Hormonal Birth Control and Clitoral Shrinkage (Episode 472)

Full Transcript: Episode 472

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 Training Workbook. I’m a certified fertility awareness educator and holistic reproductive health practitioner with over 20 years of experience teaching women to connect to their fifth vital sign through menstrual cycle charting, balancing hormone health, and optimizing the menstrual cycle without hormones.

I have been consistently outspoken about hormonal birth control over the past two decades 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 teach women’s health professionals how to utilize the menstrual cycle as a vital sign in their practices, and 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 and a brand new baby girl. 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 me today.

A brand new FAMM research episode — in today’s episode I’m going over a pretty controversial study that looks at how the pill affects the clitoris and the vaginal structures essentially. So what is the effect of hormonal contraceptives on the volume of the clitoris as well as on sexual function? And I would say the study is fairly controversial. It’s had a smaller sample size, and I know I’ve had some feedback on that. This is a study that I quoted in The Fifth Vital Sign, and we’ll get into some of those little nitpicky things and why I still think the study is relevant regardless of some of those critiques. So without further ado, let’s go ahead and jump right in.

All right, so the study itself has a really long name. So if you’re wanting to take a peek at it or take a peek at the abstract, you can go to the show notes page, which I’ll share at fertilityfriday.com/472. But for now I’ll just call it the clitoral shrinkage study. It’s got a really long name, but basically we’ll refer to it as the clitoral shrinkage study. This study was published in 2013 or 2014.

And essentially what they did is they took 40 women — and these women were not using hormonal contraceptives at the time. They were using condoms. And they had their criteria to make sure they were healthy and they met the requirements to participate in the study. But essentially what they did with these 40 women is before they gave them anything, they took them in for screening. And so they screened them and they actually did a detailed screen of their clitoral anatomy and vascularization, and then they administered a sexual questionnaire which assessed their desire and orgasm frequency and sex frequency and things like that. So they were essentially trying to get different markers of sexual function. They were looking at physical markers. They also did hormone testing, so they were also looking at the testosterone levels and a variety of other hormones to identify their hormones. And so it was an interesting look into sexuality of the participants.

And so after they did this pre-screening situation, they then put them on contraceptives and they divided them into two groups. One group was given an oral contraceptive, which is a combined synthetic estrogen-progestin containing drug — so they gave them Yasmin. And then the second group received the ring, so the vaginal ring, which is also a combined estrogen-progestin combination. But the one group got Yasmin and then the other group got the NuvaRing. And so they had these women use these drugs for six months, and then they did the testing again to see what happened.

So after the six-month period they did the same things — they measured the clitoral anatomy, vascularization, and then they looked at the hormones. And so what we’re going to talk about is what they found.

So for those of you who’ve read The Fifth Vital Sign and remember some of the data that I shared in chapter seven, which is the pill chapter, you may have remembered a brief mention of the study because there’s a stat in there that I would say is one of the scariest stats in the book. I feel like there’s two specific stats that I share in the book that really freak women out about contraceptives. And the first one is the clitoral shrinkage aspect.

So what the researchers found was that all of the women who had used these contraceptives over the six-month period had a reduction in the clitoral volume — meaning the clitoris shrunk. And the average reduction was about 20 percent. When I looked at the numbers, it’s somewhere between about 22 to 23 percent reduction overall on average. So literally the clitoris shrunk over that period of time.

And the second stat, which is not related to this study — that I would say is the second stat that’s really scary when women are kind of diving into the weeds — that I shared in my book is the stat about ovarian shrinkage. And so women who are on contraceptives do see a reduction of their ovarian volume, meaning the ovaries shrink by about 50 percent. And so those are the two scary stats.

And I think whenever I talk about these stats I get a lot of interesting reactions. So one of the reactions that I get from sharing this information — again, I didn’t make it up, I’m reading what the studies show, right? It’s not like I’m coming up with this stuff. So I find it interesting that people get upset with me. But one of the pieces of pushback I get, I suppose, is the kind of fear around talking about this stuff. Because if you talk about some of the harmful things associated with the pill, then of course people are going to say, well, you’re going to dissuade women from using the pill, you’re going to get all these women to not want to use the pill.

And I find that to be the most interesting argument. So you’re afraid that if I tell these women what the research actually found — how the pill affects the body in these different ways — you’re afraid that that’s going to make women not want to use it? And so your solution is just to not tell them? That doesn’t make sense to me.

And of course the other reaction I often get is fear — because I mean, I’ve used the pill, many women have used it, 100 million women worldwide, something like 80 percent of us will use it at least at some point or another. So most of us have used it. So I think the natural question is, well, what does this mean? Is this permanent? And so I haven’t seen any research indicate that these types of effects are permanent — that there’s a permanent shrinkage that just never recovers. These results that we’re seeing are often related to hormonal changes.

And it’s really helpful to know how the pill operates in the body. So when you think about why is this happening — go back to the clitoral shrinkage study. One of the results that they also found, which is consistent across all women — so I think one of the things to be clear on is that when we use the word “side effect,” it gives the impression that only some women experience side effects.

And when we’re talking about the pill, not every woman experiences the same experience. And so when we think about side effects, you can think, okay, well, the common side effects on the pill are depression, low libido, change of sexual function. Some women experience anxiety or panic attacks. But not everybody experiences that. Not everybody experiences these specific markers. But there are certain effects that the pill has on every woman who takes it.

And so — and that’s why we can use it as a birth control method. So the mode of action for the combined contraceptive pills — the pills that contain the combination of synthetic estrogen and progesterone — the mode of action primarily is to suppress ovulation. And then how does it do that? How does it suppress ovulation? So it interferes with the conversation that is supposed to be happening between the hypothalamus, pituitary, and ovaries — essentially the HPO axis. And when it does that, when it shuts down the conversation between the hypothalamus, pituitary, and ovaries, it shuts down ovarian function — or significantly impairs it. And as a result, we produce less of our natural hormones. And that is why we can’t get pregnant on it. That’s why it works as a birth control method. So when it shuts down ovarian function, we stop ovulating, we make significantly less of our natural hormones — estrogen, progesterone, and testosterone.

And so this is one of the reasons why we see some of these changes. And the pill is known to reduce testosterone production and availability in all of the women who take it. And how it plays out between different women — now, that’s what we call side effects. So one woman may feel low libido, or painful sex, or be affected in different ways. But if you take all the women on the pill, all of them are going to have lower free testosterone. And so that’s something to keep in mind.

And in this study, it wasn’t some of the women had a reduction in clitoral volume and others didn’t. All of them did. The only question would be how much. So there was variability in terms of how much the volume of the clitoris decreased, and the average was about 20 percent or so, as I mentioned. But all of the women in the study experienced it.

So why? One of the other markers that they were looking at was SHBG — sex hormone-binding globulin. And the way I always explain SHBG is if you were to picture some iron filings on the table and you pictured a magnet — SHBG is the magnet, and it draws these free hormones to it and it keeps those hormones bound, so unavailable in the bloodstream. And so when you have a really high SHBG level — like too high — then it really does draw a lot of the free hormones out of the bloodstream. And so in this case, we’re paying attention to testosterone.

And so one of the things that is known about the contraceptive pill or whatever formulation — in this case the ring as well — but the hormonal contraceptive family is that it increases the SHBG. And one of the reasons logically that this could happen is the body is reacting to this influx of artificial hormone. When you’re taking the pill, your blood levels of these artificial man-made estrogens and progestins — that are not the same as our natural hormones — our blood levels of these artificial hormones increase because it’s a hormonal contraceptive. And so this is one of the ways that the body is reacting and responding to this influx of artificial hormone — by raising the SHBG level, potentially to try to get it under control. I mean, if you think about it, it kind of makes sense from that perspective.

So what they found in this particular study was that the SHBG levels in the participants increased by about 300 percent overall. And so what this means is we have the magnet and the iron filings taking the free testosterone off of the market in the bloodstream.

And so what we’re seeing in the study when they’re measuring the size of the clitoris specifically — like the vascularization, the volume, all of these different things related to the physical body — is the result of what happens when we take such a significant amount of testosterone out of circulation.

And when you look at the — there’s tons of research on the effect of contraceptives on libido and on testosterone. And so this is just one study that I chose because of course it’s a really interesting stat to look at. But when you look at the kind of variety of research around this specific topic, it’s common, it’s known — this is a well-known, established fact that the pill reduces testosterone, free testosterone, in women who use it — and other contraceptives.

And so when we take that free testosterone and we bind it to the SHBG, which has now increased by 300 percent right across the board, it means all of the women who take contraceptives have a reduction in their testosterone. And so what we call side effects then is how a woman would experience that. So if we do a blood draw, every single person — I really am hammering it — but every single person who’s on contraceptives is going to have a significantly reduced testosterone. Anywhere from 50 or more percent less free testosterone compared to someone who’s not on the pill.

So then, back to this clitoral shrinkage phenomenon — that is one of the key reasons why these women experienced a reduction in the size and volume and vascularization of their clitoris. And when you look at other studies that are looking at similar findings, they’ll show that women on contraceptives tend to have thinning of the vulvar tissues as well. So when they measure the thickness of the different vulvar tissues and the vaginal opening, the labia, the different areas of the vulva — they’re finding a reduction in the thickness of these tissues. And in this case, a reduction of the volume and vascularization of the clitoris.

So this is really important. And if you think about it, if there was a contraceptive method that we were aware of that shrunk the penis by 20 percent, I feel like people would be really, really concerned about that.

But this — I think this study is important for so many reasons. One of the reasons it’s important is because they also measured qualitative data, which we’ll get into a little bit — so women’s experiences of their sexuality and things. So we’ll get to that. But I think what’s interesting is that a big part of the study was measuring physical changes in the actual body.

And if any of you who are listening have ever experienced symptoms related to contraceptives and libido — let’s say you had low libido, or you had low sex drive, or maybe reduced sensation, you found it difficult to reach orgasm — because they do talk about those specific results in the study — this study shows that the pill has a measurable, tangible, physical effect on our sexual organs. It shows it.

And if the clitoris is shrinking and if the vulvar tissues are thinning, then it stands to reason that that could affect our experience. It could affect our sexual sensation, enjoyment, orgasm — it could affect these things. And ultimately we don’t necessarily know how much unless they really do go and study it, and that might be a challenging thing to study. But what I like and what I found interesting about the study is that you can’t really argue this. Their clitorises shrunk.

And so if you’ve ever had that situation of going to a doctor and you’re kind of expressing, “This is affecting me in one way or another,” and they’re kind of like, “Well, maybe you’re just stressed out,” and they’re just completely disregarding how you feel — I feel like this study gives that credence of, no, this is a real thing. They found this.

So in addition to the specific physical aspects that changed, the researchers also found that many of the women in the study reported a reduced orgasm frequency. So they tested them before they were put on the contraceptives and then they tested them six months after they used them for that duration of time. And there was a noted reduction in libido, reduction in the frequency of intercourse, as well as the orgasm frequency. Other studies have reported that women talk about having a reduced sensation. And another thing that was reported was increased pain with intercourse.

So what does the study tell us? What are the conclusions we can draw from this? I mean, there’s so many things. But I think it’s clear that one of the big takeaways is that we have evidence that hormonal contraceptives interfere with our sexual function in a tangible way. It’s not in our head. So that’s something.

One of the things I always think about when I bring up this topic is how many women go on contraceptives when they’re teenagers — so when they are 13, 14, 15, 16 — before they have potentially a whole lot of experience with their sexual selves. When they’re still kids and they haven’t fully discovered who they are or what they like or what kind of person they are. I feel like I didn’t know myself as well when I was 14, 15 — I was still kind of figuring it out, I was still developing and changing, and I didn’t really get a handle on who I was until several years later.

And so one of the things I always think about when we’re talking about this — how the pill can affect a person’s sexuality and their drive and their libido — I think about some of the conversations I’ve had with women over the years, whether they be clients or whether they’re Fertility Friday series episodes on the podcast. But women who will say things like, “Well, I just thought I wasn’t that sexual of a person. I just thought I didn’t like sex that much. Or I just didn’t have a sex drive.” And then they come off the pill and discover this whole sex drive that they didn’t even know they had — and this part of themselves that was being essentially suppressed by these hormone-suppressing drugs.

And we have this evidence that it can have a negative effect on our sexual function, sexuality — it’s not necessarily something that we’re telling teenagers about. To this day — how many teenagers are on the pill right now? How many women under the age of 20 are on the pill right now? How many of them know that the pill could have a negative effect on their sexual function? How many know that there was a study that showed that all the women who used these types of medications for six months had a reduction in their clitoral volume of an average of 20 to 23 percent? It’s just not a thing. And even to this day, we’re not really talking about it.

So this is something where I think we can all reflect — because there’s an issue around female sexuality. There’s programs — I can think of programs that teach women about orgasm and about enjoying sex and taking it — and all of this stuff is happening to meet the need of so many women who are having a difficult time enjoying their sexuality, or reaching orgasm, or finding that connection to their pleasure, however you want to word it. And there’s this elephant in the room that I don’t necessarily hear being discussed in those kinds of situations.

So there’s all these podcasts and interviews about sexuality, there’s a whole other line of discussion and debate about this topic of kind of coming into your sexuality and all that. And I always wonder — well, where is the conversation about the pill and the fact that this is what it can do to a person? And so you could be thinking that you have this deep emotional issue and you have to connect with your inner whatever, and really you could be having a negative side effect from a contraceptive. Because it reduced your testosterone by 50 to 70 percent while you were on it, and had these negative effects of thinning the vaginal tissues, the vulvar tissues, and lowering your libido and all that kind of stuff. And so you could be searching for answers when the problem is something that no one ever mentioned.

I’ve listened to a variety of different experts talk about this issue of painful sex and low libido, and it’s always talked about in this mechanical fashion as if no one knows what could possibly cause it — and here we have this information. So I’m going to leave that piece of it, but that’s definitely something that the study tells us. And I hope that this is something you can take from it.

Because what I appreciate is — I’ve spent a good part of my adult life listening to the different challenges that women experience in different areas of their life, particularly related to reproduction — so related to their experiences of contraceptives, trying to avoid pregnancies, trying to conceive — all of these things. And it really relates to sexual activity in a big way. I’ve heard so many stories over the years. I’ve worked with so many women who experience painful sex and experience different challenges in this area. And what’s missing from that conversation — because I think we have a natural tendency to blame ourselves for everything — what’s missing from that conversation are pieces of data like this.

And the number of women who have complaints like this who go to a physician — I always say, if you had a concern that is so significant that you called the doctor, made an appointment, took a shower, put on your clothes, went out of your house, and went and sat in a doctor’s office — I always think to myself, this is a problem. Who does that? Who gets out of their house and goes and sits in a doctor’s office for nothing? So if you had an issue that was so significant to you that you went to a doctor’s office and sat down, only for them to tell you that it’s in your head or you have an emotional problem — when it could legitimately be a side effect of a drug that they prescribed to you — that’s something to consider.

And so this is why I like studies like this — because it takes us out of the realm of theoretical and brings it into the physicality. So I do appreciate the qualitative data that they shared about women’s kind of comments on their own sexuality and sexual experience. But I also appreciate how it brought it into — no, this is the size that it was before, and this is the size that it was after. And we can see that there’s a causative element here. We can see that this drug reduced the volume and vascularization of these tissues. And so that brings it into — no, this is not in your head. This is happening.

So there’s that piece of it. And of course, to reiterate, it definitely shows us that hormonal contraceptives change our hormonal profile and that there are effects beyond reproduction. So it does give us this kind of very specific thing that — no, it’s not just that it prevents us from conceiving and stops us from ovulating and that’s it. It’s not just in a silo. By shutting down our fifth vital sign, there are all of these other effects that happen because our vital sign — our reproductive cycle, our hormone cycle — is an integral part of us. And we can’t shut down such a significant part of us — if you are a reproductive-aged female, you can’t just shut that down and assume that everything is just going to be completely fine. So it does also show us that our reproduction is connected to so many different areas.

So if you’ll remember a couple of episodes ago, I shared the male contraceptive study. And so part of why I wanted to talk about this study today as well is because I thought it was an interesting follow-up to that male contraceptive study. Because remember, these men experienced mood changes, depression, and increased libido. And there were a couple of comments on Instagram when I shared about this post, and people were like, “Increased — don’t you mean decreased?” And so, interestingly, when we look at the data around what happens to women when they’re given hormonal contraceptives — decreased libido, impairment of their sexual function — is what we typically see. But for the men in the contraceptive study, there was a report of increased libido. And maybe that’s what happens when you give synthetic testosterone. There’s that.

But interestingly, there’s a decreased libido here — and whatever. But to kind of bring it to that study, obviously that study was shut down because there was a committee of individuals who felt that these side effects are too much and we need to step in and shut it down.

And what’s so interesting then is this study showed pretty significant results. I mean, I think that’s pretty noteworthy. If you were taking the medication and they wrote this on the package — like, “This medication could shrink your clitoris by 23 percent” — if that was listed there, like your clitoris could be four-fifths of what it once was — I feel like that would be alarming to people. And they would kind of take pause. I don’t know if that’s enough to shut it down and to take it off the market or anything — it’s obviously not. But I just find that to be interesting as well.

So I thought this was an interesting follow-up to the previous episode where we talked about how there was that safety committee for the male contraception — when we have some pretty interesting and I would say pretty significant results here. But basically it’s just like, “Oh, this is just what it does, and it’s perfectly fine if it interferes with women’s sexual function.” So that’s just something to ponder, and those are the questions that we just always continue to ask and don’t necessarily have answers to.

One last point that I want to highlight about this study is that there were several times when I shared the study in the past, a few years back, and someone would come out of the woodwork and criticize me for choosing a study that had a lower sample size, or a smaller sample size. And we can get into that conversation about what is a sufficient sample size and what is proper research — when you’re creating a study, what is a proper study design to encourage the most accurate results.

But here’s why I think we shouldn’t just ignore a study because it has a smaller sample size. So obviously, in a study with 40 women, you can’t draw broad conclusions about every possible thing from the one study. What’s interesting, however, is that the pill has been around for over 60 years. And so there are millions of studies on it. And when I talk about this study — for example, in The Fifth Vital Sign in the section where I’m talking about sexual side effects — I’m citing this alongside anywhere from 20 to 50 other studies that are looking at the variety of different effects on sexual function. So this study doesn’t exist by itself. It’s not that it’s the only study that ever found that there was a shrinkage of vulvar tissues in women and a reduction in libido and reduction in testosterone. So this is a well-established phenomenon. That’s something to keep in mind. If this was something that was just a kind of rare finding and it was never repeated, I could see potentially having that concern. But it is amongst a ton of research in this area that does show this very clear effect that the pill has on libido, sexual function, vulvar tissues, and so forth.

So there’s that — that’s the first part. The second part is that when a study shows such compelling results — to show that all of the women experienced this reduction in clitoral volume — my question is always, where is the follow-up? And this goes back — I think when we’re looking at research, we do have to take a step back and think about it in a broader context.

I love reading research. I find it very interesting. This is one of the reasons why I love writing and why I released the book — because I know that not everybody is comfortable necessarily reading all these complex papers, distilling and interpreting them, and writing them and including them in your writing in a way that is palatable. So that’s definitely a skill to have, and this is why we’re doing these research series episodes — because I know that a lot of you are really interested in what the research has to say, and this is an interesting way to kind of engage with some of this research.

But we have to look at it — research isn’t perfect. Research is done by people. And all of the people — myself included — we have our own bias. And so I am not coming at this subject completely objective. There’s no way. I’ve worked my whole career with women who’ve had issues with contraceptives, so I’m certainly coming at it from a certain perspective.

And when you’re reading a research paper, the researcher is coming from a certain perspective as well. And if you read enough research papers, you can start to see how the researcher’s perspective can affect how they interpret results. And this is something I’ve seen a lot.

There was an example of that that I shared in the same chapter in The Fifth Vital Sign where there was a study, and the study was designed to find out why women complain about contraceptives. And in fact, I’ll make a note of that and I’ll make a point of including it in this series at some point because that study is super interesting.

But a quick summary of it is that they were looking at — of all the questions you could ask about contraceptives — because this is something I think about too, because I have a certain perspective and there’s certain research that I would love to see done. And so the questions that I would be asking if I was a researcher and I could conduct a study may be different. And again, even the questions that are being asked that drive the studies that are being done — that comes back to the researcher’s bias as well.

So of all the questions that could be asked and all the research that could be done, there was a study that was looking at why women complain about contraceptives. And the purpose of the study was to find out why they complain. So the researchers found that 50 percent of the women in the study had issues with the contraceptives. They had side effects. They had complaints — they complained about libido, depression, anxiety, sexual side effects, all these complaints.

And when you see that kind of a study, maybe someone that’s coming from my perspective would look at that and say, okay, so 50 percent of women are complaining about the pill and coming off of it, trying to find a better version or trying to find a different alternative — then maybe there’s something wrong with it. Maybe if half of the people who are taking it have an issue, maybe there’s something wrong with it. And maybe if I was writing the paper, that would be my conclusion — like, wow, this is pretty significant. I mean, if you went to a restaurant and half of the people hated the food, wouldn’t you think there was something wrong with the food?

No — the researchers in that instance came to the conclusion that it’s difficult for doctors to properly advise patients about the side effects without also dissuading them from using it. And so they were literally talking about how difficult it is for doctors to convey — how hard it is for them to get these women on the pill because when they tell them about the side effects, some of them don’t want to take it. This is really difficult for the doctors, right?

So this is a great example of how the researcher and their bias and their perspective can literally change how they interpret the exact same results. They can come to a completely different conclusion with the same exact information because they’re looking at it in a different way.

And so when we’re looking at research, we always have to remember that there’s no such thing as perfect, unbiased research. They can do their best to design the studies well, but at the end of the day, it’s always human beings sharing about what they’re doing. And who funds research? Research isn’t free. Research isn’t something that everyone just — you can just get 2,000 people in a study and just make them do everything and whatever and have all the people do all the time. Research costs a lot of money. So who’s funding the research?

And so, to bring it back to the clitoral shrinkage study that we’re talking about today — when I see a study like this with a small sample size showing that all of the participants had this significant negative result from using these contraceptives for a six-month period, my question is, well, where’s the follow-up study? Why wasn’t that done? Where’s the study now with a thousand women or two thousand? But if the research is funded by the drug companies who benefit from the sale of these drugs, how is it going to benefit them to do a study with 2,000 women to confirm that all of them have a certain level of clitoral shrinkage — to really solidify it in the research forever, to have this giant study that shows this negative result? What would be the benefit for them?

And I personally think — well, maybe this is one of the reasons why we’re left with this interesting study, small sample size. We’re not really seeing the follow-up on that. If I find an interesting study that looks at this further, then I’ll include it in the series, or if you know of a study that did that, please share with me via socials.

But I think there’s always an opportunity to critically think about what’s going on in the research world and how it can change what is even being studied, what questions are being asked — and remember that the questions that are being asked are based on how we look at the world. Whatever question we’re asking, whatever we’re curious about is based on our own bias and our own way of looking at the world.

And then you could take that a step further. There’s plenty of researchers who do plenty of interesting research that is not accepted — because in order to be published in the research world, your research has to be approved and it has to go through a peer review process. So if the company that does the reviewing and the publishing — if they don’t think that what you’re doing is interesting or if it doesn’t match whatever their worldview or their perspective is — then there’s a potential that that study doesn’t get published.

And I’ve certainly been kind of around this small fertility awareness niche for long enough to know that plenty of researchers who do certain types of research on certain topics tend to have to kind of shop around to different publishers to get these types of research fully published in mainstream channels. And there are certain researchers who don’t really get that notoriety and either self-publish or whatever to get their work out there because they’re not picked up by these major publishers.

So anyways, just some things to ponder — because I found that argument to be really interesting about “let’s disregard the whole study because it’s not a big sample size.” And I say, well, I don’t think we should disregard the whole study because there’s plenty of studies that show similar results. And I think we should be asking the broader question of why isn’t there a follow-up to a study that has results like this.

So I think that is where I’m going to close today — where I’m going to conclude. I really enjoyed bringing this study to you, and I hope that you enjoyed hearing about it. Like I said, you can find details about the study over at fertilityfriday.com/472. That’s where you’ll find information about today’s episode and the link to the abstract for the study that we’re talking about today. And you can also head over to fertilityfriday.com/research — and that’s where you’ll find the list of the FAMM research episodes.

I’ve really loved doing this. I mean, I’ve always got my head in the books. Some of you may know that I’m currently working on my next writing project — finally getting to the point where I’m pretty much wrapping it up. So I’m really excited to bring some more news about that too in the future. But basically my head has been in the books for a long time. I’ve been doing a ton of research and writing as I work on my next book project, and so this series comes out of that kind of natural tendency of me to be reading really interesting research and just wanting to bring it to you and to have these discussions.

So I hope you’re enjoying the series. I hope you enjoyed today’s episode. And if you found it interesting or you can think of someone who you think would really benefit from hearing it, please make sure to share it — again, fertilityfriday.com/472. And I hope you have a wonderful week, weekend — whenever you’re tuning into the show. And of course, as always, be well and happy charting!