Teaching the Billings Ovulation Method

The Correlation of Physiological Events of the Female Reproductive Cycle with Observations Made at the Vulva
Dr E.L.Billings AM, MBBS, DCH (Lond.)

Point of Change

Figure 5 shows that the ovaries are now active and are producing oestrogen ( _ _ _ ), which stimulates the cervix to activity. Fluid mucus is produced and this frees the plug so sperm can now enter the cervix. A change in sensation from dry to no longer dry is now experienced at the vulva and is recorded on the chart with a white baby stamp or the symbol . The appearance of the mucus may be thick and cloudy. This cloudy, sticky mucus does not indicate infertility. The fact that it has arrived at the vulva means that it has left the cervix, leaving it open to sperm cells.

Figure 5. Point of change in sensation at the vulva, from dry (green stamp or the symbol ) to no longer dry (white baby stamp or the symbol ) and is associated with the rise in oestrogen being produced by the ovary ( _ _ _ ). Sperm are now able to enter the cervix.

In the same way where there is a Basic Infertile Pattern of mucus (Figure 6) the ovary has become active. The point of change is noted at the vulva where the sensation changes, indicating that now the sperm cells can enter the cervix. The recording of this change is made with a white baby stamp or the symbol (Figure 6).

Figure 6. Point of change in sensation at the vulva from a Basic Infertile Pattern (yellow stamp or the symbol ) to mucus which feels moist and looks cloudy (white baby stamp or the symbol ). This change is associated with a rise in oestrogen being produced by the ovary ( _ _ _ ). Sperm are now able to enter the cervix.

Figure 7 shows the changing pattern of fertility. (The Basic Infertile Pattern has been unchanging.) The ovary is producing greater and greater amounts of oestrogen ( _ _ _ ). The mucus is changing from being sticky to that giving rise to a wet, slippery sensation. Clear strings of mucus may be noticed. The maximum amount of mucus may diminish and a slippery sensation continue for a day or two. The last day of the slippery sensation is the most fertile day in the cycle and is termed the Peak because it is the peak day of fertility and is associated with a heightened sensitivity and swelling of the vulva.

Figure 7. The Peak, the last day of slippery sensation is marked with a (x) on the white baby stamp or the symbol . Progesterone production is indicated by the solid line ( ____ ). See Figure 8 "Day 1 past Peak".

Stamp

Symbol

Sensation/ Appearance of discharge

Wet

Wet

Wet

Sticky

Dry

Dry

Dry

Dry

Dry

Dry

Sticky Cloudy

Wet Clear

Slippery Clear

Slippery Clear Strings

Stamp

Symbol

Sensation/ Appearance of discharge

Slippery

Slippery

It is marked with a cross (x) on the record. This point is very close to the time of ovulation. Already the ovary is producing progesterone ( ____ ) as the follicle is preparing to shed the ovum into the fallopian tube. Progesterone is activating the lower part of the cervix to produce thick, sticky mucus which, over the next 3 days, will gradually close the canal of the cervix. However, during these 3 days there remain small channels through which sperm cells can travel. These rapidly reach the outer part of the fallopian tube where the egg cell will be waiting to be fertilized.

The egg can now be seen in the fallopian tube (Figure 8). The cervix is beginning to close with the thick mucus under the influence of progesterone ( ____ ) from the luteinized follicle (the corpus luteum). The progesterone has an influence on the mucus so that the woman appreciates the change in sensation at the vulva and she feels dry or sticky.

Figure 8. Day 1 past the Peak. Ovulation has occurred (or is imminent) and sensations at the vulva are no longer slippery, but either dry or sticky. They are recorded with a numbered green or yellow baby stamp or a numbered symbol or . Thus the Peak is verified retrospectively.

Stamp

Symbol

Sensation/ Appearance of discharge

Wet

Wet

Wet

Sticky

Dry

Dry

Dry

Dry

Dry

Dry

Sticky Cloudy

Wet Clear

Slippery Clear

Slippery Clear Strings

Stamp

Symbol

Sensation/ Appearance of discharge

Slippery

Slippery

Dry

There is no longer any lubricative sensation at the vulva. This is due to changes both in the cervix and in the lower part of the vagina, which are both under hormonal control. The mucus is dried as it passes through the vagina by the action of the Pockets of Shaw.

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