Overcoming PCOS Naturally Without Hormonal Birth Control (Episode 540)

Full Transcript: Episode 540

Lisa Hendrickson-Jack: This is the Fertility Friday Podcast, episode number 540.

Today I’m sharing a brand new episode in our FAMM Practitioner Series. I’m sharing my conversation with Kármen Kollár, and in this episode she shares her very interesting and unique journey into this work. So Kármen is a fertility awareness educator — that is how she jumped into the FAMM program. She was already a fertility awareness educator when she decided to join the program, and she shares why she chose to join FAMM to enhance her skill set and confidence in a variety of specific areas.

As you listen to this episode, you may resonate with some of Kármen’s experiences, as she certainly wasn’t open to the approach of — let’s say — painkillers or the birth control pill as the first port of call for her period issues. And what’s interesting about that path, for those of you who are listening and have chosen that kind of alternate path, is that it’s not necessarily an easier path. When you don’t take birth control pills to suppress your cycle, then if you have an issue with your menstrual cycle, the issue persists — and it persists and persists until you have the tools to address it and resolve it so that your cycle actually becomes normal. And the normal track, as we all know, that we are provided by our medical providers typically is simply the birth control pill to give us a bleed every 28 days. And we have then the impression that the issue is resolved, but ultimately if we were to come off that birth control pill, the issue would still be there because we haven’t really addressed it.

So really interesting topics coming into today’s episode. Before we jump in, I want to share a little bit about Kármen. Kármen is a dedicated holistic reproductive health coach and fertility awareness educator with a mission to empower women to take control of their menstrual health and fertility naturally. She helps clients transition away from hormonal birth control, overcome irregular menstrual cycles, and unlock the profound health insights hidden within their menstrual charts. Kármen guides clients in mastering the art of fertility awareness — a lifelong skill that enables them to conceive or prevent pregnancy naturally and understand the root causes of their menstrual health issues.

So without further ado, let’s go ahead and jump into today’s episode.

So I’m really excited to be here today with Kármen. She has been in the program for several months now. We’re in the midst of everything — in the midst of client case reports and practicum studies and everything. So a great time to have this chat. Welcome to the show.

Kármen Kollár: Thank you, Lisa, for having me. I’m happy to be here.

Lisa: Well, thank you for being here. And I was joking when we were doing our little pre-chat because I am not saying your name correctly with your accent. So I would love for you to introduce yourself, let us know where you are from. And my absolute favorite question to ask is, when did you first start menstruating — and then feel free to kind of let us know your experience, what kind of led you to jump into this world of fertility awareness teaching.

Kármen: Okay, so my name is pronounced as Kármen, and I’m originally from Hungary, but right now I’m based in Finland, where my husband is from. And the first period — I can’t pinpoint the exact age, but I was around 13 when I got my first period, 13 or 14. And I remember that my mom had already undergone a hysterectomy at that time, so she suggested that my sister have the talk with me, since she felt kind of out of touch with the whole process. And my sister did her best — she showed me the panty liners, the pads, the tampons, explained the difference, told me that I would have a monthly bleed approximately, it might come with some pain. And that was pretty much it. So that’s how I started my menstruating years.

And my cycles were irregular right from the start. And my mom and I used to joke that my period was very friendly because it would disappear for the entire summer, allowing me to enjoy the beach. So initially I thought that was a good thing, and I didn’t have pain either, so I wasn’t concerned. But then a few years later, when I was about 15 or 16, my mom started to get concerned about the irregularity, and she took me to see a gynecologist for the first time. And the OB-GYN said that everything’s fine, maybe my cycle needs some more time to normalize, but I can also take some hormonal contraceptives. The usual. Both my mom and I were uneasy about that, so we decided against it.

And around the same time I was also struggling with some pretty bad acne, and the dermatologist at the local health center brought up hormonal contraceptives again. But at my next visit, I saw a different dermatologist, and she shared a very personal story about her close friend who had recently died from a blood clot caused by the pill. So she highly suggested against prescribing hormonal contraceptives for acne, and this story really solidified my instinctive feeling that I didn’t want to go on hormonal contraceptives.

And then I had some other things in the upcoming years — like my irregular cycles continued, and I had somewhat improved acne but it was persistent. And I also had some unexplained weight gain and weight loss periods, and I couldn’t really attribute it to anything. But then in my early twenties, things took a turn for the worse, because I started experiencing some sudden crashes, as I call them, and dizziness. They got so bad — especially after movement classes, my dance classes — that I even stopped dancing for a while out of fear, because I thought maybe it’s the dance classes which are causing this. But the symptoms didn’t improve.

And then I also had some lower belly pain at some point and I was diagnosed with lactose intolerance, but switching to a lactose-free diet didn’t solve those issues. And then one morning the pain was so intense that I actually fainted in our bathroom. And I don’t know how long I was there on the floor. But after that — it was very early in the morning, so everyone else was sleeping in the house — I woke up, I went to my mom, and she arranged for a full hospital examination for me the very same day. And initially they thought it was a gastro issue, but I was also referred to the obstetrics and gynecology unit, where on ultrasound there was a cyst in my ovary which had recently ruptured. So that’s what caused that very severe lower belly pain. And I was admitted to that part of the hospital for observation and I was staying there for several days, not really knowing what was happening, because no one was really explaining anything.

But after I was released, I finally saw an OB-GYN who explained that based on my results, I most likely had PCOS. And she sent me to do some further hormonal tests and a glucose tolerance test, which confirmed that there were elevated male hormone levels, I had insulin resistance, and so I finally got the PCOS diagnosis.

And I was quite lucky, I think, because based on the stories I’ve heard, many women don’t really get much information after the diagnosis. But my OB-GYN was very nice and proactive, and she even arranged an appointment with a nutritionist for me, who introduced me to the diet they usually use with diabetics — like the 160 grams of carbs per day. She explained what low glycemic foods are. And I was also prescribed Metformin, but I couldn’t tolerate it due to severe, severe nausea. So I didn’t end up taking that for long.

And this was the point where I started learning more about my cycles and my health, because my grandmother had diabetes and I was really determined: “Oh my God, insulin resistance — I really don’t want to end up like that. What can I do?” And I started digging and reading about menstrual cycles and nutrition, and I read books and articles.

But I still knew relatively little about my cycles, now in retrospect — because one day I proudly told a friend that I was glad I got my period, which meant that I must have ovulated, right? And my cycles are regular. And she was studying fertility awareness at the time, and she gently corrected me and explained that I can have a bleed without having ovulated. And that was a shocker. At first I didn’t even understand what she was talking about. But it sparked a deeper curiosity, and I got the book she suggested, which was Taking Charge of Your Fertility, which for many women is the start of their fertility awareness journey. So I’m forever grateful to my friend Sofia for that conversation, because she really started me on this journey.

And I just continued taking care of my health and figuring out what worked for me and what didn’t. And about three to four years after my initial PCOS diagnosis, I had another round of tests, and those showed no signs of PCOS anymore — the male hormone levels were normal, the glucose tolerance test was clear, and even though my cycles were still on the longer side, they had mostly normalized. So I had become asymptomatic, basically, and I was very, very thrilled about that.

Lisa: Well, thank you so much for sharing so much. I love asking these questions — I always learn more, even though we spend so much time together. It’s interesting to hear what led you to this work, having your own personal experience with irregular cycles and the various challenges with medical professionals. Really interesting part of your story that you kept going to doctors who were telling you to go on the pill — until you had the one doctor who, after having had a friend who passed away as a result of a blood clot, strongly advised you against it.

Having not gone on contraceptives, the issue was still there, right? The issue was persisting. And that forced you to figure it out. And that’s kind of one of the big things about contraceptives — how they mask symptoms. Had you gone on contraceptives, there are a lot of those symptoms you probably wouldn’t have had, and you wouldn’t have been forced to deal with it. I’d love to hear your thoughts on that because it’s like a challenging journey — it took you several years to sort it out, but on the flip side, you did sort it out.

Kármen: Yeah, well, it is really mind-blowing if you think about it. What’s the chance that you come across someone like that who then really solidifies your beliefs? But I think I’m also lucky because my mom is more natural-minded, and even though we were considering contraceptives, we never really thought that I would go on them. And I remember I was quite fierce and adamant about it — because even when I got into my first serious relationship, I was very determined that we would use barrier methods and I’m not going on hormonal contraceptives, because I just thought it was so unfair. Why would I put synthetic hormones into my body? Even though I didn’t fully understand at the time how the cycle works and how contraceptives work, I just had this very instinctive feeling. I just knew that they contain synthetic hormones, and that was enough for me to think, “There must be better options. Why would I do this to my body?”

So I think that’s kind of very deep knowledge, or maybe I was still connected to my body and I really wanted to understand the root causes of things. It really drove me to find better solutions, because I was never satisfied with the “Oh, we don’t know what it might be, but here’s this pill you can take.” And every time I asked, “What does it do? How will it help me?” — the responses weren’t very satisfactory.

Lisa: Well, something else — it feels like, when you tell your story, it was like it was meant to be. Like, I think you were supposed to do this work. Because also when they identified the PCOS and they tried to put you on Metformin, which is obviously the most common solution — between the birth control pill and Metformin, those are the two main go-tos for PCOS as far as the conventional system is concerned — but you couldn’t tolerate it due to severe nausea. So it was almost like you were predisposed to sort this out in other ways. You mentioned that about three to four years after your initial diagnosis your tests were normal and your cycles had mostly normalized. Would you share with us what you did — how did you sort this out?

Kármen: Yeah, of course. Well, initially I started with diet changes, because that was the thing the nutritionist explained to me back then. I really started counting carbs and weighing the food I was eating. But initially it wasn’t working, because I think I was undereating protein — which in retrospect I understand, but back then I didn’t know why I was always hungry. Because if you eat only a little carbs and then you don’t eat other foods that would give you the feeling of fullness, then obviously you’re going to be hungry. And on top of that I was also told to lose weight, which most women with PCOS are told — but they never tell you how. So my best solution, which I’d obviously seen from different sources, was doing aerobics exercises, and I was doing this very intense aerobics workout almost daily. And so that made me even hungrier, and I just figured that would not work in the long term.

There was a point where I was very disappointed, but then I decided — okay, let’s just try to feel out what my body actually feels like doing. And I dropped the amount and intensity of my workout. I went back to dancing, which I always loved, but it’s less intensity. And I was still watching my carbs, but I became more flexible with it. So if I had movement that day, I was okay with eating a bit more. And not super fast, but over many months I started losing some weight, and I started feeling better because my blood sugar was more balanced. And I could really see the connection between what I ate, how I moved, and my overall feeling — and also my cycles.

And I think there was an additional piece which I understood a bit later — that my mental health is very strongly connected to it too. Because I noticed that when I had periods of more difficult or stressed times in my life, then it was harder to balance my blood sugar levels, my mood was shifting more often, I’d put on maybe one or two kilos. And then when I felt more balanced overall, everything was easier with my cycles too. Those were the main blocks — the diet, the movement but not too intense, and then just trying to pay attention to the mental health aspect as well.

Lisa: At what point in this journey did you actually encounter the charting piece?

Kármen: Well, at the end of my master’s I got a scholarship to the US to study there for one year, and this is where I met this friend Sofia who introduced me to this concept. We were living in the same residence center, and it was just a random pre-dinner conversation in the kitchen. And I just ordered the book — I think maybe the next day, because she showed it to me and I was like, “Oh my God, this is amazing, I need to know all this stuff.” And then I started reading parts of it. But I wasn’t using charting for birth control back then, or measuring my basal body temperature regularly. Initially I was just starting to understand more about the cycle and my cervical mucus patterns. I did measure my temperature every now and then, but I wasn’t confident enough to learn this from a book alone.

So eventually I found an educator — Brandy Oswald at Sage Wellness — and I took a course with her. She teaches the sympto-thermal method. So after that I was quite confident in using it for my own purposes for birth control. And then I started charting regularly, and right after that I also did a fertility awareness educator training.

But there’s an important part I didn’t mention — I was at graduate school at the University of Chicago, and I was very convinced that I would be working in academia and become a lecturer. But as time passed, I decided — or realized — that that’s not where my heart was. And by that time I was already married to my current husband, and we decided that we would move back to Finland. This transition triggered an identity crisis for me, because I wasn’t sure what I wanted to do with my life anymore, especially since I didn’t speak Finnish. And suddenly the pieces started to come together. I’ve always had a passion for helping people and teaching. I realized I could combine this with my growing interest in fertility awareness, and over the years I’d had many conversations with friends about their reproductive health concerns. And it became clear to me how little we are taught about our bodies, and that most women need more information to make informed decisions about their health — and to be able to heal themselves the way I did. And so that’s when I decided to pursue a career in fertility awareness education.

Lisa: I just absolutely love hearing how things unfold. It’s just like all the pieces aligned — although I’m guessing that when you were experiencing it, it didn’t necessarily feel like it was all going right. It’s always in retrospect that it’s like, “Oh, all these things led to this point.” You mentioned you took a fertility awareness educator program prior to joining FAMM. Do you want to share a little bit about what you were looking for that you didn’t quite get in your fertility awareness program?

Kármen: Yeah. Well, in the fertility awareness educator program I did before, I had practice clients, and I already started teaching, and I was quite confident in teaching the method for birth control or to get pregnant, even with more complex charting scenarios. But I was really bothered by the fact that when I noticed something on a chart, I could not help my clients address their hormonal and menstrual cycle issues in a deeper, more tailored way. And I did not want to teach them only to chart — I wanted to be able to use cycle charting as a diagnostic tool, as we do in the FAMM program, and as a basis for suggesting diet and lifestyle changes and helping them to feel healthy and good again. I also wanted to learn more about how to build a fertility awareness business. And what I didn’t realize back then — but now is also clear to me in retrospect — is that there was so much more I could still learn about observing and categorizing cervical mucus.

I really got even more than what I expected, and I think FAMM is really amazing in making you feel like, when someone comes to you with a problem, you really have ideas and you have a system to guide them and to help them. And you also understand very well where your boundaries are, where you might have to refer people further.

Lisa: I mean, thank you for sharing that. I feel like I remember when we had the conversation — it’s like, “I know all this stuff already, what are you going to teach me?” But there’s always a lot to know. One of the challenges — and I’m sure this has come up on the podcast before — is when you graduate from a fertility awareness educator program, most of them teach you to teach women to chart. But when you start working, especially if you eventually have a lot of clients, you find that a lot of these women are struggling with something. Most of your clients are not just charting along with everything perfectly even-keel. And without that additional insight, you’re just feeling a little helpless. So I’m glad that you mentioned that.

Now that you’re midway through the practicum and everything — do you want to share some of the ideas you have about how this may impact your practice going forward?

Kármen: Well, as I’m already doing my practicum, it is already impacting my practice. I think the major changes are that I really have a very solid framework for how I work and how I help my clients. Even before I was working one-on-one and always tried to tailor the content to that person’s needs — but I can just offer so much more now from the perspective of balancing hormones or addressing menstrual cycle issues. So I think how it transforms my practice is that it gives even more structure and more laser focus. It’s a very good framework for figuring out what’s most important, what should we address first, what are the steps, what are we going to do. And I just feel overall more confident in bringing my clients through that process.

And one more thing which came to my mind — I think it’s also very nice in FAMM that you have so much experience with client work, and just by observing you teaching us and giving us ideas about how to teach, I think I developed so much as a teacher. My skills of supporting my clients — how to talk, how to ask questions, how to hold their hand and bring them from A to B — that’s just something which comes with your experience, and tapping into that is really priceless.

Lisa: Oh, thank you so much, Kármen. That is wonderful. And part of the reason I’ve designed the program the way I did — I’ve designed it to be this group setting where, for instance, when we do our hot seat sessions, that’s simply having one-on-one sessions with everyone there. The reason we do that is because when I first started practicing, I had a combination of group coaching programs and one-on-one programs. And what I found was that my group coaching clients, by the time we hit month two, their knowledge would be in a far different place than my one-on-one coaching clients. One of the reasons is because we’d have these weekly sessions and the sessions were to educate in a more general sense, and then we’d also have our hot seat sessions. There was kind of like a fast track of information. When several women are in succession in a group setting and one woman has a question and we answer it, many other women in the room had a similar question. So by the time her hot seat comes up, a lot of those questions have already been answered. So we’re really able to zero in on what’s more important to her.

And after doing this for so long, I asked myself: how did I get to this place where I feel so comfortable with all these different kinds of charts? And the real answer is that I just saw a lot — I worked with many, many clients for a very long time. And how can I recreate that for our FAMM practitioners? What you experience is that you have a lot of women in the class, so you get to share in the experience of us interpreting their charts in real time. And then when we expand into the practicum, everyone brings all of their clients. So within a very short time you’re exposed to a lot of charts — and not curated, perfect-looking charts. Real charts that come in sometimes half done, some notations wrong. And we have to actually address it, because that’s what it’s really like when you’re working with real humans.

Kármen: I think that you explained it correctly. You can see and you can feel that there are really years and years of work and experience behind that.

Lisa: As we start wrapping up — for anyone who tuned into this episode, whether it’s to learn more about PCOS or because they’re a fertility awareness educator or in a different kind of profession and thinking about joining this program — what would you want them to know?

Kármen: I would want them to know that they are in great hands. That if what they are looking for is to fast-track their learning and have access to the experience they would probably build themselves with sweat and blood over the next 20 or 30 years — then this is the place for them. Because you really can’t put a price tag on this. And you can really, even if you have already done a fertility awareness educator program, there is so much to learn. And there are so many additional tools and information and knowledge with which you can support your clients. So I think it’s really worth it.

Lisa: Oh, thank you so much — that’s so sweet. And so — I know you work with clients all over, not just in Finland. Share a little bit about what you have going on, your programs, and where our listeners can go to learn more about what you do.

Kármen: Sure. Well, at the moment I’m teaching clients one-on-one during an approximately four-month course, and I’m teaching women who want to avoid or achieve pregnancy with fertility awareness. But I’ve also recently started working a bit more with women who have PCOS, and also women who are going through perimenopause. I welcome anyone, and I work with clients from all over — most of my clients are from Finland and Hungary and Europe, but I’ve also worked with people from North America. And I can be found on my website, which is karmenkollar.com. That’s where you can find my coaching offer, some useful materials, and how to contact me. I hope to see you there.

Lisa: Great, thank you so much. And we will make sure to link all of the places on our show notes page. Kármen, this has been an absolute pleasure. It’s been a nice opportunity for several thousand of our closest friends to learn a little bit about your journey. I’ve really enjoyed our conversation, and I just find it fascinating how listening to your journey, it really sounds as though you were kind of meant to do this work — or like led in this direction, just because of the series of events that took place in your life that led you here. So I really appreciate you sharing your story with us. This was great.

Kármen: Thank you so much, Lisa. It was really nice to reflect back on these things. The pieces come together when you talk about them. So it was a pleasure.