Overcoming Infertility After 13 Years on the Pill (Episode 523)

Full Transcript: Episode 523

Lisa: Today’s interview is powerful. I’m sharing my conversation with Clarissa Briones, who is a current member of our FAMM Fertility Awareness Mastery Mentorship Program. She shares her experience with subfertility after coming off the pill. Her story is something that I’ve heard time and time again, and there are so many important nuggets out of her story — so many important opportunities to kind of reverse engineer and learn about some of the strategies that would be more optimal for women to think about when they’re approaching their use of the pill, especially as it gets closer and closer to their childbearing years.

This is something I’ve spoken about in The Fifth Vital Sign. This is something that Lily and I spoke extensively about in Real Food for Fertility — this whole concept of how we should be looking at our relationship with the pill, especially as we get older and as we start planning for our families.

Today’s episode is, I would say, a must listen. And if you know anybody in a similar situation — any friends who’ve been on the pill for quite some time and you know they plan to conceive in the future — I feel like this episode is something that would be extremely helpful for anyone in that situation who’s never really considered what would happen if you came off the pill and you didn’t get pregnant right away.

I’m excited to be here today with Clarissa Briones. Thank you so much for being here.

Clarissa: Thank you for having me. It’s really an honor to be on this podcast. It really feels like a full circle moment because I am such a huge fan. I listen to your podcast all the time.

Lisa: Amazing. I love doing these episodes with our FAMM practitioners. At the time that we’re recording this, I still can’t believe that we’re kind of two months out because it feels like we started just yesterday, but you have made it a lot of the way through the program. Congratulations — it’s a huge accomplishment, even making it this far. I’m really excited to have you on the show. I feel like a good place to start, so the listeners can get to know you a little bit — maybe share with us a little bit about what you do and also how fertility awareness came on the scene for you. How you discovered charting and what inspired you to jump into the program and make this more of your main focus.

Clarissa: Great question. I’ll start by sharing a little bit more about what I do now. I am a certified fertility health coach and I aim to help women get pregnant naturally. I do that through a holistic approach that really works through their mind, body, and soul. I do believe that fertility is more than just physical — I feel like there’s a magical element, maybe a spiritual element, that we don’t always talk through as often. And I found this work through my own personal fertility journey.

When I started trying, I started trying — quote-unquote, later in life — but I was 30 at the time. I had been focused up until that point on my career. I had already graduated college, I had a stable career, we bought a house. I just wanted to make sure that all my ducks were in a row, checking off those boxes. And I never anticipated that I would have challenges getting pregnant. I always knew I wanted to be a mom, and for me it just felt like something that was so certain, so sure, that I never thought to question it.

I was really healthy — or so I thought. I didn’t realize at the time how stressed I was, or how much underlying inflammation I was having, and probably nutrient deficiencies too. But at the time I thought I was really healthy. I worked out a lot. I looked like I was healthy from the outside looking in. When we started trying, we tried for a few months just on our own — nothing happened. And naively I thought, okay, you just really have to have sex all the time in order to get pregnant. So we were having sex all the time, not knowing that there were actual certain days that I should have been timing it accurately. It ended up being a three-year journey. But for probably a year and a half, we were absolutely not timing it accurately, knowing what I know now.

About a year in, it started to take a really big toll on me — emotionally and mentally. I was really depressed. I felt like I was just triggered by everything. I couldn’t understand why I wasn’t getting pregnant. I felt like I hit rock bottom in my life. I felt like such a different version of myself. And I wanted to get back to how I used to feel. I started to explore some of the mindset pieces and just tried to work through that component and make myself really feel better on the journey.

This was around the time when I hadn’t discovered charting yet, but I had discovered your podcast and also your book. I read your book and that was a life-changing moment for me. Because up until that point I had been on birth control before we started trying. I was on it for 13 years, and for no reason other than just to avoid pregnancy. I had no idea the effects that it was having on me. I had no idea how detrimental it could be. I felt like I just made this decision without a lot of information. Reading your book gave me a whole lot of insight, introduced me to the world of charting, and from there I was just hooked. I remember telling my mom, my friends, everybody about the book — like, have you read this? Because every woman needs to read this book.

This fertility journey ended up being a gift for me because it not only allowed me to discover cycle charting, which really empowered me as a woman to understand my body and to understand how it worked and to take back the reins — because up until that point in my fertility journey I felt like I had no control. I felt like everything was out of my control. And I am a type-A, high-achieving woman. To have something not go my way, no matter how hard I worked at it, was really just shocking to me.

The charting piece helped me identify that I had low progesterone. I actually had a hypothyroid concern too. I had very little cervical mucus as well. On paper, even though I thought I was really healthy, once I started to dig into my chart and then get some subsequent hormone testing, I was able to identify some barriers that were preventing me from getting pregnant.

Discovering all of this just really excited me and fueled a passion for the fertility industry, because I thought, why didn’t I know this? Why didn’t anybody ever teach me this in school, or even friends or family — this was never information that was passed down to me from generation to generation. I just felt really compelled to be part of this mission and spread this awareness and this knowledge to other women. That’s when I decided to become a fertility coach. I hadn’t gotten pregnant yet, but I thought, it’s okay, I’m learning a lot, and I want to share this with other women. I know it’s going to work. And sure enough, it did.

It was really cool — the chart I had when I got pregnant, up until that point I had only ever had a 10, maybe 9, at most an 11-day luteal phase. And when I was tracking my cycle that time around, I was at day 13, then day 14, then day 15. By then I was like, I’m pregnant, I just know it, I feel it in my bones. And I knew we had timed sex accurately at that point, I was tracking my cycle, and I felt really confident. It ended up being day 21 when I finally took a test. I’m like, okay, I guess I should take a test to confirm. But I didn’t even need that test — I just knew it. I knew it in my body. I knew it based on my chart that I was pregnant. That was a really cool feeling, to not even have to rely on testing to find out. I was working with another fertility awareness practitioner, Nora, who’s been in your world. She was helping me dive deeper into my chart and understand it. But yeah, this has just given me a lot.

Lisa: Knowing what you know now — you had taken birth control for 13 years, which is really common. I’ve seen a lot of clients who’ve been on birth control for 10 years or more. And just like you said, it’s something that we go on at a young age, and at the time we don’t have a lot of information about it. We’re never taught about our fertility, so we never have a reason to think about reevaluating whether it’s still the best thing to do. If there was something that you could tell your 28-year-old self, what would it have been?

Clarissa: I’ll actually take it back to age 28 — that was a pivotal moment. That was when I had gotten engaged, and I remember going to my annual appointment with my OB-GYN and asking her specifically: should I get off birth control now? Because I just had this inkling — if I’m going to start trying soon, maybe I should give my body some time to wean off of it and just see what happens. And I remember asking her that question and she told me, oh no, unless you want to get pregnant tomorrow, make sure that you do not get off birth control. Because the second that you do, you’re for sure going to get pregnant. So if you’re not ready now, you might as well just stay on until you’re actually ready. And I thought, okay, that’s fine. I trusted her. I trusted her expertise, her knowledge. After all, she’s a doctor — what do I know compared to her? But it was just this little voice in the back of my head. And looking back, that was the first time that I kind of ignored that intuition.

Knowing what I know now, I absolutely would have told myself at the time to trust my intuition and to get off of the pill and just see what was happening. Even beyond that, if I had known at the time I started taking birth control that there were natural options, I for sure would have gone this route. I tend to be a more natural-oriented person. But thinking back — I didn’t even think to question it. There was no information presented to me other than, here, take this every day, unless you want to get pregnant don’t skip a pill. It was all about avoidance. I was just scared at the time of getting pregnant.

Now, thinking back, I absolutely would have gone this route. I would have loved to track my cycle. I’m a data junkie, so all of this gets my wheels going. It would have been a really cool piece to implement into my routine. Now I have a daughter — she’s a year and a half — and I cannot wait to pass this information on to her, to give her this knowledge, to help her feel empowered, and to help her make an informed decision. If she chooses to get on birth control and that feels right for her, that’s fine. But at least she’ll have all of the information.

Lisa: I actually had chills when you answered that, because this is an example that I give a lot. I can still remember having a consult with a woman who had just come off the pill and was frantic. And the reason that she was so frantic is because of all the things you said — we’re all taught that we can get pregnant all the time. We go on the pill and while we’re on it, we’re still terrified that we can get pregnant at any time. And because we’re always terrified, the thought of coming off the pill is terrifying. This is something I always say: it’s not the pill that alleviates the terror, we’re still terrified — we’re just on the pill and terrified.

And this is where the concept of the intention scale comes in. If you ask yourself on a scale of 0 to 10 how much you want a baby today — the crazy thing is you could be at a zero or one in the sense of, we’re waiting until we get married, and then the day you get married you are a 10. Your mind can switch in an instant, but your body, if you were on the pill, it takes 9 to 12 cycles for everything to normalize. Realistically, what I’ve observed is that it does take about a year or so before the cycle seems to go back to being really robust and consistent. And if you factor in the nutrient depletion piece and all the different nutrients that are depleted on birth control, it does take a bit of time for that to come online.

When you said that two years before you went to your doctor — this is literally still happening. Your little voice was strong enough that you called the doctor, you made an appointment, you got up that morning, you drove across town. And then your doctor was like, no. I just want to highlight that because we all have that intuition. The older that we get, the more we know that when we ignore it, things don’t go the way we want.

Clarissa: It is logical to think, well, I haven’t seen what my actual period looks like in 13 years — I wonder what it looks like. Although while you’re on the pill and you have that withdrawal bleed, you think, oh, everything’s perfect. I have this predictable period. It comes exactly according to the calendar. I could predict it to the day, to the minute. And I really thought I was having a period. But once I started charting — there were definitely some gut issues and things that I can now look back on and think, oh, I did have that while I was on it. I was really fine being on it, it worked for me. But it’s interesting that you don’t think to question it until you are actually struggling to get pregnant. And I never thought it was because of the pill. I just thought, something must be wrong with me. But there was really nothing wrong with me. Even though I thought there was, it was just my body getting back into balance. And knowing what I know, I would definitely never get back on it.

I remember about day six after I had my baby, my midwife asked, are you ready to get on birth control? And I told her I’m using fertility awareness. I said it so proudly — oh no, I’m not getting on that pill again. I know when I’m fertile, I’m going to start tracking my cycle. And she kind of looked at me like I was crazy. She was just like, okay, are you sure? Because you know you definitely don’t want to get pregnant too soon right after giving birth. And I’m like, no, I’m good. I got this. I’m fully confident I know when I’m fertile and when I’m not. It just felt so against the grain, and I don’t understand why it is or why this is not more common. But it’s just something that I will always use going forward. I have no need to get back on any type of birth control. I am a FAM person for life.

Lisa: Tell us about your experience in the program. Tell us how old your daughter was when you started, some of your concerns before you joined, and then how you managed — because this is a huge question for so many people.

Clarissa: I was really worried about it at first, just because I’m a new mom. When did we start — October? At that point my little girl was only nine months old. I was nervous about that because being a mom is very time-consuming. I work full-time right now, but I work from home. I was worried about, am I going to be able to commit to this with the time commitment? But it has worked out. I think when you find a way to make it work, and you’re passionate about something, when you enjoy the subject, when you want to show up on the calls, when you want to do things, it makes it that much easier to prioritize it. And you and Amy just really pulled me back in — like, no, it’s okay, we’ve got you, let’s do this together. You’ve been nothing but supportive.

Now with her at almost a year and a half, it’s totally doable. Whether you are pregnant, whether you have a little one, whether you have multiple little ones at home — even on the calls there are other moms, other women who are trying to get pregnant — it’s just such a great variety and diverse group of women. We can all learn from each other, we can all support each other, and it’s just really an encouraging place to be.

Lisa: When you started the program, you were not cycling because you were postpartum. Maybe share what your experience has been — and even if you want to dive into your experience now that your cycle has come back.

Clarissa: I was obsessed with charting when I was in my fertility journey, and then once I got pregnant I didn’t have a cycle, I stopped, and I kind of got out of that rhythm. When my cycle didn’t return once I had my baby, I again just wasn’t really charting because I didn’t know what to chart. But you helped me to understand that essentially while I’m pregnant I’m in this extended luteal phase, when I give birth it’s almost like the period phase, and now I was in this extended follicular phase up until the point that I ovulated. Once you said that to me it just clicked — of course, that’s what’s going on. And that prompted me to get back into charting. I started to chart my mucus before I got my temperature or my cycle back.

Once my cycle did return, I was able to start seeing a really different shift. It was interesting — my temperatures were lower than they typically were. And my cervical mucus was just insane. The amount of cervical mucus I have now postpartum is crazy compared to where I was pre-fertility, because like I mentioned, I really didn’t have a whole lot before. Even being able to talk through those changes and not experiencing this before, thinking, maybe this isn’t normal, is something wrong? — it was really great to be able to just talk through that and get back into the rhythm and routine of charting. I also started seeing the effects that breastfeeding has on things, because I am still breastfeeding my daughter full-time, and we were doing co-sleeping too, so she was literally on me all the time. I know that’s partly why I didn’t get my cycle back — it ended up being about a year and two months before I got my cycle back.

It’s a lot of different learnings — looking at things from the fertility angle and now looking at things postpartum and just trying to understand what those differences are.

Lisa: Within the mentorship program, we do encourage all of our practitioners to chart regardless of where they are. And I have always firmly held the opinion that it is essential for somebody who is teaching other women to chart to have some level of experience with it themselves. I have always felt like the hot seat format — chart reviews for our practitioners in a group setting — speeds up the learning in ways that you just can’t otherwise, because it exposes you to so many different situations that you wouldn’t see in your own chart.

Clarissa: I wish I would have done the temperature charting before I got my cycle back because I was just doing the cervical mucus. I couldn’t figure out the routine with co-sleeping and the baby and waking up at different times and not getting enough sleep. But it would have been really cool to be able to predict and see that ovulation with the temp shift too. Next baby, I’m definitely going to do that. But for me right now, the temp drop has been really helping a lot. It’s not perfect, but as a postpartum mom that has made it a lot easier to incorporate into my routine. I’ve been using that for the past cycle and I just got my period recently, so I’m on cycle two postpartum. Having the experience of all the charts we see in the hot seats — between all of the other clients’ charts and our own — is really helpful and really insightful for sure.

Lisa: For somebody who is thinking about charting, on the verge, or has dipped their toe into it — what would you want her to know?

Clarissa: I would say, don’t stop. I think initially it was hard for me — I was trying to figure out how to do this temperature thing, sometimes I would forget to track, sometimes I would forget to wipe before I used the restroom, and you think, oh gosh, if I’m not doing it perfectly, what’s the point? It’s not about perfection, it’s about progress. Your awareness and knowledge will deepen the more you do it. If you’re just looking at things with one cycle, it doesn’t tell you the full story. You’ve got to keep going to see those patterns and trends, and the answers will reveal themselves the more that you keep going. If you’re feeling discouraged, if you’re feeling like this is hard, if things don’t make sense — that’s natural, that’s okay. You’re exactly where you’re meant to be. And then I would also say, enlist support. You don’t have to figure it out on your own.

Lisa: For somebody who is thinking about jumping into the practitioner program — what would you want someone to know?

Clarissa: I would say it is a thousand percent worth it. I would totally sign up again. It’s not even just a program — it’s a community. I really feel like I have support around me. If I have questions, if I need something, it’s not just about learning the material or gaining the knowledge, it’s about really just being supported and held by these other women and by you and Amy and the whole group. There’s the knowledge component, there’s the community component, and then there’s also just this deepening understanding of this really useful, helpful tool. And it’s going to help you feel more confident. As practitioners, we may do this ourselves, but until you actually start teaching these things to your clients and helping other people, that’s when the confidence comes. I feel like if somebody comes to me with a certain issue or concern, I have the resources, I have the community, I have people I can talk through it with. And I think that confidence is really just priceless when you think about joining a program like this.

Lisa: As we wrap up, I wanted to share three takeaways from this conversation — because it’s one I’ve had hundreds of times.

Takeaway number one: our intuition is really smart. Even without any formal scientific knowledge or background on reproductive hormones, most of the women that I’ve spoken to over the years have had this thought cross their mind — especially if you’ve been on the pill for a while and now you’re planning ahead for conception: I wonder if I should take a break. And it’s not just a fleeting thought. The thought is there and it’s talking to you. It’s interrupting your day. Because who makes a doctor’s appointment for no reason? Who wants to go to the doctor? Exactly — no one. This intuition is strong enough that many women go on to make a doctor’s appointment specifically to ask if they should come off birth control. We need to listen to our intuition.

Takeaway number two: why is it that so many of us are willing to just delegate our medical decisions to the doctor? Whatever it is that the doctor says, we just do it. Your intuition was irritating enough that you found yourself in the doctor’s office. You made an appointment, you got ready, you drove across town, you took a bath, you did your hair — all the things. And then your doctor said, no, you’re good. And then you just let your doctor make that decision for you. This is not anyone’s fault. This is how our society has positioned itself around the medical field. We have been trained from birth that the doctor is like a god figure and we need to do whatever they say. But this is a societal issue. When Clarissa’s doctor told her, oh yeah, you’ll for sure get pregnant, guaranteed — that was not based on scientific facts or research. That was based on her doctor’s opinion. And when Clarissa went back six months later, having been unable to conceive, the doctor said, oh well, infertility is pretty common. But that piece of information didn’t enter the discussion when she asked about coming off the pill early.

It’s hard. It’s not fair. But we need to be the ones taking responsibility for our health decisions. It doesn’t mean we ignore what our doctors say. But picture yourself at the head of a boardroom table — all of your healthcare providers are around it. You do need a doctor. You might have a fertility specialist, a nutritionist, a naturopathic doctor, a functional medicine doctor, an acupuncturist, a fertility coach, a fertility awareness instructor. All of these individuals are going to share their opinion based on their experience. But it should be up to you to make that final decision about what’s best for you.

Takeaway number three: we don’t need to ask permission in the first place. If you want to come off the pill, come off the pill. Why on earth would we feel like we have to ask our doctor’s permission to come off the pill? But again, this is no one’s fault — this is the society we live in. Of course it’s nerve-wracking to come off the pill because you’re told that’s the only option. Fertility awareness provides a non-hormonal option that, when you learn to use it to the highest efficacy — using the post-ovulatory double-check method and the pre-ovulatory double-check method, using two different markers on either end of the fertile window to verify when it starts and when it stops — that leads to a perfect-use efficacy of 99.4%. The bottom line is that you can do this. But most women have never even heard about fertility awareness. And unfortunately, this is an area that doctors are not educated in. Most doctors are trained in medical school that it’s just the rhythm method that doesn’t work and everybody who uses it is basically using nothing.

Here’s the thought I’ll leave you with: hormonal contraception was the first drug ever created to give to healthy people who had no health conditions whatsoever, to shut down a perfectly natural process in the body. I’m just going to go over that one more time. Hormonal contraceptives — the pill — were the first drug ever put on the market to give to healthy people, people who did not have a health issue, designed to shut down a perfectly healthy and normal process in the body.