In today’s episode, fertility coach Lisa Hendrickson-Jack joins us to explain how the fertility awareness method can be used for the TTC fertility journey as well as for postpartum and lifelong bodily awareness. Lisa is a certified Fertility Awareness Educator and Holistic Reproductive Health Practitioner who teaches women to chart their menstrual cycles for natural birth control, conception, and monitoring overall health. In her book The Fifth Vital Sign, Lisa debunks the myth that regular ovulation is only important when you want children by recognizing the menstrual cycle as a vital sign. Drawing heavily from the current scientific literature, Lisa presents an evidence-based approach to fertility awareness and menstrual cycle optimization. She hosts the Fertility Friday Podcast, a weekly radio show devoted to helping women connect to their fifth vital sign by uncovering the connection between menstrual cycle health, fertility, and overall health.
Episode Topics:
How Lisa got into this work
What a vital sign is and why we should consider the menstrual cycle a vital sign
What fertility awareness method (FAM) is and what the three main signs of fertility are
A bit on perimenopause, menopause, thyroid issues, hypothyroid, self-care, charting/FAM as a key way to learn about developing issues and to have increased body knowledge
Common issues folks trying to conceive have (pill takes time once getting off, male issues, PCOS, Endometriosis)
Some things a person can do to optimize chances of conception and why it’s important to plan ahead
The problem with the birth control pill - history and physiology of what it does and what a “false bleed” is
Choosing a care provider and team for your fertility journey and/or for menstrual issues
How to successfully use fertility awareness for birth control -- is breastfeeding alone reliable (the Lactational Amenorrhea Method), checking cervical mucus to know when ovulation resumes
Ways Lisa can support you in the fertility (and women’s health in general) journey
Resources:
Fertility Friday podcast
The Fifth Vital Sign by Lisa Hendrickson-Jack*
Facebook: Facebook.com/FertilityFridays
*Disclosure: Links on this page to products are affiliate links; I will receive a small commission on any products you purchase at no additional cost to you.
Sponsor link & offer:
chiyo (formerly nouri) - meals delivery service for NYC, Long Island, & northern NJ customized for the fertility, prenatal, and postpartum time of life
Interview Transcript
Lisa T: Hi, Lisa. How are you doing today?
[00:00:02] Lisa H-J: Hi, I'm so glad to be here. Thanks for having me.
[00:00:04] Lisa T: I am thrilled to have you. Lisa has written this wonderful book that I introduced to her at the top of the episode, and I am wanting to spread the word to everyone that I know, please read it. Not just women, but humans in general.
[00:00:20] I think this is information that every person should have. We don't learn about our bodies enough and our cycles. And so I'm really thrilled to dive into some of this good juicy stuff. First I just wanted to mention just for whatever it's worth, the little bit that I knew about the fertility awareness method.
[00:00:37] Growing up, my mom started trying to have my sibling to conceive my sibling when I was six. And it took her almost eight years to do that. They had a lot of struggles.
[00:00:50] And along that way, she was charting. She had her little handwritten chart next to the bed and her thermometer, and she would take her temperature every morning and do all the things. So I kind of learned a tiny bit then. But there was so much I didn't know. And just to finish that story about her at the end of the eight years, they finally gave up and she was, I think, 42 at the time.
[00:01:13] And then they conceived my sister and I was almost 14 when she was born. And I'm so grateful to have a sibling, but it was a really hard eight years. And then speed forward to when my husband and I were thinking about trying to conceive. It was the funniest thing. I was like, okay, I want to look into this. I think I might want to start charting like my mom did. I was working at a nonprofit and one day I was like, "My desk is kind of wobbly, what's going on?" And so I start looking underneath, I find the book Taking Charge of Your Fertility.
[00:01:49] Lisa H-J: Holding up the desk?!
[00:01:50] Lisa T: Holding up the desk. And I was like, perfect. Isn't that fantastic? So I was just was like, "Oh my gosh, it's a sign. I have to read this." And so that started my journey into the charting and I was like, "Oh yeah, this is what my mom did."
[00:02:04] Lisa H-J: Wow. That is incredible.
[00:02:07] Lisa T: I thought it was just a really, really kind of cool thing, but even reading that book. That book is very different from your book. I mean, there are definitely lots of similarities. I feel like it's more of a textbook and has a great use as well. But then again, speed forward to in the last year or two, I had heard good things about your book, The Fifth Vital Sign, and I finally got around to reading it and I, "Oh my gosh. I just was like, why did I wait? I needed to read this like years ago. Where was this?" I mean, because I was on the pill for years and I wish I hadn't. And I realized all the migraines and different bad side effects over the years... and after I had my babies, I was like, I never want to go on any form of hormonally based, especially birth control, but like everything. Everything I looked at, I was like, I don't like the side effects, I don't like the risks. So, so this information is so great. So sorry, that was a little long-winded.
[00:03:04] Lisa H-J: No, that is, that is awesome. And I mean as you I'm sure, probably know, or probably guessed, I mean, when you talk about this information -- so for me, I discovered at a pretty young age, I was about 18 or so when I discovered fertility awareness and obviously it's, life-changing whenever it happens, but what that means for me is that I was able to take that for granted. In my twenties, I used fertility awareness to avoid pregnancy. And then when I was ready to start my family, then my husband and I just kind of switched it up, do the opposite things on the opposite days. But what happened is really when I had my son. So I had been teaching at a not like a super public online, social media type of way. But when I had my son, I realized that most women still don't know this. So it's interesting to have an experience where, you know, even for you, for your mom to have been using it so many years ago, and to still know that most women don't know.
[00:03:57] You know, you know, even that they're not for fertile every single day. And so the book was essentially a way for me, it was kind of like my contribution. It's like, if we wait for the school system to decide this is important and to make it part of the curriculum, we'll just keep waiting. And so this was kind of like that.
[00:04:13] "Okay. I'm going to do my best to put what I know into one place so that it can be accessible for women who need it."
[00:04:20] Lisa T: Amazing. So before we jump into like, what is the fifth vital sign and all that good stuff, can you just tell us a little bit more about how you got into this work, how you became passionate?
[00:04:29] Lisa H-J: Yeah. Well, I mentioned that I found fertility awareness at a young age. So when I had, from my very first period, it was painful and heavy. So my experience with menstruation as a young lady was not the greatest. And I was really into sports, you know, as a ballet dancer, you know, basketball, all the things. And so obviously having super heavy, painful periods is not conducive.
[00:04:50] So I didn't know anything other than, you know, I heard that girls go on the pill and then their "periods" are lighter. So I went to the doctor's office and I literally was like, "My periods are painful and heavy." And before I finished my sentence, he was writing out the prescription. So I got what I came for, you could say. And so then I had this experience of like, wow, you know, "I'm fixed!" My periods were super light and easier to manage and you know, very minimal pain. And I didn't know that they weren't real periods. And so I would come off the pill periodically because I actually wasn't sexually active when I went on the pill.
[00:05:27] And then lo and behold, they would come back and they were just as horrible. So what happened in my case was that when I actually did become sexually active, I decided to come off the pill because I didn't trust it because I never took it at the same time. And I felt like I'd always be in a constant state of horror and stress and terror.
[00:05:45] So I feel like I was kind of the opposite in that respect. And it was around that time that I discovered fertility awareness. So I was going to use condoms. And then I still did, but then I discovered fertility awareness and that was this really kind of transformative thing. Cause when I went to school, I learned erroneously that I could get pregnant every day.
[00:06:05] The teacher stood in front of us and told us like there's no safe days. Like basically, if they looked at you, then you are going to be nine months pregnant that day. So basically I was terrified. So I [used] condoms a hundred percent of the time but I chose not to be on the pill because I had this fear of like, "What if I got pregnant on the pill and I didn't know when I was still taking it?" I had this whole story in my head. And then I learned that you're not fertile every day that there's a fertile window that you could monitor with your cervical fluid and your basal body temperature and cervical position. And there was a period of time where you can't get pregnant -- [it's] scientific and biological. I bought Taking Charge of Your Fertility and I read it and I started charting and it was just like a weight was lifted off. I wasn't terrified anymore. And even my fear of like, I don't know why I had that fear of like getting pregnant, not knowing that I was pregnant for a long time.
[00:06:59]But then all of that was gone, too, because when you chart, if you did have a condom breakage situation and you did get pregnant, then you would know right away. And so anyways, that is how I discovered it. And then of course I was super passionate and super keen. And on my university campus, just like how you found that book under your desk, there was a group of women who did charting some of whom were educators, training, all of those things to professionals who knew what they were talking about.
[00:07:27] And that's how I learned. That was kind of phase two of my own journey. And so I just didn't ever stop attending. Eventually, I was part of the group and we were teaching and we, you know, a group of us took a training program together in my early twenties. So I was teaching at a young age, you know, differently to how I do online and all of that.
[00:07:48]It was in person, very grassroots, but this was what I was doing in my twenties. And this is basically how it started. And then the internet came about and social media and podcasts and the rest is history.
[00:08:01] Lisa T: That's so cool that you were doing it that young. Well, so can you explain for those who were like Fifth Vital Sign? What the heck does that mean? Can you explain that a little bit?
[00:08:11] Lisa H-J: Yeah, for sure. I mean, a vital sign is essentially a bodily response that you can measure. And the ones that we're most familiar with are our heart rate, body temperature, respiratory rate, blood pressure. And we all know that if you go to your doctor, they'll check your vitals.
[00:08:25] And if your blood pressure, for example, was too high or too low, not only would it tell the doctor that there's something wrong, but there's reasons for high blood pressure versus low blood pressure. So it gives the doctor a bit of a roadmap for how to look -- similar to temperature or something like that.
[00:08:40] If you have a fever, they kind of, there's like a short list of things that could cause it. And the menstrual cycle is also a vital sign and it can be used as such. And what that means is that similar to the other vital signs, there is a parameter of what is actually normal. When I say menstrual cycle, I'm referring to the whole thing.
[00:08:58] So often when I say menstrual cycle, you think period, which is part of it. But I'm talking about, you know, the first day of your cycle would be the first day of your period, the first day of your true flow going until the day before your next cycle. And in there, we've got cervical fluid production, we've got ovulation, we've got the duration of time between ovulation and your next period, which is called the luteal phase or the post-ovulatory phase.
[00:09:19] And so if we break the cycle down and all these parts, then there are overall categories, what we consider normal, but there's also within each of these parts of the cycle, what we would consider normal. And so you can gather information from, you know, if you have a yeast infection or some abnormal kind of discharge to if you potentially have something really serious, you know, like continuous bleeding that could give you a sign that you have uterine cancer, you know, God forbid, but just to give the gamut. And so it's really unfortunate that this isn't just how medicine is done because by having women track their cycles cycle-to-cycle, even the regular variations to see how your cycles are affected by stress all the way up to if you have an endocrine issue that disrupts normal cycle functioning, your menstrual cycle can be this incredible window that tells you if something's wrong. So of course, I teach my clients to chart in a specific way. But from that perspective, you can get information even at a subclinical level. So getting that heads up before it's uterine cancer -- bad example, but you know what I mean, right.
[00:10:22] You can gauge all of that. So that's one of the things, I mean, I think you kind of mentioned it when you talked about Taking Charge of Your Fertility. So a lot of women get into charting because of course there's some benefits to it. There's some very practical applications.
[00:10:36] If you had some negative experiences with hormonal contraceptives, bad side effects, and you're looking for a hormone-free contraceptive that is effective you know, many women choose fertility awareness for that reason. Because it is as effective as hormonal contraceptives when used correctly. So perfect use -- 99.4%. Certainly we could talk a little bit about why the typical use can be a bit different. But if you learn the method, take the time to understand it and use it correctly it's extremely effective. Other women are using it to get pregnant, but there's this kind of elephant in the room where when women start to chart, they quickly start to notice that their cycle curiously changes with respect to their health. And so this is the part of it that I really address. And that's probably what made my book a bit different.
[00:11:21] Lisa T: And yeah, that's what I was going to point out is that that's what was so eye opening was, I was like, Oh my gosh, there's so many other uses, there's so much more value in fertility awareness than just trying to not have a baby or trying to have a baby just for our body knowledge to, to know when we're getting sick or like you were saying you can have insight on very specific potential health challenges that we might encounter in our life way before a doctor would ever even know it.
[00:11:48] Lisa H-J: I mean, that was my personal experience. So of course for me, I wasn't there for like the whole enchilada. I just wanted the birth control to be honest with you. So when I started charting that's it. I was just like, "Wow, like I can use this. I can know when I'm in my fertile window, know I'm good to go and I don't have to be afraid.
[00:12:09] And, and that's all I was there for. And then I love the iceberg analogy because there's like 90% under the surface that you don't see. So I'm charting. And I remember reading that there were different cycle lengths, right? It was very liberating like, Oh, you know, 28 days, every woman doesn't have a 28 day cycle, which is true.
[00:12:26]But my cycles were like 40 to 45 days. But I, being like all of 18, it's like, obviously didn't know a whole lot. With my 45 day cycles, I was like, "Oh cool. Like, my cycles don't need to be 28 days. Like I, you know, I'm Lisa and I have long cycles." And unfortunately for me, I had charting instructors around me who were aware and they looked at my chart.
[00:12:51]One of my charting instructors looks at my chart and she's like, "Lisa, your cycles are too long and your temperatures are too low. You need to get checked for thyroid." And that moment, I will always remember because I did get checked for thyroid and I did have hypothyroid and it was identified because of my chart.
[00:13:06] And I was just amazed that someone could look at my menstrual cycle. And this was at the time before apps. So I had my chart, like on a piece of paper, my spreadsheet. But yeah, so I was amazed and that is basically where this all began for me because there is the practical application, which is amazing, but there's also this other health related aspect that is really transformative.
[00:13:31] Lisa T: Yeah, and thyroid issues are so common, I'm learning more and more and more. And so I always point out in our postpartum wellness topic of childbirth class, when we're talking about, okay, you go for your six-week checkup to your midwife or your OB. And they usually will say, "Hey, you've healed enough that you can have vaginal intercourse again.
[00:13:50] And that's when they'll say, "You know, let's go over the birth control options if you're planning on using that. And so I always want to plant that seed of fertility awareness right then. I take like just a minute or two, I recommend your book. I'm like, "Do not pass go," look into this. Because if you look at the risks of black-box warnings of the other options, it's very eye-opening. Another thing I like to mention is what you were saying just a few minutes ago, about how effective it is, you know, that when it's done, according to the plan, that it is just as effective as our most effective forms of birth control without the side effects, without the risks and with more body knowledge.
[00:14:29] And back to the thyroid thing, I'm now 46, so I'm like done childbearing. I have my two children and we're all done with that. So I haven't been charting, but I'm, you know, reviewing your book again. I'm kind of like, you know what, hypo thyroid runs rampant in my family. Maybe I really should be charting to get a little more insight if I were to start developing hypothyroidism. So anyway that's not really for this audience. I would love to like, learn more about that whole going toward perimenopause and menopause. Maybe that's for a different discussion.
[00:15:01] Lisa H-J: I mean, we could touch on it a little bit. So this is kind of where it comes in as well, where, you know, most women are thinking of charting for a specific purpose. But for someone like me, who's been charting for so long, it's helpful. And charting in, in many ways can help for women who are navigating the pre-menopause period. So menopause is an event like menarche is an event. And so menarche is the first period and menopause is actually the last one.
[00:15:29] And it's defined as, you know, you have a period and then you go a year without having a period. And the average age is somewhere between age 50 and 55. And so the 10-year period preceding menopause. So if it's between 50 and 55, so that can be, you know, between 40, 45 is when you can, you might start to see some cycle changes. And charting can be helpful especially if you have that additional awareness of what's normal and what can happen.
[00:15:58] And so one of the things that can happen during that 10 years before menopause is that the cycle can shorten. So what I always say to my clients is that, you know, even if your cycles are always regular, always the same, every woman will have a cycle at some point in the reproductive life, you know, if she's charting and paying attention to it, that is shorter or longer than what is typical for you.
[00:16:19] And so it's not uncommon during those 10 years before your last period to start seeing the cycles shorten a bit. And so, you know, 21 to 24 days is not totally out of the options and what is happening in cases like that is that the ovulation is happening sooner. And so I think that it's helpful, like, if you're not trying to have a baby and if your partner hasn't been snipped that it is helpful to know that that can shift. So that you don't accidentally have sex the day after your period thinking it's fine and it's not fine. And also then as you get to the two years before the last period, you might notice that the cycles lengthen.
[00:16:57] And one of the things in general that I think many women discover in their forties. And so I'm not in my forties yet. I'm almost there. But certainly I've worked with a lot of women in their forties. Is that you can't get away with what you used to get away with. I mean, we start to see that in our thirties.
[00:17:13] So, you know, in your thirties you can't get away with everything you could in your twenties and specifically, I mean like the drinking the coffee every day, the eating the sugar all the time, the not sleeping and the living hyper-stressed. So one of the things that charting does, and so for anyone who's not familiar, when I say charting, I'm simply meaning that you're recording the main fertile signs.
[00:17:34] So you're writing down your cervical fluid, you're writing down your, you know, your periods, you're tracking the cycle length, and you're paying attention to these things. And so, for example, if you're eating all the sugar you know, or I could call out a lot of things or not eating, skipping meals, you know, doing exercise like CrossFit seven times a week, twice on Sundays and not eating enough, there's a lot of things that you can do that can disrupt your hormones and disrupt your cycle. So when you're charting, I feel like you, it shows you. Like, if you start a new CrossFit routine I'm picking on CrossFit. If you start a new exercise routine and all of a sudden you notice that your, so the second half of the cycle between ovulation and your period, if you notice that instead of the normal 12 days, that's like 10, and then you start to see spotting.
[00:18:21] You kind of have that opportunity to be like, "Oh, wait a minute, this changed, what did I, what did I do?" And you have the opportunity to correct it. So when you're charting, you kind of, can't go totally off the rails. Like when you're paying attention to your cycle, because your vital sign is calling out to you.
[00:18:37] Like if you stop having a period, if you stop ovulating, if you start spotting randomly, if you start experiencing really intense PMS and you notice that it's at a specific time in your cycle, these are things that when you're paying attention, it's kind of like your body can't talk to you in words. So it's tapping you on the ovary and being like, "Look, you need to stop."
[00:18:58] And so when you're, if you have that kind of going into your thirties and in your forties, when you're dealing with the pre-menopause phase, then it can be even more of a reminder. Because in your forties, you can get away with it even less. And so menopause and the pre-menopause, it shouldn't be this horrifying, constant hot flashes like emotional rollercoaster. And if that's what's happening, when you start charting and you start paying attention to when you're experiencing those symptoms and paying attention to how you should be taking care of yourself, I feel like it can be a very useful tool for women in that phase.
[00:19:33] Lisa T: Yes. Yeah. And another thing that really resonated with me when I was reading your book is. The functional medicine approach and the traditional foods approach and the self-care approaches, all of these things were big things that I changed in my life personally, when I experienced some adrenal fatigue a few years back. And I think I had some heavy metal toxicity in my system. Those things were the things that made the huge difference, eliminating coffee and getting more rest. And you know, all of those self-care things, as well as some herbs and things, and supplementing vitamin D.
[00:20:09] So many of the things that you talk about in your book. And so again, I'm like, everybody needs to know this because yes, as we age, we start realizing we can't push ourselves the way we always have; things start to change as we're aging.
[00:20:22] Lisa H-J: Well, and I mean, what's the phrase like there's many ways to skin a cat.
[00:20:27] Given what I do, I think that I find myself with my clients all the time, going back to basics and you know, for what it's worth. It does seem kind of ridiculous to be a grownup and have somebody tell you to like, sleep and like eat. But at the end of the day, that's what it is. And I know from experience that, you know, for women, I remember I posted something about this and someone got offended because it's like you're putting women into a category and et cetera, but most women that I know have, you know, someone that they're taking care of, whether it's their family, whether it's their parents.
[00:21:00] Aging parents, whether it's their siblings, their siblings, children, like whatever it is, many of us find ourselves in the caregiver role. And with that, our own care falls to the wayside. So, yes, as grown women, we often need someone to tell us that we actually need seven hours of sleep, at minimum at night.
[00:21:22] We actually need to eat three meals a day. Like we have to take care of ourselves. And that's why I love the cycle. I love being in the field where the cycle's the focus for many reasons. One is because it doesn't matter what you say. Like you can sit there and tell me how you don't need sleep. And I'm good with two meals a day and I don't need protein. Like you could tell me whatever you want, but the cycle is an actual vital sign. And so if your words don't match what we're seeing in the cycle, then I don't even really have say anything. We can just pull it up and look at it together.
[00:21:55] Lisa T: Yes, that's great. And then bringing some of those principles back to likely the people who are listening, can we talk about folks who are -- let's first talk about folks who are trying to conceive since we're doing a fertility journey series here on the podcast.
[00:22:10]What are some of the most common issues you see in folks who are trying to conceive when they're having trouble? What are some of the common reasons?
[00:22:20] Lisa H-J: So that is, I feel like in many ways it's a loaded question, but I'll share with you some of the things that I see. So without going all the way down, the birth control rabbit hole, certainly a fairly significant percentage of women are on birth control or have used birth control.
[00:22:37] And we live in a culture where birth control is really prioritized. And when I was growing up, birth control was actually presented as one of the options. And so when I made that choice to use condoms, I actually felt like condoms worked because I had learned the condoms were 98% effective and they were an actual legitimate form of birth control.
[00:22:56] And so I'm finding with younger women that that's not what they learned. It seems that the education has shifted to hormonal contraceptives are, you know, basically the only effective way. So it's very common then for women to be on birth control and for them to be on birth control up until the moment before they want to have a baby.
[00:23:17] And I've spoken to a number of women, who've actually, you know, let's say they're planning to get married or their partner and themselves are planning to start trying, let's say, in the spring or something like that. And they'll go to their doctor and literally be like, "Hey, I've been on the pill for, you know, 15 years. Do you think I maybe should come off of it a couple of months ahead of time before we start trying?" and often the doctor will say, "No, unless you want to get pregnant now just to go off of it right before you're trying or ready to try. And so there's a category of women who come off birth control and so the important thing to know is that there is a temporary period of subfertility post-pill, whether the doctors are talking about it or not. There's different ways in the research that we can see that. One of the ways is how long does it take for a woman's cycle parameters to go into normal post-pill.
[00:24:03] And it is nine to 12 cycles. Cycles are not months especially post pills. So that can be, you know, 12 to 18 months post-pill. So it doesn't mean you can't get pregnant right off the pill, but it means that, literally, if you were to watch the cycles of women that are coming off the pill or other types of hormonal contraceptives, it can take nine to 12 cycles before all the parameters are normal.
[00:24:26] And then if we look at the time-to-pregnancy, so there's time-to-pregnancy studies where they'll have women coming off birth control and see how long it takes them to get pregnant. And with combined hormonal contraceptives, it often takes twice as long. So in the research, what they often say is that, well, you know, it doesn't affect fertility because they're looking at the study after a 12-month period.
[00:24:46] So when you look at the studies, it'll say like the 12-month conception rate is about the same as the regular. So the pill doesn't do anything and no one needs to worry about it. But when you look at the research, the women who had you know, HA -- hypothalamic amenorrhea, like the women who had cycle problems, they're not included in the study.
[00:25:05] So what this looks like for real women coming off the pill is that it can take a couple of months before you have your first period. And then the studies show that it can take about twice as long to conceive. So if it takes a normal, healthy couple about on average four months to conceive, so an average of 25% chance per cycle, right immediately off the pill, it can take eight months instead. And so as you can imagine, after a lifetime of being taught that you can get pregnant, you know, any day when your husband looks at you or your partner looks at you or whatever, the first month you're good, actually. The first month, you're like, "Yeah, that makes total sense. I just came off the pill." But by month two, you're already freaking out and you can imagine that by month, six or month eight, you're already having fertility consultations and potential procedures. So this is the one -- not the only thing, but I just need to say that.
[00:25:59] Lisa T: Yeah, that's huge.
[00:26:01] Lisa H-J: Yeah. The implication then for all the women who are listening, like if you haven't necessarily started trying actively is that it is important to consider the type of birth control as you get closer to when you want to have kids.
[00:26:12] And I say, if you want to have kids in your lifetime and you're like 30 or above, you should start to consider the type of birth control. Cause whereas the pill might've been the perfect choice when you were 20. It may not be the perfect choice now because of that transition period. Like if it takes, you want to give yourself 18 months to two years, especially if you were put on the pill because you had cycle problems. Because if you had cycle problems like when I say cycle problem, let me be specific. If your cycles were irregular, if you didn't know when you were going to get your next period, if you were put on the pill to regulate your cycles, or if you had extreme, extreme pain or things of that nature, then it's important to know that whatever issue was there is still there and the pill is just masking it.
[00:26:54] So that's something that I see. So obviously that's its own conversation. And to answer your question, a few other issues that I see. So certainly male factor is something that I talk about a lot. So in order to make a baby, like in a very kind of basic sense, you need to have healthy eggs, healthy sperm, healthy cervical fluid, which we could talk about more. And a healthy body, right? Healthy, healthy place for the baby to grow. And so fertility awareness cycle charting is very helpful and important for timing sex correctly.
[00:27:29] And you know, to be honest, I don't know exactly what percentage of women. There's a percentage of women who are trying to conceive that when they get the timing right, they get pregnant. But you know, these days, a lot of couples that are facing fertility challenges, it goes beyond that. And many women are already charting by the time they've been trying for quite some time and they're pretty well-versed on all of that. But yes, getting the timing right is really helpful. But you know, in my work I've seen women who, you know, they're charting, they have cervical fluid, they're timing sex correctly. So for anyone who's listening, who isn't really aware of it, when you're approaching ovulation, you make cervical fluid and that can look like the, the creamy, white hand lotion or raw, clear stretchy egg white type.
[00:28:13] And when you're trying to make a baby, you want to have sex when you see the cervical fluid. So whether it's the lotiony, but particularly when you're seeing the clear stretchy, or if you go to the bathroom and it feels really slippery. So, you know, after your period ended, then you start to see it, that's when you want to have sex until you confirm ovulation.
[00:28:30]But I've seen plenty of women who are trying to conceive and they're having sex at the right time. And then they just keep getting their period. It's not happening. And certainly, I rarely see women in that situation over and over again when their partners sperm is ideal. And most of the time in that type of a situation, if their partners have been tested, they've been told that everything is fine and we could talk about the difference between fine and optimal if you like. And I would also just say that I think we all, we often automatically assume that it's her issue. So obviously there are times when it is when she has some sort of, maybe she's got a gut problem, some sort of underlying infection, when she has some sort of endocrine issue, if her cycles are irregular, she has a metabolic issue like polycystic ovary syndrome, or if she's struggling with, you know, a variety of things. So there's certainly a lot of you know, female factor issues, but most people don't realize that male factor is like 50% of the time. That means half.
[00:29:35] Lisa T: Right, very important to just emphasize that. And I love that you actually have a section in your book speaking about how to optimize male fertility as well. So there is a little piece in there for, for partners. And did you say in the book that I think you said something along the lines of that when we're on the pill that can really -- and you'd actually just use this terminology a minute ago -- can mask issues? Can you talk a little bit more about that? Like, can it mask PCOS, can it mask endometriosis? Those are two of the things that I feel like are recurring themes that I hear when people are saying they're having trouble conceiving and they're going to fertility specialists two of the, you know, list.
[00:30:17] Lisa H-J: Yeah, that's a really important point. So a good starting point is just to kind of define what it is that the pill does in the body. So there's a lot of white lies.
[00:30:26] Lisa T: Yes. Please do. Open our eyes.
[00:30:29] Lisa H-J: It's like super frustrating, but basically we're told that the pill either makes your body think it's pregnant or regulates the menstrual cycle. So I like analogies. And so I'll give you one. So if I were to buy like a summer house and so I'm not up there all the time, but there's like a problem with the piping. And so whenever I turn on the water, like the piping, like of water spills everywhere, because there's a problem with the piping.
[00:30:53] So the pill is what turns off the water. So when you're trying to solve the problem of the pipe, like, so I go up there, I shut up the water. Problem's gone. But then like when I actually go up there to hang out and I turn on the water, it's still spilling everywhere. So there's the analogy to, to base this discussion.
[00:31:12] So when a woman has PCOS, it's thought of oftentimes as an underlying metabolic condition. So typically a woman with PCOS has an issue with glucose intolerance, insulin resistance, meaning that when she eats a lot of high-glycemic carbohydrates, her body does not process it well. It causes a lot of stress and inflammation in the body and that interferes with ovulation.
[00:31:35] And so it's characterized by long irregular cycles. And so just to put it out there. When you're charting, it's just the most obvious thing. She is ovulating. It's just she's ovulating sporadically. So she may have cycles that are 45 days or 50 days, but she still has cycles.
[00:31:53] And I've worked with a number of women who are skinny. I'm saying this for a reason. Many health professionals learn that women with PCOS are overweight and that's one of the signs that they look for. And so there's women who are not overweight, but they have these metabolic issues that are interfering with their cycle.
[00:32:10] So to me, it's super obvious and I'm like, "You need to go get yourself tested for PCOS." But I've had clients who basically tell me that the doctors say, "No, you can't have PCOS. You're skinny." So that's called lean PCOS in the research, but I'm just giving that as an example. So this is an underlying metabolic condition.
[00:32:27] Women with PCOS are twice as likely to develop type two diabetes. So what do we do? Do we counsel her on her diet? Do we try to get her blood sugar balanced and whatever? No, we say her cycles are irregular. Let's put her on the pill to regulate the cycles. So what happens is that she still has the metabolic condition, but now you've shut off her body's way of telling you about it. This is why we call it the Fifth Vital Sign. So in the book, I give the example of the fire alarm. So you've got a grease fire in the kitchen, the fire alarms going off and you're like, "Oh, let me just take out the battery. I'm just gonna go downstairs.
[00:33:01] Lisa T: I loved that. That was so powerful. Yeah, really powerful.
[00:33:06] Lisa H-J: And see, the thing is that like, it's a fine line that I walk, right? Because I'm not totally anti-pill. I used the pill when I was in high school. Because I didn't know what else to do. But the challenge is that this is a temporary solution that doesn't fix the problem.
[00:33:21] What it does is it gets rid of the symptoms. So you no longer have this -- it's obviously very challenging for a teenage girl to not know when she's going to have her period and to be surprised with bleeding. And so it's obviously a very attractive option, especially if she also has pain and that the pills kind of helping her to manage that.
[00:33:38] But the white lie is that she's having a period. So the pill, it shuts down the conversation that happens between your hypothalamus and ovaries. And so you're literally shutting it down. You're not having a period. You're just not. And just to put it into perspective. So when the pill was first developed, the first iteration didn't have a bleeding phase.
[00:33:59] So it didn't have like the sugar pill phase and the creators of the pill gave it to a bunch of women. And so they stopped getting their periods entirely because if you take the pill continuously, you just don't bleed. And so these women, many of them thought they were pregnant, cause this was in the fifties.
[00:34:14] And it wasn't like a good thing. Like some of these women were trying to get pregnant and so they thought they were pregnant. And then the doctors had to tell them that they weren't pregnant and then they were devastated.
[00:34:22] So the doctors decided to add the sugar pill phase so that it was more like the cycle. So from the beginning they made it to mimic a cycle. So when you have a bleed on the period on the pill, it's called a withdrawal bleed. And so now fast forward, 70 years later, 60 years later, I think so something like that 60, I think, but fast forward, what happens is that women are used to it now. So now we have the 84-day pills and plenty of women use it continuously because there was no medical reason to install a fake bleed. So my point is that when you're on the pill, it gives you a bleed every 28 days, depending on the type that you're taking and it can make you feel like everything is normal now, but you've just shut off your menstruation. So when you let's say, now you're married, you're 32 now. And you're ready to have a baby.
[00:35:18] You never dealt with the PCOS. You never dealt with the metabolic issue. So you're in a category where when you come off contraceptives, you're more likely to have a delay in the resumption of your cycle at all. And then obviously a delay and the resumption of normal cycling, because you never dealt with the PCOS. So from a functional perspective, if you address the underlying causes of the PCOS, if you address the insulin resistance, if you address the glucose intolerance, if you work with someone who can support you to do that, it's possible to get the cycle in line without the pill, so that you're truly cycling within normal range.
[00:35:57] Lisa T: When you said we never dealt with the issue. I also just want to mention, and you can tell me if I'm wrong on this, but when a doctor is like, "Oh, you're having, you know, issues, we're just gonna slap a band aid on it. We're just going to prescribe the pill." Often there was never a name put to what was actually happening, right? So a person didn't even get a diagnosis to even have any idea what they were dealing with for later, right? Is that correct?
[00:36:27] Lisa H-J: Yeah, that's such a good point. Because there's this tendency for the pill to be the treatment. It depends on the practitioner. I mean, you can just paint them all with the same brush, but there's less of an urgency to test her blood, you know, to see if she has high androgens, to do an ultrasound to see if she has cystic, you know, cysts. And so depending on the practitioner, absolutely. Initially, when you had asked the question, you'd also mentioned endometriosis that's also and I would say, I know it was a bit of a challenge because currently to my understanding, the most accurate way to get a diagnosis is actually through laparoscopic surgery.
[00:37:07] So, you know, that, that raises a question, you know, are you going to test every 21-year-old girl with severe period pain? Like, are you going to give them all and does she need, you know, a laparoscopic procedure, but. But see the thing about it is that if you want to have children at some point in your life, you will have to address it eventually, period.
[00:37:29] So if you have horrific periods, pain with sex, pain throughout your menstrual cycle, et cetera, and you're never screened and you never address it. It makes perfect sense that you need relief from the symptoms because no one needs to live like that. But there is an argument to be had for addressing it on both sides.
[00:37:50] So for example, I talk about period pain, you know, a lot and I'll often say that, although it's really common, it's not normal and it can be a sign of a problem and et cetera. And so I get some pushback from women with endo, or at least suspected endo, because they'll say like, "I can't function without this. And you know, what do you want me to do? Do you just want me to come off of the pill?" So then I have a few things to say, you know, one of them is, "If you want to have children at some point, eventually you'll have to come off the pill. You can work with a functional practitioner who specializes in women's health and hormones while you're still on the pill to start addressing inflammation, to do what you can, look into abdominal therapies, see if you can break up the adhesions, like there are things you could do while you're on it, you know, three, four, five, six months before you're even considering to come off of it when it's that serious to see if you can minimize some of it so that when you finally are ready to transition off, you've done everything you can to minimize it."
[00:38:48] So I'm just saying that we can have a conversation about what this could look like. And certainly I've done a number of interviews with different practitioners, practitioners of Mercier therapy, Arvigo therapy, different types of abdominal therapy modalities that can offer a potential treatment outside of just surgery being the option.
[00:39:10] And certainly there's an argument to be made for looking into what is it that's causing the inflammation, what is it that's causing the problem? And there's one other thing I should say, which is that, you know, endometriosis is the development of endometrial tissue outside of where it's supposed to be.
[00:39:27] So endometriotic lesions can develop another areas. And not every woman experiences pain depending on one of those lesions develops. So there are women that have endometriosis with no pain and it's only when they can't get pregnant and they've literally tried everything else. They finally submit to the laparoscopic procedure and that's when they discover the endo.
[00:39:47] So what's the final statement on this? As women, we need better healthcare. And we need to at least understand that if we're using the pill to "regulate the cycle" even though it does no such thing and suppress those symptoms, we need to understand it as a temporary measure to help us cope so that we can, at some point realize, you know, if I want to have children, if I want to make sure my cycles are healthy, at some point I'm going to have to deal with this.
[00:40:14] Lisa T: Great. Thank you. Also in terms of people trying to conceive, what are other ways that they can really optimize their fertility?
[00:40:27] Lisa H-J: Well, that's a great question. I mean, of course I think it's good to start with the menstrual cycle. I think it's good to start with just a healthy understanding of what's normal.
[00:40:38]We plan a lot of things in our lives, we plan our careers, we plan our weddings, you know, we plan renos. We plan a lot of things and in many ways kind of, because of how we're taught about prep, like we were just taught that it just at a drop, but dime, you know, and we spend so much of our lives actively avoiding pregnancy mean totally terrified of it.
[00:40:58] We don't generally plan pregnancy as much as we plan everything else. I think now that people are seeing that a lot of couples are struggling with fertility challenges, women are kind of more apt to be asking these questions, but generally speaking, I think I can still say that we don't really plan for it.
[00:41:16] So it's not to say you have to be totally crazy about it. But I think that in my perfect world, we would look at fertility differently. We would still of course prioritize contraception as a concept so that we can really make that choice of when we want to have children.
[00:41:32] But my idea of feminism, isn't just that I can avoid pregnancy when I don't want to baby. It's also that I can have a baby when I want to. And I'm informed about how to optimize. So if I was like, you know, 19, and I'm trying to optimize my chances, what would be helpful would be to have that knowledge and information about how your body works, how your fertility works, how your fertility changes with age.
[00:41:55]It doesn't mean you can't get pregnant, you know, when you're in your thirties and forties, but it's not the same. The chances of conception and successfully carrying a baby to term are not the same at age 40 as they are when you're 20, they're just not the same. Women who are in their late thirties and early forties have a higher miscarriage rate.
[00:42:13] And that's one of the reasons why it can be more challenging. By the time you are in your early forties the numbers are pretty scary; it can be as high as 50% of pregnancies end in miscarriage. By the time you're 45, it's like 75%. And anyone who's listening who either is in their forties and has been trying and has had miscarriages, or if you're a practitioner and you're listening and you've worked with clients in your forties, who've tried to get pregnant, you know that to be true. Because you know that one of the things for women who are trying to conceive as they get into their late thirties, early forties is miscarriage rate goes up. And this is something that people don't talk about. So just being aware of that, And then strategizing your type of birth control.
[00:42:54] So I feel like we don't need to bash hormonal contraceptives. They have their place. And my only comment on it is that women need to understand how it can affect fertility and how when you come off of it, there's a transition phase. And so even if all you did was like, come off of it. I mean, I would recommend at least a year, but if you come off of it even six months ahead of time, I would recommend more like a year or two before you're ready to try. But even if all you did was that, that would be great. And then certainly start to educate yourself on the concept of preconception, nutrition, preconception diets. I talk a lot about ancestral foods. I talk a lot about liver. Liver's nature's multivitamin. I always used to wonder, like, where did people get their vitamin B12 and iron and folate and choline, like where did they get those nutrients, you know, before whole foods.
[00:43:48] And it turns out that the ancestral cultures likely got it from liver, organ meats, fish you know, seafood, things like that. So I would say, educate yourself and have that in a plan of a focused preconception diet. And then any necessary supplements, like getting yourself tested, getting a nutrient panel done for you and potentially your partner as well.
[00:44:09] There's no man alive that's so healthy that he doesn't need to take a pre-vitamin and the prenatal in the preconception phase. So the idea that you're the one that needs to take all the supplements and you're the one that needs to do that; you can just throw that out the window?
[00:44:21] Lisa T: That's so good. We don't hear that.
[00:44:23] Lisa H-J: Well, my favorite word is defenestrate. It literally means to throw out the window so we can defenestrate that idea that men just get to eat Cheetos and like drink beer. And we had to take all the supplements.
[00:44:35] Lisa T: That's a great word.
[00:44:36] And I just want to mention that Lisa goes into lots of details about nutrition and self-care and all of these great ways to lay a great foundation for fertility and for optimal menstrual health in her book.
[00:44:49] Lisa H-J: There's one other thing to add -- cause you had asked like what can you do if you're trying to conceive -- and I would say that you know, starting with the charting and starting by understanding what's normal and what's abnormal. But if you do run into challenges and you do discover issues with your cycle, or if you're trying to conceive and it's not happening, I think that the concept of establishing a team is just an important concept to have. So many of us think that it's just my doctor or just my fertility specialist, but unfortunately, issues of female hormones, reproductive cycles, medicine has a certain perspective to offer us, but many women find support outside of the medical. We still need doctors. We still need fertility specialists. We still need to run the tests. We still need to all the diagnostics. We need a specialized doctor on our team. But if you're dealing with issues of thyroid, if you're dealing with issues with PCOS or HA. If you have gut issues, if you have underlying infections, if you have a specialized issue, you want to consider working with someone who has experience in that specific area. And in addition to the medical doctor, you do want to consider functional practitioners. That can be a doctor trained in functional medicine. It can be a naturopathic doctor. It could be a doctor of traditional Chinese medicine. It can be someone who can support you with charting and understanding the Fifth Vital Sign like we've been talking about, but I always use the analogy of a boardroom. Like you're sitting at the table, and no woman struggling with fertility challenges can just have one practitioner that's supposed to know everything. She needs a bit of a team. And if you have a specific issue, you want the person who works with clients. Like if you have a thyroid issue, you want the practitioner who like half of his patients are thyroid patients. You want the person who deals with those issues specifically. That's how you get the best outcomes.
[00:46:41] Lisa T: Agreed. Yeah, on the podcast in this series, so many people have talked about the need for a team kind of collaborative effort when you're trying to conceive. And so that's a great time to move into talking a little bit more about finding the right practitioner for you. Do you mind if I read a quick paragraph from your book on this topic?
[00:47:02] Lisa H-J: Cause I went on about it.
[00:47:04] Lisa T: I love it. It's great. I've found that this really resonates in terms of seeking a care practitioner, not just for the fertility journey, but for pregnancy, for life, for so many things.
[00:47:17] So you say, "The first step is finding a practitioner whose perspective already aligns with yours. Find someone who already provides the type of care you're looking for. Someone you don't have to convince to see things your way. If you require support that goes beyond the services your practitioner provides, it's time to see someone else. You wouldn't walk into McDonald's and demand steak and lobster. They sell burgers there. And I know you wouldn't take your car to the library for an oil change. It's time to get clear on the fact that different health professionals offer different services."
[00:47:49] I love that. You know, what I talk about in birth class, for those who have chosen to give birth at the hospital, you can't expect certain things. You can't expect to be catching your own baby and likely you can't expect to give birth out of the bed because, you know, you've signed up for a pizza place, not Chinese food, you know?
[00:48:09] So that really resonated in several aspects of finding a practitioner. Are there other things you'd mention in terms of seeking out good care?
[00:48:19] Lisa H-J: Yeah, I think that one of the challenges as you become more aware of your cycles, and so let's say you're charting, you've been charting for, you know, six months to a year, and you've started to see that when you're really stressed, when you don't sleep, it affects your cycles. And so you go into your doctor's office with your charts, and you're so excited, to enlighten this person and the doctor looks at you and says, "Uh, I don't deal with that. I don't want to see them." And so I've had a lot of women who get really, you know, frustrated, right? You know, "My doctor didn't even want to see it." And remember, doctors in medical school are not trained to read menstrual cycle charts. It may as well be chicken scratch. It's like, they think it's like wizards and bones and fires. Again, I can't generalize because there are actual medical doctors that do take specialized training programs to be able to read cycle charts.
[00:49:10] Lisa T: Where are those? I want to find those.
[00:49:12] Lisa H-J: Look up Napro Technology; it's a thing. It's like a fantasy world of actual doctors who are--but the key in that statement was they took additional specialized training of their own volition outside of what they were taught in medical school. These are people who learned about the cycle and really are passionate about it to the point that they took additional training of their own volition and expense.
[00:49:35] So I think that we want to, in the example of the hospital, we just want to be really clear on what your doctor can do for you. And so one of the questions I get a lot in messages and emails, it's like, "Lisa, do you know, I live in Phoenix, like, do you know a doctor in Phoenix?"
[00:49:51] And the answer is always like, "No, I don't. I don't know a doctor in Phoenix." But it's so interesting. Like if you were looking for a new car, you know exactly what you would do. Like you would look for dealerships around you. But for doctors we don't do that. We don't think about that.
[00:50:08] So the best advice I can give you is if you have a specific challenge, so let's say your challenge is PCOS. Like you think you have it, you don't know, like certainly go to your medical doctor. You know, you have to talk in their language. So you have to say things like long irregular cycles, like, so you have to use their language.
[00:50:26] But if you're looking for support that involves, you know, dietary changes, lifestyle improvements, different types of supplements. Like if you're looking for an, a more natural or functional approach, then you want to start by, you know, functional medicine or polycystic or women's reproductive health or women's hormones, female hormones, and your city.
[00:50:49] And it might sound real basic that I'm saying this to you, but I know as well as you know, that you probably didn't think of doing that. Like it's just the strangest thing, but it is what it is. And so like, that's step one. You can also talk to your friends, your colleagues, like people who, you know, and see if you can get referrals.
[00:51:05] That's an excellent way to see if you can find somebody. And when do you do. Do this, and you have a short list. You can look at their websites. I always say like, you want the person who's written the book on it, or you want the person, on their website, they have blog posts all about PCOS. They talk about how they work with their clients all the time, because they work with so many PCOS patients.
[00:51:22] So you want the person that already has shown you -- and that's great about living in this world -- like at this time when people have so much information online, so you can really see because a functional practitioner who specializes in gut health, you'll see that. And a functional practitioner who specializes in female reproductive health, you'll see that. And then you can call the office. You may not be able to talk directly to the practitioner. But you can call with some questions. You can say things like, you know, "Does she see a lot of PCOS patients?" And literally, if you just do those four things, you will get so much more information and you'll have a very clear sense of like who you would rather go to.
[00:52:00] And then when you go finally to this practitioner, think of it like a date. So it's like we think we are stuck with our doctors forever or something where it's very strange. Like if I went to, I I've, I've had it happen. So if you go to a hairdresser and they like give you a horrible haircut, like, do you go back?
[00:52:19] No. But like, if you go to a doctor and they have no bedside manner and they're terrible, they treat you horribly. Sometimes we go back. So when you go to your practitioner, it's hard. Because it can get expensive and like you have to pay it's not like you get to go for free. But you can go and ask some questions, you can ask them, "Do you deal with a lot of patients with this issue?"
[00:52:39] And like, "Have you had patients recover? Have you ever had anybody whose periods went back to normal with this condition?" Or so you can actually ask them and you don't have to be rude or anything, but you can just ask them all these questions and interview them like you're on a date and you also get to choose.
[00:52:56] And if you don't like their answers, you can find someone else.
[00:53:02] Lisa T: Yes. Thank you. I harp on this topic in class. It's never too late to switch care providers if you're feeling like you're not well aligned,
[00:53:13] Lisa H-J: It sucks. I just have to put it out there. Like this is the part though, that really, cause I talk about this in my classes also, because you know, I'm empowering women with all this cycle information and you know, they're going in knowing more about... well, I suppose I could backpedal and say that no matter how many degrees your doctor has on the wall, your doctor will never know more about your body than you will. And so that's the hard part. When you start charting, you have all this information and knowledge, and it doesn't mean that you don't need a specialist.
[00:53:42] It doesn't mean that you don't need help, but it can get very difficult. Especially because now you actually know you can get help and you know that you deserve it. So this is the part that sucks because sometimes it can take two or three appointments. Sometimes you have to go through several practitioners before you find someone who is on the same page and who can help you.
[00:54:04] So just, you know, I'm not trying to skirt over the fact that it can just really, really suck, but you're worth it. And I hope that the first visit is like, it's like a match made in heaven, but if it's not, don't totally lose hope. One thing I've learned from doing podcasting over the years -- and you've probably found the same thing -- is that there, the world is filled with incredible practitioners who know what they're doing and do excellent work, but they're not out there doing the work they're like actually working.
[00:54:33] So they're not necessarily out there like on Oprah, but you could have the most incredible person in your town and you wouldn't even know because they're not like on a billboard or whatever. So definitely look where you are. You'll be surprised. I mean, I found like a naturopath near me that does vaginal steaming, like how [cool is that?].
[00:54:53] Lisa T: Wow. You're in Canada, right?
[00:54:56] Lisa H-J: I am, yeah. I wasn't looking specifically for that, but I did some sort of search and I literally found like a naturopath down the road that offers that service. And I was like, "Woah." So you just never know what you can find.
[00:55:08] Lisa T: Well I know we're running short on time. So the last couple of things I would love to ask you before you share about the work that you do and share how people can get in touch with you. Real quick, this could actually be own whole episode, I'm sure. For after people have given birth and/ or for birth control, but specifically for people in the postpartum period you can keep this as brief as you need to, or want to: how many hours of straight sleep do you need to get before your charting your temperature is going to be accurate?
[00:55:40] Lisa H-J: Oh, that's a good question. Well, just like a brief answer would be that in order to get, ideally the most accurate temperature, it's about five hours of uninterrupted sleep. That allows your body to go back to the kind of resting metabolism.
[00:55:57] Lisa T: We don't get that at first.
[00:55:59] Lisa H-J: Well, but here's the thing. When you're postpartum the duration of time that it takes for your cycles to return -- so, how long it takes between giving birth to your baby and having your first ovulation -- it can vary quite a bit. And then the most significant factor would be whether or not you are breastfeeding and like the length and duration of your breastfeeding sessions.
[00:56:21] So for a woman who is not able to breastfeed she can have her first ovulation within like five weeks. So if you do not breastfeed at all, then this would be relevant. So the temperature is postpartum is only really useful after you have your first ovulation. The temperature has no predictive value at all.
[00:56:46] So for example, if you do breastfeed, and let's say you don't have to go back to work at three months. And so you just breastfeed and you're breastfeeding. And you know, you introduce the solids at six months and it's all breast milk. Just you and the baby sucking away. Some women will get back their ovulation and menstruation at three months, five months, eight months, a year.
[00:57:06] But if you happen, let's say to be eight months and that's when you have your first ovulation, there's no point in taking your temperature. So I always say to women postpartum that the primary sign is different. Like when you're in the postpartum phase, before you have your ovulation, you need to learn how to check mucus.
[00:57:23] And if your mucus patterns are not stable, I talk on my podcast about the Marquette method, which is actually, it uses a fertility monitor. So it measures the estrogen metabolites. And so there are legit ways to track and chart postpartum. You would want to work with an instructor because it's a different kind of thing when you not cycling. You have to know how to tell when you're going to move into that fertile window. And you would want to, to figure out if you can do that with your mucus, depending on if your mucus patterns are normal, or if you need to do something else, like I mentioned with the Marquette method.
[00:57:58]But the point of what I'm saying is, so your question can be relevant, but it also could not be, cause by the time, if you're in the eight month category, But you still need a chart throughout that time, but you're not charting temperature. So you would only start charting the temperature after, by that time, maybe, maybe, maybe sleeping a little better.
[00:58:15] Lisa T: Okay. That makes sense. I thought maybe doing the charting of the temperature would perhaps help you know when your ovulation has returned, but, okay.
[00:58:24] Lisa H-J: It will, yes, but AFTER. So if you're trying to space your children and you wait until that temperature goes up, like you're already pregnant because probably if there's one day in the entire postpartum that you are going to want to have sex, it's probably going to be that week before your first ovulation.
[00:58:46] Lisa T: Good to know. And I always tell people do not think that breastfeeding your baby around the clock is the best form of birth control because it's not right. Just that alone.
[00:58:57] Lisa H-J: Yeah. It's really, it's really interesting. So I like this, like you can tell it's like everything I'm like, Oh, cause I read a few research, but there, there is a method, the lactation amenorrhea method. It's an actual method. It's so interesting because there's research on it. And it's, you know, the way that it's described as that if you are breastfeeding and like you said, all the time around the clock, et cetera. I think that what's helpful is to understand why many practitioners don't recommend breastfeeding as birth control.
[00:59:29] And I would say the reason why is because in order to even conceive of that possibility, You basically have to be on demand all the time. No formula, no supplementation, no work, no pumping. So it, it can be used as a method for a period of time for some women. There's a reason why. Yes. But there's a reason why.
[00:59:51] So I would personally feel more comfortable with a combination. So understanding the role of breastfeeding and how you can intentionally breastfeed consistently and continuously to some women. Want to have a bit more time with other period, right? So you can, you can find ways to like basically just breastfeeding on demand all the time.
[01:00:09]But you would, in my I'm bias because I teach the charting. And so I think that it's really helpful to combine those two. Because what the lactation amenorrhea method does not necessarily tell you is how to tell when the fertility returns and the fertility returns when you see the mucus. And so you need to be checking for that basically every day.
[01:00:32] Lisa T: Yep. That sounds like a better plan to me than just, just the breastfeeding timing alone. Great. Well, I know we're almost out of time, so please, won't you share with us the different ways that people could work with you in addition to reading your wonderful book, the Fifth Vital Sign.
[01:00:50] Lisa H-J: Well, thank you so much. You've been so sweet and I can totally tell that you read the book cause you're like, "this section and this section." So just for, you know, everything that we talked about pretty much today is in the book. I don't talk a lot about postpartum in the book. So that part isn't in there; maybe in a future edition.
[01:01:08] And so if this topic really interests, you certainly you can tune into the podcast. My podcast is Fertility Friday, and so if you type Fertility Friday into your favorite podcast player, you'll find it. I'm releasing episode 350 this week, so there's a lot of content. It can be a bit overwhelming, but yes, that would be a great place to start.
[01:01:28] I do have programs, I run group programs and I do one-on-one coaching. And this year I'm launching a new practitioner training program because when I first started, it was really women, clients asking for support. And as I've kind of been banging my mouth for almost a decade now publicly, I get a lot of practitioners wanting to know how they can incorporate this into their practice.
[01:01:50] So this is kind of the new direction, which is, it's super fun. I'm really excited about it. And I suppose I should say, you know, fertilityfriday.com. That's, that's helpful. That's where you'll find me.
[01:02:01] Lisa T: Yes. Nice and easy URL to remember. I'll be sure to link to everything in the show notes. So you can find that over at birthmattersshow.com and thank you so much, Lisa. This has been lovely and so informative, and I wish we had more time because I have so many more things to ask about and to learn about from you, but maybe I'll check out that practitioner training because I really am so fascinated by all things hormonal and women's health.
[01:02:28] So thank you so much for taking the time. Thank you for this wonderful work that you're doing to really improve lives.
[01:02:35] Lisa H-J: Oh, well, thank you so much for having me. This was a lot of fun.