The Different Types of Secretions and
the Billings Ovulation Method
The most important
characteristics of the five types of mucus secretions are
given in Tables 1 and 2. The secretions of the glands of
the isthmus are also given in these tables. I would now
like to explain the normal ovulatory cycle on the basis
of our knowledge of these types of cervical mucus (Table
3). I shall illustrate the situation in general for
mature women 23-37 years of age and shall explain by
examples the situation for young women 13-22 years of age
and for women approaching the menopause (38-47 years),
and also draw your attention to some factors during
lactation.
Table 1. Cells detected
in, and crystalline structure of, the various mucus
secretions
0, not present; (+),
present sometimes in small amount; +, present in small
amount; ++, moderate amount; +++, large amount
| Cells
and crystals observed in mucus |
Mucus |
| G- |
G+ |
L |
S |
P6 |
Pa |
F |
| Cells |
|
| Leucocytes |
++ |
+++ |
(+) |
0 |
(+) |
(+) |
(+) |
| Lymphocytes |
++ |
+++ |
0 |
0 |
0 |
0 |
(+) |
| Epithelial cells |
++ |
+++ |
0 |
0 |
(+) |
(+) |
(+) |
| Sperm cells 12-24 hr post coitum |
0 |
0 |
+ |
++ |
+ |
0 |
0 |
| Enzyme granules |
+ |
+ |
+ |
+ |
+ |
+++ |
+ |
| Crystals |
|
| Rectangular |
0 |
0 |
+++ |
0 |
0 |
0 |
0 |
| Hexagonal |
0 |
0 |
0 |
0 |
+++ |
+++ |
0 |
| Parallel needles |
0 |
0 |
0 |
+++ |
0 |
0 |
0 |
| Irregular |
(+) |
(+) |
0 |
0 |
0 |
+ |
(+) |
Table 2.
Some physical, chemical and biological properties of the
various cervical secretions and secretions of the isthmus
and the vagina
| Mucus characteristic |
Mucus type |
| G- |
G+ |
L |
S |
| Place of
biosynthesis in cervix |
Lowest third |
Lowest third |
All cervix |
Upper half |
| Hormonal and
other stimulation |
Low progesterone |
High progesterone; interleukin 1 |
Averzge and increasing levels of
oestrogens |
High oestrogens; noradrenaline |
| Average
viscosity by NMR (95% interval)
Apparent
viscosity
|
11 (6
to 17)
High
|
30 (15
to 45)
Very high
|
3.5 (2.4 to 5)
Medium
|
1.3 (0.9 to 2.2)
Fluid
|
| Function in
ascent of spermatozoa |
Barrier to sperm advancement |
Barrier to sperm advancement |
Attracts malformed sperm |
Conveys normal sperm to the
crypts |
| Presence during cycle |
First infertile phase |
Second infertile phase |
Fertile phase |
Pre-ovulatory phase and Peak day |
| Sensation at the vulva |
Dry |
Dry |
Wet, sticky |
Wet, lubricative |
| Approximate time
for mucolysis |
24 hr |
36 hr |
5 hr |
5 hr |
Table 2
(cont'd)
| Mucus characteristic |
Mucus type |
| P6 |
Pa |
F |
Z |
"Vaginal mucus" |
| Place of biosynthesis in
cervix |
Upper fifth |
Upper fifth |
All cervix |
Isthmus |
Vagina |
| Hormonal and other
stimulation |
High and decreasing oestrogens;
noradrenaline |
High and decreasing oestrogens;
noradrenaline |
Probably none |
Probably none |
Low and average levels of
oestrogens; |
| Average viscosity by NMR (95% interval)
Apparent
viscosity
|
2.0 (1.4 to 3)
Fluid
|
2.0 (1.4 to 3)
Fluid
|
7 (2
to 11)
Medium
|
1.5(1 to 6)
Commonly Fluid
|
5(2 to 10)
Low or medium
|
| Function in ascent of
spermatozoa |
Conveys normal sperm from crypts
upwards |
Absorbs Z secretion and performs
mucolysis |
No known function |
Various enzymatic activities |
- |
| Presence during cycle |
Beginning and end of the fertile
phase |
Beginning nd end of the fertile
phase |
Throughout cycle |
Probably throughout cycle |
Infertile phases |
| Sensation at the vulva |
At Peak day wet and very
lubricative |
Loosens plug. Wet and very
lubricative |
Sticky |
Wet |
Flaky |
| Approximate time for
mucolysis |
1.5 hr |
1.5 hr |
24 hr |
- |
36 hr |
|
