Cervical Mucus, Fertility Awareness & Managing Your Fertile Window (Episode 367)

Full Transcript: Episode 367

Lisa: 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. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health.

Today I’m sharing a brand new episode in my Fertility Awareness Reality series. I’m sharing my interview with Brittany, a member of my recent Fertility Awareness Mastery Live group coaching program, and we are talking about her experience transitioning to fertility awareness as her primary birth control method. These episodes are some of my favorite because they give you some insight into what it’s really like when you’re trying to learn fertility awareness. What are some of the real challenges that women are actually facing? And also, especially if you’re new to the podcast or if fertility awareness is a new concept for you, it also hopefully gives you some confidence to know that you’re not alone, even though it might feel like it in your current circle. There are plenty of women who are doing this. It is possible to learn. It’s possible to do and to use well. And certainly, if you have cycle challenges, it is possible to heal and repair your periods and your cycles. So with that in mind, let’s go ahead and jump into today’s episode.

Lisa: I’m excited to be here today with Brittany. Brittany was a member of my most recent Fertility Awareness Mastery Live program. And we’re actually recording this about a month after the program. So this is a great opportunity for us to check in to see how everything’s going. Welcome to the show, Brittany.

Brittany: Hi, how are you doing?

Lisa: I’m doing good. It’s always a little weird because it’s like a private conversation — just you and me — but it’s like a private public conversation as well for the couple thousand of our closest friends. I would love to start just by giving you an opportunity to share a little bit about your birth control history with the audience. Let us know how old you were when you had your first period and kind of how that all went, and if you’ve ever used birth control before, and kind of how you’ve managed your fertility up to this point.

Brittany: Well, I started my period when I was 14 — a little bit later. I was a freshman in high school and all my other girlfriends were like, “Oh my gosh, you haven’t started yet. You’re so lucky.” It was actually New Year’s Day. I don’t ever remember having very many problems. The only times I ever had any sort of pain associated with my period was when I would go to church camps and there would be a whole bunch of other girls. For some reason I would get cramps on those trips, but otherwise I don’t remember having cramps or anything like that. I actually have never been on hormonal birth control. I got married when I was 21 years old and obviously we wanted to have some sort of contraceptive, but for moral reasons I really wanted to avoid hormonal birth control. Hormonal birth control — one of the things it does is it weakens the lining of the uterus, the endometrium. If by chance the ovulation suppression doesn’t occur, then that would be what we call abortifacient. And so the baby would be there but then it wouldn’t be able to implant. I felt like that was a moral problem for me. So anything that makes it to where a fetus can’t implant is problematic in terms of birth control. My husband has been really helpful and supportive in terms of that aspect of it, but he did want us to have something. And so we’ve done mostly barrier methods. Actually, around the time I was getting married, I had a friend recommend Tony Weschler’s book, Taking Charge of Your Fertility. I read it and I was like, “This is great.” But the book, while it was helpful in explaining things, wasn’t helpful in really getting down to brass tacks about what things actually look like. And that’s kind of why I started looking into your client class.

Lisa: Thanks for taking us through that. I think it is important to recognize all the different reasons why women choose the different birth control methods that they do. There are a lot of women who are concerned about the possibility that their birth control method could actually be preventing implantation in the event that they do have a fertilized egg. So I think it’s important to recognize those things. That’s why I always say there’s no one method of birth control for all women and for all couples, because there are so many differences between us in all kinds of areas. For some, they may not consider that, or it’s not necessarily an issue for them. But for others, that could also come into play — for example, with the IUD, the copper IUD could potentially allow for the fertilization of the egg but just interfere with implantation. And I also wanted to touch on what you mentioned about the degree to which your partner participates in fertility charting being highly variable. I wouldn’t want anyone to think that if their partner is not participating, that makes them a weird couple. It doesn’t.

Brittany: And there are sometimes when I really wish that I could get some involvement, because when it comes to being intimate — especially with using barrier methods — all of that falls on me. It would be nice to get a divided 50/50 sort of thing. But at least we still have ways that we can be intimate when we have these moral restrictions but also don’t want to be having babies all the time.

Lisa: Yeah, and it is a challenging situation. This is one of the general critiques about birth control as a concept, because for men, the options are condoms, withdrawal, or vasectomy. It is obviously not 50/50 for a lot of people, although it is for some. And the other thing you mentioned — when I was going trying to learn about different birth control methods, I did have a nurse practitioner tell me that none of the birth control methods prevented implantation. Like that wasn’t what they did. And so it was really hard to hear that and then go do the research for myself and be like, my physician kind of gave me inaccurate information. There was no desire for education. It was just like, don’t worry about that.

Lisa: Well, first of all, I’m sorry to hear that. Ultimately, when you’re asking questions about what I would term the mode of action of a birth control method, our personal beliefs and politics shouldn’t get involved — it’s biology. So we should be able to talk about the biology. The quick review of the mode of action of most hormonal contraceptives: the primary mode of action is to prevent ovulation. However, the secondary modes of action — there are two. One is to block the cervix with a thick mucus plug under the influence of the artificial hormones. And the other is to thin the uterine lining and make it not receptive to a fertilized egg. So the abortifacient possibility is not the primary, but it is one of the ways that it works to prevent pregnancy. Particularly the progesterone-only pill formations do not always prevent ovulation — a good percentage of women actually keep ovulating when they’re using progestin-only methods like the progestin-only IUD. For the progestin-only methods, it is kind of the primary mode of action to actually make the uterine lining not receptive to a fertilized egg. I believe in informed consent. So if we provide the information, then as a client, you get to take that information and decide what’s going to work for you and your partner.

Lisa: Unfortunately, the opinions of your practitioner are going to determine what information they’ll provide. Some practitioners may provide information about fertility awareness-based methods, while many if not most wouldn’t, or would very likely downplay their potential effectiveness. It’s not because the method itself isn’t effective — it’s more so because they’re not educated about it. So let’s jump into the session part of our session. Let me know where you’re at with everything and what your top questions are today.

Brittany: The first thing that I would tell anyone who’s thinking about taking your class is the differentiation in the types of cervical mucus. I read Toni Weschler’s book and I knew that you were supposed to sort of track cervical mucus. But I maybe just assumed it was like quantity — like the more you had, the closer you were to ovulation. Now that I’ve taken your class I am well aware that it is not that simple. If you look at the chart that I sent you for my most recent cycle that I started on the 24th of March — I have a few days of red flow and then my first day where I didn’t have a period, I had what looked like peak mucus. And there’s just so much of the really stretchy sort of stuff that I feel like a freak of nature sometimes. I know different women have different bodies and different normals, but just going straight from period to the stuff that hangs from you while you’re using the bathroom — sorry, TMI.

Lisa: You’re on the TMI podcast, FYI. But yes — this is something we talked about. One of the patterns that Brittany is seeing is a longer mucus phase. If I look at a couple of charts, you had mucus for about nine days leading up to ovulation, kind of in and out. We talked about some of the reasons why that might be — a few different strategies in terms of supporting cervical health. And I think one of the biggest challenges we identified during our work together was stress management, sleep patterns, and I think I told you to eat breakfast or something. We were looking at some of those basic lifestyle factors. In terms of charting, this makes it challenging because it means you have fewer days available for unprotected sex in the post-ovulatory phase. In terms of how to manage this — I would say first and foremost, when we’re talking about managing the fertile window in the pre-ovulatory phase, the first thing I try to do is reset the expectation of what this really looks like. If your cycles are averaging about 29 days and ovulation is happening somewhere between days 14 and 18, you really don’t have a week or two of infertile days before your window. At most, if your cycles are averaging around 29 days, the first six to seven days — depending on your mucus patterns — would be the only window where there could be unprotected sex. And if your period is five days long, that’s five of the first seven days. So it’s kind of disappointing for some women when they’re discovering fertility awareness.

Brittany: I was actually surprised when I started charting that my cycles have been 27 to 28 days. Before I had my children they would be all over the place — down to 24, up to 35. There were a couple of times where I thought I was pregnant because my cycle had been six weeks long. But after I had my first child, my son, they did sort of even out. Pregnancy can sort of help to level some of the hormones sometimes. I was pretty surprised to see that they’re actually following the length that everyone says they should, because I was not expecting that at all.

Lisa: That’s certainly a good thing, because it means the cycles are falling into a normal range — a good sign that you have normal ovulatory function. And what I like about fertility awareness — and your class really helped me see this — is that it’s all about data collection, analyzing data. It’s not about predicting. You can go back and say, “I’ve ovulated on day 13 or day 15 for the past six cycles,” but that doesn’t mean that this cycle you’re going to ovulate on day 15. It’s not about predicting what’s coming. It’s about knowing when things are out of the ordinary.

Lisa: In terms of practical management, we started in January together, and we’re recording this at the beginning of April. I’m acknowledging the frustration because obviously you haven’t been able to utilize many of your pre-ovulatory days. Because if you see stretchy mucus or any cervical fluid in those early days, you do have to consider those days fertile. So in your case, at least for the moment, for many of these cycles there just aren’t very many days in the pre-ovulatory phase. This also applies to my PCOS clients — I’ve had a number of clients who either have lots of days of a little bit of peak mucus, or multiple patches of it. So then sometimes you have 20 days where you’re seeing all this mucus in the pre-ovulatory phase because ovulation would be delayed for a lot of women with uncontrolled PCOS. In terms of pregnancy prevention, the strategy here — we talked about the six-day rule, meaning at least for right now, from day seven forward, I would consider that fertile for the pre-ovulatory phase, and then once you’ve identified your patterns of ovulation, you can start moving forward. There are also symptothermal-specific strategies — the six-day rule and the doering rule — to manage the pre-ovulatory phase by identifying the last pre-ovulatory infertile day.

Brittany: The other thing I noticed on my most recent chart — I have a couple of days right after my period that are listed as 10C, and then the last four days were 10K. And they actually are pretty different. The way that they look — the 10K that I wrote down was never stretchy to the point where it was hanging down. It was stretchy on the toilet paper, clear and not cloudy. I’m wondering if there’s a way to identify: okay, this type of mucus occurs outside my ovulatory window, under these conditions — maybe I’m not eating the right sort of things or I’m not getting enough sleep?

Lisa: So some women do notice, outside of their fertile window, a basic pattern of mucus — we call that the basic infertile pattern. Most of the time that’s dry, but in some women they’ll have mucus in that way. From what I have here, you did have primarily in the pre-ovulatory phase days of mucus — some days it was white in color and stretchy, other days it was clear in color and stretchy. I don’t have enough information yet to identify if you’re continuing to see that similar kind of mucus pattern in the post-ovulatory phase as well. I’ve certainly seen women who have the lotiony mucus all the time — they have it before they go into their fertile window and then after they ovulate, they continue to have it in the post-ovulatory phase. In cases like that, if there is a pattern that we can identify where you’re showing a consistent mucus pattern that’s different from what you see in the fertile window, we would denote those with yellow stamps — we call it yellow stamp management. In your case, I would say we would need at least one or two more charts to gather that information. But you are already starting to notice a difference there, which is encouraging.

Brittany: I was thinking — it would be really nice to just have an app that you pull up every time you go to the bathroom, and it has literally a picture of every different type of mucus, and you just pick all the ones that apply. Just for data collection.

Lisa: I’m sure someone is working on that right now. One of the differences with the system I teach is that we’re looking at the color, how much it stretches, and the quality — whether it’s gummy versus stretchy versus pasty. So it’s a little bit different in that respect because you can at least classify it. The concerning types are if you’re seeing yellow or gummy, where it’s actually kind of forming into a ball or like gum, where it’s hard to stretch. With that said, when we had our sessions together, I think the main concern I had was about the stress management and how you were sleeping. From what I remember, you just had a really taxing schedule. One of the challenges was that often you’d be going to bed after 11 o’clock, maybe midnight, and then waking up at like five.

Brittany: I still am not sure how my body is just like, okay, we’ll get along. I hear so many people say that if they have less than seven hours of sleep they just can’t function, and I’m like — I sometimes don’t feel like I have options. I have gotten a little better. I’ve gotten to where I’m just like, look, right now I am going to take a nap because I’m really tired. And in terms of eating as well, I’m trying not to feel guilty taking time off of what I feel like I’m supposed to be doing to eat food. And I know when you say it out loud like that it makes so much sense, but it’s just this mindset of taking care of other people and making sure that you’re not letting people down.

Lisa: I can relate. I don’t have this perfect life either. Certainly going to bed early is one of the things I’ve struggled with. But one of the things we talked about in class is that you’re having this challenge with the mucus patterns. And ultimately, certainly if you’re seeing mucus patterns that are concerning — like if the mucus is yellow or gummy — absolutely go to your doctor, get a swab, have them do a culture. It’s just general maintenance. We should all get those general checkups done if we have any concerns. But before we jump to conclusions, I want to encourage you to reflect on those things. It is not sustainable to have five hours of sleep a night. You can keep it up for a little while. You’re a bit younger than me — I’m turning 39 this year — and what I can tell you is by the time you reach my age, there’s a lot less give. This is actually a blessing that you’re charting at this stage because it’s going to help you to start to see the limits of your body. Charting helps you to see how far you can push yourself. Because once you kind of get into a good groove and your cycles start to fall into healthy patterns, you might notice that if you have a super stressful month or if you fall off with the sleeping or the eating, you see a change.

Brittany: I have some liver in my freezer.

Lisa: That’s amazing! There’s the hidden liver strategy — if you make all the meals, you can pate it. Make a wonderful pate, put it in an ice cube tray, and then if you’re making soup or anything with ground meat, add liver. One of the things you mentioned was that since the class stopped about a month ago, you found it a bit challenging to stay consistent with charting, specifically in the post-ovulatory phase. Did you want to talk about that?

Brittany: There’s something about the post-ovulatory phase — the hormones and everything — it’s just a little bit harder, a little bit more like slogging through cement rather than running on a track. It’s not that I wasn’t paying attention in the moment; it’s just that it was too much work to write it down. I think part of it was that I rearranged the furniture and literally the book got closed, and I was not able to just pick up a pencil and write it. When you’re on this knife-edge of having so much to do, finding the spot in the book and writing down the last three days’ temperatures is just overwhelming.

Lisa: I just want to say that what you’re experiencing is really common. Most people who are actively charting have experienced a couple of days slipping by. First and foremost, when you’re using this for birth control, know what to do when in doubt or when you miss an observation. If you’re in the pre-ovulatory phase and you miss an observation, you need to consider yourself fertile. A comment I wanted to make about the pre versus post-ovulatory: the pre-ovulatory phase is the only part of the cycle where pregnancy can happen. Pregnancy can’t happen in the post-ovulatory phase, period, once you’ve confirmed ovulation and done your cross-check. Like — can’t happen. Impossible. We could talk about why — there’s no egg. But the pre-ovulatory phase, yes — that’s the only part where it can happen. So it makes sense that many women who chart are much more concerned during that time. I’ve seen it many many times where we’re totally on top of charting, all the notations are there, and then once ovulation happens and you’ve confirmed it with the temperature and the mucus, you kind of go “meh.” That’s not an uncommon thing. Technically speaking, whether you have a dry day or it’s shiny after you’ve confirmed ovulation is not relevant for the purposes of birth control. That’s more fifth vital sign tracking.

Brittany: Last month I stopped charting on day 14 and it doesn’t look like I had recorded a really solid thermal shift yet, so I might not have ovulated until day 20, which means I would have had a shorter luteal phase, and that could indicate some sort of health problem that I missed.

Lisa: I really wouldn’t take it that far in this particular chart because since you didn’t chart, you don’t know — so you can’t just assume you have a health problem. That’s the point — without collecting that data, we don’t know. The value of collecting the data is really what it is. So if you are having that difficulty, you could take advantage of the pre-ovulatory motivation and even have a conversation with your partner like, “I’m going to tell you when I’ve confirmed ovulation” — give yourself that motivation to at least get to the point of confirmation. A couple other things: think about what could work for you to make this process easier. Is there somewhere you could put the book? Can you put it in the bathroom? Can you put it beside the bed, always open to the page with your pencil? Would it be more useful for you to use an app? I’ve been recommending the Read Your Body app. All of my clients are different — some really love having the book, some really like having the app. Also, is there a mental note you could put in your mind — “before bed I’m going to do this” or “when I brush my teeth I’m going to do this?” Attach it to another habit that you’re already doing. And it’s not about being perfect — have a plan ahead to forgive yourself if you miss a day. Because what can happen is we miss a day, we beat ourselves up, and then we end up missing a week and a month. Instead of making it into a bigger deal, just start tomorrow and make it less of a deal. And if temperature taking is a really big deal, you could consider investing in something like the TempDrop, so that at least you’re getting the temperature collection and all you are responsible for is noting your mucus.

Brittany: If you don’t mind, I would like to ask one question — I’ve heard of some people who actually take their temperature vaginally. I’ve thought about that because when I’m barely waking up and I poke the thermometer in my mouth and try to hold it there for 10 minutes, sometimes I’ll kind of fall back asleep and my mouth will open and then it doesn’t actually get the warming effect. And you can kind of see that on the chart — those days that it was down at the very bottom of the 97s. So I was having some mouth-open sleeping while I was taking my temperature. I was just wondering — is vaginal temping literally just as simple as using the thermometer vaginally?

Lisa: Yes, it is. There are three top ways to take the temperature: orally, vaginally, or underarm. The only difference is that vaginally, the temperature may be slightly warmer because it’s internal compared to oral. And then the axillary — under the arm — could be slightly cooler. So if you change mid-chart, you may just want to make a note to say “checking vaginally now.” There are definitely benefits from vaginal checking. Some women, especially if they’re having issues like you described with keeping their mouth closed, find vaginal temping more consistent. You literally just put it in there, put your legs together, and wait 10 minutes.

Brittany: I might try that. Because one of the things I was having a problem with at the beginning was really low temperatures — down in the 96 to 97 range instead of 97 to 98. I bet taking my temperature vaginally would help even that out more.

Lisa: Definitely. Well, as we bring our session to a close, I just want to thank you so much for coming on the show and sharing your experience. I love doing these episodes, and I know that my clients really love them too. It’s a passion of mine to continue to give this space to share our experiences as women — our experiences with birth control, our experiences adjusting to fertility awareness — because that conversation doesn’t happen in a lot of places. For the listener who’s considering fertility awareness or even considering jumping in and taking the FAM Live class — what if anything would you want her to know?

Brittany: Just that it really is helpful. I absolutely love knowing how my body works, because that’s not something that you learn in school or from your doctor. It’s really nice knowing what’s happening in my body right now, what hormones are going on. And I was trying to quote-unquote chart for a decade before I took your class, and I wasn’t getting the value of the information from the cervical mucus because I didn’t know how to chart the cervical mucus. So I would say if you have the resources and the time and the patience to really learn how to chart, it really is valuable. And it’s not just for women whose bodies are, you know, messed up from the fake hormones — because like I said, I’ve never taken hormonal birth control. But there’s still a lot of other sources of hormonal disruption, like stress. It changes things. And being able to track that is really important.

Lisa: Absolutely. Thank you so much for being on the show. 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/367. I hope you have a wonderful week — and as always, until next time, be well and happy charting.