20Membrane%20sweeps.pdf
Manchester University NHS Foundation Trust. Latent phase of labour [Internet]. [cited 2025 Feb 26]. Available from: https://mft.nhs.uk/app/uploads/sites/10/2018/05/Latent-Phase-of-Labour.pdf
March of Dimes. Stages of labor [Internet]. [cited 2025 Feb 26]. Available from: https://www.marchofdimes.org/find-support/topics/birth/stages-labor
NHS. The stages of labour and birth [Internet]. 2021 [cited 2025 Feb 26]. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/the-stages-of-labour-and-birth/
Cox J, Hockenberry M. The Stages of Labor [Internet]. 2016 [cited 2025 Feb 26]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5102500/
Graham L, O’Brien E, Dempsey G. Management of Labour: An Overview [Internet]. 2019 [cited 2025 Feb 26]. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6513223/
American College of Obstetricians and Gynecologists (ACOG). What are the symptoms of labor? [Internet]. 2020 [cited 2025 Feb 26]. Available from: https://www.acog.org/womens-health/experts-and-stories/ask-acog/what-are-the-symptoms-of-labor
MedlinePlus. Childbirth: Stages of labor [Internet]. 2021 [cited 2025 Feb 26]. Available from: https://medlineplus.gov/ency/patientinstructions/000595.htm
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NHS. Signs that labour has begun [Internet]. 2021 [cited 2025 Feb 26]. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/signs-of-labour/signs-that-labour-has-begun/

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Welcome to week 36 and the ninth month of your pregnancy! With just four weeks to go until your due date, you might be feeling eager to shed some of those unpleasant pregnancy symptoms and start to move around easier. Labor can begin at any time, so it is good to make sure your hospital bag is prepped, the freezer is stocked, and you have the essentials ready for the first days at home with your newborn. In this article, we will talk about some changes going on with your baby and body this week. We will also talk about week 36 pregnancy symptoms and offer some tips for how you can physically and mentally care for yourself in these final four weeks of pregnancy.

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Key takeaways

In the final weeks before birth, most babies move into a head-down position in the womb and drop deeper into the pelvis
Weekly, or every other week, visits to your healthcare team are normal as they monitor your blood pressure, urine, and the baby’s positioning ahead of birth
Cramps, pelvic pain, and swollen feet and ankles are all normal during these final weeks of pregnancy

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Your Body at Week 36

Your baby drops

Around 36 weeks, your baby can change positions inside your uterus. This includes moving further down into your pelvis, and turning to a head-down position in preparation for birth. You are probably seeing your healthcare provider pretty frequently at this point so that they can check on your blood pressure and urine. In these appointments, they are probably feeling your stomach to see if they can determine the position of the baby. It’s important to remember that it is not uncommon for the baby to change positions for another week or so until they settle [1]. Depending on the uterus’ position in your body, it is not always easy to figure out your baby’s position by feeling your belly. The most accurate way to see a baby’s position is via ultrasound [1]. Your baby’s positioning in the womb can determine which method of birth is safest for you and your baby.

Depending on your OBGYN, midwife, or birthing clinic, you might be offered an external cephalic version, or ECV, if your baby remains in a breech position around week 36 or 37. ECV is a non-invasive procedure where your OBGYN or midwife will try to physically move the baby into a head-down birthing position [2]. It is a safe procedure for both you and your baby, though it can be physically uncomfortable [3].

Research has recommended that in some cases, trying to ease tension in your body can help to create more space for the baby to move [1]. Some recommendations for easing tension in the pelvis include prenatal yoga, taking a brisk daily walk, swimming, stretching, and eating a healthy diet to treat constipation [1].

Cramping and contractions

In these final weeks before birth, it is not uncommon to experience cramping or light contractions. Like other changes to your body functions during pregnancy, this is linked to changing hormone levels, bloating, constipation, and the physical pressure your baby is putting on your body and internal organs [4].

Remember that contractions that do not come at regular intervals, or which vary in how long they last, are likely Braxton Hicks, or practice contractions. Braxton Hicks contractions can be uncomfortable, but are usually less painful than labor contractions and typically go away completely for a long period of time and come back [5].

If you experience regular, intensifying contractions accompanied by a backache or heavy, aching feeling, it might be a sign that labor has started [6]. Keep track of the frequency and duration of your contractions, and contact your healthcare provider. It is also important to contact your healthcare provider if you experience any sharp or stabbing pain in your abdomen that starts suddenly and does not go away, contact your healthcare provider immediately [7].

Your baby’s development at 36 weeks

It might be hard to believe but your baby is still at work growing this week, gaining up to an ounce (around 28 grams) a day [8]. This week your baby’s first fine hair, or lanugo, is beginning to fall out [8]. It is also normal for your baby to shed its vernix caseosa, which is the white creamy substance that helps protect your baby inside the womb - this is the white substance you sometimes see in pictures of newborn babies [8].

At 36 weeks, your baby weighs between 5.75 and 6.75 pounds (2.6 to 3.1 kilograms) and is likely between 17.5 and 19 inches (44.5 to 48.3 centimeters) long [8]. This is around the size of a papaya fruit!

Although you are nine months pregnant, your baby would still be considered premature if it was born this week. Babies are considered “at term” after week 37 [9]. Babies born at 36 weeks might need a little extra time in the hospital upon arrival, but generally have the same long-term health outcomes as babies who are delivered at term [10].

Pregnancy symptoms in Week 36

Swollen ankles and feet

Moving around might be more and more challenging now in this ninth month of pregnancy, but it is important to try to move around as much as you can (if it is considered safe to do in your pregnancy). Gradual swelling in the feet and ankles is usually normal during pregnancy, caused by the body producing around 50% more blood and other bodily fluids. Fluid retention also usually gets worse the closer you get to giving birth as your body prepares for labor [11].

It is good to know that standing for long periods of time, warm weather in the summer, high salt intake, and drinking a lot of caffeine can all worsen swelling [11]. Staying hydrated, eating a low-salt diet, taking regular walks (if it is safe to do so in your pregnancy), wearing comfortable shoes, resting, and foot exercises can all relieve swelling [12].

If you experience a sudden increase in swelling, particularly to your hands, feet, or face, it is important to contact your healthcare provider as this might be a sign of preeclampsia, a serious condition that requires medical attention [13].

Pelvic Pain

Pelvic pain throughout the last half of pregnancy is unfortunately common particularly towards the end of pregnancy [14]. Additional weight on the pelvis, particularly when your baby grows larger or drops lower in your body, can put strain on the pelvic joints [14]. Though not harmful to your baby, it can make day-to-day activities and sleeping more difficult. Pelvic pain can also affect your balance, so be careful moving about as you might be less stable than normal [15].

Exercises to strengthen the pelvic floor and abdominals, and stretches to relieve strain around the pelvis can help provide relief [14]. You may find a maternity support band or girdle can also provide some relief.

If the pain continues to worsen, or you are unable to move around normally, contact your healthcare provider. While those who suffer from pelvic pain in pregnancy are often able to give birth vaginally, it is important that your healthcare team know if you are suffering from pelvic pain when you go into labor [14].

Improved breathing

You might notice you are actually breathing a bit easier this week. If your baby has dropped further down into your pelvis, this will ease some pressure on your lungs and diaphragm [16]. This process is also known as lightening. Improved breathing from lightening can be a big help if you are practicing any deep breathing techniques to use during labor!

Tips in Week 36

Pack that hospital bag: your baby can come at any time so it is a good idea to pack a hospital bag, if you have not already done so. Be sure to check the website of your hospital or birthing center for recommendations on what to pack. Phone and tablet chargers, sanitary pads, snacks, and basic toiletries will always come in handy. If you are planning to have a partner or friend stay with you in the hospital after you give birth, that person will need to pack some things as well.
Prepare those newborn essentials: some baby clothes and diapers for those first few weeks are essential! Remember that newborns grow very fast, and it is impossible to know their size before you meet them, so best to have a couple of sizes on hand. Depending on where you give birth, it is also likely you will need an infant car seat to take your baby home.
RSV vaccines: you might have already been offered a vaccine to protect against the respiratory syncytial virus, but it can be given right up until you go into labor. This vaccination lowers your baby’s risk of severe lung infections.
Plan your parental leave: depending on where you live or your workplace, you might already be on leave, or getting ready to start it soon. Parental leave is an important way for you to prepare mentally and physically for welcoming your new baby.
Prepare physically for birth: childbirth is major hard work for your body! You can help it prepare through some exercises to help encourage strength and flexibility in your hips, abdominals, and pelvis, like child’s pose, deep squats, and cat/cow pose [17]
Meal prep: those first days home with your baby will be busy, and preparing meals for yourself or your family might be challenging. If you are cooking in the coming weeks, consider preparing twice the amount you normally would and freezing the extras. Having some extra meals prepared and ready to heat up can help in those first days and weeks with your newborn.

Following your pregnancy with Natural Cycles

Did you know that you can use Natural Cycles for more than birth control? Use NC° Follow Pregnancy once you become pregnant to track your pregnancy from that first positive pregnancy test all the way through birth and postpartum. The app enables you to track your pregnancy symptoms and monitor your physical and mental health throughout the pregnancy. Weekly guides give you updates on the development of your baby and the changes you are experiencing in your body. After birth, the NC° Postpartum helps guide your recovery. You can also use Natural Cycles for non-invasive, hormone-free birth control after giving birth.

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When is it safe to deliver your baby? [Internet]. University of Utah Health | University of Utah Health. 2024 [Cited 2025 Mar 5]. Available from: https://healthcare.utah.edu/womens-health/pregnancy-birth/preterm-birth/when-is-it-safe-to-deliver
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When thinking about menopause and perimenopause, we usually associate it with symptoms like hot flashes and irregular periods. But did you know that joint pain is one of the most commonly reported symptoms of perimenopause? Across various studies, musculoskeletal pain has been reported by 50 to 89% of perimenopausal women [1]. If you’re feeling that stiff, achy feeling in your joints during this stage of life, you’re not alone.

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Key takeaways:

Joint pain is a surprisingly common symptom of perimenopause, with an average of about 70% of women experiencing it during this transitional life stage
Your body goes through a lot during perimenopause, including muscle loss, weight gain, and hormonal changes — all of this can put extra strain on your joints
There are plenty of remedies available to help soothe joint pain but be sure to chat with your healthcare provider to find the best treatment option for your body

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Perimenopause joint pain can make everyday activities difficult to manage, so it’s important to understand why this happens and what you can do about it. In this article, we’ll answer the question, “does menopause cause joint pain?” along with the causes, symptoms, and available treatments for any perimenopause joint pain you may be experiencing.

Why do we get joint pain during menopause?

Joint pain is a common symptom many of us will experience after menopause and in the years prior. You may have heard or used the term “menopause” to refer to the time in our lives when we near the stop of our menstrual periods, but this time period is actually called “perimenopause.” The term “menopause” refers to your last period, which can only be confirmed after no bleeding for one full year, after which we become postmenopausal [2].

Perimenopause is characterized by irregular hormonal fluctuations of the female sex hormones estrogen and progesterone in your body. As these hormones fluctuate irregularly, they also gradually decline over time until menopause, at which point levels are very low [3, 4].

These fluctuations, particularly with estrogen, may be related to the symptoms associated with perimenopause, including joint pain and bone density loss. Estrogen contributes to many bodily processes that maintain bone and cartilage health, so the gradual decline of estrogen over the course of perimenopause may be the underlying cause of joint pain, although more comprehensive studies are needed to confirm that link [3, 4, 5].

Is joint pain linked to perimenopause?

So yes, while joint pain can be linked to perimenopause, it may not necessarily be the underlying cause. Many other factors like weight, physical activity, genetics, and more can cause chronic conditions like arthritis or temporary injuries, all of which can also be the cause of joint pain.

But if you’ve consulted with your healthcare provider and it seems like the joint pain is directly linked to perimenopause, know that this is a normal part of the aging process. The good news is that there are quite a few treatment methods available to help you navigate this transition (more on that later).

What causes joint pain during perimenopause?

Perimenopause comes with a host of symptoms including menstrual irregularity, hot flashes, trouble sleeping, mood changes, and yes, joint and muscle discomfort [2]. You might also notice a gradual loss of muscle mass and strength throughout perimenopause and into postmenopause [3]. It’s common to gain some weight as well, since the body starts to use energy differently and your hunger signals might change during perimenopause [2, 5]. Both of these factors — muscle loss and weight gain — could put extra strain on your joints, causing discomfort or outright pain.

It’s important to remember that while uncomfortable symptoms are a common feature of perimenopause, that doesn’t mean you should just “get on with it.” Help is available and it’s worth connecting with your healthcare provider — particularly if your symptoms start to get in the way of your everyday life.

What else causes joint pain?

As we mentioned earlier, perimenopause and the hormonal shifts associated with this life stage may not be the direct cause of your joint pain. It’s very possible that another condition is causing your joint pain. Some common joint pain sources include:

A muscle sprain or strain [6]
Chronic conditions like inflammatory arthritis or fibromyalgia [7, 8]
Tendonitis or tendinosis, meaning pain in tendons rather than specific joints or muscles [9]

Each of these does require separate medical attention and treatment and may not be associated with the hormonal fluctuations of perimenopause, although one condition could be exacerbating the other. It’s a good idea to reach out to your healthcare professional and talk about your symptoms and history. This can help you pinpoint the root cause of the pain so that you can find the right treatment for lasting relief.

How to treat joint pain caused by perimenopause

When speaking with your healthcare provider, they may recommend one or a combination of some of the treatments outlined below. Remember that each one may not work in the same way for everyone, so you may have to try a few to find the right one for your body. Let’s go through a few in detail:

Ice packs: For at-home, immediate relief of the joint pain associated with perimenopause, try temperature therapy in the form of an ice pack. Joint pain is often associated with inflammation, so applying a cold compress for about 20 minutes can provide relief and help increase mobility [10].

Over-the-counter (OTC) painkillers: At OTC doses, medications like ibuprofen (U.S. brand name: Advil), acetaminophen/paracetamol (Tylenol), and naproxen sodium (Aleve) can relieve mild to moderate joint pain associated with perimenopause, or many other types of joint pain you may be experiencing. At higher prescription doses, they can also help reduce inflammation. Consult with your healthcare provider for more information on which dose would be best for your case. [11]

Diet adjustments: A healthy diet can help prevent the development of chronic conditions like osteoarthritis, and might also make it easier to tolerate the symptoms of an existing condition. Eating lots of fruits and vegetables, or even following a plan like the Mediterranean diet, can help you manage your weight and the symptoms associated with perimenopause more effectively. It’s also a good idea to lower your salt and alcohol intake while you’re making these adjustments. [12].

Low-impact exercise: Gentle, regular physical activity (such as walking, yoga, and light strength training) can help alleviate some of the joint pain and other symptoms associated with perimenopause as well. It can also contribute to higher quality sleep, elevate your mood, and reduce the risk of injuries. Just remember to keep the exercise at light to moderate levels and listen to your body throughout the workout [13].

Sleep: Disrupted sleep patterns are common during perimenopause, and a poor sleep schedule can have quite an impact on your daily physical and mental health. Sleep plays a role in metabolism, nutrient absorption, and more, so it’s important to prioritize when your body is undergoing the perimenopause transition. Healthy sleep can lead to healthy muscles, healthy bones, and a healthier body overall [12].

Hormone replacement therapy: Since joint pain may be related to the decrease in estrogen that happens over time during perimenopause, hormone replacement therapy (HRT, also known as menopausal hormone therapy or MHT) might help ease the symptoms. While there are many methods of HRT, it usually involves taking a daily pill, patch, or spray [14].

HRT may not always work the same way for everyone, but the research thus far is promising. The estrogen decline during perimenopause can lead to five primary changes, all of which can result in joint pain:

Increased inflammation
Decreased bone mineral density
Arthritis
Sarcopenia (a loss of muscle mass and strength)
Fewer muscle stem cells

Replacing the lost estrogen with supplementation in the form of HRT or MHT can ease these effects, leading to less inflammation and better musculoskeletal function overall. This also means there is a lower chance of developing further sarcopenia, arthritis, and osteoporosis into postmenopause [14]. Be sure to speak with your healthcare professional about the risks, benefits, and course of treatment before making a decision about hormone therapy.

Vitamin supplements: Getting the right amount of minerals like vitamin D and calcium can support bone and joint health. These are found in foods like egg yolks and dairy products, but they can also be found in the vitamin aisle at your local pharmacy. We’ll dive into a few more supplements that may help with joint pain below, but make sure to talk to your healthcare provider about recommended doses if you’d like to start taking supplements [14, 15].

Can supplements help with perimenopause joint pain?

Aside from calcium and vitamin D, supplements like magnesium and collagen can also help strengthen your body and ease joint pain.

Limited studies have shown that increasing magnesium intake either by diet changes (leafy greens, legumes, nuts, and whole grains) or with supplements can help increase bone density in postmenopausal women. Some of its functions in the body include energy production, bone development, and the transport of calcium across cell membranes [15].

Collagen is also an essential nutrient that can be taken as a supplement. It contributes to cartilage health, and has been shown to have a positive effect on bone strength and mineral density when taken consistently over time [16].

Again, it’s worthwhile consulting a healthcare professional before you start making any sort of major dietary or supplement adjustments. They can provide the best personalized guidance to make sure you’re on the path to perimenopause joint pain relief.

When to see a doctor about perimenopause joint pain

As we’ve mentioned throughout this article, it’s a good idea to talk to your doctor about any sort of pain you’re experiencing, particularly joint pain that makes everyday activities difficult. There are many underlying causes for joint pain, including perimenopause, and understanding that root cause can help you get effective treatment.

We do want to note that if you have severe, sudden joint pain, especially in one joint, that’s associated with swelling or the skin color changing, that may indicate an injury that needs urgent medical attention. If these symptoms are associated with shivers or a fever, this may indicate an infection that also needs immediate medical attention [17].

Most of the time however, joint pain is just a normal part of the aging process. Luckily, there are many remedies and treatments available to help keep you moving through perimenopause and beyond.

Learn more about your perimenopause journey with Natural Cycles

Tracking your cycles and symptoms over time with a tool like Natural Cycles can help you and your healthcare provider have informed conversations about the pain you’re experiencing and the right treatments. Natural Cycles is more than just a tracker though — it provides learning resources, community, and uses science-backed technology to give you deeper insight into your body. See if Natural Cycles is right for you today.

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