PMDD and Copper IUD: Overcoming Hormonal Imbalance (Episode 401)

Full Transcript: Episode 401

Lisa Hendrickson-Jack: 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 client call in my Fertility Awareness Reality series. For those of you who are tuning into the podcast for the first time, if you’re a new listener, I have a couple of series that have basically been going on for a couple of years now. So I have my Pill Reality series, fertilityfriday.com/pillreality, and I also have my FAM Reality, which is fertilityfriday.com/reality. And so these sessions are real women, and in my FAM Reality series, it’s real clients sharing their experiences, whether it’s their experiences with birth control, hormonal contraceptives and transitioning off of it, trying to conceive or trying to avoid pregnancy using fertility awareness. And so for those of you who are in that stage of wondering, you know, is this method right for me? Is this something you could do? Is it practical? Could it really work? These episodes can be really helpful because they’re just literally conversations with real women who are actually doing it.

Today I’m sharing my conversation with my client Alden. And although this hasn’t been a topic that has really come up on the show specifically, today we’re talking about PMDD, premenstrual dysphoric disorder. So there’s a number of past episodes where I’ve addressed PMS, and ultimately PMDD is a severe form of PMS. And what PMDD and PMS have in common is that it’s a sign of a significant drop in progesterone prior to your period. It’s not hormonally what’s supposed to be happening. And so in situations where you have moderate to severe PMS or even if it’s going into the realm of PMDD, it’s really a sign of a hormonal imbalance. And so we should be looking at the root causes, the foundational factors that are contributing to your body’s essentially inability to produce sufficient progesterone during that phase of the cycle. Alden shares her experience. She also shares her experience with the copper IUD and how the copper IUD really exacerbated her symptoms and how transitioning to fertility awareness has just been an incredible journey for her and how much her symptoms have improved as a result of all of the hard work that she has done to balance her hormones. So without further ado, let’s jump into today’s episode with Alden.

And I’m excited to welcome Alden to the show today. Alden is a member of my Fertility Awareness Mastery Live group coaching program. And we’re at — the time we’re recording this — we’re kind of almost done. We have a few weeks left. So we’ve had several weeks together. So welcome to the show, Alden.

Alden: Thank you so much, Lisa. I really appreciate being here.

Lisa: Well, thanks for being on the show. I’d love to just start by giving you an opportunity to share a little bit about your story so the audience can get to know you. So my favorite question to ask is how old were you when you had your first period? And then just kind of take us through, let us know if you’ve used contraceptives before, how that went, and then what kind of led you to jump into fertility awareness charting at this point.

Alden: Thank you for making a platform in a space where we can talk about these things and help educate each other. I had my first menarche when I was 12 years old and I distinctly, distinctly remember it because I can’t remember if this was my first bleed or my second bleed, but I know I was at Disney World. And we’d just been walking around Epcot all day. And I was a very active child. You know, I was from the backwoods of New Hampshire, biking, swimming, rowing. You know, all the things. So walking around Epcot wasn’t like a huge feat for me. Like it was something I could do physically, but I was so tired after it. And I just remember going back to our hotel and we were staying at the yacht club, you know, on the back side of Disney World, if anyone knows where that is. I just remember my feet were killing me and I laid face down on the bed. And that was probably my first experience of like severe exhaustion from PMS and then my period. And my mom was very understanding. And she didn’t call it like anything like the curse or anything like that, which I was grateful for. But within that, she also didn’t know how to support any issues I was having. It was more like, here, this is what you have. And here are the pads and the tampons if you want to use them, but pads are a little better in her opinion. And then like, off you go, you know, that was it. Which I was grateful for that education and that support.

And then I continued through high school with fairly normal, fairly regular periods, fortunately. I did struggle with lower back pain accompanying my periods. And I would say I never had full amenorrhea where I lost it, but I definitely was — due to a lower calorie diet and overexercising — it was a shorter period. Then when I got to college and I started becoming sexually active with my long-term partner, I was like, you know, I was like, over here being this like straight A student, very type A, very responsible. I was like, okay, I’m going on the pill. I’m doing the responsible, you know, adult college thing. I’m being responsible over here. And so I started taking Ortho Tri-Cyclen. And I remember I went and I got it from the hospital health center at my college that I was at down south at the time. But the nurse, she was just like, you know, this could make you gain weight. And I was like, oh, that’s fine. I was like, I don’t care if I gain like five or ten pounds. And she’s like, oh, maybe like five to ten pounds. And I was like, okay, that’s fine. That was all of the informed consent I got about the pill. I got the pamphlet which I read and it said sometimes there could be blood clot issues, but otherwise I didn’t know about like severe nutrient depletion and how it could potentially stop progesterone use long term and things like that, all of which had happened to me since. And so I took it and that was in 2013 and I took it for three years.

And I remember towards the end of it, I was like walking — at that time I was living in New York City — and I was walking down Eighth Avenue talking to my mom on the phone. I was like, mom, I think I’m going crazy. I think I’m losing my mind. And this comes from someone with a history of a lot of different mental health stuff in my family. So I was really very concerned. I was like, you know, do I need to go get like a brain scan, things like that.

Lisa: And can I just interject for one second? When you said that you felt like you were going crazy, could you just expand on that and let us know what some of your symptoms were?

Alden: Totally. So my symptoms were, I was having just very, very intense mood swings. And I would go from being totally fine one minute to having — being on the verge of a panic attack the next or crying the next or being just like hyper happy the next. And there was sort of no in between. There was just like the pendulum was constantly swinging. And when I would wake up I would be completely exhausted even after eight hours of sleep. I couldn’t function throughout the entire day. And when I would eat, then I would within the next two or three hours I would get very hungry — and now I know it was hypoglycemic — and I would be dizzy and fatigued. And then I was also struggling with, I would say, more mid-level depression at the time and, as I mentioned, anxiety as well. And so yeah, it was just a sense of instability and exhaustion is how I would put it. And also a lack of like — my body wasn’t responding to me taking care of it like it used to. Like no matter what I ate, I just kept gaining weight around my belly and I didn’t know why my body was responding in the way it was. There was just a sense of discordance and imbalance. And I also started like reacting really badly to foods that I’d never reacted badly to before, like dairy and stuff like that. I’d always had issues with gluten, but so I started like increasing food sensitivities.

And then I went off of the pill in 2017 and the symptoms got much worse. I now believe that to have been post-pill PCOD — like pill-induced hormonal imbalances. And I went and I started feeling a little better through just like basic getting more sleep and like taking care of myself and eating more. And then I was like, oh, but the thing is I don’t feel safe not being on birth control. Like I didn’t trust my body. I had no idea what like a fertility window was, you know. I had no idea how to support myself in that sense. And so I was like, okay, I need to go back on birth control. And so but I knew I was done with hormones, or so I thought. So I was like, I’m going to get the non-hormonal copper IUD. And I did it.

And I got the copper IUD and I know people on this podcast have mentioned this before, but it was hands down the most painful experience of my life. Getting it in was torturous, truly. I was mentally prepared for it but it was still very painful.

Lisa: And can you just describe it? I always feel like I always ask for more details because so for women who’ve had it and experienced it, I think it’s validating to hear that they weren’t the only ones. Yeah. And in all of the interviews that I’ve done over the years, whether it’s on this series, the reality series, or the pill reality series, I mean I’d have to go back and count the numbers, but it does seem like it’s like 80 percent of — it’s a high percent. Not every single woman who gets a copper IUD inserted has really severe insertion pain, but it’s a high percent. It’s most of the women who I’ve interviewed. So just tell us a little bit about that experience. Did the doctor mention anything about the pain? And what happened?

Alden: Totally. The gynecologist I had at the time was genuinely lovely and I felt very supported and comforted by her. And she had actually tried to make me get the hormonal IUD, the one with like the low dose progestin, and I just really didn’t want any more synthetic hormones. But I didn’t know at the time that the copper IUD causes estrogen dominance, but that’s another story. And getting my IUD in, I was sort of mentally prepared in the sense that I had read some people’s stories. And I knew that it would cause heavier bleeding after the fact of getting it in. And I knew that it was painful upon insertion. So I was sort of mentally prepared going in. But then when — and I did get it put in on my period, because I had heard from my doctor that that made it less painful — it just felt like when it starts getting pushed through the cervix, it felt like the worst period cramp you’ve ever had multiplied by a thousand and then someone stabbing you all around your pelvis. That’s what it felt like for me. But then it just was like it wasn’t a flash of pain, it was just like constant. Constant for the entire time of the insertion, so about three minutes.

Lisa: Okay. And then did it subside afterwards? For the rest of the day were you okay?

Alden: The pain in the cervix itself subsided, so there wasn’t like this intense searing cramp in the cervix anymore, but I was a little more sore. And then I couldn’t lift weights for the next three days because it hurt my uterus too much.

Lisa: So yeah, when you said that it was hard for you to lift weights for three days afterwards — what I found doing these interviews is that some of the women who I interview, they have that kind of searing insertion pain that one time and then it pretty much subsides and they’re pretty much good for the rest of the day. But certainly some of the women who I’ve interviewed have this sustained dull cramping that lasts even beyond the first day. One woman who I spoke to, it lasted for a week. So she still had these cramps a week later.

One of the things I often ask is, did your doctor warn you or did your doctor offer pain medication? Because I think one of the things that a lot of women don’t know is that there are some practitioners — very few — who actually offer numbing. So it sounds terrible because I think you would get an injection in the cervix. But ultimately, that would likely be a lot less bad than the actual insertion pain. So did your doctor even talk about that, or did you know that numbing is a possibility?

Alden: I did not know that cervical numbing was a possibility. I was told to take Advil before I arrived. And so I did, I took a painkiller before I arrived. And they remember them double checking with me being like, did you take it? Has it been within the last hour? And then also, as I mentioned before, I was on my period when I got it inserted as well. And then there was nothing in terms of a cervical injection or anything to help dull the pain. And I also want to preface this with like, I do have a very high pain tolerance. So it was no joke, extremely, extremely painful. And I had been warned that there would be insertion pain by the doctor, but the only offer of pain relief was to take Advil previously.

Lisa: I often wonder — there are certain medications that can dilate the cervix partially that can be applied internally and things like that. So there are things like that that are done in different situations, potentially in a situation where a person’s having a termination, or even potentially with labor, where there are certain things that can be done to dilate the cervix slightly. And so just logically, especially for any of the listeners who actually are doing their fertility awareness stuff and actually check their cervix — logically, it would make sense that if you could dilate it a little bit, that this whole problem could be just not that big of a deal. So I feel like there’s a lot of things that medical professionals could do. There are medications, there are specific things that they would have at their disposal that could make this a lot better for women. But I’ve also heard people say certain health professionals don’t even believe that the cervix has nerve endings. So I feel like there’s just no push.

So for anyone who’s thinking about having an IUD placed, I think it’s really important just to be aware of these things so that you can advocate. Unfortunately you shouldn’t have to, but so that you have to push for these options.

Alden: I know of people who’ve asked to go under anesthesia during it, but then have gotten like a major hospital bill and things. So in terms of something that is a solution that’s also financially accessible — yeah, like numbing and potentially partially dilating, I feel like that’s perfectly reasonable. And you shouldn’t have to be sitting with your legs spread wide open in the stirrups in severe pain just to try to give yourself some form of contraception.

Lisa: Well, some women don’t experience the pain. Which is yeah, but most women seem to. So back to your story. So you have the copper IUD inserted, you declined the hormonal option for obvious reasons. And then obviously your copper IUD — you alluded to it — it wasn’t the greatest experience. So what happened?

Alden: Yeah. So I was sort of mentally prepared for an uptick in bleeding because that’s what I’d read the copper IUD had done. And I’d really done a lot of my own personal reading through medical textbooks and things like that about it. So I was like, okay, I know this is what it’s going to do. And as I mentioned, I had a relatively light period all throughout high school. So I was like, oh, I have an easy period, I’m not going to be bleeding for 15 days. Cut to — so for the pain after insertion, for me it was about five to seven days after just like this constant ache and cramping just randomly, even though I wasn’t on my period anymore at that point. And then when I got my first period on the copper IUD, it was about seven to eight days of extremely heavy bleeding. So I have it out now. I got it out this May of 2021. And now I have two to three days of bleeding with only one of those days being heavy, whereas it was seven to ten days of very heavy bleeding and cramps that would literally put me in the fetal position on the floor constantly — like every cycle without a doubt. I was like, okay, you know, the first six months are the worst, you just gotta get through it.

And so the cramps eventually after the first six months did subside, but my period was still super long. I ended up getting anemia from it. And upon cycle tracking, I found — when I started cycle tracking towards the tail end of having my IUD — I realized I wasn’t ovulating during it. And because of that, having my IUD in, I got severely low progesterone levels. I had postmenopausal progesterone levels. So for the past four years though I’d had the copper IUD for contraception, my hormonal health had been consistently getting worse and worse. And I didn’t really know why, because I was really working on like cycle syncing my workouts and eating different food, but nothing seemed to help support it.

And then it got to the point where my PMS turned into PMDD. And it was 14-plus days every cycle of just complete hell — like severe depression, panic attacks, brain fog, fatigue, not having enough energy to get through the day. So two weeks out of every month were just not a good time. And it was a really hard struggle. And again, it was that sense of instability and ungroundedness and exhaustion. And the hardest part about it was that I knew something was wrong with my body and I would go to different doctors and they’d just be like, you’re making it up, your blood tests look fine — because they weren’t doing hormonal blood tests. They were just doing like CBC and differential blood tests. There were no hormonal blood tests being done. The most they could find was anemia, which I took some iron for, and that’s because I was getting such bad periods.

And then, last August, I started reading In the Flo by Alisa Vitti and also Beyond the Pill by Dr. Jolene Brighten, as well as The Fifth Vital Sign by you. And I was like, oh wait, maybe I need to like remineralize my body and stuff. And so I started — I’d say the biggest things for me were actually taking like magnesium and omega-3 fish oil. I noticed the biggest difference on those. And my doctor basically gave me the choice. She was like, you can start taking synthetic progesterone or you can start taking antidepressants. You know, I’m not against antidepressants — my family members take them. The thing was, I knew that wasn’t what my core issue was. I knew that there was something else underlying that the antidepressants — yeah, maybe I’d feel better, but it wouldn’t be helping the issue. So I was like, okay, how can I advocate for myself and help myself feel better now, but like not cut myself off from the doctors so much that they just think I’m not believing anything they say. So I started taking the progesterone again, but I only took it during the second half of my cycle, so post-ovulation, during my luteal phase basically. And that did help a ton with my symptoms. But like if I went off of it, everything was still there and worse.

I made the decision to get the copper IUD out in May of 2021 and I immediately got back in the car. My partner drove me to the hospital to get it out and the second I got back into the car, I started crying. But it was crazy because I could feel inside of my uterus, it felt more open. And I was having issues where maybe it was slightly crooked or something. It would always like poke me when I would bend over something and I couldn’t engage my core as much as I would like to during workouts. So I all of a sudden felt like I could do that and I had like so much more access to my lower abdominal region. So that was just something interesting to notice.

And within the first cycle, my symptoms started improving with PMDD. I still work through symptoms, and I’ve gotten accessibility with my university to get like pre-menstrual leave and stuff. But it’s so much better. And now it’s down to like five days. And I know how to manage it with nutrition and supplements and more lifestyle stuff because I don’t have something in my body sort of actively working against my health now.

And then that is how I found the fertility awareness method. Because I was like, okay, obviously the copper IUD isn’t working for me. I stopped taking the progesterone after I got the copper IUD out because I was like, I really don’t want to keep putting this in my body if I don’t have to, if I can find other ways. And then I started tracking my cycle, taking my temperatures, tracking my cervical mucus. Because I was working with a nutritionist at the time called Good Witch Kitchen and she’s like a cycle educator, a cycle nutritionist. And she was like, have you heard about the fertility awareness method? And I was like, kind of. But like, I don’t know how to use it. And she was like, you know, you’re pretty type A, I think you can handle it.

And also, I think a lot of people, the reason they don’t want to use the fertility awareness method is like, oh, it’s so much work. And I’m like, yeah, but all of these horrific side effects from the birth control pill and losing two weeks of my life to PMDD — that’s a lot of work. So I’d rather not have to deal with that if I don’t have to. And also just like the body awareness and the increased body literacy that tracking my cycles, charting my temperatures, tracking my cervical mucus has given me — it has given me a lot more actual awareness. And I don’t want to say control because I don’t like the word control, but like more of a partnership with my body instead of trying to control it with hormonal contraceptives or shutting down my fertility through the copper IUD. And so that’s how I came upon the fertility awareness method. And now I’m taking Fertility Awareness Mastery to just like dig into it even more.

Lisa: There’s just so many aspects of your story. There was something that you said towards the beginning — you had mentioned even when you had your first periods at the very beginning that you would feel just completely exhausted. And so that’s something that I think is just something interesting that stuck with me. Because there’s a lot of things happening. One of the things I think is really important for everyone to consider is that everyone is not the same. And so that’s why you can take 10 different women, put them on the same birth control. Some of them are going to report that they don’t really notice any side effects and others, it’s really going to do like a landslide through their lives.

And for whatever was happening regarding your body and the hormone levels, yes, it’s normal to have some shifts in energy throughout your cycle. I think anyone can attest to that. But obviously, if you’re so exhausted and it’s just this notable thing and you can barely function, that’s not normal. That’s outside of what we consider normal. And so one of the kind of questions we’ll never really have the answer to is — you know, was there something there that was then exacerbated by the hormones and obviously significantly exacerbated by the copper IUD?

And so copper IUD is interesting. I’ve had a number of series episodes where women are sharing their experiences with the copper IUD and similar things. Some women use it and they don’t really have a lot of negative side effects. And so for the women who it kind of meshes with, it’s obviously the greatest thing ever. No hormones, you can still ovulate, it’s this great thing. But the copper IUD does release copper ions, which can cause different challenges. The copper is one of the reasons why it works, because the copper has a spermicidal effect. And another mode of action is causing local inflammation, which, again, for some women, the increased period is manageable. But in your case, it was outrageous.

And there was something else I was going to say. So with the copper release, it can imbalance the zinc — leaving you kind of deficient in zinc, with excess copper. And the interesting thing about that is the hormonal contraceptives, the birth control pill, does the same thing. So you can take the pill and that’s a hormonal thing but causing a deficiency in zinc and a copper excess as well. So that would give us an indication that it can affect hormones. And it’s known that the copper IUD can, because of the inflammation and other reasons, lower progesterone levels. So if you’re already potentially at risk of that, and you use this and your body just isn’t responding to it very well — you know, you did use it for four years. I think one of the interesting things about your story is that the symptoms were so bad that you were using it and taking progesterone to try to mitigate the PMDD symptoms.

Alden: Yes. And it was interesting because I remember my partner in like 2019 being like, maybe you should get this copper IUD out. He’s a scientist. He was like, maybe you should get this copper IUD out. He’s like, I don’t think it’s helping you. He’s like, you’re clearly struggling. And I was like, no, it’s not the issue. It’s not hormonal. Because I didn’t know all of the things you just said. I mean, I knew about the inflammation within the uterus and things, but for some reason I didn’t even know it was a potentiality. I just thought, oh, if it’s not hormonal, it’s not an issue.

Lisa: Well, and something that you had said at the very beginning also, when you first got the prescription for the pill, your informed consent was her telling you that it could cause a little bit of weight gain. And this is something that we could talk about till the cows come home. But this is the whole point of that informed consent piece. Because if every single woman who was seeking birth control was provided with just a full list of side effects — just so that you know what they are — the conversation would be longer because many people would then ask, oh, I didn’t know it could do that. How could it do that? But it doesn’t mean that everybody who had that conversation would then choose not to take it. So this is one of the — in the literature, this is kind of the argument against informed consent, which is if we tell them, then they’ll be less likely to take it, we don’t want to discourage them from taking it. But at the end of the day, if you had known that these were potential symptoms, then at least it would have given you the opportunity to piece it together sooner. What I find is that when I’m doing these interviews, because we don’t have that informed consent, you end up in a place of desperation, googling in the middle of the night, and then finding some forum where a bunch of women who are using the same contraceptives are sharing their experiences. Then you’re kind of — oh okay, I didn’t know it could be connected. And that means years sometimes of suffering before you even know the cause.

Alden: Yeah, because like I mentioned before, when I was walking down Eighth Avenue telling my mother that I didn’t feel well, that was in 2016 going into 2017. So at that point I’d already been on the pill for three years. And I did not know that those were the enormity of what the side effects were. I didn’t know it could be caused by the pill. Because like you said before, it’s like oh you see mood changes and you’re like, oh maybe that means sometimes I’m not as happy as I normally am. Yeah, you don’t think about what it is.

Some of the — I think one of the interviews I did — throwback to the interview I did with Holly Grigg-Spall when she released Sweetening the Pill — I’m pretty sure that she was talking about these forums and these women would have kind of strange side effects, meaning kind of like really — so you know the word anxiety, it would fall under that category, but it’s kind of like your partner goes out to pick up milk and you think that he’s gonna die. Those kinds of like — verging on paranoia — paranoid thoughts, yeah. And what’s interesting about that, why I bring it up, is because you’re — let’s say you’re experiencing that, and it was a specific brand — and you think that you’re just nuts. And then you end up on a forum with a bunch of women who are taking the same brand. And they’re all telling you that they’re all having those same kind of paranoid thoughts. So that’s why sometimes it would be helpful for there to be more of a specific explanation or definition, so that you know that you’re not nuts. Because if you’ve never heard someone else’s experience or a sort of critical mass’s experience of what those symptoms actually feel like in detail, then it’s very easy to minimize them or gaslight yourself and be like, like any doctor has done to me where it’s like, oh it’s all in your head, you’re overblowing it, you’re imagining it, you look fine. And it’s like, no, I’m truly, truly experiencing this.

Lisa: Yeah, so I mean this is where I think the charting aspect really comes in handy. Because charting is kind of like an entrance into this whole other way of looking at the body. And so once you start just tracking your mucus, tracking your temperature, et cetera, you start eventually to see how things are connected and related. And so you start to get a sense, ideally, of what’s normal for you. So for instance, you being in the class and the listeners of the podcast — you’ve gotten a sense of what a normal cycle is like and what isn’t normal. Even if it’s common to have some level of PMS symptoms, it’s not normal to basically not be able to function for a week or two of your life. That’s not normal. It’s common for women to have a little bit of spotting before their period, but it’s not optimal. It’s common for women to have like a shorter luteal phase, like eight, nine days. It’s a thing that happens and it is quite common, but it’s not optimal. It’s not normal.

So once you get into the charting, then you start to see for yourself what’s really happening. You start to get a sense of what’s normal for you. And I think when you start that process, similar to yourself — I feel like you fall into a category where you kind of had to figure this out. I feel like some women choose charting for different reasons. Some women come into it because it’s interesting, because it suits their personality. Maybe they’re just from off the bat — their personality was like, I don’t really want to use hormones. But you tried a bunch of different things and you were kind of forced to look for something else. And I think a lot of women find charting unfortunately because their body rejected the other stuff. So what’s left.

Alden: Yeah, exactly. And it’s like, looking back at it now that I have more body literacy, I do think there were probably pre-existing hormonal imbalances before I started the pill and things like that. But it’s like that definitely got exacerbated by things. And now I know through charting, like, okay, my progesterone’s still a little low. So what can I do to support that? You know, eating more and sleeping a little more, you know, within reasonable amounts, and just like managing my stress and taking more vitamin B6, but not too much. And things like that.

Lisa: Well, and one of the things I think is really — it’s easy especially from month to month. So by the time we’re recording this, you mentioned that you had it removed in May. And so by the time we’re recording this, it is November. It’s not going to be released in November, but that’s about six, seven months. But if you think about the progress in that time, because what you mentioned is that you went off the progesterone replacement therapy. And you mentioned that you went down from having basically two weeks of really severe PMDD symptoms to having — it’s still there obviously, you’re still dealing with it, you’re still kind of dealing with the fallout — but there’s a very significant improvement. And also to consider that it means that you’re not taking that additional hormone. So it means that your body is recovering, your body is starting to produce more progesterone with all of these changes that you’ve made. And that’s huge. That’s a really big accomplishment. And it kind of flies in the face of what a lot of us are told, which is basically that there’s nothing you can do and you just have to be on XYZ forever.

Alden: Yeah, which in my experience isn’t true. Getting out the IUD and focusing more on cycle tracking and being aware of my body and like really targeted support has honestly — it sounds melodramatic but it’s completely not — it’s been life-changing. Like I feel like I actually have my life back. And I just keep reminding myself that it took me many, many years to get into the state I was in, so it’s not going to change overnight in terms of getting back to a more fully stable health point. But it’s so, so much better than it was.

And I think you’ve mentioned this before in your podcast, but something that really helped me was getting — I had to fight for it — but was getting hormonal blood testing done. And then I also got a DUTCH test and cycle mapping done. And really like seeing the levels of progesterone and estrogen and estradiol and everything — it was like, oh okay, this is why I feel this way. It was so nice to have it on paper and be like, okay, now I need to take these things to address this estrogen dominance and things like that, and support myself in that way. And I did the DUTCH test and cycle mapping in June. And so that was about two months after I got out my IUD, the second cycle after. And I had a little bump of progesterone in my luteal phase. I remember I was so excited when I saw that on the cycle mapping. I was like, I’m going to frame this. Like, I have progesterone in my luteal phase, fam.

Lisa: Well, and see, that’s where I come from with the cycle charting — the cycle kind of being the indirect hormone measure at times. I don’t come from a place of, oh, I don’t think your body can do this. Because in my experience, most — I mean, it doesn’t mean that we don’t need help. It doesn’t mean sometimes you don’t need to supplement or take progesterone for a while. So obviously I’m not anti-medicine. But what I’ve found is that if you can give yourself — I think a colleague of mine says it in a really great way — you know, if it took you eight years to get to this place or whatever however long, consider maybe giving yourself at least eight months to sort it out. And I feel like this is not bad advice, especially when you know you’re dealing with a hormonal challenge. Think about a year from now. So think about next May, May 2022. And once you get to that point, because you’ve been charting, you’ll actually be able to look back at several charts from that time. You’ll be able to look at those parameters like your luteal phase, you’ll be able to look at your periods, your cervical fluid. And even if you don’t feel always on a cycle-to-cycle basis that you’re making progress — from my standpoint, that is really helpful for you to take an opportunity to kind of look when you have more data. Because sometimes the changes cycle to cycle are there, but they’re not necessarily every cycle this giant push. But a year out, that’s a wonderful opportunity to look at how far you’ve come. And I would really encourage you to do that.

Alden: Yeah, totally. I mean, even in the past six months — I’ve been charting for eight months but I’ve had my IUD out for six months — I’ve seen just such major positive shifts in my chart. Like six months out even, I’m noticing positive differences. Like, I would like my luteal phase to be a little longer now, but it’s longer than it used to be. And I’m seeing a clearer temperature shift, you know, the day after my ovulation. And my temperatures are higher. And also my menstrual blood used to be like this dark, dark, dark like brick brown — that’s the color that indicates low progesterone — for like the first three days before my period even started fully. Then now I get it and it’s just boom, like this bright gorgeous red. And then it ends and it never really tails off into anything brown or overly light pink. And so for me, like that’s huge. That I’m also able to note that and know what it means and use it as a parameter for like, hey, things are getting more balanced.

Lisa: Well, I mean, for the majority of our call we’ve spent on your story. I think usually in these calls we have a little bit more time for a bit of a session portion. One question I did want to ask you, just as we’re wrapping up, is — so a big part of your journey specifically has been focused obviously on hormones and sorting this out. And that has made up a lot of our conversations within the group. But I wanted to check in with you about the charting aspect and the birth control aspect of it. You know, obviously there’s a bit of a learning curve. How has that transition been for you and your partner to kind of move towards this method instead of relying on the copper IUD?

Alden: Totally, yeah. I want to honor the fact that I’m in a hyper-privileged position that I can have access to all these doctors and really continuously fight for my health. And also that I have a partner who is willing to go this more natural contraceptive route and who I trust to follow these protocols with me. Because I know a lot of people don’t have that. But he has been wonderful and he and I have been together for 10 years and he’s seen this whole intense journey I’ve gone through. So he’s definitely of the mindset like, anything that will help her feel better, we’ll do. And so it’s been really, really educational to see — like, oh, you know, I think you grow up being taught like, you’re fertile all the time, any time you sit anywhere you could have a baby. And it’s like, oh no, that’s not it. Because of my history of hormonal contraceptive use and the hormonal imbalances I’m currently working through, I do have a longer fertile window than like the average ideal person. As we’ve noted, I tend — instead of six days, mine is more like 11 to 14 days. But even then for me, that isn’t like, oh the end of the world, you know, I have to be super aware that I’m fertile these days. I just communicate with my partner and we either abstain or use alternative methods on those days. And I find that as long as there’s an open line of communication and body awareness and also this regimented clear — okay, these are things that we can do — then there hasn’t been an issue and everything has felt very supported.

Also, in using the fertility awareness method for birth control, I feel so much better health-wise because of everything we’ve discussed, that for me the technically extra work it takes to track your cycle and know your fertile window versus your infertile times — it’s not a negative thing to me. If anything it’s a positive thing. And I just find that open lines of communication between you and your partner are really what you have to utilize to then make it work as an effective form of birth control, which it has for me for the past six months. And one day when we hope to have children, we can just flip that really easily and start trying in the fertile window.

Lisa: Well, yeah, I’m glad that you have been able to navigate and negotiate that. And I think it really highlights that there is no perfect birth control method. All methods have their challenges. They have kind of their ups and downsides depending on how you look at it, right, depending on your perspective. So I think you’ve addressed that a couple of times in a way that makes a lot of sense.

For someone who’s listening, maybe they’ve faced some of the same challenges that you have with different contraceptive methods and they’re considering fertility awareness charting or they’re considering getting their IUD out or whatever the case is — what if anything would you want them to know?

Alden: I would say listen to your own body and trust your own body because whatever it is you’re feeling, you’re feeling it. And that also, you can do the work to make it feel better. Like if you’re someone who’s struggling with PCOS, you just don’t have to be on the pill for the rest of your life to band-aid manage your symptoms. You can learn body literacy and use fertility awareness method and lifestyle changes to help support yourself. Because at the end of the day, your body wants to help. Your body wants to help you get better. You’re not at war with your body. It’s about figuring out how to be in partnership with your body and support it instead of trying to shrink it and shut down fertility and everything. Supporting your health means your body will support you back. So yeah, trust yourself. That’s my main thing.

Lisa: That was good. And then last question — if someone’s thinking about jumping into the group program, the Fertility Awareness Mastery Live group coaching program, what if anything would you want them to know?

Alden: I think for anyone who is thinking about jumping into this — I personally had about six months of charting experience before I jumped into it. And I was also listening to this podcast and reading books and everything. And it’s a great way to continue to expand your knowledge and to also deepen your charting skill set. Like there were so many things with charting that I had like the basics right, but there were so many — especially within the Justisse method — there were so many things that Lisa has really helped me learn. So just don’t be afraid that it’s going to feel too overwhelming because Lisa will really support you through it. And you don’t have to have six months of charting experience to jump in. It can be like, I want to learn fertility awareness method, and I’ll take this course. So it can be for absolute beginners or people who have some experience. And there’s a mix of both in our class, and I think you can get something from it no matter what.

Lisa: Oh, that’s so nice. Well, Alden, it has been a pleasure chatting with you today. I really appreciate you taking the time to share your story. I know that this will be really helpful for a lot of women who are listening. And we have a class a couple of minutes after this — I’m going to see you again in a minute.

Alden: Yes, totally. Well, thank you so much, Lisa. I appreciate all you do and have a good lunch.

Lisa: Thank you for listening. If you enjoyed today’s episode, please share it with a friend. You’ll find the show notes page for today’s episode over at fertilityfriday.com/401.

I hope that you enjoyed today’s episode with Alden. It was really a great opportunity for her to share her story, especially for those of you who have experienced PMS — whether it be mild, moderate to severe — or if you’ve experienced PMDD. And certainly I feel like it’s always really important to go back to the basics. This is how I look at things. And if you do experience moderate to severe PMS, I know in our culture we’re kind of told that it’s normal, it’s fine, women are emotional, we’re moody, all that kind of stuff. But ultimately, it’s really important to know what’s normal in the menstrual cycle and what’s not normal in the menstrual cycle, because that allows us, first and foremost, to even be able to identify if there’s something wrong.

So, although it is normal and perfectly acceptable to experience changes in your mood to some extent, changes in your energy levels throughout your cycle — when you get to the point where it’s interfering with your life, you’re having severe kind of mood swings that are causing fights with your partner, where you can’t get out of bed because you’re so tired, when it’s really starting to affect your life — that is certainly the point where we should say, no, this is not normal. Sure, there are differences that happen in our moods across the cycle. Sure, there are differences that happen in energy across the cycle. But there is a limit to what we can call normal. And so I think it’s just really helpful just to remember that it is not optimal to have these symptoms. And it is a sign of a hormonal imbalance — because women who have progesterone dropping too soon in the luteal phase — there’s a number of things that we can do to improve progesterone production.

In the show notes page, I’ll actually link a couple of recent episodes that I did. I did an episode on low basal body temperature, and I also shared an episode on low progesterone and improving progesterone production. So I’ll link those two episodes in the show notes if you’d like to hear more information about some of the general strategies — highly effective, by the way — that you can do on your own to improve your overall hormonal balance throughout the cycle, particularly progesterone in the luteal phase, which is directly related to PMS symptoms.

So with that said, I hope you have a wonderful week — weekend — whenever you’re tuning into the show. And of course, as always, until next time, be well and happy charting.