Fertility Awareness Chart Interpretation for Practitioners (Episode 501)

Full Transcript: Episode 501

Lisa Hendrickson-Jack:

This is the Fertility Friday Podcast, episode number 501.

Today’s episode is all about chart interpretation. We’re going to go into what some of the most common mistakes are when you’re jumping into interpreting menstrual cycle charts, and some of the key strategies that help to make it a lot easier. So without further ado, let’s go ahead and jump right in.

It’s hard to believe that it is the end of 2023. This is the last episode of 2023. And I was thinking about how I want to finish out the year. And I thought, what better way than to talk about chart interpretation? This is a topic that has come up so much this year. It’s something that I’m always talking about with my FAMM practitioners. And we just created an incredible new resource for women’s health professionals — how to interpret virtually any chart your client throws at you. And so I thought this would be a great opportunity to dive into some of the tips and tricks and strategies that have helped me to increase my confidence and ability to interpret virtually any chart that my clients share with me. And so, you know, what better way to close out 2023 than to help you feel more confident about the way that you’re interpreting, whether it’s your own charts, or your clients’ charts, or a combination of both.

So I want to start with some of the common charting interpretation mistakes that I think are really, really common, and I think that perhaps it comes from whether it’s a lack of experience or kind of like an over-excitement or exuberance. And so I think one of the most common chart interpretation mistakes that practitioners make, especially when they’re starting to interpret their clients’ charts and looking at a variety of charts for the first time, I would say the biggest thing is just taking it for face value and jumping to conclusions about what you’re seeing. So especially if you’ve been a listener of the podcast for a while, you’ve certainly heard me talk about how the menstrual cycle is a vital sign and how we can learn so much from paying attention to the menstrual cycle charts. And that is absolutely true. I would say, however, when you’re looking at a menstrual cycle chart that somebody shares with you or if you’ve ever been in one of those forums online and people are just throwing up charts, we often really want to just look at the chart by itself and then be able to make a whole bunch of conclusions, and we want to be able to know exactly what’s going on. And what’s interesting about chart interpretation is you could have a very similar looking chart, let’s say from three different people. So I wouldn’t say that anyone’s chart looks exactly the same, but let’s say that you’re looking at the menstrual cycle charts of three different people, and they could look very similar and you could literally have three completely different scenarios that are causing whatever it is that you’re seeing there. And so that, I would say, is the biggest challenge.

So from the practitioner standpoint, that means that before we start jumping to conclusions about what we’re looking at, we have to do a bit of investigation. So if you’re working with clients, before you run to interpret their chart and even tell them something — “Oh, you must be this thing” — and then now you’ve given them potentially a diagnosis and you’re not a medical professional, so you shouldn’t be doing that. You shouldn’t be giving people diagnoses. And then also now you have this idea in their head and it could just be something completely different. And then if you take it a step further, you could even be telling them to take this thing or to do that thing or take this supplement and really we haven’t even figured out what is on the chart yet. So that’s a pretty significant mistake and I think that it’s pretty common as well until you get the proper training and experience to be able to really look a bit deeper into it.

So what do we do about this? I would say the first thing we need to do is we need to get our clients charting in a standardized way. So this is something that I do with all of my clients. With fertility awareness, we often hear those words like, you know, fertility awareness method. And we kind of assume that there’s this unified thing called the fertility awareness method that everybody agrees upon. But when you dive into the fertility awareness world, you discover that there’s a lot of different ways to chart your main fertile signs. So for example, Taking Charge of Your Fertility was my first resource learning to chart and for many of you it may have been your entranceway into this world of charting. And in Taking Charge of Your Fertility, for example, when they’re looking at cervical mucus charting, Toni is often sharing a method of internal checking and talking about it in a specific way. Whereas, if you were to look at, let’s say, the Billings method, they are looking at cervical mucus checking in a different way. They’re not doing internal checking — more of a how does it feel throughout the day, if you feel a feeling of wetness, that kind of thing. If you look at charting through the Creighton method or the Justisse method, they’re doing an external wiping option where they’re looking at more so how the toilet paper feels as you’re wiping throughout the day. Not just how it feels in general and not necessarily through internal checking. And then you have methods like the Marquette method, which cervical mucus checking would be completely optional in that method. And they’re actually looking at biomarkers. So they’re looking at the urinary metabolites of how we’re processing estrogen. So they’re actually doing a urine test and then identifying the fertile window based on when you start to show those signs of estrogen to indicate that you’re moving into the fertile window.

So just with those examples, hopefully you can start to see that within the fertility awareness world, there’s a lot of different ways to get at the same thing. What are we trying to get at when we’re looking at cervical mucus, whether we’re checking internally, externally, or looking at hormonal biomarkers? Well, we’re trying to identify when the fertile window opens and then when it closes.

So the first thing that I do with my clients when we are getting into the chart interpretation conversation is I actually am teaching them how to chart in a specific way so that we can all be on the same page and we can get into charting in a standardized way. And this is, I would say, one of the most important steps to correct chart interpretation. And it doesn’t mean that you can’t use their current charts or their past charts to help you identify what’s going on. But it does mean that there is a limit to how much information you can gather when your client is charting in their own way.

So for those of you who’ve been longtime listeners, you’ve heard me say that when I’m encouraging my clients to take their temperature, I talk about the 10-minute rule. And so that involves holding the thermometer in place for 10 minutes. And it’s funny because for some people it really bothers them — like this is crazy, this couldn’t work, and all that kind of stuff. But from years of being in the field, and you can certainly try it yourself, when you hold that thermometer for 10 minutes, you actually can see for yourself. Not every single person, but the vast majority of clients of mine who have tried this will find that it actually makes a difference. It helps the temperatures to be more stable. And whether or not it makes a difference for you personally, if you are teaching clients, if you are working with other humans who are also charting, then it makes a massive difference to have that as a standardized method.

With the cervical mucus charting, if you’re charting in different ways, whether it’s internal checking versus external checking, that can make a big difference in terms of how frequently you’re noting your observations, how much mucus is showing up on the chart and whether or not you’re even interpreting what’s happening. Is it really mucus or is it vaginal moisture? And so these are things that are going to make a difference because let’s say you have a client who has cervical mucus every day and they’re noting that. So if it’s a true kind of mucus or discharge every single day, that could be a sign of an infection. It could mean that they have yeast or even a sign of abnormal cervical cells. But if you have a client who’s checking internally, and that’s what they’re noting every day — vaginal moisture — then you could be making assumptions about what’s going on in their chart, but not really being clear on what is actually happening.

The first step is then to educate your client, put everybody on the same page, make sure we have a standardized way of doing things, and then the second step would be to see what happens. Now that we are charting correctly, then we can get our baseline charts — what I always call it — and see what’s really going on. And so what this means is that in the process of chart interpretation, the more deep, nuanced chart interpretation doesn’t start when your client throws a chart the very first time. That is what opens the conversation, that first chart. But then we have your first chart together. And that is when we really start to see more of what’s really going on.

So another key piece of chart interpretation is starting off by knowing what’s normal and what’s abnormal, especially when it comes to menstrual cycle charting. I think there’s a lot of different factors that come into play. So my personal thought is that women who are attracted to menstrual cycle charting, who gravitate to it, we tend to be a little bit type A. Because this is something that we’re choosing to do. We’re choosing to put our menstrual cycle under a microscope. We’re choosing to track fluids that are coming out of our body. We’re choosing to note our temperatures. And so what can happen when you start to really look at your chart under a microscope is you can start to see problems everywhere and start to think that everything is a really big problem.

So the key is to hold these two realities where we want to get the detail so that we can accurately interpret what’s happening in the chart and we want that level of detail so that not only can we tell which days are fertile or not, but potentially identify underlying issues, see signs of different health issues that could be showing up. But on the other hand, we don’t want to drive ourselves nuts by looking at every possible thing as an issue. So the most important piece is to know what’s normal versus what’s not normal so that we can start to find a balance.

I can share that this year I had a variety of different stressful experiences, some for positive reasons, some for challenging reasons, but it was certainly an interesting year. And so between having a young baby — my daughter is now 17 months old — and working on a book that I’ve been working on for the last several years, plus a lot of traveling, long story short, lots of stress this year. And so I did have two cycles in particular that were certainly notable. One cycle was quite a long one, and then one cycle I actually had some spotting. The long cycle that I had coincided with an extremely stressful time, lots of travel, and my diet was quite a bit different than it normally is — quite a bit lower in protein. And in that context, when I was looking at this long cycle, I was able to interpret why. I wasn’t surprised by what I saw. I wasn’t scared. I wasn’t shocked. I wasn’t really concerned. And then I did have a very, very stressful period of time in the fall where, for the first time in 20 years of charting, I had what I think was five days of light spotting before my period — and that had literally never happened before in my life.

When I looked at the situation, it was an extremely stressful time where my sleep was not happening the way it needed to. There was a lot of stress. A lot of things were going on. I was working a lot and traveling a little bit too. And in both circumstances, I knew why I was seeing these changes. And in both situations, it certainly was an important wake-up call. My body was literally telling me it’s too much now. And that’s actually the part — the knowledge part — that I want for all of my clients and practitioners, so that we can get to a point where we can interpret and understand what’s happening in our cycles without freaking out and assuming our bodies are broken and everything is totally wrong, and really take that as an opportunity to course correct.

Once I got through that period and those goals I was working towards, then it was a time for me to course correct. My subsequent cycles, when I was focused on my foundational factors — my eating, my sleep, my supplements, all the things that I usually do — I was able to just get right back into more normal parameters.

It’s important to know what’s normal versus abnormal first of all in a general sense — what a normal cycle really looks like in general. I’ve had clients over the years who’ll say, “Well, this is normal for me.” However, if your cycles are always 42 days, that might be normal for you, but that doesn’t make it normal. So we have to know what the normal parameters are — the overall cycle length, the length of the follicular phase before ovulation, the length of the luteal phase after ovulation, what the period’s like, all those kinds of things. But then when you’re working with clients or when you’re looking at your own cycles, you also want to know what’s normal for you.

To put it into context: why would someone have a 45-day cycle? Well, did they just come off the pill? Is this their first cycle off the pill after 20 years? Or is this somebody who has never been on the pill and their cycles are always long and sometimes irregular? Or is this somebody who has recently had a baby? All of those pieces matter because that same 45-day cycle could look very similar in these different situations but could mean something completely different.

One last piece I wanted to talk about today is knowing which factors in general impact the cycle, and knowing how certain factors impact the cycle. This is key to chart interpretation, and this is what helps us to put everything into context. Temperatures are one of the most variable factors when you’re looking at the menstrual cycle chart. With my experience with the symptothermal method, I have found that the temperature is very, very helpful, especially for women who are newer to charting, especially as a practitioner too, when it really helps to triangulate what’s going on — to compare the mucus to the temperature. The temperature is kind of a more definitive sign because you have a number on a graph. But with that said, there is a lot of fluctuation and variation with temperature, whether that’s related to sleep disturbances or sleep duration, incorrect temperature-taking, seasonal allergies, drinking alcohol, waking up at different times, or even using different devices.

You want to be aware of how stress impacts the menstrual cycle — both acute stressors like travel or work-related stress, and chronic stress where it’s more all the time. How exercise can impact the cycle, how diet can impact the cycle, whether a person is undereating or their macros are imbalanced and it’s causing blood sugar problems, and of course various health conditions. There’s just a lot of different ways that the cycle can be changed and disrupted.

So to kind of go over the main points that we talked about today: I started by talking about some of the common chart interpretation mistakes — the biggest one being running in and jumping to conclusions by taking the chart at face value, as opposed to taking that as information and then having your client complete a baseline chart to really get into what’s going on. I talked about the importance of using a standardized way of tracking. And then the key takeaway from my personal story is to really know what’s normal versus abnormal in the general sense, and also what’s normal versus abnormal for that specific client. And then the last point: knowing which factors impact the cycle. There is a difference between a one-off scenario where you have that one cycle where something’s kind of off and you can tie it into something that was going on, versus the person who has the chronic issue all the time. Those are important distinctions to make when you’re looking to increase your skill in chart interpretation.

So I hope that you enjoyed today’s episode. And of course, as always, until next time, be well and happy charting.