Understanding Your Anovulatory Cycle (Episode 307)

Full Transcript: Episode 307

Lisa Hendrickson-Jack: Welcome to the Fertility Friday Podcast, your source for information about the Fertility Awareness Method and all things fertility. I’m your host, Lisa Hendrickson-Jack. I’m the author of The Fifth Vital Sign and the Fertility Awareness Mastery charting journal. I’m a certified fertility awareness educator and holistic reproductive health practitioner with nearly 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormonal health, and optimizing the menstrual cycle without hormones. I’m outspoken about hormonal birth control and its impact on fertility and overall health because you have the right to know how your body works and how artificial hormones disrupt that natural process. I host live coaching programs to help you achieve optimal fertility and health because it’s important to have healthy menstrual cycles regardless of whether or not you want to have babies. I’m also a wife and mother of two beautiful boys. I know, I know, I’m a busy girl, but I managed to fit it all in. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health, and I’m so excited that you’re here with us today.

Today I’m sharing a new episode in my Fertility Awareness Reality Series with my client, Korrin, and we really jumped into what turned out to be a really interesting cycle. So when I’m doing group sessions, one of the great opportunities that it presents is for everybody to see just a range of different cycles, a range of different situations, and in our group we had a couple of different interesting situations come up with regards to cycle irregularities. So as this episode is coming out it’s very timely, because if you’re listening to this episode in real time we’re in the midst of a really strange period of time where a lot of us are under a lot of stress because there’s a lot of uncertainty, and so many of you who are tracking your cycles may or may not notice some changes or some differences. So in today’s episode we talk about Korrin’s experience with what appears to be an anovulatory cycle, something that she hadn’t experienced before. Members of the group were saying to her, thanks for having this really complicated cycle for all of us to learn from — it’s kind of like a joke, because obviously you can’t control that, but it really does give a great opportunity to gain some insights. So without further ado, let’s jump into today’s call with Korrin.

And I’m really excited to be here today with Korrin. She is a member of my current Fertility Awareness Mastery group program, and we’re about three quarters of the way done. We’ve been seeing each other weekly for quite a while now, and so I’m excited to be here with you. Thank you for being on the show.

Korrin: Yeah, thanks for having me.

Lisa Hendrickson-Jack: Well, we were chatting in the pre-chat — we probably could have continued chatting there — but I’d love to jump in and give you an opportunity to share a little bit about your experience. So, when your period started, what that was like, how you’ve managed your fertility throughout the years, and basically what brought you to wanting to learn fertility awareness at this stage.

Korrin: Yeah, gosh, I feel like it’s a lot to summarize, I guess. I think I started at about 12 years old. I come from a family of — I have two sisters, one older and one younger. My older sister went through it first, so I sort of knew what to expect, and it wasn’t anything that was super celebratory in my family, but it also wasn’t shunned — it was just kind of a normal thing. As a teenager I would say that I was pretty promiscuous. In middle school I went to an all-girls Catholic school for two or three years, and then in high school I transitioned to a normal public high school, so I was super excited as a freshman, a little boy crazy. Pretty soon after I was sexually active, my best friend’s mom at the time — she was like a huge proponent of birth control, a baby boomer, a child of the sixties, all about making sure women had access to birth control — said if I didn’t feel comfortable talking to my mom about it, she was happy to take me to Planned Parenthood and make things happen. So I took her up on that, and I went to Planned Parenthood with her and got on the standard birth control pill. I followed up with Planned Parenthood for the majority of my birth control needs through high school, so I was on the pill for probably a year or two, and then I learned of the Depo-Provera shot. I transitioned to that and got the shot every few months for probably about two years. During that time I really didn’t consider a lot of the side effects that could be going along with the pill or any of the birth control I was on, especially the Depo. Looking back, I noticed the most changes in my body and my mood probably when I was on that. It wasn’t impacting my quality of life in any major way — I definitely gained weight during that period, but I wasn’t ever super uncomfortable with my body. It was just kind of like, this is a normal part of growing up in high school. I switched to the NuvaRing at the beginning of college and used that for two to three years until the end of college. Then at that point I was like, I don’t really want to do this anymore. I don’t know if it was just intuition, or if I’d heard some of the horror stories of women not being able to regulate their hormones naturally or conceive soon after stopping the pill. At that time I was also working with a naturopathic doctor pretty consistently, and I really wanted to regulate my hormones and see what my body was like without any prescriptions or birth control — just see what my baseline was. So I stopped using the NuvaRing. I had a really consistent boyfriend, and he’s now my husband, and I went off birth control probably about six months before I got married. Right after coming off, my skin was crazy — I’d always struggled with acne during middle and high school, and my skin just went berserk. So I was going through my graduate program with terrible skin, trying to regulate my hormones off birth control while preparing to get married. It was a crazy time in my life, and I dealt with that for about a year or two. Then about a year after I got married, I got pregnant. During that time I felt like my cycles were consistent and happened usually about 30 days apart, but I just knew there was something off in terms of my hormones, and I was working with a naturopathic doctor still, doing some hormone testing — the kind where you spit into little vials and they test your hormones. I actually had that hormone testing done the month I got pregnant with my daughter. After that, it didn’t really matter anymore, and since then I’ve just been building my family. I’ve got a couple of kids now, and things kind of regulated pretty naturally after pregnancy.

Lisa Hendrickson-Jack: Well, just a couple of questions — do you remember about your age when you first went on birth control? I have it down as 14.

Korrin: Yeah, I think it was 14, maybe 15.

Lisa Hendrickson-Jack: And by then you had cycled already for a couple of years. So you have kids, I have kids — looking back now, imagine that you are your mom. I totally get the empowerment of every woman having access to birth control, but how do you feel about that idea of going around your mom to give you medication that actually has a black box warning?

Korrin: Yeah, I definitely have mixed feelings about it. I’ve thought about this so much — my daughter is seven, and there will come a point where we have that discussion. I’m sure my mom knew; it wasn’t information that was hidden from her, it was just a situation I didn’t feel comfortable going to her about, but I’m sure she knew, and at some point I was able to have conversations with her about it. I’m still having the conversations with my husband about how we’re going to handle that as parents with our own child. I’d love to say she’s going to be really interested in learning about fertility awareness and excited to track her symptoms, but at the same time, thinking back to when I was a teenager, I just didn’t have that kind of relationship with my mom, so I probably would have rolled my eyes and said no way. So it’s such a hard one.

Lisa Hendrickson-Jack: And I mean, anyone listening who is a parent, or an auntie, or has friends with kids — they come out with their own personalities and their own thoughts, they’re their own humans, so you can have whatever ideas you want, but it doesn’t mean it’s going to fly when your daughter or son is at that age. I don’t have an answer to the question, and by asking it I’m not trying to say there is a correct answer. As a parent, it gives me some degree of stress, the thought that it’s considered okay to go around you as long as nobody gets a serious side effect — but if my daughter ends up in the hospital because she’s got a pulmonary embolism, are you going to supervise her recovery? Because I’m pretty sure as the parent that’s my job. So that’s why I’m asking, because we think of the pill like Tic Tacs, but they are not Tic Tacs.

Korrin: Yeah, we do certainly think of it that way. It’s such an individualized situation — every family is going to be different, every child is going to be different, parents have different beliefs about the pill. I hope when we get to that point we’ll have a much more open communication style with her, encouraging her to bring us issues so we can talk about how to handle different situations, but I just know how I was as a teenager, so I’m not overly optimistic. At the same time, it would be great if we could have a conversation that there are other options out there than just the pill, and maybe she won’t be sexually active until later in life and it won’t be a conversation we have super early. There’s really no way to predict the future.

Lisa Hendrickson-Jack: Well, it’ll be interesting as the years go by, because my kids are about the same age as yours — my oldest son is seven and my youngest is four, so I have two boys, who are going to learn all about this too. It’s not like boys don’t get to learn about it — it’s all going to be part of the conversation, so they’ll have a different experience. I can’t tell them what choices to make, but they’ll have the information whether they like it or not. But let’s shift back — so you’ve had a couple of kids, share with us how you’ve been managing your fertility and what drew you toward fertility awareness.

Korrin: So in between pregnancies I tried the Paragard IUD. I had kind of a rough first pregnancy and really wanted time to focus on nursing, and I’d finished my graduate program and started my internship in dietetics, so I needed some time afterward and didn’t want to worry about birth control. I had heard about the fertility awareness method and read Taking Charge of Your Fertility, I think during my first pregnancy, but it never felt solid enough for rules, for birth control or fertility planning. So in between pregnancies I tried the Paragard IUD and took it out before trying to get pregnant with my son — it took six or seven months, which I think in hindsight was really a timing issue since I’ve learned more about fertility awareness since then. After he was born I got another Paragard, and that’s what I’ve been using. I really wanted to learn more about a concrete method with very specific rules, where it seems like you’re either fertile or not — that’s been the most enlightening thing about taking the course and reading your book. There’s a pretty clear “if this happens, you’re fertile, and you’re not fertile at all outside of that,” so it’s been nice to have a more black-and-white set of rules.

Lisa Hendrickson-Jack: Well, and you already know what I’m about to say — you can’t be a little bit fertile. Either you’re fertile or not, because either you’re pregnant or you’re not; you can’t be a little bit pregnant. I did want to ask, since you got your first Paragard right after your first child — did the insertion hurt, or was it okay?

Korrin: Yeah, I got it very soon after natural childbirth, so I guess it’s all within the context of having just had a baby without medication. I got it through my midwife, and I don’t believe she used any numbing medication — it was just, okay, we’re going to use the speculum and place the IUD. It wasn’t comfortable by any means; looking back, it was intense cramping for a day or two and then it calmed down. It didn’t impact my ability to take care of my family or my baby, so it was manageable, but again, that’s within the context of natural childbirth 12 weeks prior — the concept of pain is a little different, I suppose.

Lisa Hendrickson-Jack: Yeah, and the cervix is different too, right? After you’ve had a baby, your cervix will always be slightly dilated — that’s just how it will be. You can still feel the changes in cervical position throughout your cycle, but there’ll always be that tiny bit of dilation, and that’s fine. But that also means getting an IUD placed after you’ve had a baby, or after any procedure that required your cervix opening, would potentially be less painful.

Korrin: Yeah, I remember my best friend got an IUD about five years before I did, and she hadn’t had any children — she said it was one of the most painful things she’d been through. So I was kind of prepared for the worst-case scenario. When I got mine, I was like, okay, this feels like period cramping, no big deal, but it wasn’t comfortable.

Lisa Hendrickson-Jack: Well, thank you for sharing that. I feel like it’s a public service announcement, especially after all the IUD stories I’ve heard on this podcast — anybody who’s planning to get an IUD placed or removed has the right to ask for numbing medication, and if the doctor refuses to provide it, find a doctor who will, because there’s no reason to have this seriously painful experience for something that should be fairly straightforward.

Korrin: Yeah, and that’s what my second experience was like getting an IUD after my son was born — I’d been following up with an OB because he was breech and I had a cesarean section. So since I was already using an OB for that care, after he was born I went in with her to have an IUD placed, and she had it all set up and used numbing medication. It was a much different experience — it took a longer period of time, but it was more comfortable, not as much cramping, and not as much discomfort afterward.

Lisa Hendrickson-Jack: That’s interesting, because what I’ve gathered so far is that the only real difference is the doctor you happen to get. So instead of leaving it up to chance, now you know — you have the right to ask for numbing medication, and if the doctor gaslights, ignores, or minimizes your request, find someone who’s willing to do that. I just can’t deal with the amount of women who’ve experienced excruciating pain getting an IUD placed, which is completely avoidable with simple numbing medication.

All right, well, let’s jump into the session part of our call. I’m going to share my screen so we can look at your charts. In our last hot seat, about a week ago, you had an interesting chart to report because you had what appeared to be an anovulatory cycle. Let me know what you want to focus on today.

Korrin: Yeah, last cycle was just so different, having had an anovulatory cycle — I’m expecting sort of a regular cycle again this month rather than last month. I think one of the things that’s been most variable is just cervical mucus, and I know how much you love to talk about cervical mucus, but from month to month there’s a pretty wide variation in my experience of the sensation. I’m still trying to figure out cervical position, so that one’s a little more challenging. Sometimes there’s a lot of cervical mucus, and other cycles there’s not so much — maybe that was because it was an anovulatory cycle last time, so that’s why I didn’t experience as much.

Lisa Hendrickson-Jack: Okay, so this was the chart from January into February that appeared anovulatory. For listeners who can’t see your chart, it appeared anovulatory because although there was a little bit of mucus, it wasn’t a lot, and the temperature went up for a couple of days but then went back down, staying in the pre-ovulatory range for the remainder of the chart. That’s classic for an anovulatory cycle — typically you see temperature patterns that either stay in the pre-ovulatory range or become erratic, but either way there’s no discernible shift. Your cervix also remained in a low position the whole time, so there were just no signs of ovulation, whereas in your previous cycles it’s quite clear when you ovulate — you get a temperature shift. So this was very different from the previous ones.

Korrin: Yeah, and I had travel right in the middle too.

Lisa Hendrickson-Jack: Right, and the timing of that travel lined up right around when ovulation looked like it could have taken place, so that also made sense in the context of what we were seeing on the chart. Now we’re into the February–March chart.

Korrin: One of the things that was interesting was talking about what you’ve noted from other women you’ve worked with about their actual menstruation after an anovulatory cycle — you mentioned it tends to last a little longer, and that was definitely my experience this month. I was actually bleeding for seven days, which isn’t typical for me — usually more like five — and you also mentioned to keep an eye out for mucus earlier rather than later, that there might not be any pre-ovulatory dry days, and that seemed to be the case as well.

Lisa Hendrickson-Jack: One of the things we talked about in general with anovulatory bleeding was why it’s happening. So for some women — in your case, you have a history of robust ovulatory cycles — I was on the hunt looking through the research literature and consulting with colleagues, because I’ve heard different explanations as to why it happens. For anyone listening who doesn’t know what we’re talking about, an anovulatory cycle appears to be a menstrual cycle — it starts with your period and typically lasts about as long, or longer, than a regular cycle, but you don’t have signs of ovulation. You didn’t actually ovulate, but you do have a bleed. Some women experience the bleed as lighter and shorter than their typical menstruation, and other women experience it as a fairly normal or even heavier bleed. Either way, you’re getting this bleed around the time you’d expect your actual period, but it’s not a true period since you didn’t ovulate. One of the reasons behind it, when you look at the literature, is that in a cycle like that you’re experiencing the ongoing effects of estrogen — you may have a follicle developing, or several — and this estrogen causes the uterine lining to thicken and develop as it should, but because ovulation is delayed or isn’t happening, the lining can build up to the point that something has to give, and the bleeding releases as a result of that excess uterine lining. So it makes sense that some women may experience the bleeding as quite heavy, like a regular period, or in your case even longer than typical.

Korrin: Yeah, it’s definitely a bit longer, and it just seemed to not go away toward the end — it was a little more than typical for me.

Lisa Hendrickson-Jack: Well, this is why it’s important to chart with the understanding that charting isn’t about expecting your cycles to repeat — it’s about observing, not controlling, and understanding that each cycle is new. You don’t always know in advance what’s going to happen. Not all women who travel end up having an anovulatory cycle — this isn’t something we could have necessarily predicted, but travel, stress, and a variety of situations can cause changes. Some women see ovulation delayed, or if they’ve already ovulated, their luteal phase might be a bit shorter. In your case, the travel coincided right around when your body looked like it was gearing toward ovulation, so it does seem ovulation was delayed, and based on that excess-estrogen theory, your body eventually had to release the built-up lining and start again. One of the trends I’ve seen in anovulatory cycles is that after the bleeding, women often move quickly into their next ovulation — it doesn’t always happen that way, since we can’t predict it, but you want to stay on top of checking for mucus and be prepared for the unknown, since every day is potentially fertile until proven otherwise in a situation like this.

Korrin: That’s a good reminder, especially what you alluded to before — one of the things that made me feel more confident is recognizing that with this method, it’s either fertile or not; we draw that line in the sand.

Lisa Hendrickson-Jack: One of the other things I mentioned last time was that even though we started a new chart, technically we’re on day 14 of this chart, but your previous chart was 36 days, so 36 plus 14 is 50 — another way to look at it is that we’re actually on day 50, because there was no ovulation. There’s no right or wrong way to think about it, no one’s grading your chart, but it’s helpful to keep in mind that it’s really just one long cycle, because technically the cycle doesn’t end until you’ve truly ovulated and had your true menstrual period.

Korrin: Yeah, it’s just fascinating to think that the body goes through that sort of fake menstrual cycle.

Lisa Hendrickson-Jack: The way I’ve witnessed it, it always appears to be a bit of a reset, and I’ve also seen it happen in women who typically have ovulatory cycles, who have that strong, established hypothalamus-pituitary-ovarian axis connection — so this isn’t a situation where there’s an endocrine issue; it’s literally a situation where something delayed ovulation and your body is just resetting itself. Some women have 50-day cycles with no bleeding in between at all, where their body is trying to gear up to ovulation and it’s just not happening — but that’s typically related to a different type of condition. So the question becomes why some women have an occasional random anovulatory cycle while others go much longer without a period at all — something to think about. But did you have — I know one of your main focuses for joining the class was to feel more confident using the method for birth control. We went over the rules, the cross-check rules, mucus versus temperature versus cervical position — was there anything related to that, or completely unrelated, that you wanted to go into today?

Korrin: I don’t think so — I think it’s just going to be a continual learning process for me, honestly. I’m giving myself a lot of time, and I think that’s a good reminder, to go into each day just observing what my body is trying to tell me. That’s the thing that really spoke to me the most from your book and throughout the course — that our bodies are really trying to communicate things to us all the time, and it’s our job to listen and observe. Charting has given me that extra motivation to actually record what my body is communicating, so I think it’s going to be this continual learning process, without expectations of what my body is going to do — some cycles might have more mucus, others less, some might be anovulatory, and I’m still working on cervical position. One other question that came to mind — my husband has been thinking about getting a vasectomy for a long time, for his own comfort level, and I’m curious to hear if there are any experiences you’ve heard about with side effects from that procedure.

Lisa Hendrickson-Jack: With any procedure at all, there are side effects. Vasectomies aren’t my area of specialization, so off the top of my head I can’t say specifically, but I have an episode coming — I interviewed someone recently, though it was more on the topic of varicocele than vasectomy specifically, though I believe she did also have a vasectomy discussion. There are specific side effects associated with vasectomy, and I have a few more sessions coming up, so I’ll look into the research — I found a researcher in Toronto who has published a lot on vasectomy and some of its specific challenges. For any procedure, any time you’re going under the knife, it’s a good idea to do your research and look into the side effects, even if the percentage chance is small, just so you have that information going in. I did release an episode about how both partners should take responsibility for their part in reproduction, so there’s something to be said for a partner stepping in to take care of that aspect. From my perspective it’s a bit different, because I’ve personally used fertility awareness for my whole life, so in my relationship there was never really a need for that — but since you’re at the beginning of your journey with fertility awareness and haven’t yet started using it actively for birth control, neither you nor your partner may be fully comfortable with it yet. There’s no right or wrong answer here, but it’s important to go into any procedure informed, even if the risks are small, and make the call that makes the most sense for the two of you. I’ll follow up with some of the additional research I found.

Korrin: Yeah, no, I appreciate that. It’s funny — going through the course and hearing the statistics about withdrawal was really interesting, because I think my husband used that as a birth control method when he was younger, and it’s just so controversial to think of that as a method — teenagers everywhere are told it’s not effective, and it’s not something I’d really rely on unless fertility awareness is part of the picture too, so both partners are doing their due diligence.

Lisa Hendrickson-Jack: I want to acknowledge, you’re not alone — I’ve shared many times, a little tongue-in-cheek, that when we get into the class, some women will say, wait, are you telling me there’s a time in the cycle where he can actually ejaculate inside of me and I won’t get pregnant? Even after reading Taking Charge of Your Fertility and possibly my book, and listening to a hundred podcast episodes, they’re still surprised. It’s really hard to fully de-program what you’ve been taught by reading alone — the only way to de-program it is by learning the method, taking the time to chart so you understand everything theoretically, and then actually having unprotected sex and seeing your period come, cycle after cycle. That’s really the only evidence that helps you move past the fear — there’s a difference between understanding something intellectually and actually knowing it. All women who learn fertility awareness have to go through that scary process — it’s like walking into fire, terrified you’re going to get burned, until you get to the other side and realize this is real. So many of my clients freak out the first time, convinced something went wrong, and then their period comes and they’re like, oh my gosh, this actually worked. So part of my job is helping with that de-programming. The other part of why I talk about withdrawal isn’t because I’m promoting it, but because it’s the reality of life — in my work I talk about how couples manage the fertile window, and there is a percentage of couples who use withdrawal, and when you look at the research, it’s up to 96% effective when used perfectly. It does beg the question why there isn’t more research on it, but who’s going to fund research for a free birth control method available to everybody? When I talk to teenagers, I talk about condoms, because condoms protect against both pregnancy and STIs, so I feel condoms are more appropriate there, but when it comes to adults in established relationships, withdrawal combined with fertility awareness is one of the options.

But as we bring our conversation to a close today, I just want to thank you so much for being here and sharing your experience — I’m looking forward to following up with you in our group program. For the woman who’s thinking about jumping into the program, or thinking about transitioning to fertility awareness, what would you want to say to her?

Korrin: I think it really gives women the ability to feel competent and confident about what their body is telling them and how to respond appropriately. I love the concept of using the menstrual cycle as a vital sign, because it gives us so much information about where our bodies are at and what they’re doing in response to how we’re taking care of ourselves. The course really helped me build the competency I was looking for, and I’ve learned so much — thank you for sharing this information and making it accessible to women.

Lisa Hendrickson-Jack: Well, thank you so much for being here, Korrin — I love doing these episodes, and I know my clients love them too, so I’m always happy to provide that space for you to share your story.

Korrin: Thank you.

Lisa Hendrickson-Jack: Thank you for listening. If you enjoyed today’s show, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/307. I hope you enjoyed today’s interview with Korrin — I love having the chance to chat with my clients and share these sessions with you, to give you a window into what it’s like to transition to fertility awareness, and to give you the courage to know that women are really doing this. It’s not something new or fringe. One of the comments I heard from both groups this time was, “none of my friends do this” — that feeling of being a bit of a weirdo, of knowing there had to be a better way but not knowing anyone personally who was actively charting. Being part of a group is so helpful because you’re surrounded by other women doing the same thing, and it really normalizes it. For me, I discovered charting in college surrounded by women who were doing it, so it was totally normal — some using it to avoid pregnancy successfully, others to get pregnant when they were ready. That normalization really helps you get over the fear of transitioning from hormonal birth control to fertility awareness, even at a zero on the intention scale, when you’re surrounded by women with lots of successful charting experience. That’s a big part of why I continue this series — I want to help normalize the fact that it’s completely possible to avoid pregnancy without hormones. This option is valid and available, and more and more women are wanting the full experience of understanding their bodies and the connection between their cycles and their overall health. So thank you for tuning in today, for spending time with us, for sharing these episodes with your friends, and for helping spread the word about fertility awareness. Until next time, be well and happy charting.