PCOS Ovulation Signs: How to Tell If You're Ovulating Naturally

If you have PCOS and irregular periods, it can feel impossible to know if (or when) you're ovulating. But ovulation can and often does still happen, just not always on a textbook schedule. Wondering why your periods haven’t returned after coming off the pill? This blog explores the common reasons and next steps.

Whether you're trying to conceive or just want to understand your cycle better, learning to spot ovulation signs is one of the most powerful steps you can take.

Why Ovulation Matters in PCOS

Ovulation is when your ovary releases an egg. With PCOS, ovulation may happen less often, or not at all, due to hormone imbalances like high insulin or raised LH levels. Without regular ovulation, it’s much harder to conceive and periods may be irregular, heavy, or missing entirely.

Supporting regular ovulation is key for both fertility and long-term hormone balance, even if pregnancy isn’t your immediate goal. Learn more about how functional nutrition can help you manage PCOS naturally here.

How to Tell If You’re Ovulating with PCOS

Here are five signs I look at with clients to help identify if and when ovulation is happening:

1. Cervical Mucus Changes

One of the most reliable signs of approaching ovulation is the change in cervical mucus.

• Around ovulation, mucus becomes clear, stretchy, and slippery, similar to raw egg white.

• This fertile mucus helps sperm travel more easily, so your body produces more of it just before the egg is released.

• To check: Notice what you see when wiping or during your shower. A wet, stretchy feeling often indicates your fertile window.

2. Ovulation Pain

Some women feel a small twinge or dull ache on one side of the lower abdomen around ovulation.

• This is known as Mittelschmerz, a German word meaning “middle pain.”

• It's usually harmless and may last a few hours to a couple of days.

Not everyone feels this, but if you do, it can be a helpful clue.

3. Basal Body Temperature (BBT) Shift

Your resting temperature rises slightly after ovulation, due to increased progesterone.

• Track your BBT with a digital thermometer first thing every morning before getting out of bed. Here are the Flo Health app instructions.

• You’re looking for a sustained temperature rise (around 0.3–0.5°C) that lasts for at least 3 days.

This doesn’t predict ovulation, but it can confirm that it has happened.

4. Ovulation Predictor Kits (OPKs)

OPKs detect a surge in luteinising hormone (LH), which typically rises before ovulation.

• However, many women with PCOS have consistently raised LH, which can lead to false positives.

• If your OPKs are often positive without other signs (like fertile mucus or a temperature shift), you may not be ovulating despite the result.

That’s why it’s best to combine OPKs with other tracking tools.

5. Other Hormonal Symptoms

Some women also experience:

• Breast tenderness

• Mild bloating

• Increased libido or energy

• Mood shifts

On their own, these signs aren’t definitive, but they can add to the bigger picture when used alongside mucus or BBT tracking.

How to Track Ovulation with PCOS (Without Obsessing)

It can be overwhelming trying to track everything, especially if you’re already feeling frustrated or stuck. My advice: keep it simple and look for patterns over time, not perfection.

Here’s what I suggest:

• Start with mucus

Track what you notice daily for 2–3 cycles. This is one of the easiest and most reliable indicators.

• Add BBT if possible

This helps confirm whether ovulation has taken place, even if cycles are irregular.

• Use OPKs with caution

They can be helpful, but don’t rely on them alone if you have PCOS.

• Use a paper chart or app

Choose whichever method helps you stay consistent.

What If You’re Not Ovulating?

If you're not spotting any of these signs, or you’re feeling unsure, don’t panic. There are evidence-based ways to support regular ovulation with PCOS, including:

Food-first strategies

• Balance blood sugar with protein-rich meals and fibre

• Support healthy fats (like olive oil, nuts, seeds, oily fish)

• Avoid long gaps between meals

• Reduce ultra-processed foods and added sugars

Key nutrients & supplements

• Myo-inositol: Backed by research to support ovulation in PCOS

• Vitamin D: Often low in women with PCOS, check and supplement if needed. learn more about the 10 signs of low vitamin D in this blog.

• Magnesium and omega-3s: Support insulin sensitivity and hormone regulation

Gentle movement

Regular movement (like walking, resistance training, or yoga) improves insulin sensitivity and can help restore ovulation over time.

When to Seek Extra Support

It’s a good idea to speak with a health professional if:

• You’ve gone more than 6 months without ovulating or having a period

• You’re trying to conceive and want to know your next steps

• You want help choosing the right testing (such as progesterone or an ultrasound)

Final Thoughts: Yes, You Can Ovulate with PCOS

Even if your cycles are unpredictable or missing, ovulation is possible with the right support. By tracking your body’s signals and making targeted nutrition and lifestyle shifts, you can build a clearer picture of your cycle, and take steps toward better hormone balance and fertility. Learn more about how the DUTCH cycle mapping test can help give more clarity on what your hormones are doing throughout the monthly cycle.

If you’re starting to think about pregnancy with PCOS, you may also want to read my guide on planning for pregnancy with PCOS.

Need help figuring out your next step? Book a free PCOS strategy call and I’ll help you work out what support you might need.

I offer 1:1 online consultations and structured support for women with PCOS who want a clear plan for ovulation, weight, energy and hormone balance.

Book a free 30-minute PCOS Strategy call to see how we can work together. I work with women online locally in Manchester and across the UK.

Disclaimer: This blog is for general education and is not a substitute for individual medical advice. Always speak to your GP before starting any new treatment or supplement. Updated June 2025.