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Additional Possible Fertility Signs

Lesson 11

Lesson Objectives:

  • Learn how to recognize and chart additional fertility signs

Major Points in this Lesson:

  • In addition to the primary and secondary fertility signs that may be checked (BBT, cervical fluid, cervix position and results from devices...) some additional fertility signs may also shed light on your fertility status.

  • Additional possible fertility signs include: ovulation pain, breast tenderness, sex drive changes, abdominal pain, vulvar swelling, lower back pain, intermenstrual bleeding or spotting, complexion changes or anything else that you can associate with your cycle phases.

  • Additional fertility signs can vary from woman to woman and from cycle to cycle and so cannot be used to definitively identify and pinpoint ovulation.

  • Additional fertility signs are useful for noting your own unique pattern and for cross-checking with your primary signs.

  • You may or may not notice additional fertility signs. There is no need for worry if you do not experience or cannot identify additional fertility signs.


Other secondary signs that may sometimes be related to your fertility status are: intermenstrual pain, also called "ovulation pain" or "mittelschmertz"; abdominal bloating; low-back pain; intermenstrual bleeding; vulvar swelling and breast tenderness.

You may or may not notice these signs. Not noticing these signs does not in any way indicate a lack of fertility. You may also have signs of your own that you notice throughout your cycle and from cycle to cycle that are not mentioned here. If this is the case you may find it useful to record these observations in your notes section or customize your chart to track them using the custom signs feature on

Because these additional signs are not always consistent, may vary from woman to woman and even from cycle to cycle for the same woman, they are not included as standard fertility signs on your data entry form on your Fertility Friend App or on Instead, you can use the checkboxes on your data entry page on or select the "specifics" menu on your app to note the most common additional signs. You can also customize your data entry form to create your own for personal signs.

The most frequently noted additional signs are:

  • Ovulation Pain: Also known as mittelschmertz, which means "middle pain," this refers to a slight pain that you may feel near your abdomen or ovary around the time of ovulation. It does not necessarily occur at the exact time of ovulation. It may happen up to a few days before, during or soon after ovulation. Further, not everyone feels ovulation pain. As such, ovulation pain is useful to cross-check other signs, but cannot be used to definitively confirm or pinpoint ovulation. Also, it is very difficult to know if the pain you feel in your abdomen during mid-cycle is related in any way to ovulation or your fertility. This is because other pains are often mistaken for ovulation pain, especially when you are especially alert for signs of fertility. Nonetheless, it is still useful to record, even if you are unsure if it is related to your fertility. As you become more in tune with your fertility signs, it will become easier to recognize ovulation pain if you experience it. Women who have never noticed ovulation pain often begin to notice it when they begin to chart their fertility signs.

  • Increased Sex Drive: You may notice that your sex drive is cyclical. For example, your sex drive may be highest at around the time before and at ovulation when you are most fertile. Another pattern might also be normal for you. If you notice that there is a pattern to your sex drive, it can be helpful to record your observations to make predictions about your fertility.

  • Ovulation spotting: Some women see slight spotting at the time of ovulation. This is quite rare, but you may see that your cervical fluid is streaked with blood or has a pink tinge. If you do notice this, it should be noted. If it is heavy, unusual for you, or lasts longer than a day or is otherwise a cause for concern, you should ask your doctor about it.

  • Tender Breasts: You may notice a pattern to the sensitivity of your breasts. They may feel more sensitive at around the time of ovulation and they may continue to feel sensitive or tender throughout your luteal phase. Again, if you notice that there is an observable pattern to the sensitivity of your breasts, it is useful to record it in the checklist on the data entry page so that you can make future predictions or notice changes from cycle to cycle. For some women, tender breasts are an early pregnancy symptom, however, there is no way to know if you are pregnant by the sensitivity of your breasts. Breast sensitivity may be linked to increased progesterone. Progesterone is increased both during the luteal phase of your menstrual cycle when you are not pregnant and during pregnancy. The sensitivity of your breasts may be useful for you to cross-check other signs if you have a consistent pattern but it is not a useful fertility sign on its own.

  • Your own observations: You may notice some specific changes yourself that can offer clues about your fertility pattern. Everyone is different, but there are clues that you may find on your own. Changes in your complexion, your energy level, your moods, or anything else that you notice shows a cyclical pattern can offer insight into your fertility pattern. Record any such observations on your chart. You may be surprised to learn that something seemingly unrelated may be related to your fertility.

Further Reading:

Next Lesson: All about Ovulation.

Search Fertility Friend's Educational Resources:

Test your knowledge: Lesson 11 Quiz

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