It has been a long time since I heard “the talk” about becoming a woman.
At school, the coming-of-age tale was a short video titled Julie’s Story about a girl getting her first period. Our school nurse explained sanitary pads and tampons and told us to mark the first day of each month’s bleeding on a calendar so we could count to the next one.
We went home shuddering about this secret, gross thing we were going to have to deal with until we were older than we could imagine. I was oblivious to the innumerable ways my monthly cycle would speak to me about my own body.
Why Charting Is a Game Changer
Your menstrual cycle involves a lot more than your reproductive system. Your body uses your adrenal glands and thyroid to produce estrogen. Breaking down reproductive hormones requires the liver and gallbladder. Fertility Education & Medical Management notes: “Because of the interdependence of all of these systems, the health of your monthly cycle is a great indicator of your total health, and any changes in your monthly cycle can indicate potential health issues."
When symptoms such as moodiness, hair growth, weight loss or gain, acne, anxiety, difficulty sleeping, fatigue, and migraines cause lifestyle changes, it’s time to investigate what may be causing them. This is where charting your cycle sheds invaluable light.
Anna Halpine, CEO of FEMM, explains: “Women are often not taught that the important indicator of their health is ovulation, rather than bleeding. Bleeding is a sign that a good ovulation occurred, and that the uterine lining built up and shed as a result.”
Apart from my school nurse telling us to mark days on our calendar, for a long time, charting wasn’t something I was even aware of. In my experience, the value of decoding symptoms of feminine health is something not every medical professional is willing to entertain. During undergrad, I asked a nurse in my university’s infirmary about some discharge I’d noticed. When I told her I wasn’t sexually active, she told me not to worry about it and sent me on my way.
It wasn't until our engagement that my husband and I learned how to chart using the sympto-thermal method, just one of several fertility awareness methods. I determined my fertile and infertile days each month by tracking biomarkers such as my basal body temperature and cervical mucous. By charting, I learned that what I’d observed back in college was a normal sign I could use to understand what was going on inside my body any day of the month. It may not have been something to “worry” about, but I wish the nurse had encouraged me to understand it.
Perhaps I might have even discovered a possible health issue linked to my miscarriage down the line. Christina Robinson, a nurse practitioner, notes, "If charting indicates a short luteal phase (the time between ovulation until your next menses begins), this could indicate a higher risk of miscarriage. If there are multiple days of spotting at the end of the cycle, this could also be in indicator. Both point to a progesterone deficiency which increases the risk of miscarriage." With up to 1 in 4 clinically recognized pregnancies ending in miscarriage, this sort of biological information is important for any woman to grasp.
When Irregularity Strikes
“The main thing a woman should understand and chart is whether she ovulates," Halpine says. "All charting methods are there to teach her this critical information.” And there are a host of methods to choose from—Marquette, Billings, sympto-thermal, and Creighton, to name a few. They all share a common understanding of how follicle-stimulating hormone (FSH), estrogen, luteinizing hormone (LH), and progesterone levels shift during the cycle. And they indicate how abnormal hormone levels might express themselves (a heavier or lighter period, perhaps, or painful PMS).
In short, FSH signals your ovaries to mature your eggs and produce estrogen, which builds up our uterine lining. When there’s enough estrogen, LH triggers the release of an egg, aka ovulation. After ovulation, your progesterone levels should increase while estrogen levels decrease; this is called the luteal phase. If the egg isn't fertilized, your progesterone levels drop, the uterus sheds its lining, you have your period, and the whole process starts over. At least, it should.
The first step in a diagnosis is for you to identify three irregular cycles within a calendar year. Halpine defines “irregular” as “cycles shorter than twenty-four days or longer than thirty-six days, cycles without a clear ovulatory pattern, or cycles with a luteal phase of less than nine days or greater than eighteen.” Charting allows you to pinpoint whether all three patterns are regular.
Next, blood work can analyze your hormone, vitamin, lipid, glucose, and insulin levels. Ultrasounds of your ovaries and other organs can give further insight to support a diagnosis. The more accurate the diagnosis, the better your chances of effective treatment, whether you’re trying to regulate a thyroid issue or eliminate debilitating abdominal cramps. Low progesterone levels, for example, can easily be remedied by taking progesterone supplements.
Get the Information You Need
Some hospitals and clinics provide doctors, nurses, certified instructors and classes on how to use a FAM properly, whether to track your period, pinpoint a health issue, achieve or avoid pregnancy. Depending on your health insurance, all or part of the costs may be covered. Once you have the knowledge, there are no further costs.
Discuss charting options that might be available to you with your ob/gyn. Ask friends or family who are using different methods about their experience. Or visit FertilityCare.org to find a local certified instructor.
While I won’t underestimate the wisdom of a good instructor and the power in learning how to accurately use and analyze your monthly chart, there are apps like Kindara, Pink Pad, and FEMM to help automate those calculations. Whether it’s on your phone or on paper, Dr. A. Nicky Hjort, M.D., OB-GYN, emphasizes the most important thing: Choose a method you’ll use consistently.
We Need to Pay Attention
I have friends who say they can feel themselves ovulate—I’m not one of them. But because I have other means of observing changes in my body, I can know if it’s trying to tell me something—whether all is well or something is amiss.
Jennifer Chirdo, RN, BSN, MS, is a FertilityCare Practitioner and a charting single woman. Chirdo shares that a number of conditions can be discovered through charting, ranging from hormone effects secondary to eating disorders, chronic stress, excessive exercise, and sexually transmitted diseases. Charting can also uncover and help treat conditions such as insulin resistance and pre- (or pre-existing) diabetes, thyroid disease, and even reproductive cancers.
Moreover, some cycle patterns reveal a likelihood of developing postpartum depression through accurate assessment and evaluation of PMS, which can indicate serious hormonal issues. If a woman knows she’s at risk of PPD, she can learn safe, healthy, and holistic ways to address and intervene during and after pregnancy.
Through three successful pregnancies and a miscarriage, I am able to keep tabs on what my body is telling me. For instance, I’m aware that I’ve likely remained infertile while nursing each child for at least a year because of cervical dryness, a biomarker I learned from charting. Nurse Robinson shares, "Our hormones are altered while breastfeeding and, while it would be possible to ovulate without seeing cervical mucous, it’s a very, very small chance." I’m still nursing our youngest, but we’re going to use a monitor to take a little childbearing break when she’s weaned. Because I’m not nursing as much, I’ve been using the FEMM app to track my fertile and infertile days.
I take it for granted that I have this knowledge that so many others don’t. When it’s time for me to give "the talk," I will be sure that my daughter isn’t left in the dark about the beautiful ways her body is capable of letting her know what’s going right—and what’s not. The knowledge is literally inside us. All we have to do is learn how to listen.
Photo Credit: Clara Nebeling