EWCM while on the pill?!

[Sol]

I'm just on my second month on the pill and it's around the time I used to ovulate. (Last pill of the second row, monophasic pill.) I've just noticed stretchy CM (not all of it, but certainly some) and I'm worried. Could it be that I'm still ovulating even if I'm on the pill? I don't think it was like this last month and I'd like to start trusting the pill one of these days, so is this usual or should I worry?

[amew]

No answers here, but it happens to me, too. I have been on the pill for about 9 years. During that time, I have been on at least three or four different pills, one of which was triphasic and the rest of which were not. I get EWCM every month about mid-cycle without fail and have the entire time I have been on the pill. I do not have any reason to believe that my pill is ineffective (I haven't had a pregnancy or so much as a late period the entire time I have been taking it), but I do wonder why I get EWCM given that I shouldn't be ovulating. I actually posted about it on WC way back when, but no clear answer ever came to light.

[taffers]

I got EWCM when I was on the pill and never got pregnant. :)

[KarenS]

The pill works by suppressing ovulation and by preventing implantation through the withdrawal bleeding (your period) if you *do* happen to ovulate, but it doesn't stop all processes that your body goes through. You still go through the various physical cycles of fertility, including the changes in CM and often the rise in temperature right before ovulation.

Karen

[Sol]

Thanks for your answers!

[Inda]

I always had an abundance of EWCM on the pill and only got pregnant once...j/k, never got pregnant on the pill, but true on the EWCM.

[Asha]

actually, had ewcm while on the pill but haven't had it very often while off the pill, but i am a strange bird when it comes to fertility issues.

i thought you still ovulated while on the pill, but the pill doesn't allow implantation. though, i could be wrong.

[KarenS]

i thought you still ovulated while on the pill, but the pill doesn't allow implantation. though, i could be wrong.Depends on the pill. Some of them suppress ovulation, some of them prevent implantation, and some do both.

http://www.mcgill.ca/studenthealth/information/womenshealth/contraception/thepill/
How does the Pill work?
In order for pregnancy to occur, an egg must be released from your ovaries and become fertilized by a sperm. This fertilized egg must then implant itself in the lining of your uterus, where it then grows into a fetus. Birth control pills work in three ways to prevent pregnancy. The combined pill works by preventing the release of eggs, so fertilization can’t take place. Both the combined pill and the minipill also cause the mucus of the cervix to thicken, making it more difficult for the sperm to get through your cervix and into your uterus. This means the sperm cannot reach the egg to fertilize it. Both pills also prevent the lining of the uterus from thickening, which means that a fertilized egg is unable to implant itself in the lining and grow.

What the pill doesn't do is prevent the entire monthly cycle. Your body still goes through it's standard cycle of more fertile and less fertile periods, including the usual mucus changes and so forth.

Karen

[BTB]

What the pill doesn't do is prevent the entire monthly cycle. Your body still goes through it's standard cycle of more fertile and less fertile periods, including the usual mucus changes and so forth.

That's arguable.... Ordinarily the hypothalamus releases GnRH, which induces FSH and LH release by the pituitary, which stimulate estrogen/progesterone release. There is a negative feedback loop, such that E/P act on both the hypothalamus and on the pituitary to downregulate their prospective products. Works well - lots of E/P around, less GnRH/FSH-LH around to "goose" more E/P out, and vice versa. The cycle can "ramp up" or "ramp down" that way. The bottom line is, while on the pill, you can have some hormonal fluctuation, but it's dampened significantly. That's the whole point of triphasics - to try to mimic the normal hormonal monthly values. Since you're swallowing E/P while on the pill, your GnRH and FSH/LH are low (relative to your endogenous hormone concentrations, but not to pill levels) thus you're not making as much of your own E/P as you would off the pill - but you are making some.

Combined estrogen/progesterone pills suppress ovulation in 95% of cycles studied. Thus, 5% of the time you ovulate while taking birth control pills - 1 cycle out of 20. Those cycles, conception is inhibited by other changes caused by regular pill use, including inhospitable cervical fluid and a thin endometrium not suitable to implantation.

"Minipills" - better known as progesterone-only pills to avoid confusion with low-estrogen-containing combined pills - suppress ovulation in 50% of cycles studied but are only slightly less efficacious when taken correctly than are combined OCs, due to those "extra" effects of endogenous hormones.

Plain English answers to your specific questions: Yes, you can ovulate on the pill. If this is your second month and you're taking it correctly you can "trust" it now. Changes in EWCM - even to "fertile" EWCM - are not uncommon, and you should not be worried. Just keep taking your pill correctly. :)

[KarenS]

That's arguable.... Ordinarily the hypothalamus releases GnRH, which induces FSH and LH release by the pituitary, which stimulate estrogen/progesterone release. There is a negative feedback loop, such that E/P act on both the hypothalamus and on the pituitary to downregulate their prospective products. Works well - lots of E/P around, less GnRH/FSH-LH around to "goose" more E/P out, and vice versa. The cycle can "ramp up" or "ramp down" that way. The bottom line is, while on the pill, you can have some hormonal fluctuation, but it's dampened significantly. That's the whole point of triphasics - to try to mimic the normal hormonal monthly values. Since you're swallowing E/P while on the pill, your GnRH and FSH/LH are low (relative to your endogenous hormone concentrations, but not to pill levels) thus you're not making as much of your own E/P as you would off the pill - but you are making some.:p :p

Ok, fine. I was kind of right. :)

K.

[Sol]

That's super informative, thanks BTB. The 50% figure still worries me though. Would total efficency increase somewhat considerably if I use condoms too during the three or four days I might be ovulating or would it just be for my peace of mind? My husband and I have spent our first six months of marriage apart and reality is only starting to sink in now.

[Asha]

the use of condoms always increases protection against pregnancy. when i was in other monogomous relationships, we always used condoms for extra protection.

[Sol]

Well, of course. What I was asking is if using them for just three or four days every cycle would make a substantial difference or not.

[BTB]

The 50% figure still worries me though.

So you're on progesterone-only pills? That's a 50% ovulatory suppression rate, NOT a 50% failure rate... very different labels there.

The theoretical failure rate with combined pills is 0.1%. Thats 0.1 woman who will become pregnant out of 100 women taking combined pills perfectly for one year. The typical use failure rate is about 4% (4 women become pregnant each year out of 100 women using the combined pill under real-life conditions for one year).

For progesterone-only it's perfect use failure 0.5%, real-life use failure rate of about 6%.

What I was asking is if using them for just three or four days every cycle would make a substantial difference or not.

It depends on which three or four days you use them. :) If you are familiar with fertility sign changes throughout your cycle and your observations are accurate compared to what's happening internally, and your condom use truly coincides with when you are ovulating, then it will make a difference to use condoms. Doubling up on methods always results in a better efficacy than any method alone (provided both methods are used correctly, sometimes compacency starts when there's perceived safety from the other method).

If you're inaccurately determining your fertile window, then using condoms at times which don't align with ovulation won't improve your odds of preventing pregnancy any.

Since you're on oral contraception, it would be devilishly tricky for you to use fertility observation. Hormonal methods and FAM don't play well together. FAM and condoms, though, without hormonal intervention (or any other barrier method plus FAM) are usually a better fit.

Ok, fine. I was kind of right.

Kind of, I'll give - but also kind of not right. :P It's not quite right to say the pill doesn't prevent the monthly cycle, when doing so is how it suppresses ovulation (when it does so). It's not as if the body goes on as usual, but just no egg is released. No egg is released (when that effect occurs) BECAUSE the body is NOT doing it's usual thing. Hormonal fluctuation which occurs in the presence of regular hormone ingestion is not the regular, rhythmic cycle a woman not on hormones has. It's disorganized. Variance, yes. But not technically a "cycle".

However sometimes (1:20 or 1:2) ovulation is not suppressed, so no one can really say the pill absolutely does prevent fertility changes and cycling. :)

[Sol]

Thanks again. I'm on drosperinone/ethinylestradiol pills, so that's actually estrogen/progesterone and then that 50% mentioned doesn't apply. I got confused with monophasic/triphasic versus estrogen-progesterone/just progesterone.

I did realize that 50% was just the ovlulatory supression rate. It's just that 0.1 doesn't look that good to me right now either. I do think I'm normally very good at realizing when I'm ovulating. I just had blind faith that the pill was going to prevent me from ovulating 100% of the time and I wouldn't have many symptoms, somehow.

I guess it all boils down to the fact that I didn't research the pill fully; I actually went to my gynecologist determined to get a copper IUD and stay hormone-free and after a couple visits, when we were deciding on the date and I was about to pay for it I just realized I can't really handle any further stressors alone right now and left with a free pack of the pill. The first month went well so I kept buying them.

Last month I did feel that everything cycle-related had tampered down, but this month has been just normal, except for the fact that the pill diuretic still works and I've been unusually angry. But I could always blame the fact that I have a very stressful job with endless hours, I'm graduating from college, getting married (again) in six weeks and seeing my husband after six months apart. Yeah, that'll do.

Thanks once mroe