Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.
Amy Beckley, PhD:
Hello everybody. This is Amy Beckley, and this is the Proov podcast. I am so honored to have with me Kristina Cahojova from kegg — lots of K's! Kristina, thank you for being here. Please tell us why you're here and who you are.
Kristina Cahojova:
Hey Proov listeners! I am here because we're going to talk about the importance of cervical fluid and how it helps you when you're trying to conceive or when you're just wanting to know your general health. The reason why Amy invited me is because I have a company that gives you devices which are helping you to track the changes of cervical fluid.
Amy:
Awesome, awesome. All right. So, most of our listeners are very fertility minded. They've heard the word cervical fluid. So we're going to have a really awesome discussion about cervical fluid. We got some visuals, some demos, we've got the big old giant uterus. So Kristina, what is cervical mucus?
Kristina:
So cervical fluid is a fluid that your body creates. You can have fertile cervical fluid or not fertile cervical fluid, and basically it's a barrier between your internal reproductive organs and your external reproductive canal. Cervical fluid is good because it protects you from infection most of the time. It also can signal you have an infection, but also it creates the pool for sperm so they can survive inside you for a longer time, which means that when you are ovulating only once a month, cervical fluid is this life-giving fluid that nourishes the sperm so they can stay alive inside you.
Amy:
Okay. So, cervical fluid or cervical mucus [is] interchangeable. What patterns do they have across the cycle? Because I know it changes depending on where you are in your menstrual cycle.
Kristina:
Yeah. So there are different ways how women track the attributes of cervical fluid — many wipe themselves with toilet paper, many use fingers, many take the cervical fluid directly from the cervix — and what people chart are the stretchiness, the color, the quantity, but also the feel, like if they feel slippery or not. And so the attributes of circle fluid based on these visual observations are like dry, sticky, different colors, stretching, how much it stretches.
Then you have the chemical composition of cervical fluid, which is something that we are looking into like free electrolytes in the cervical fluid. That means as you're entering your fertile window, the amount of water in your cervical fluid increases [and] the free electrolytes also increase. They're different components to cervical fluid, which make it easier for sperm to move within it.
To put it short...you should feel dry when you're not fertile in very, very, very simple words. But when you [are in your] fertile window or you [have] fertile cervical fluid, then it can feel for you like excess of arousal fluid because it has a very similar composition and also very similar feeling. So when you wipe yourself or when you feel it, it is very slippery, very stretchy. It really looks to many women like arousal fluid.
Amy:
So the different types of cervical mucus... Everyone's tracking cervical mucus or cervical fluid to help them know where they are in their cycle, right? So the most fertile type of mucus is usually the four or five days before ovulation. And typically [what does that mucus look like]?
Kristina:
Again, so we have a chemical analysis and then we have what women report and what they observe based on different tools that they use — and they use different methods. When they observe it, they usually chart the fertile cervical fluid as slippery and very stretchy, so you can stretch it for more than two centimeters — not sure how much it is in American metrics, but more than two centimeters. And then you can either feel it or observe it.
So non-fertile cervical fluid, according to many protocols, is the one that is not stretchy, so you can't stretch it. And then many fertility tracking awareness methods, they consider this to be non-fertile cervical fluid, which it's according to fertility awareness protocols, I have to say that this fertility awareness protocols are meant for users, or many of them are targeted to users who use observational cervical fluid because they don't want to conceive. Because when you understand when sperm can survive inside you, you can guess when sperm can survive inside you, so many women use it not to conceive.
So these fertility awareness based protocols, sometimes they consider cervical fluid to be fertile, even though it's not, but just to be on the safe side, they consider it to be fertile. So I don't want to say that every cervical fluid that is, you know, you can, you think is slippery is fertile because that's not true. But according to these protocols, they would chart it as fertile.
Amy:
Okay, okay. Yeah. For women that are trying to conceive, it's the egg white cervical mucus, right? So that's the stretchy, it's kind of like the consistency of egg whites. We get questions all the time with, "Do I have enough cervical mucus? Is this good quality cervical mucus?" Can you tell us about any research that's out there about how much is enough or is there such a thing as too much cervical mucus?
Kristina:
Yep. So I have found different — or when I speak to fertility specialists — there is not research that says like, "Hey, this cervical fluid is just bad." Like, the general consensus is that women who have more of it, more cervical fluid, have higher chances of conception just because they're multiple days over. So, the sperm can survive in them longer, which gives them a higher chance.
But any amount of cervical fluid so far it appears, is fine. If it's fertile and if you know, you're ovulating and you have it, then you can conceive. So if you have, for adults, cervical fluid one day, you still can conceive. Apparently it's easier if you have it for five days or if it's observable for more, your chances are higher, but you shouldn't be unhappy if you still have some. I think that still gives you good chances of conception. And I think Amy, you can tell about your experience, I have seen your data. You don't also have a lot!
Amy:
So we're talking about how my cervical fluid is mostly internal, it's not external. And so, on the outside, when I wipe with toilet paper, there's really usually nothing ever there. When I walk, I have a little bit of a wet sensation, but it's just few and far between.
I see that a lot with our users and people are always asking, "Well, that means I don't have enough cervical fluid. Like, that's why that's why I'm infertile." And it's not true. It's just not so much that it's actually coming out onto toilet paper.
Kristina:
Exactly.
Amy:
So we see a lot of women using products like fertility friendly lubes. Do you have any thoughts on, let's see, the two products that I see the most often are the sperm friendly lubes and the Mucinex.
Kristina:
Yeah. So, Mucinex, let's start with that. I heard from some fertility doctors that it's an urban legend, from others that, "No, that works!" But no one could really point me to any research study that could claim that it really works. So I don't know, but I know that women use it.
For those that do not know what it is, it's a syrup that helps you when you are sick to cough. But also many people believe that when you are taking it, your cervical fluid is also better because it impacts all bodily fluids. So, that also should be more viscous let's say. So that's one approach.
The...sperm friendly lubes — again, I don't have a conclusive opinion on that. I heard from specialists for and against. But the one thing that I think I agree the most with is that the fertile cervical fluid is in the cervix. So, yes you can see the residue outside, you can feel it, but the most important one is the one that is in the cervix because that's the one that sperm have to swim through and this is the one that they need. And I don't think that your lube for sex you are inserting in your cervix. So I think it definitely may help sperm because many lubes actually kill sperm. So when you have sperm friendly lube, what it does is at least doesn't kill this sperm. Let's put it that way.
Amy:
Okay. So, little caveat on this. There's a sperm friendly lube out there — most, most of them are like this, not all of them — where the instructions say you have to insert it about 10 to 15 minutes before intercourse to warm up. And if you don't do that, you actually kill the sperm because the fluid has not reached body temperature and it's not the right environment, and the sperm hit it and they die. So if you aren't using — this as a PSA for all the people listening, —if you're using sperm friendly lube, read the directions and follow them. If you don't, you could actually be doing harm.
Kristina:
Yup. Yeah but that has more to do about the temperature and the nature of sperm. So I had a wonderful discussion about sperm with one lady that has a fertility tracking course firm company. And the discussion was very interesting because like guys, they have a ton of sperm to be honest, like they have a ton of sperm and their selection is like the fittest survive. The best sperm survive. The one that doesn't have any genetic problems survive.
So the reason why they die so easily is because like the best ones should survive, and they die in low temperature so naturally, if you're putting some fluid that is not like your own cervical fluid, so it has different temperature, they will die. So it makes sense.
And in us, in women, the selection for the eggs to be fertilized, it comes before. So, we have so many thousands of eggs in everybody, but who knows how come, why they are selected for ovulation and the other one doesn't. Many think it's because of natural selection, but who knows? We still know so little. So I think the physical aspects of sperm, they die easily, is actually a good one, and we just should help it. Every product and every medical blood product should be used with a user manual because there's a good reason why the user manual exists, especially here.
Amy:
Yes, absolutely. Absolutely. So doing some science and biology: when the egg — the follicle — is developed, it starts producing estrogen. That higher estrogen causes those cervical crypts to start increasing their cervical fluid, both quantity and viscosity so that you get this more fertile pattern.
I always like to say, if you're using sperm friendly lubes because you're not producing enough cervical fluid, you might not be producing enough estrogen. And instead of just treating the outward facing problem of cervical mucus, you should maybe talk to your doctor about hormones and say, maybe there's a hormone imbalance or something like that. That's why I caution people that are just using Mucinex or lubes [as it may be] just masking the symptoms and not solving the problem.
Kristina:
Yeah, I absolutely agree...There are few different types of women who track cervical fluid. Number one: those that are trying to conceive and they're trying to find the most fertile days for conception. Number two, those that are tracking cervical fluid because they don't want to conceive. So they're looking for the dry cervical fluid that they feel safe to have sex and they won't get pregnant. And number three: there's a group of women who are tracking cervical fluid because they want to discover their hormonal imbalances with estrogen.
So I absolutely agree with you. The reason why women should track cervical fluid is not just to conceive, but also understand, like "I am producing fertile-like cervical fluid three times in my 60-day cycle. That is a hormonal imbalance and you should fix it with your doctor. And it really says something, you know, many women also produce fertile-like cervical fluid just before they go into a period, like having periods.
So fixing hormonal imbalance should proceed all the other things before you're trying to conceive because if you don't fix it, you can miscarry and there are so many things that could go wrong. So tracking cervical fluid and understanding also progesterone, you should do that as your homework before even attempting to think of IVF or anything else.
Amy:
Yeah, absolutely. Absolutely. So, okay I'm going to backtrack a little bit. So, using cervical mucus to help you get pregnant, so to determine when your fertile window is, right? Most people that use Proov are also using ovulation tests. Tell me why cervical fluid tracking is different from LH testing.
Kristina:
Yeah. That's very simple. An LH test, what it does, it's tracking luteinizing hormone in urine, and that usually happens just before ovulation. So for women with healthy enough patterns of cervical fluid, that day coincides with optimal cervical fluid quality. So they can conceive — problem solved.
You don't need to track cervical fluid if LH testing is working for you. But not all women, you know, it's the optimum day for them to conceive when the LH test turns positive. The reason why is because LH test says ovulation is going to occur, but for sperm to get there, you need optimal cervical fluid. And many women have the best cervical fluid or the most cervical fluid days before ovulation, before the LH test turns positive.
So what usually happens [is that] women who can't conceive with LH test, what they're looking then into is tracking cervical fluid so they can expand their fertile window from [the] one to two days defined by the LH test to more days. So they increase the chances of conception. So if you don't have problems, you should conceive with the LH test. If you do, or if you can't, it's not the end of the world. You have to try to track your cervical fluid to understand your hormone imbalances. You can take Proov because even if you have sufficient cervical fluid and you see a beautiful cervical fluid pattern, you still might not be able to conceive because you don't have enough progesterone.
So, there is nothing bad or wrong with LH tests; they're [an] excellent tool for women to understand when approximately they're ovulating, but there are limits to it. So they don't define the full fertile window and they don't tell the optimum day for conception because it may be today when the LH test turned positive, but it also may not be today. So cervical fluid is like the next step when the LH tests don't work.
Also, another thing to know about the LH tests that many women have multiple positive LH tests and there are other issues with LH tests, which is still fine because if you have multiple, just try more days, but many women just don't [ever have] positive LH tests, but they still can conceive. Because the way it works — and Amy can explain — is that it's looking for a chemical reaction on a paper that the test presents a certain hormone in the urine. And you may miss the window, you already have ovulated, you know many things can happen.
So LH just gives you one to two days — depends on the brand or depends on the product — and cervical fluid gives you as many days as you have the presence of fertile-like cervical fluid. [For] many women it's one, [for] many women it's two, and [for] many women it's five or even eight. I encountered a woman that had 11, but they also had like seven kids. So I was like, no wonder that.
So it really depends. I also saw a woman, which is very interesting that [she had] a positive LH test, but at that time, her cervical fluid is already dry. So they are not producing fertile-like cervical fluid on that day. So if they would be trying to conceive with just an LH test, they will think, "Oh, it doesn't work." But it's not true; they are functioning well.
Amy:
Yeah, that's me. That's me a hundred percent. So, the number behind it is 20%. There are 20% of women that by the time they get a positive LH test on their urine strip has already ovulated. 20%. I've been tracking my cervical fluid with kegg — we'll introduce the product here in a second — but the kegg has identified four fertile days, and that last day where my LH surged, I went back down to low. So if I was just using LH to try to conceive, I would have missed my optimal time to time intercourse because by the time I got a positive LH test, it was almost too late...So it really, really helps. So let's talk about kegg!
Kristina:
Yeah, but at the same time, Amy, you see there is nothing wrong with you. You still would be able to conceive, you just have to understand the full fertile window. And that's why I don't like certain brands that they claim like, "Hey, 99% effective or accurate," because women read the paper and they think, "Oh, the day [I get a positive test] is almost a 100% chance of conception!"
Amy:
No, I saw your ad before you even launched, it was so genius: "It's 99.9% accurate at detecting LH, not 99% accurate at detecting ovulation," which is a hundred percent true. I mean, we're accurate at what we do. We know we're accurate at measuring LH doesn't mean you're actually going to ovulate.
I mean, there's women that have PCOS, they get the false LH surge, [meaning] you get the LH surge and you don't have a good ovulation. You have a weak ovulation. You're still not able to conceive. And so, yes, you've accurately detected LH, but that only tells you that you had LH, it doesn't tell you that you ovulated, or that you were healthy, or that you timed intercourse correctly. It just tells you that you've tracked LH. Yay. Awesome. "I tracked LH with 99% accuracy."
Kristina:
Wait for it: "I didn't get pregnant. So I need IVF." I've heard so many stories like that. I'm like, "No, no guys, like you did like maybe 10% of what you could have before even thinking of IVF." That's not how it works. I think the big corporations, they have done a good job that they know that people interpret the package that way so they don't do anything about it. But what it leads to is a lot of women thinking that they can't get pregnant.
Amy:
Right, absolutely. So, alright let's talk about kegg! I got one. So this is the kegg. This tracks cervical mucus. It's something you insert in your vagina for — I mean, it takes what, like 30 seconds a day, 45 seconds a day? It's super easy. I do it while I'm brushing my teeth, I'm multitasking, you know?
So, the reason I love this is because, as we talked about before, I don't have outward cervical mucus. Like I just don't. And so do I have cervical mucus? I have no idea. So, I bought one and I started using it, and I was given this 4-day fertile window. It went from low to possible to likely for two or three days, usually between two and three days each cycle, and then it went back down to low. And it coincided exactly with the LH surge. So I had those three or four fertile days and then the LH surge, and then it was low. It was great. So I was like, "Oh, so I do have cervical mucus."
Kristina:
Yeah. Usually most of the women that we have seen, we also have seen women that don't, but we are not a diagnostic device (that we can't say), but those women that perform, that had the free electrolytes during the fertile window, they have. And interestingly, as you're saying, we have women who are tracking fertility for natural fertility awareness reasons.
And one thing that I had been told many and many times over that [with] the kegg you also get data, so they can spot the trend before they can observe it. And I'm like, yeah, thank you. That's very cool because that also tells me that women who don't have enough or that I didn't speak to, they may get some data, even if they couldn't visually observe it.
So I have to also say, like about our product that there are other products, to be honest with you guys, there are also other products that track the changes in cervical fluid, but we are the first product that doesn't use any cables. It doesn't use any CDs or something. It just looks small and smart and it looks like a pelvic floor exerciser, like a very small, silly condom-wrapped intimate device, which also vibrates if you want it to vibrate to help you to squeeze your pelvic floor. So we've tried to think a lot about how it feels for them [inaudible] and I don't know how long Amy your kegg lasts, but my kegg lasts [for] a whole cycle, so I don't have to charge it.
Amy:
Yeah. And I love in the app where it tells you what percent charge the kegg is. So if you're getting low, you can just go plug it in. I love that. I'm going to go back to this, you know, it detected you were fertile before you could actually feel you were fertile — that's huge. Especially for people that just don't have the outward fertile mucus, like, I didn't know I was fertile on day 10. I didn't know. My LH test was negative and I didn't feel anything on the outside, there was nothing on the toilet paper. But using the kegg, I was like, "Oh, this is awesome."
And I loved that it took the subjectiveness and made it objective. So, when you think like, "Oh, is it sticky? Did it stretch two centimeters or one centimeter? Is it fertile? Is it not? I don't know." It's really hard because it's, "Is it creamy? Is it sticky? Is it glue-like?" I don't know. I don't know what that means.
Kristina:
Exactly. Yeah. But it's very important to say that these terms like sticky glue-like, egg-like, were invented so they help women to understand what they see because observing your cervical fluid is something private. You’d kind of be like, "Hey, doctor, look at this, you know, like, what is it?" So...the terms that were invented to help women, yes, they're subjective, just because they're so general, it can lead to confusion. So I think having additional data, so you understand it, is better.
Also, I think it's very important to say that we are displaying one layer of information to our users, which is the impedance curve, but the impedance waves — we have so many waves that we are collecting because the way how kegg works is that it streams electricity, to be honest to you. Say like electricity and it measures the response of the wave. So they're like differently charged waves. And based on the response, we can see the free electrolytes.
And many people would say like, "Yeah, you can then distinguish pH and viscosity, and who knows what." The answer is yes, but we are trying to also clean your results from residual fluids, from some abnormal metrics, because many women have some different fluids in their vagina. So we are doing way more backend cleanup than you really see. And in the future, we are trying to come up with different data that we can show to women. So they can also observe the trends beyond the simple impedance wave because many, many people consider it useful.
Amy:
Yeah, absolutely. I mean there's just so much about cervical fluid and cervical mucus. And when you're just like, ding ding ding, shot with different information, it can mean different things. I saw a post on Instagram [and] it was one of those questions, right? Like, "When does creamy cervical mucus happen?" And it was like, "before ovulation or after?"
I clicked after because what I've been taught is that creamy cervical mucus is because of the increased progesterone and that's after ovulation. And I got it wrong. And I was like, "No, no, no, no, no, you people need to be schooled that your science is wrong." And then she pointed me to a reference where they talked about creamy cervical mucus being before there's enough estrogen, before ovulation. And I'm like, "We're just confusing people!"
Kristina:
Yeah, because...in different methods creamy means something else and that's why it's so confusing! Yeah, I know. I could talk about it forever.
Amy:
You've got 40 seconds, you put this up there, you let it vibrate, you're good to go. You take it out. You enter in, did I have a positive LH test, did I have a positive Proov test, did I have intercourse today — done, done, done. It shows your curve. It tells you when you're fertile. Done. Like it's so easy. I love it.
Kristina:
Thank you! We put a lot of love into it.
Amy:
The cervical fluid thing is just like, you know, we get it all the time. "Well, do I have enough? Should I use Mucinex? What do you think of this for that one or whatever?" And it's a really complicated thing and so I love how you've simplified it to make it easy for women to understand. I appreciate you being on here, helping everybody educate on cervical fluid, what it is, what it's not, what we know, what we don't know.
Kristina:
Yeah. I think, Amy, what is important to say about cervical fluid: it's so important. It's so important, yet there is so little research on it because the nature of collection of cervical fluid prevented an extended research into it. So women are confused. They use it, but there is so much still to be learned and one thing that we're doing at kegg is finally we are collecting information.
So we are working with some doctors that use it on their patients. So they get additional clinical data on the top of kegg data. So we're trying to even learn and have some evidence for what people were just thinking like, "Hey, does Mucinex work? Did it not work?" It's very hard to say, but right now, as you're getting data, hopefully one day we will come to a conclusion — What helps improve the quality of the cervical fluid and what doesn't?
So far, one thing I can tell you — even though not a claim, okay, this is outside of claim — but dehydration is such a big deal in women's lives and it impacts cervical fluid incredibly. So if people drink a lot of coffee, a lot of alcohol, very little water...the fertile window pattern is way, way, way narrower. And that's what we have observed already. Again, not a claim. But it is logical.
Amy:
Yeah. So for a longer fertile window, drink more fluids. Be more hydrated. I mean, it makes sense. It makes a lot of sense.
Kristina:
Yeah. So it makes sense. But again, it's just everything that we are learning. One thing that makes me a little mad is that cervical fluid plays such an important role, not just in conception and not conception, but also infections, and about the pregnancy because you then form a cervical fluid once you're pregnant. We have data now, but there is so little research in all these topics or like anecdotal evidence that it's so saddening! We are women. It's so important. We are half of this world yet [so little] research has been done on this so important topic.
Amy:
I know, we need more research. Absolutely. We've tried to do some research on progesterone and answer very, very simple questions about progesterone. And you go for grant funding and try to get research funded, and it's like, "Oh, no, progesterone has been around for like 60 years; that's old science." I'm like, "No, you don't understand it yet!"
Kristina:
At least you've got a grant. But I was trying to get a grant for cervical fluid and they're like, "Yeah, sure." And then I don't have a green card, so I can't get it. It's okay, I will get a green card next year so then I will do it.
Amy:
All right, Kristina, where can they find kegg? How can our listeners find their own kegg?
Kristina:
Yeah. So it's kegg.tech. [That's] easy or Google "kegg fertility tracker" and good news is, guys, that everyone gets a complimentary Proov when they buy kegg because we want to help women and we realized timing is not everything. You also have to have progesterone to conceive.
So we are giving all of our customers a free Proov so they really understand what makes their conception journey troublesome or challenging.
Amy:
Yeah. We tell Proovers all the time that you've got to time intercourse and you've got to ovulate successfully. Those are two separate thoughts. Kegg will help you time, Proove will help you confirm successful ovulation. Two pieces of the puzzle; you need to have both.
Kristina:
Exactly. Yeah. Because you can have fertile-like cervical fluid and you can have a fertile window. If you fail to ovulate... It doesn't mean that when you have fertile cervical fluid that you automatically ovulate. That's not the thing, unfortunately.
Amy:
Yeah. Yeah. Again, fertility is so complicated. I think somebody posted something on Instagram that there's 91 different ways you can be infertile, like 91 different ways! It's so complicated, right?! So I love that there's just simple things out there that make our lives easier as women, as couples either just want to learn about our fertility, we want to try to get pregnant, we want to try to get pregnant not now but later, we want to try to figure out what my symptoms for some hormonal imbalance.
So having these tools is just so amazing. So I appreciate you spending a little bit of time with us. We will link the website to the show notes. I also believe we have a special code that gives I think $20 off of kegg, we'll put that on there too.
Kristina:
It's free shipping and I think it's actually $50 off, but I will post this too.
Amy:
Even better! All right. Well thank you, Kristina!
Kristina:
Thank you, Amy, thank you so much! I hope everyone gets pregnant when they want.
Amy:
Awesome, yes, that is the ultimate goal! Thank you.
Kristina:
Bye!
