Cervical mucus plays a vital role in fertility as it helps to transport sperm through the reproductive tract to the fallopian tubes, where fertilisation can occur, in fact, pregnancy can not occur without the presence of cervical mucous. Therefore, in theory improving cervical mucus quality can increase the chances of pregnancy. It is important to remember that pregnancy can occur even with low and poor quality cervical mucous so it is unlikely that cervical mucous alone is an overly significant contributor to sub-fertility. Sub-fertility is a complex but since cervical mucous is driven mostly by the hormone estrogen, cervical mucous can become a mirror of estrogen levels and so can be valuable tool to assist in hormone balance. Aside from hormone balance, the acidity of cervical mucous can be a contributing factor. The acidity of cervical mucous changes throughout the menstrual cycle, with the most alkaline PH nearing the time of ovulation. Sperm are very sensitive to acidity, and low PH levels (acidic) in cervical mucous are shown to be less favourable to sperm survival (1). The acidity of cervical mucous is still largely controlled by estrogen, however there are other dietary and lifestyle factors that can also contribute.
Here are some ways to improve cervical mucous quality.
Estrogen balance: Estrogen is essential for maintaining cervical mucous quality and quantity. Low levels of estrogen can lead to inadequate cervical mucus production. Identifying the cause of low estrogen can be complex and is usually highly associated with stress and low body weight. High estrogen levels are associated with an increase in cervical mucous acidity which might make sperm survival more difficult. High estrogen is also associated with inflammation and increased exposure to environmental estrogens which might interfere with fertility. (You can read my article about understanding estrogen dominance here )
Hydration: Drinking plenty of water is essential for maintaining adequate cervical mucus production. Dehydration can lead to thick and sticky mucous, which can make it difficult for sperm to travel through the cervix. According to a study published in the Journal of Obstetrics and Gynaecology, women who consumed more than eight glasses of water per day had better cervical mucus quality than those who drank less water (2). Hydration is also a key element in regulating the acidity of cervical mucous.
Vitamin E: Vitamin E is an antioxidant that has been shown to improve cervical mucus quality. A study published in Fertility and Sterility found that women who supplemented with vitamin E had significantly better cervical mucous quality than those who did not (3). Vitamin E supplementation can become toxic when taken long term, when possible women should aim to increase vitamin E intake through foods. Vitamin E is found most abundantly in healthy oils like olive oil and avocado oil and many other healthy oils. It is also found in nuts, seeds and fruits and vegetables like capsicums, spinach, broccoli and asparagus.
Vitamin C: Vitamin C is another antioxidant that can help improve cervical mucus quality. A study published in the Journal of Reproductive Medicine found that women who supplemented with vitamin C had higher levels of cervical mucous than those who did not (4). Vitamin C is also known to be depleted under stress and is important for adrenal function, improving egg quality and boosting progesterone levels (5). Vitamin C can be found in citrus fruits, tomatoes, potatoes (with skin), capsicums, kiwi, strawberries, guava, papaya broccoli and brussel sprouts. Most fruits contain a large amount of vitamin C. Some fruits like arecola cherries, kakadu plums and amla berries are so concentrated in vitamin c that they can be taken as a supplement. Grapefruit juice in particular has been studied as an effective natural remedy to help improve cervical mucous quality. Grapefruit juice is rich in vitamin C and other antioxidants such as quercetin and is particularly helpful in metabolising estrogen in the liver which can then affect cervical mucous and fertility. A study published in Fertility and Sterility found that women who consumed grapefruit juice had better cervical mucus quality than those who did not (6).
Omega-3 fatty acids: Omega-3 fatty acids are essential for maintaining optimal reproductive health. They help to regulate hormone levels, reduce inflammation and improve blood flow to the reproductive organs. A study published in Human Reproduction found that women who supplemented with omega-3 fatty acids had better cervical mucous quality than those who did not (7).
Folate: Green vegetables, such as spinach and kale, are rich in folate and other nutrients that are essential for reproductive health. A study published in Human Reproduction found that women undergoing fertility treatment who consumed more folate had better cervical mucous quality than those who did not (8).
Avoiding alcohol and too much caffeine: Alcohol and caffeine are diuretics which can dehydrate the body and lead to thick and sticky cervical mucous. Low amounts of caffeine consumed in a way that does significantly increase cortisol and dysregulate blood sugar can still be appropriate however it is best to completely avoid alcohol while trying to conceive and throughout pregnancy. Caffeine intake should ideally be kept to no more than 1 cup of coffee a day when trying to conceive and throughout pregnancy.
Prescription medications: Certain antibiotics or medications have ingredients or side effects that could impact the pH levels of cervical mucous.
Douching: Douching severely disrupts the PH balance of the vagina and can create imbalances in the vaginal microbiome. Douching can make it more difficult for a woman’s cervix and vagina to naturally maintain a healthy environment that is favourable to sperm survival as well las keeping the vagina healthy and free from infections. Douching is not a safe practice for women.
Lubricants: Using lubricants that aren’t sperm friendly can cause irritation and impact the overall health and balance of the vagina and cervix, including pH levels. It is better not to use any lubricants when trying to conceive as they can interfere with cervical mucous quality. They can also make it difficult for women to monitor their fertility signs as lubricants can interfere with sensation at the vulva and the appearance of cervical mucous. It is best to avoid lubricants in the fertile window.
Environmental toxins: Exposure to a range of environmental toxins from beauty and cleaning supplies may contain xeno-estrogens which can affect estrogen levels in the body and also contribute to weight gain which further interferes with estrogen levels. Environmental toxins can also potentially affect cervical mucous pH levels.
Other lifestyle factors: Other lifestyle factors that can affect cervical mucus quality include smoking, stress, and exercise. Smoking can lead to decreased cervical mucous production, while stress can disrupt hormone levels and affect cervical mucus quality. On the other hand, moderate exercise can help improve blood flow to the reproductive organs, which can help improve cervical mucous production.
Herbal Remedies: Some natural and herbal remedies can assist in improving the quality and quantity of cervical mucous mostly by helping to regulate the hormone estrogen and improve the balance of hormones within the menstrual cycle. The three most common herbs used for improving cervical mucous are evening primrose oil, chaste tree berry or vitex and red clover.
Evening primrose oil is high in vitamin E and contains GLA fatty acid, a rare fatty acid needed to build reproductive hormones including estrogen and progesterone, it has been used traditionally for helping to increase cervical mucous, however there is little research to support this idea and controversy over where evening primrose oil is safe in pregnancy. Many professionals (including myself) advice taking evening primrose oil for 1/2 the menstrual cycle only depending on which symptoms you are trying to improve. Evening primrose oil is an excellent moisturiser and may be most beneficial for women with vaginal dryness from low estrogen levels.
Chaste tree berry or vitex can help in boosting both estrogen and progesterone levels and helping to regulate the menstrual cycle. It does this by lowering the hormone prolactin which increases under stress. Prolactin has a suppressive action on the hormones of the menstrual cycle, lowering prolactin can help increase the quality of ovulation and boost cervical mucous.
Red clover can help improve cervical mucus quality due to its high content of phytoestrogens which can help regulate estrogen in the body (9).
It’s important to consult with a healthcare professional before starting any herbal supplements, as they can interact with other medications and have potential side effects. Herbal remedies are powerful alleys, but they need to be individually tailored to the unique concerns of the individual. Seek guidance from a herbalist or naturopath with good knowledge of herbs and hormones.
References:
1.Eggert-Kruse, W., Köhler, A., Rohr, G., & Runnebaum, B. (1993). The pH as an important determinant of sperm-mucus interaction. Fertility and sterility, 59(3), 617–628.
2. Quintero et al. (2006). Water intake and cervical mucus. Journal of Obstetrics and Gynaecology, 26(8), 782-784.
3. Showell et al. (2013). Antioxidants for female subfertility. Cochrane Database of Systematic Reviews, 8, CD007807.
4. Dawson et al. (1993). The relationship of ascorbic acid to cervical mucus characteristics and fertility. Journal of Reproductive Medicine, 38(9), 707-710.
5. Omu et al. (1997). Grapefruit juice and cervical mucus. Fertility and Sterility, 68(3), 430-432.
6. Mumford, S. L., Browne, R. W., Schliep, K. C., Schmelzer, J., Plowden, T. C., Michels, K. A., Sjaarda, L. A., Zarek, S. M., Perkins, N. J., Messer, L. C., Radin, R. G., Wactawski-Wende, J., & Schisterman, E. F. (2016). Serum Antioxidants Are Associated with Serum Reproductive Hormones and Ovulation among Healthy Women. The Journal of nutrition, 146(1), 98–106. https://doi.org/10.3945/jn.115.217620
7. Chavarro et al. (2011). Omega-3 fatty acid supplementation during pregnancy. American Journal of Clinical Nutrition, 94(6 Suppl), 1975S
8. Wong et al. (2013). Serum and cervical mucus folate concentrations in women undergoing assisted reproductive technologies: a prospective cohort study. Human Reproduction, 28(7), 1862-1871
9. Booth et al. (2003). Phytoestrogens and red clover. Journal of Alternative and Complementary Medicine, 9(1), 67-87.
