You may have heard the term "hostile cervical mucus" — maybe in chat rooms about fertility, or maybe you or someone you know has had their cervix described this way. Is your cervical mucus actually about to attack someone with a knife? (Spoiler: no.) What does your cervical mucus have to do with fertility? How do you know if something's up? Let's get to the bottom of this!
What is cervical mucus, anyway? (And why does it matter?)
Cervical mucus is exactly what it sounds like — mucus discharged from the cervix, prompted by the body's release of hormones. (It's not the same fluid that shows up when you're sexually aroused.) The color and consistency of your cervical mucus changes according to where you are in your menstrual cycle, thanks to, you guessed it, your hormones, and each time that mucus changes, it's serving a different function. For example, right before you ovulate, your mucus should become clear and elastic, so sperm can move through it and catch a ride to the fallopian tubes, in order to fertilize any eggs that might be there. Observing your cervical mucus to determine when you should have unprotected sex in order to get pregnant is part of the fertility awareness method of natural family planning. Sometimes, though, your cervical mucus doesn't change, and that's when things can get tricky, fertility-wise.
When cervical mucus goes awry
Before we go any further, let's make one thing clear: "hostile" is not a medical term. It's inappropriate to use, says Dr. Amos Grunebaum, OBGYN, a fertility and women’s health expert who works with Fairhaven Health. When the term is used, he says, "it refers to cervical mucus that does not allow sperm to penetrate from the vagina through the cervix to the uterus. If that mucus is too thick or too acidic, or if there is not enough cervical mucus, then the sperm has difficulty doing its job."
You need the right kind of acidity in your cervical mucus for it to work in transporting that sperm - low acidity and high water content is ideal. At the beginning of your cycle, your mucus is super acidic, but that acidity should abate as you get closer to ovulation. There are many reasons why it might not (we'll get into how you find out that it is in a bit). Dehydration is one culprit; the more water you drink, the better the quality of your mucus, since it impacts your overall bodily functions, including your vaginal discharge. The side effects of certain medications, like Clomid, which ironically is used to treat infertility, can unfavorably impact cervical mucus. If your mucus is too low in acidity, it could be because you have an infection, like bacterial vaginosis or pelvic inflammatory disease (PID). Douching can also cause adverse changes to your cervical mucus. PCOS can also interfere with the quality and amount of cervical mucus, since it can impeded ovulation. And since your fertility does change with age, that's a factor here as well.
Hormones, of course, play a big role in what your cervical mucus looks like and whether or not it can facilitate the movement of sperm. If you have low levels of estrogen, which can be caused by age, thyroid issues, conditions like premature ovarian insufficiency and Turner's Syndrome, chronic cervicitis, cancer treatment, and weight loss, among other things, that can inhibit ovulation and the occurrence of that slippery and clear fluid (think raw egg whites) you need to transport sperm.
Is something up down there?
You can assess your own cervical mucus — that's what the cervical mucus method of fertility awareness is all about, so you may be able to tell if you're getting the ideal discharge around the time you're ovulating. If you've been trying to conceive for more than a year and you're under the age of 35, or you're over 35 and have been trying for six months without getting pregnant, check in with your doctor for testing.
You might have heard of the postcoital test (PCT), a means of evaluating the interaction between sperm and cervical mucus after intercourse. The efficacy of the PCT is in question, and it's no longer used frequently. A semen analysis, a test that's done in order to evaluate male fertility, should be conducted by your healthcare provider.
Cervical mucus + fertility
The state of your cervical mucus is unlikely to have a serious impact on your fertility, since it often stems from an issue that can be resolved. That doesn't mean it can't make getting pregnant challenging — if your issues with cervical mucus are due to a hormone imbalance, or problems with your uterus, those issues will need to be addressed. Ethinyl estradiol, an estrogen medication that's included in both birth control pills and treatment for menopausal symptoms, can be used to make your cervical mucus more fluid.
Intrauterine insemination (IUI) could be a successful means of getting pregnant in the case of cervical mucus issues, since the sperm is placed directly into the uterus, so the matter of mucus is bypassed entirely.
It can never (and we mean never) hurt to find out what your hormones are up to now, especially if you think you might want kids one day. Modern Fertility hormone test can give you the information you're looking for AND help you translate it into action — you can take your results to the doctor, talk online with nurses and a whole community of people who, like you, know that knowledge is power.