Fertility Awareness with Irregular Cycles (Episode 432)

Full Transcript: Episode 432

Lisa Hendrickson-Jack:

This is the Fertility Friday Podcast, episode number 432.

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 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. I know, I’m a busy girl, but I managed to fit it all in. This podcast is designed to empower you to take full control of your cycles, your fertility, and your overall health, and I’m so excited that you’re here with me today.

Today I’m sharing a brand new episode in my Fertility Awareness Reality series. I’m sharing an interview with my client Maria, and one of the topics that we dive into in today’s episode is charting your cycles when they are irregular. And so certainly one of the biggest myths around fertility awareness and cycle charting is that in order for it to work you have to have this perfectly regular predictable cycle. And that certainly plays into what I would call rhythm method thinking — thinking that if your cycle isn’t quote predictable it won’t work. Because with fertility awareness we’re not actually trying to predict the cycle. We are learning to chart the cycle, understand the cycle in real time, and identify in real time which days of your cycle are fertile or infertile in order to either prevent pregnancy if you are using the method for birth control, or achieve pregnancy if you’re trying to conceive. And so in today’s episode we get into a little bit of that and also talk about although you can still chart your cycle successfully and use the method accurately and to a high degree of efficacy, some of the challenges that are associated with charting through irregular cycles. So without further ado, let’s go ahead and jump into today’s episode with Maria.

I’m excited to be here today with Maria. Maria is a member of my current Fertility Awareness Mastery Live group program. And at the time of recording this, I think we’re just a little bit past halfway through. So we’ve been together for a little over a month now, had many, many sessions already. And I think at this point, we just finished the birth control kind of unit, if you will, in the program. So thanks for coming on the show, Maria.

Maria: Yeah, it’s my pleasure to be here.

Lisa Hendrickson-Jack: Well, I’m glad to have you. We had some tech difficulties, which was really interesting. But you were super patient and we were able to overcome them. So I’m actually really excited that we’re making this happen.

Maria: Yeah, me too.

Lisa Hendrickson-Jack: Well, so to get everything started, I would love just to ask you a little bit about what brought you to fertility awareness. So maybe let us know how old you were when you had your first period, if you have a birth control history, and what made you decide to move to fertility awareness at this stage.

Maria: So I had my very first period in middle school, so sixth or seventh grade, and then I didn’t have another period again until I was 17 in 11th grade, and that’s when I had more regular periods. And then in terms of birth control, I only use abstinence. I’ve never used hormonal birth control, except for I think early in my 20s I had to go on one cycle of progesterone because I had a period that wouldn’t stop. And then other than that, I haven’t used any type of birth control other than abstinence. And then I came to fertility awareness because I’m getting married, and one of the requirements to get married at my church is to take a class on natural family planning. So I originally went to a Billings Method instructor, didn’t ever really feel confident in using that method, and didn’t really feel comfortable learning with the instructor just because our communication styles didn’t match well. And then I stumbled upon your podcast when I was trying to better understand cervical mucus, and then that’s when I signed up for the class.

Lisa Hendrickson-Jack: Well, yeah, no, thank you. I feel like the class ended up being very timely because your wedding is right around the corner. And I’ve had quite a few women over the years who take the class in a similar situation — who are planning to get married and are wanting to jump in and learn about fertility awareness at the start of that, often to avoid pregnancy for a time. So you’re in good company there. I think if anyone has listened to the podcast for a while, you know most women do have a pill history, so it’s a little bit more these days on the rare side to have not. So there’s definitely still a percentage of women who’ve never used it, but it’s just not as common these days. But I think it’s really nice sometimes to have that kind of story showcased on the podcast.

So in your case, our main focus, kind of the primary focus, has been on birth control. And then of course it always comes up that we’re looking at cycle health and things like that, but we’re kind of juggling those two primary factors. And also — I’ll just put this out there and ask because I know a lot of the listeners, this is one of their challenges — obviously in order to make this work, your partner has to be on board. So I’m sure that you and your partner have had conversations about fertility awareness and using it as birth control. So is there anything you’d want to share with the listeners of how your partner has been with this process and what it’s been like learning alongside him?

Maria: Oh, my fiancé has been very supportive. With our Billings Method instructor, she had us both go and she explained fertility to us both — you know, what it means for him, what it means for me. And then whenever I learn, he doesn’t sit with me during class mostly because it happens while I’m at work anyway, but the videos that are part of the course I’ve had him watch them with me so he understands what I’m doing and what I’m looking for. And of course, when you have two people who aren’t sexually active with each other talking about this method, it can be kind of awkward. But that’s just part of transitioning to that different stage of life where you are thinking about having children. So it is important for him to understand. And I think it has definitely brought us closer together because we are having this type of conversation with each other and learning a new skill.

Lisa Hendrickson-Jack: Awesome. Yeah, I know it’s — I think especially for women who have never really had to have those conversations, if they’re on hormonal birth control or have otherwise used a method that didn’t really require the communication, like it was just kind of taken care of, I think that it can be really intimidating. I think a lot of women might be afraid, like, is he going to be open to it? And I think we can really get in our heads about it. But I always like to share those kinds of stories because my experience has been — I’ve been personally using the method for a long time, and I’ve worked with hundreds of women at this point who have used the method, and I really haven’t come across a really negative experience from men around this method. I’ve actually encountered the exact opposite. So just for reassurance for anyone out there.

Well, let’s jump into the session part. So you did send me some charts. We’ve had a couple of sessions together already. And I think in our first hot seat session, our primary thing was looking at some of the overall lifestyle stuff, but we’re also kind of looking at some of the differences between the Billings Method that you had used previously and the Justisse Method and kind of getting used to everything. So let me know where you’d like to start. I’m gonna see if I can share my screen with you.

So you can see we can see the same thing. But while I’m doing that, let me know what you’d like to focus on today, what questions you had, all that good stuff.

Maria: So looking at my first chart, I’d just love to know if — because when we first had my hot seat, I thought I had ovulated and then you thought that no, it doesn’t look like you ovulated yet. And then one or two days later, then I saw the cervical mucus and then I saw the temperature rise. So just trying to see if my understanding of when the fertile window opened is correct.

Lisa Hendrickson-Jack: Okay. And I have my chart open on my iPad if you just want to tell me what day we’re looking at. Okay, well, yeah. So because of our tech difficulties, I would have to shut down the thing to open it. So I’m looking at your chart from May to June.

Yeah. So if I remember correctly, when we had our session — I don’t remember exactly when we had our session — but I remember looking at your temperatures and not being convinced. So our session would have been day 29, on the 31st. That’s right.

And so for the listeners, basically what we see on the chart by day 29 — which, as many of you know, that’s around the length of an average cycle kind of thing, so you would expect to have ovulation by then — but what we saw was several dry days and then some days of — I would put cycle day 15 through to cycle day 23 as the days that you actually marked with the non-peak mucus stamp. So like the lotion-y. Based on what you actually wrote down, you wrote down smooth sensation, and on the toilet paper it was either shiny or a little damp. I would mark those as green dots.

Maria: Okay. Does that make sense? So you would mark it as a green dot instead of light purple because…

Lisa Hendrickson-Jack: Because of how you marked it. So the way you marked it when you were wiping was a smooth sensation, and based on the notations that you put down, on the toilet paper you would have seen either like a damp or a wet or a shiny, but you didn’t note that there was any actual mucus that you could pick up.

Maria: Yeah, so I wasn’t actually able to pick up any mucus.

Lisa Hendrickson-Jack: Yeah. So because you weren’t able to pick it up, we would put that into the dry category.

Maria: Oh, I see now. Okay. So learning the color coding — it’s new. So basically, if you see something on the toilet paper but you can’t pick it up, it’s green.

Lisa Hendrickson-Jack: Well, yeah, unless it’s lubricative.

Maria: Correct. Okay. Yeah, unless it’s lubricative. Yeah. The lubricative and the dry no cervical mucus is really clear to me. It’s when to put the light purple versus the green that I haven’t been able to wrap my head around, but yeah, now that makes sense that you’ve explained it to me.

Lisa Hendrickson-Jack: Cool. Awesome. Well, yeah, so we’re just getting obviously into the nitty-gritty of some of the Justisse notations here. But basically, to put it in layman’s terms for the listeners, we have dry days and we have mucus days. And so with this standardized way of charting, we’re identifying which is which. So that’s basically what we’re doing.

And so under the dry category, basically we put a line in the sand. Dry days, essentially with this method, are days when you wipe with the toilet paper — and sometimes it can feel dry, sometimes it can actually feel smooth. So basically what you experienced was a point of change in the sense that it was dry, there was nothing for about — was this like seven days?

Maria: I think I did my bath for eight days.

Lisa Hendrickson-Jack: So you had dry after your period stopped, you had dry for eight days, and there was nothing at all. And then it did shift. It shifted from that completely dry sensation with nothing on the toilet paper to a smooth sensation. And then you started to see something. You started to see a little bit of dampness, a little bit of shininess. So with this observational method we would still consider those to be dry days, even though there was that smooth feeling. The dry days are no mucus days, and then the mucus days are obviously mucus. Anyways, so we got that. So I would switch those to green.

But when we had our session — so kind of back to what we’re talking about — you were at that stage of your cycle where it would have seemed like you should have ovulated. The temperatures were not in the post-ovulatory range. And then you had gone back to dry. So what we see here on day 30 and 31 is that you did have two days that you marked with a lubricative sensation. So on those days, you did have something you could pick up. You wrote down that it was clear, stretchy, and you saw it one time. So was it only the one time in that day that you saw?

Maria: So on the days that I finally saw the fertile mucus, I actually didn’t see it the very first time I tried to wipe, because I was trying to use the front to back method — from the back — and nothing came up. But then when I went to wipe again from the front and I looked at the tissue paper, that’s when I saw the fertile mucus. For some reason. And then so when I used it on the very first day, I saw that twice, and it was kind of the egg white looking one but kind of cloudy. And then the next day is when I saw like the very clear cervical mucus. And then yeah, I only remember seeing that once during that day.

Lisa Hendrickson-Jack: Okay. And is that pretty typical? So in your cycle, you had two days where you actually saw the clear stretchy, and it’s quite obvious in the sense that you didn’t have those observations on any other days. But on the other hand, it wasn’t like a large quantity per se. Is this pretty typical for you?

Maria: I mean, no, so it was quite a large amount. It’s just that it didn’t appear when I was — I guess maybe the way things are oriented — it doesn’t pick up when I reach from the back, but when I reach from the front and wipe, then yeah, there was a bunch that came out.

Lisa Hendrickson-Jack: Okay. So it was a lot, it’s just not a lot of times during the day.

Maria: Yeah.

Lisa Hendrickson-Jack: Okay. So then there’s two temperatures on here. So the temp drop is the blue one?

Maria: Yes.

Lisa Hendrickson-Jack: Okay. I always ask and I think it always is the blue one. I’m just making myself some notes on your chart here so I don’t have to keep asking you which is the temp drop.

So I’m looking at your oral temps then, the red ones.

Maria: Yeah.

Lisa Hendrickson-Jack: So I would draw the line just a little bit over the 97.7 mark, kind of just right over that higher temp there. You see what I mean? There’s two temps that are right around 97.7.

Maria: Yeah. I think I did try to mark it. It’s between 97.8 and 97.6.

Lisa Hendrickson-Jack: Yes, exactly. Yes. So I’m basically drawing the line where you did, maybe just slightly like over the top, but it doesn’t matter. You can draw it through the dot too. So same place, basically.

And then based on what we’re seeing here, ovulation likely happened on day 31 based on the temperature, because after day 31 we have the temps going up over the line and they stay there.

Your luteal phase is 12 days, so that’s good. Yeah. But your cycle is 43 days.

Maria: I’ve had long cycles for a really long time. So for as long as I can remember, I’ve had pretty long cycles. The range is shorter — the variance in length has shortened as I’ve gotten older. When I was younger, it used to go from between 30 to almost 50 days. But now it’s between 35 and like 42. That’s been common for me. So that was one of my hesitations with using natural family planning — my irregular cycle, being able to identify ovulation. But this experience so far, now that I have a job that kind of forces me to get up by a certain time, it’s really helped with getting that consistent temperature reading at the same time every day. So previously, when I’ve tried the thermal method, I would often skip it in the morning, but I’ve been better about it now. So when I saw the cervical mucus and then saw the temperature rise, I actually felt like I was getting it.

Lisa Hendrickson-Jack: Okay. Well, I think because we still have a couple hot seats together and you have another private session, I think we can take some time in those upcoming hot seat sessions to talk a little bit more about the length of your cycle. Have you ever looked into that? Like has that ever come up with your doctor or anything? Or was it just kind of like, okay, this is just how my cycles are.

Maria: Yeah, I would say it’s more like that. This is just how my cycles are.

Lisa Hendrickson-Jack: Okay. Well, so just to give some general info — ideally cycles under 35 days, falling into that kind of 24 to 35 day range. So when they’re consistently higher than that, there’s typically something happening, especially with the history of it being quite a bit longer. And so it could be related to something like PCOS. So not to say that that’s what you have, because we don’t have enough information on this phone call right now to make that kind of decision. But just to kind of put it out there that it could be — I think of often these things as being on a spectrum. And so you might be on that spectrum, we would have to find out.

So to get an actual diagnosis, we would want the doctor to test for androgens to see if your androgen levels are normal or if they’re high. There might be other signs of that — if you’ve ever had unwanted coarse hair in places you didn’t want, or cystic acne. So those can be signs of excess androgen. If they were to do an ultrasound, they could see if there were multiple cysts on the ovaries. Typically, when we’re looking at the criteria — the Rotterdam criteria — it’s looking for two of the three. One is the long irregular cycles, two is the high androgen levels, and three is the cysts on the ovaries. And so that’s something you could look into and see if that applies.

If that is what it is, then we could just work on some of the specific PCOS-related factors like insulin resistance and stuff like that, and see if it helped to normalize your overall cycle length. So that’s just the kind of overview, and I’ll make a note and we’ll go into that a little bit more in upcoming sessions.

So to address your concern — because there’s a lot of information out there that would say if your cycles are irregular that you can’t use fertility awareness — I think that’s typically based on the idea that fertility awareness is basically the rhythm method and that you need to have these predictable cycles in order for it to work, which isn’t true. So we can certainly work with whatever the cycle is like as long as we know the rules.

With that said, one of the challenges when you do have longer cycles is that you have a long pre-ovulatory phase, so it’s a lot of time to manage. As we’ve talked about in class, the only time that pregnancy is possible in the cycle is in the pre-ovulatory phase. And in your case, you’re not really showing a ton of mucus. Many women that have longer cycles often do have multiple patches of mucus or more days of mucus, and that can be really challenging because you have to consider all those days fertile. So in your case, we would just have to work on some strategies to manage the pre-ovulatory phase.

For instance, when you’re learning, one of my recommendations is at least for the first several cycles to not have any unprotected sex in the pre-ovulatory phase. And so with a pre-ovulatory phase that’s lasting 30 days, that’s a long time, you know. So there are specific challenges that come up for women that have longer cycles. So overall, it would be good for us to see what we can do to identify maybe why the cycle’s so long, so that while you’re also learning to chart, we’re also working on getting it down to under 35 days, which would be a bit easier for you to manage.

Maria: Okay. And I’ve already shared that with my fiancé — the fact that right now, the safest time for us is the post-ovulatory phase. So he understands and he’s on board with it.

Lisa Hendrickson-Jack: Awesome. Well, yeah, so we’ll definitely check in more about that.

And then on these days — I wish you could see the chart, but basically all I did was write in the coverline. Your peak day would be day 31, because that was the last day that you had the mucus, and that obviously matches up with the estimated ovulation date based on the temps. And again, I’m using the oral temps.

So you’ll see if you look at the temp drop temperatures, they’re slightly different. So based on the temp drop, the first day that the temp was a little higher — it would depend on how you looked at it — either day 31 or day 33. But when there’s both, I tend to go with the oral temp, just because I have a lot more years of experience interpreting oral temps.

Anyways, so the peak day would be day 31. So you can go into your app and mark that as peak on day 31. And then that day would be considered fertile, obviously — the days of mucus plus the three days after. So that would be day 32, 33, and 34. And so based on mucus, the first post-ovulatory infertile day available for sex would be day 35. And then based on temperature — going with the oral temps again — day 32 was the first day of the rise. So we’re doing the count of three temperatures here. The first day based on temperatures would be the evening of day 34. So the later of the two is day 35. So basically, that would be day 35 in this particular cycle, based on the cross-check of mucus and temps, as the first post-ovulatory infertile day.

Maria: Okay.

Lisa Hendrickson-Jack: And then you’ve just started your next cycle. So just to get a sense of it — from your experience, a 43-day cycle, within the last year, is that just pretty typical? Is that a bit longer or shorter than average?

Maria: I would say that that’s average. Sometimes it’s gone as low as 33. I think that’s the shortest I’ve seen it go in the last couple of years. It’s usually in the high 30s, low 40s.

Lisa Hendrickson-Jack: Okay. And have you noticed anything different over the years? Has there ever been a thing where you’re like, oh, when I do this it’s shorter? Or has it always felt kind of random?

Maria: So I’m an attorney for a pretty big company, and then I was in law school before that. So just the nature of my work, I never really got a chance to pause and think about something that I might have done to affect it. I guess I’ve always assumed that because of the nature of my job, the level of stress I have, and then finishing law school and getting my law license — I just assumed that stress played a significant role in my cycle length.

Lisa Hendrickson-Jack: Well, I’m sure it does to some extent. Maybe give me like a snapshot. I’m thinking of a past client that I had, and she was a law student also. And I remember there’s no way around it — when you’re in law school or any other really demanding professional program, there’s a lot of things that need to happen. There’s less sleep, there’s so much work, there’s a lot of responsibility. So you can’t really maximize those lifestyle factors. In the midst of it, you just kind of work around it and see what you can do.

So just give us a little window — are you able to sleep? Do you have lots of late nights? In terms of the stress — is it related to the workload? How does the school and the job affect your ability to get good sleep, get exercise, eat what you would like to be eating?

Maria: So I’ve also recently changed jobs, and in my new job the hours are not as long as they were in my previous position. In my previous position, I would have some overnight shifts. I would have to work overnight for a separate thing that my company does to kind of monitor things, and then I’m just sleeping in a cot in my office and then going to work at 8am and sometimes staying until 8pm. That’s not uncommon. And then I go home, take care of my dogs, try to spend some time with my fiancé before going to bed. And some days I will literally eat and then go straight to sleep, and then some days I do want to socialize, so then I’ll get three or four hours of sleep before having to get up again.

But in my current job — because I understand that you have to sleep for at least five hours to get basal body temperature — I make sure I get a minimum of five hours of sleep and make adjustments based on that.

And then the one thing I will say about improving cycle length — I think that when I was able to eat three meals a day and then get a decent amount of sleep, I see the cervical mucus appear at least, because there was one cycle before I started taking this class where I didn’t really see the cervical mucus like I normally do, and that was a little bit concerning. And during that time period, definitely not sleeping a lot and definitely not eating three meals a day.

And I know that some people when they don’t eat they tend to overeat. That’s not true in my case. I can skip a meal in the normal breakfast and lunch hours, have my first meal at about 3pm, and still eat the same amount of food, and then maybe eat dinner at 7pm and not overeat. But yeah, when I’m eating three meals a day, which didn’t happen very often in my previous job but happens more often now, I’m having a better cycle length. I’m also trying to get in better shape. My trainer was saying you really have to eat breakfast and you really need to eat a minimum amount of protein — which you’ve mentioned in our sessions that if I’m not eating enough protein, that’s also going to affect my cycle health. And I never thought about that before.

Lisa Hendrickson-Jack: Well, yeah, no, thanks for giving us a bit of a window in there. And again, just to acknowledge — when I think about life and how the cycle fits into it — if you think about a couple of decades of your life, like your 20s or your 30s, there are going to be periods of time or phases in there where, depending on the job, the educational commitments, your family commitments, relationships, etc., there are going to be phases where you just can’t hit that optimal kind of thing that we’re aiming for. Three meals a day, lots of sleep, whatever. So I feel like it’s important to acknowledge that, but always to work around it.

And so I think it just so happened that the switch in positions is probably going to help you to implement a lot of the things that we’re talking about in class, and then we’ll be able to see if it makes a difference in your cycle and how much.

So I think we have a few great things to talk about in our upcoming hot seat sessions. I have a few ideas and suggestions for you. And basically, the great thing about using the menstrual cycle as a vital sign is that we get that feedback. So if we do make some changes and do our best within the confines of what’s happening right now in your life — you’ve got a wedding coming up and I’m sure as much as it’s a happy event, it’s always stressful to some degree.

And just to comment on that, because you mentioned that when you skip meals, some people would then overeat later because they’re so hungry. And it’s interesting because I often see the opposite — even if you try to eat a bigger meal, you end up eating less than you would if you ate three meals. For others, they may skip that meal but then at night eat like three bowls of ice cream. I say that because I really love ice cream. But just to put it out there because there’s different ways that it can play out.

Either way, as we wrap up today — I think what we covered: we covered a bit of the charting specifics, went over some of the notations, analyzed your chart, so we have a better sense of what this cycle looks like. And this full chart from May to June is the first full chart in the class. Obviously it took a bit longer because of the delayed ovulation. But I feel like this really helps me get that baseline chart in so that I see what we’re working with. And this will be really helpful in strategizing for using the method for birth control as well as strategizing health-wise to see if we can tighten up the cycle and get ovulation happening a bit sooner.

So any last questions for me?

Maria: No. I’m glad we were able to have the session. Thank you.

Lisa Hendrickson-Jack: You’re welcome. Me too. Well, so for someone who’s listening and they’re thinking about using fertility awareness — in your case, you didn’t come off of contraceptives, you just hadn’t used them, and this was the way that you wanted to manage your fertility. So for someone who is using birth control and is absolutely terrified to rely on this, what if anything woul