Everything you need to know about Aunty Flo and what it says about your reproductive health. 

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Most women don’t usually give much thought to their monthly cycle, unless they suffer irregular periods or other menstrual-related health conditions.


In fact, many women see it as an inconvenience, especially if those nasty period cramps start kicking in or a beach holiday is on the calendar. 


However, when you’re trying to conceive, you should understand that your menstrual cycle is closely linked to your ability to conceive/fertility.


Dr Christopher Ng, an obstetrician and gynaecologist at GynaeMD Women’s & Rejuvenation Clinic, answers commonly asked questions about this topic. 


Scroll through our photo gallery to learn crucial facts about your cycle and your reproductive health.

1. How do I know if my menstrual cycle is normal? 


For most women, a normal menstrual cycle occurs every 21 to 35 days and lasts two to seven days, says Dr Ng.


Monthly variations in one’s cycle are also common, so don’t fret if your period doesn’t fall on the same day every month. 


Dr Ng adds, “It is also assumed that women with regular menses ovulate monthly, but this is not always the case. If they’re looking to get pregnant, women need to test with a urine ovulation kit during their fertile period to determine if they are ovulating or not.” 

2. Can I conceive if my periods are irregular?


The good news is you can conceive even though your periods are irregular. However, Dr Ng points out that this situation makes trying for a baby more of a challenge


He explains, “Some women can still ovulate even if they have irregular menses, but it would be much harder compared to women with regular menstrual cycles as the fertile window is more challenging to determine with irregular periods. Most women with irregular menses tend not to ovulate, too.”  


If you're hoping to conceive and your cycle is irregular, consider scheduling a preconception screening to determine your fertility and what steps you can take to boost your chances of conceiving.

3. I’ve been on birth control pills for several years ― can I still conceive? 


“The oral contraceptive pill is short acting — it works for the day you consume it,” Dr. Ng explains. “If you stop taking it the next day, its contraceptive effects are gone. There is, therefore, no delay in conceiving once a woman comes off the pill.”


The misconception many women have is that the pill is associated with difficulties in conceiving when they come off the pill (especially if they’ve been on it for a long time). However, fertility issues are not due to being on the pill, he notes. 


The problem lies with the fact that when trying for a baby, women will be much older, compared to when they first started on the pill. Indeed, conception problems are linked to attempting to conceive at a later age, since fertility decreases with age.

4. How can I tell if I am ovulating, and how much time do I have to conceive during this period?


“The best way to determine if one is ovulating is to use urine ovulation test kits during one’s fertile period, which for most women is between day 12 to 18 of their menstrual cycle,” recommends Dr Ng. “Women can try testing twice a day, in the morning and evening.” 


Another alternative is to take a blood sample for progesterone levels approximately seven days before your expected menses (that is, day 21 of a 28 day cycle). This will show if ovulation has really occurred, although it cannot tell which day (this is determined by the urine ovulation test kit), says Dr Ng. 


Once the ovulation test is positive, try to have intercourse on that day itself and preferably the next day. This is because an egg will only survive for a day after ovulation.

5. When’s the best time to have sex (to improve your conception chances) and when can I test for pregnancy?


As mentioned previously, you can use a urine ovulation test kit to determine if you are ovulating and have intercourse on the day itself, as well as the next. 


“If women find it too stressful or inconvenient to test with a urine ovulation kit, the other method is to have intercourse on alternate days of their fertile period (such as day 12, 14 and 16, for example),” advises Dr. Ng. 


As to when one should use a pregnancy test, Dr Ng recommends that you should test a week after you miss your menses.

6. How exactly does age affect one’s chances of conceiving? 


Unfortunately, fertility does decline with age. In terms of numbers, Dr Ng notes that a woman’s natural fertility decreases by 1 per cent every year after age 35. 


“This occurs because egg quality and quantity decrease with age, and the chance of spontaneous ovulation is also likely to decrease as women get older,” he explains.


As for men, your age can also reduce the chances of conception because of decreasing sperm quality and other medical issues. However, the effect of age on fertility is much less for men as compared to women. 

7. What should I do to boost my chances of conceiving?


“Women should start taking oral folic acid and antenatal multivitamins once they start trying to conceive,” Dr Ng suggest. “They should also time their intercourse during their fertile periods (that is, when they are ovulating).”


Additionally, a healthy lifestyle with a well-balanced diet, regular exercise and reduced stress can also boost fertility.


“All things considered, the best way to boost one’s chances of conceiving is to try starting a family when one is younger rather than older, due to fertility decreasing with age,” Dr Ng advises.

8. What are some health conditions that affect fertility? 


A common health condition that may compromise fertility is polycystic ovary syndrome (PCOS), which occurs when a hormonal imbalance leads to cysts in the ovaries, accompanied by infrequent or prolonged periods. 


Another condition is endometriosis, where tissue normally lining the inside of one’s uterus grows outside it, potentially blocking the fallopian tubes and affecting implantation. 


“It is also generally accepted that healthy women have a better chance of conceiving, compared to women with pre-existing medical conditions like diabetes, thyroid, liver, kidney or heart disease,” Dr Ng adds. 


Sort all these medical conditions out with a relevant medical specialist before trying to conceive. This won’t just ensure a better conceiving outcome, it will also prevent these health issues from having a detrimental effect on the pregnancy.