What do you do when you want to fix a menstrual cycle issue, but you don’t want to be pushed birth control to circumvent fixing it? Are regular OB/GYNs to be avoided?
As a fertility awareness educator who has helped women and couples with reproductive issues, I know it can be hard to know if OB/GYNs will share your health goals. More often than I can count, I have seen some variation of the following scenario play out online, particularly in more “natural,” “crunchy,” or Catholic Facebook groups: A woman reaches out for advice related to some menstrual cycle or other gynecological issue, and nearly every reply suggests a course of action other than seeing a traditionally-trained OB/GYN.
Other women chime in to exhort the original poster to see some sort of restorative reproductive medical (RRM) provider, often of the NaPro Technology variety. If one isn’t available nearby (as is the case in many areas of the United States), it is frequently suggested that the original poster seek out a naturopath or other alternative route.
As someone who has, at various points in my life, reached out for help from RRM providers, I understand the knee-jerk impulse to avoid an OB/GYN who might not share your values or health goals when it comes to treating something like endometriosis without birth control, or (as was my case) treating infertility without resorting to IVF. Especially if you’re someone who’s inclined to turn to natural solutions to get to the bottom of an issue, it can seem like most mainstream solutions to gynecological issues are completely counter to that, pushing women in one of two extreme directions. On one side of the spectrum, you’re offered birth control to shut down your reproductive system in order to circumvent issues like endometriosis, polycystic ovary syndrome (PCOS), premenstrual syndrome (PMS), and more. On the opposite side, you’re offered drugs and procedures to send your fertility into hyperdrive to combat subfertility or infertility.
It’s no surprise then, that many women are increasingly turning to restorative reproductive medicine to treat various gynecological health issues. Generally speaking, RRM protocols like those found in NaProTechnology, FEMM, and NEOFertility work to correct the underlying pathology of issues like PCOS and infertility, in order to restore the body’s natural functioning. The philosophy behind RRM is that infertility and painful periods are symptoms of a broader, underlying problem; by getting to the root of the problem, you can restore the body’s natural functioning so that a woman’s body can cycle and reproduce as it normally ought.
But seeing posts like the one I described above, I have to wonder if there isn't a way to empower women to press for more answers from traditional doctors, especially if a NaPro doctor or other RRM provider isn't easily accessible. I also wonder if the distrust of mainstream doctors has gone a bit too far, to the point that women trust the advice of other laywomen over medical experts. Is there a middle ground where women can gather information themselves, so that if their only option for care is someone who is not NaPro trained, they can advocate for the right tests and treatment?
I have personally felt that same suspicion over "mainstream" doctors. My story is a good example of the need to reach out to a mainstream provider, while being prepared to advocate for yourself to get the kind of care you want. It can undoubtedly be a frustrating experience, but it can also be an empowering one that yields fruits beyond what you might originally expect.
Mainstream OB/GYNs vs. those trained in restorative reproductive medicine
Let me rewind back to 2015, when I was a newlywed struggling with increasingly heavy, painful periods and infertility. I waited for months to get help for these issues, fearing that I would meet with the same refrain I’d heard other women who shared my plight of painful periods were facing: “If you won’t go on birth control, there’s nothing I can do for you.”
But eventually, like many women experiencing the same, I reached my breaking point. I simply could not handle another period where I was stuck on the couch for three days with a throbbing headache, cramps, backaches so intense they sometimes made me nauseous, and pads full of big, dark clots, followed by days of prolonged brown spotting. So I caved, and called to make an appointment with my newly assigned primary care provider. When I was told she was off island (we were living on Guam at the time, stationed there by my husband’s employer, the U.S. Navy), I didn’t care that I’d have to see someone else. I assumed all of the providers in the family practice clinic at Guam Naval Hospital would more or less be the same in their approach to dealing with heavy periods. I’d resolved to see someone–anyone–and I was determined to fight for the kind of evidence-based care that I wanted.
When the day of the appointment dawned a few weeks later, I was gearing up for a fight.
It’s true that the doctor with whom they scheduled me was not an officially-trained NaPro doctor, like I would have sought out, had there been one on the island. But to my complete and utter surprise, he was very familiar with NaPro, taught fertility awareness charting with his wife, and wanted to treat my painful periods and my infertility in an evidence-based way that was also in accordance with my personal convictions. To say I was floored is an understatement. I quickly realized that if I hadn't reached out to a doctor whom I assumed was merely "mainstream," I never would have found out that he was actually knowledgeable about restorative reproductive techniques like NaPro, even though he wasn't formally trained in it.
Now, not everyone can be as lucky as I was, to stumble across a NaPro-familiar doctor where I least expected to find one. But I have to believe that there are other physicians out there who have great dedication to treating their patients well, who might be staying on top of the latest research about fertility awareness and how information from a woman’s unique cycle can assist in more precise treatments. No matter who your regular OB/GYN is, you can broach the topic yourself to find out. This can be an opportunity to open up your physician to a whole new way of treating reproductive issues that they may never have heard about before.
After all, many physicians see the negative effects of birth control on their patients and want to be able to offer something different, but simply don’t know that other, better options exist for treating the root causes of some of the most common reproductive issues women face. (Thankfully, the organization Fertility Appreciation Collaborative to Teach the Science, aka FACTS, is working hard to correct this lack of education in the next generation of physicians.) There are also physicians out there, like my husband, who may not be NaPro trained, but are knowledgeable about fertility awareness, and can offer referrals when needed.
I mentioned this earlier, but it bears repeating: While NaProTechnology has been a trailblazer in medicine, NaPro is no longer the be-all, end-all when it comes to restorative reproductive medicine. FEMM, NEOFertility, and the Reproductive Health Research Institute (RHRI) have their own successful medical protocols for treating infertility and gynecological disorders. And in spots across the country like California where I live, there’s been explosions in alternative medicine, including naturopathic and functional medicine. In my experience, these types of doctors tend to favor more restorative methods when it comes to female fertility.
Having options and second opinions are always good
There are a lot of benefits to reaching out to your doctor for help with a fertility-related issue, even if he or she is not specifically NaPro-trained. He or she might surprise you by knowing more about the issue than you’d thought, and it could be a valuable learning opportunity for both of you. As with the rest of life, we miss out when we stay in an insular bubble, suspicious of everyone else.
It’s important to take the time to educate yourself about your options, and to ask yourself, “What are my non-negotiables for treating this issue?” Find the evidence to support the kind of treatment you want, and don’t be afraid to print it out and share it with your doctor. Organizations like FACTS and Natural Womanhood have materials for just that purpose! And if you do hear that dreaded refrain, “If you won’t go on x, y, or z drug, there’s nothing I can do for you,” don’t fret. One of the silver linings from the pandemic has been the proliferation of telehealth services, including for restorative reproductive medical care.
Women are hungry for more healing options in reproductive medicine than hormonal birth control, and many physicians are eager to better serve their patients. Educate yourself on your options, don’t be afraid to trust your gut, and don’t hesitate to reach out to your doctor if you have a menstrual cycle or fertility-related issue. You might end up surprising each other!