Why Don'T I Have Any Cervical Mucus?
Cervical mucus is important for conception. Fertile cervical mucus—sometimes referred to as egg white cervical mucus—is needed to help sperm survive and swim from the cervix into the uterus and eventually the fallopian tubes. Some birth control methods dry up cervical mucus to further prevent pregnancy.
Problems with cervical mucus can interfere with getting pregnant. Mild cases may increase the time it takes to get pregnant, but won’t necessarily cause infertility. More serious cervical mucus problems can require fertility treatment or hormonal support. When cervical mucus problems stand in the way of getting pregnant, it’s medically referred to as hostile cervical mucus. Hostile cervical mucus can refer to severe vaginal dryness, problems with vaginal secretions that are too acidic, or refer to immunological problems.
Age, vaginal infections, medication side effects, and hormonal imbalances are some causes of cervical mucus problems. Even fertility drugs can cause issues with vaginal dryness.
Role of Cervical Mucus in Pregnancy
Cervical mucus is essential to achieving pregnancy as it creates the ideal environment by which semen can thrive and move freely.
Just before ovulation, cervical fluids will increase and become more like raw egg whites in their consistency. In this form, the cervical mucus actively nourishes sperm cells and enhances their ability to move through the cervical canal.
Any problems with the mucus can impede this process and make getting pregnant all the more difficult.
Causes of Cervical Mucus Hostility
Cervical mucus hostility is a term that can refer to any number of possible problems with cervical fluids. Among some of the more common causes:
- Thick, dry, or sticky mucus is often caused by hormonal imbalances and frequently co-occurs with ovulation problems. A thickened consistency directly interferes with sperm motility. Some medication side effects can cause this.
- Acidic mucus creates an environment hostile to sperm. While hormonal irregularities can interfere with pH balance, the acidity may also be the result of a bacterial or yeast infection.
- Inflammatory cells are produced in response to an infection. When this happens in the vagina or cervix, the cells can actively target and kill sperm.
- Anti-sperm antibodies are defensive proteins produced by the immune system in response to a past infection where sperm was either present or involved. While less common, these antibodies can also attack and kill sperm.
Medication Side Effects
Some medications can dry up or decrease the quality of your cervical mucus. Those drugs may include:
- Anti-histamines or allergy medications
- Cough suppressants
- Cold and sinus medications, especially if they include a cough suppressant or anti-histamines
- Some sleep aids
- Some anti-depressants and epilepsy drugs
While cold and allergy medications can decrease cervical secretions (just like they dry up the mucus in your nose), whether or not they can cause infertility is questionable. Usually, drugs like these are taken for a limited period of time and are nothing to worry about. If you are concerned about a cold medication’s effect on your fertility, you could try using a neti pot (with distilled, sterile water) to clear out your sinuses. Another option is to try a cream or aromatherapy treatment that contains menthol or eucalyptus.
If your anti-depressant is drying up your cervical mucus (and likely also lowering your libido), discuss your options with your psychiatrist. There may be alternatives you can try.
Be sure you tell your gynecologist or reproductive endocrinologist every medication you’re taking, even if you think it’s irrelevant to your fertility. Your primary care physician and fertility doctor may have to work together to find the best solution for your overall health and your fertility.
Never discontinue or change the dosage of a medication without first consulting with your doctor.
Clomid and Cervical Mucus
You may have noticed the fertility drug Clomid on the above list. It's ironic that a drug meant to help you get pregnant may at the same time lead to problems with getting the sperm to the right place for pregnancy.
Not every woman who takes Clomid will experience problems with low-quality cervical mucus. It's more common to have this problem when Clomid is taken at higher dosages.
If you do notice vaginal dryness or a lack of fertile cervical mucus when taking Clomid, you should mention this to your doctor. Your doctor may prescribe an estrogen suppository to help counteract the side effect. Another option is using a fertility friendly lubricant.
As you get older, you may have fewer days of cervical mucus. The quality of your mucus and quantity of it, may also be affected.
In your 20s, you may have had up to five days of quality cervical mucus. In your 30s and 40s, you may only get one or two days. Sometimes, the cervical mucus remains at the more watery stage and never becomes like raw egg whites. Of course, all of this will vary significantly from person to person. There’s no way to predict with certainty how many days of quality mucus a woman will have based only on her age.
The more days of high-quality cervical mucus you have, the better your chances will be of getting pregnant. That said, it's still possible to get pregnant when you have just one or two days of fertile cervical mucus. Regardless of whether you get a good number of cervical mucus days or not, if you're over 35, and you've been trying for six months to get pregnant without success, you should see your doctor for a fertility evaluation.
Douching and Cervical Mucus
Vaginal douching can wash away the valuable cervical mucus you need to get pregnant. Douching can also wash away good bacteria, leading to an increased risk of vaginal infection. It's best to skip vaginal douching or products meant as "feminine deodorants." Even if you're not trying to get pregnant, it's best to skip them!
An unpleasant vaginal odor may be a symptom of a vaginal infection. Be sure to see your doctor for a check-up if you're worried.
If it’s a yeast infection, you may be treated with over-the-counter medications or, in more unusual cases, you might require prescription medications. Many yeast medications can cause vaginal irritation and discomfort, making sexual intercourse a problem. You can start trying to get pregnant after treatment, which is usually short term.
Strong vaginal odors can also be caused by bacterial infections. You may feel embarrassed to talk to your doctor about unpleasant vaginal odors, but it’s important to your overall health and fertility. STDs can also lead to other fertility problems, including infection of the uterus and fallopian tubes. It's very important this is diagnosed and treated right away.
Previous injury or surgery on the cervix can also lead to problems with producing cervical mucus. If you've ever had a cervical conization, or cervical cone biopsy, you may not produce as much cervical mucus as before.
The hormone estrogen is responsible for the increase in cervical mucus that precedes ovulation. If you're underweight, if you exercise excessively, or if you're a professional athlete, your levels of estrogen may be low. This may not only lead to less fertile cervical mucus but also to problems with ovulation.
Gaining weight or cutting back on your exercise routine may help.
Hormonal Imbalance or Anovulation
A hormonal imbalance can also lead to a lack of cervical mucus. If you're not ovulating, you may not get fertile cervical mucus. It's also possible to have an excess amount of fertile cervical mucus and not be ovulating, depending on what's causing the problems with ovulation.
There are many possible causes of anovulation. Just a few examples include a thyroid imbalance, hyperprolactinemia, polycystic ovarian syndrome, and primary ovarian insufficiency. Treatment will vary depending on the cause.
Treating Cervical Mucus Problems Overview
When diagnosed, treatment of cervical mucus treatment can vary based on the underlying causes and other contributing factors (including age, smoking, and medication use). This may involve:
- Treating any vaginal or cervical infection with an antibiotic or antifungal
- Changing treatment or lowering the Clomid (clomiphene) dosage as higher doses may cause mucus hostility
- Prescribing a short-term course of ethinyl estradiol, a synthetic estrogen, which tends to improve the production and quality of cervical mucus
- Taking over-the-counter cough remedy containing guaifenesin, an expectorant known to thin cervical mucus, though whether it improves fertility is questionable
- Using a fertility friendly lubricant if there is no indication of either infection or anti-sperm antibodies
- Proceeding with intrauterine insemination, bypassing the cervix
In rare cases, in vitro fertilization (IVF) may be explored if these treatment efforts fail and infertility persists. While some people will suggest that drinking more water or eating less dairy may help, there is currently no evidence that either will enhance the quality or production of cervical mucus.