Justina Thompson, a Holistic Fertility Coach and founder of Nourish Fertility, answers key questions on fertility awareness, including common mistakes women make when charting, what your chart can show you about your health, how long it actually takes to see the positive impacts of lifestyle changes on a cycle and much more. Justina also provides her recommendations for the top three books on fertility, for those who just love to geek out.
1. What are the most common mistakes people make or difficulties people have when they are charting and how can these be avoided?
Some common misunderstandings amongst new charters trying to conceive (vs. using the fertility awareness method (FAM) as birth control) tend to include knowing when one’s cycle officially starts, when to mark temperatures as questionable, becoming familiar with cervical fluid differences, and targeting intercourse for conception.
While learning to chart to maximize chances of conception from a certified Fertility Awareness (FA) Teacher gives one an advantage, there are a couple of books out there meant for self-guided learning. In fact, I offer a free e-book where you can learn how to chart your cycles to maximize conception called Get Pregnant Faster & Naturally: The Absolute Best Way to Know Which Days You Can Conceive. Whether you learn fertility charting from a book or teacher these are common things beginners navigate:
Start of a new cycle
Some people tend to spot for 3-4 days before their period begins to flow which can be associated with low progesterone or something else (If this is a new symptom for you, it is recommended that you see your health practitioner to rule out infection, cysts or polyps). Pre-menstrual spotting is to be considered part of your current cycle. Day 1 of a new cycle does not begin until you see the first day of bright red blood flow.
If you take your temp more than 30 minutes later than usual, you need to mark it as questionable. The reason for this is that a person’s BBT rises .5 of a degree every 30 minutes in the morning and we want a consistent baseline.
In addition to taking your temp much later than usual, there are 3 other common factors that can disrupt the consistency of your temperature. Mark your temperature as questionable if:
- You have a cold or fever,
- You drank alcohol the night before,
- You had less than 3 hours of consecutive sleep
Familiarity with Cervical Fluid
There is a normal learning curve to observing and describing cervical fluid for everyone. In general, the majority of women’s cervical fluid descriptions will not match those provided in books or apps. I encourage a one-on-one session with a FAM Coach to process best how your individual cervical fluid appears to you. Discussing this in community forums can be confusing because each woman has her own unique perspective of what “normal” cervical fluid is.
In general, after a period ends there will be 1-5 days of no cervical fluid present. There will be a Point of Change, where sticky/tacky fluid appears during a check. Over the span of several days, it will progress into a creamy/lotiony substance and then it will begin thinning into a lubricative texture that is raw egg-white in appearance (clear or cloudy). For some, the most peak fluid may be slippery watery/water-gush. Egg-white or watery is a sign ovulation is nearing. After ovulation, what took several days (5-7ish) to build up to peak type fluid will follow a drying up pattern in a quick 1-3 days.
Targeting Best Days to Conceive
Finally, the general rule for typical cycles is to begin baby-making intercourse when peak type cervical fluid appears and continue daily until both the peak fluid has begun it’s drying up pattern and the temperature has shifted high and stayed high for at least one day. This is a nice 3-5 day window of prime fertility in typical cycles. If someone is experiencing irregular cycles or has a partner with low sperm motility/mobility, then it’s best to work with an FA teacher to learn which days to plan intercourse specific to you. A list of Certified FA teachers across the globe can be found at www.fertilityawarenessprofessionals.com.
2. What are some of the common features that may show on a woman’s chart that aren’t ideal or healthy and what could these features indicate?
Keep in mind it can be totally normal to have an “off” cycle once or twice per year. What we look for is a recurring pattern outside the variation of normal that’s happening more than twice per year. The most important thing to highlight is that none of the features indicate an inability to conceive; rather, they are a sign to start a health project to bring greater balance to one’s body in order to get pregnant faster and enjoy a healthy pregnancy.
Not Ovulating or Ovulating Infrequently
Anovulation is the absence of ovulation often associated factors such as weight (under or over), extreme exercise, and thyroid disease. Oligovulation, on the other hand, is irregular ovulation happening in fewer than 8 cycles per year typically seen with cycles longer than 36 days (and often associated with PCOS). An ongoing pattern of either is an indication to reach out to a health practitioner and pinpoint underlying causes and solutions to trigger the body to ovulate regularly.
Recurring short Luteal Phase (AKA Luteal Phase Defect)
Ideally, we would like to see the Luteal Phase to last anywhere from 11-14 days which is the lifespan of a healthy corpus luteum. Anything less than 10 days is an indication of the need to investigate progesterone deficiency with your health practitioner. While pregnancy can still go to term with a short Luteal Phase, it can be an important key if other indications of hormonal balance are also present. Having a healthy Luteal Phase is shown to minimize the risk of early miscarriage. Your health practitioner can guide you in solutions to lengthening your Luteal Phase.
Recurrent early miscarriage
This can show up on charts even if the charter did not realize she had conceived. This happens in the case of a chemical pregnancy (or very early miscarriage) where implantation occurred, pregnancy tests were positive, but bleeding happens around the time you expect your next period or about a week later than you expect a period. Without charting, this can commonly be mistaken as a late period and a false positive pregnancy test. Having a Luteal Phase of 18 days or longer followed by bleeding is a strong indication of chemical pregnancy and seeing this happen more than once is a sign to begin a hormonal balance project with your health practitioner.
Meeting with a FAM Coach to validate any of these cycle patterns is recommended for individualized assessment of charts. From there, your FAM Coach can assist you with referrals to health practitioners experienced in those areas.
3. What key health and lifestyle changes make the most difference to the cycles of the women you work with? Do these key changes vary depending on the issue with the cycle, or are they universal for all women?
While key changes to nourishing fertility cycles does depend on each individual and their specific project, there are some key changes that will make impactful differences to women’s cycles overall. There are many self-care practices that support the endocrine system which is in charge of our the hormonal feedback loop. The top 4 I see make the biggest impacts are:
- Mayan Abdominal Womb Massage: 1x/month by a practitioner or self.
- What we eat: getting rid of anti-nutrient foods, replacing with clean eating.
- How often we move: switching from extreme to gentle exercises like Yoga, working at a standing desk, and taking movement-snack breaks.
- How we manage stress: taking out 1 stressful commitment and adding in 1 stress release practice such as guided meditations.
4. How long does it usually take the women you work with to see the results of their efforts reflected in their cycles? Do some cycle changes take longer than others?
The interesting piece about our health is that changes happen in layers in the sense that the “top” layer has to be peeled back before we can address the “core” layer. The more layers in a project, the longer it takes to reach that particular goal. I suggest women chart their cycles with FAM so they can observe and journal progress along the way.
Clients who do this have reported small shifts, typically just in how they feel, as early as the first cycle after making a change (less brain fog, increased energy, etc.). The major changes we’ve seen progress to fruition with natural solutions in as little as 6-9 months up to 2 years. Again, it’s about how many layers there are to pull back, how long a person lived with symptoms before seeking solutions, and how consistent they have been in following the solutions provided by their healthcare practitioner.
The good news is that one’s journey to conception can begin before conventional infertility specialists is allowed to intervene. Often, one will not be referred to a specialist until they have not conceived after over a year of trying, sometimes longer. Then, the solutions provided by a specialist are often invasive and expensive beyond a couple’s financial reach or personal preference.
Fertility charting allows a woman to take her fertility back into her own hands by first tracking the projects in her own cycles and then by starting with minimally invasive solutions such as fertility nourishing nutrition, womb massage, gentle movement and embracing stress relief and self-love practices. These initial changes are a foundation for success whether one chooses to go the conventional medicine route, holistic route, or both!
5. Whenever I speak to my doctors (including fertility specialists) the response varies from indifference to dismissive. Have you had the same experience and why do you think it gets that reaction?
Yes, and unfortunately many other women tell me the same thing. I have met more than one doctor who has told me off the record that medical school taught almost nothing about menstrual cycles outside of “ovulation happens on day 14.” They were surprised to learn that there are several normal variations to female cycles that are all trackable with fertility signs.
On the other hand, any acupuncturists or naturopathic doctors I have met have a broad understanding of how all the systems of the body effect one another including the reproductive and endocrine systems. Alternative health practitioners can often interpret BBT charts, are familiar with the role of cervical fluid, and tend to have a much more open mind for learning new things from their patients.
With studies of the Sympto-Thermal Method (aka FAM) as recent as 2007, the hope would be that the newly graduated doctors are being exposed to this information and learning how to use it as an imperative and non-invasive tool. This has been true in many Asian countries. A group of medical doctors in the United States launched an organization called Fertility Appreciation Collaboration to Teach the Science ( F.A.C.T.S) to disseminate accurate information about Fertility Awareness to practicing physicians.
If your current medical doctor is not familiar with FAM, mustering the courage to explain it to them can go either feel good or feel disappointing. As a FAM coach, I offer a service to help with that process where I assemble a report about one’s fertility patterns and list common indications of those patterns with linked studies. Having an official document from one professional to another goes a long way in helping to validate a patient’s concerns to their doctor and can assist in getting them to approve specific diagnostic testing that they may have otherwise thought unnecessary.
Top 3 book recommendations for those struggling with infertility
In no particular order:
- Natural Solutions to Infertility: How to Increase Your Chances of Conceiving and Preventing Miscarriage by Marilyn Glenville
- Spirit Babies: How to Communicate with the Child You're Meant to Have by Walter Makichen
- Insulin Resistant PCOS: Woman Code by Alissa Vitti
- Inflammation Caused PCOS: Period Repair Manual by Dr. Lara Briden for her Anti-Inflammatory Diet
Justina Thompson, FAE, RHE is a Holistic Fertility Coach and founder of Nourish Fertility. She is a Certified Fertility Awareness and Reproductive Health Educator who consults and teaches webinars to people around the world who want to conceive faster, safely, and naturally. Justina connects individuals with the powerful science and body education of fertility charting for natural conception andnatural birth control in inclusive and Safe Space webinars. She offers one-on-one consultations to assess your fertility charts and teach about the impact that food, environment, sleep, fitness, and mindfulness have on the health of your cycles so that you can nourish your fertility for vibrant living and a vibrant pregnancy!
Click here to access your free copy of Justina's e-book: Get Pregnant Faster & Naturally: The Absolute Best Way to Know Which Days You Can Conceive
You can follow the journey to nourish cycles on Instagram via @lovemyfertility!