Taking Charge of Your Fertility
By Toni Weschler, MPH
What is the book about?
Taking Charge of Your Fertility is a textbook on the fertility awareness method, a way of charting your cycles and becoming aware of your body’s signs in order to better understand the times in your cycles when you are fertile. It is possibly the single most important book you can buy to help you with fertility struggles. Big statement, I know. The fertility awareness method (or FAM if you wish to sound like a pro) can be used both as a way to increase your chances of conceiving or as a method of avoiding pregnancy. The book has sections on both.
There are two key books (two bibles of fertility, if you will) that comprehensively cover the topic of FAM and most people who practise FAM have read one or the other - you are a rare breed if you have read both. One book is this one, the other is The Garden of Fertility by Katie Singer, not a book that I have consumed, as I am not that rare breed of person. Taking Charge of Your Fertility covers (comprehensively) the basics of your cycle, how to recognise your fertile signs (oh THAT's why I sometimes have more discharge) and how to chart these in order to understand your cycle.
What the hell is fertility charting? Good question. It is pretty simple in theory - you log your periods, discharge in your pants (gross I know), your body temperature and what your cervix feel like (if willing and able to poke around in there) and keep it in a chart. Although there are template charts at the back of the book you can photocopy and use, most women these days embrace the modern era of technology and use a fertility app on their smart phone. It means that you can whip out your chart on the train and obsess about progress, one of my favourite procrastination train activities. If you wanted to know more about charting to know whether it may be for you before buying this book then check out the American Pregnancy Association. This is also known as the sympto-thermal method and it is highly reliable. If you are interested in natural family planning in general, MomLovesBest.com have put together a comprehensive guide which is available for free here and very helpfully outlines the success rates of each method.
Most crucially for me, Taking Charge of Your Fertility has a few chapters that go into detail on fertility and weird and whacky cycles which were immensely helpful. There is a chapter on anovulation and irregular cycles, one on maximising your chances of getting pregnant (are you actually having sex at the optimal time, are you SURE?), another on fertility tests and treatments that may be needed and a brilliant 40 page annex on troubleshooting your cycle with plenty of example charts to explain how various fertility issues may appear on charts. Troubleshooting is always associated in my mind with fixing a printer, but it turns out it works just as well with a human and I bookmarked this section for frequent referral. The book is peppered with diagrams, example charts, photos (such as of the different types of cervical mucous which are highly informative but not for the faint hearted), and some comical cartoons to keep things light.
Is this book ‘out there’, ‘woo woo’, “hippy dippy’?
FAM is not the same as the inaccurate Rhythm Method. Do not get the two things confused. Utter the two words ‘Rhythm Method’ outside of strictly catholic circles and you’ll receive a response of rolled eyes and despairing shaking heads, and quite rightly so. But FAM is NOT the same thing. It is firmly grounded in biology, science and evidence. So much so that the NHS recognises it as an effective form of birth control, stating that if followed correctly, it can be up to 99% effective. The NHS require plenty of good evidence before they admit to anything being effective, so it is safe to say that FAM is mainstream. Don't expect your doctor to have heard of it though....
Toni Weschler is a women’s health educator with a master’s degree in public health. She has been lecturing and teaching on fertility awareness since before I was born, and I am no spring chicken. She is a keen advocate for fertility awareness education as empowering knowledge for all women of reproductive age. In summary, she is a total star in the field of fertility awareness. There is no better candidate out there to have written the bible on FAM.
Who is this book for?
All women of reproductive age. That is another bold statement but I stand by it adamantly. Understanding your cycles is not just about trying for a baby, although it is totally essential for that purpose, but it also provides an invaluable insight into your general health and wellbeing. I can see when I am stressed, it is on my chart. I can see that I haven’t eaten in a way that my body appreciates that month, it is right there on my chart. I can see that I am oestrogen dominant, yep, there it is on my chart. It provides a monthly report card of your health, one that you cannot cheat (I know, I’ve tried). My ability to chart my cycles due to this book even induced some envious comments from my husband, who quite correctly identified that maybe he has hormonal imbalances, stress or illness, but how the hell is he to know? Unlike me, who has it right there in black and white every month, a frequent feedback loop on my health and vitality (or lack thereof in my case).
Is it just basic biology?
Yes, this book is basic biology. But not any biology that you will know, having never been taught it growing up or it being knowledge that is easily accumulated on your travels as an adult woman. Initially perturbed by an Amazon review (I should know not to read these but I just cannot help myself) that this book is just basic biology and covers nothing more than the ordinary teenage girl is taught in school, I delayed buying it, to my considerable detriment. I am in awe, as the school attended by that reviewer must have shown unprecedented dedication to fertility awareness, as the content of this book is a far cry from the personal development education I received. Mine involved one lesson from a slightly awkward, male biology teacher who made a couple of ill advised jokes about ‘it not staying up, the story of his life’ which was met with complete silence from his teenage audience, with the open jawed faces staring back at him an equal split between utterly perplexed and totally horrified. The extra teaching received if you were female came in the form of ‘The Tampax Lady’ who visited the class (the males were excused and filed out to the playground in giggles) who told us all how to insert a tampon and to remember when using sanitary pads always place them sticky side down to avoid an impromptu pubic wax. Did anyone teach me about fertility charting, signs of fertility throughout the cycle or anything else of use? No they did not. In fact, the message was, be careful because you can get pregnant ANYTIME. It is so easy to fall pregnant. I understand why that messaging is used in schools, but it is factually utter rubbish. Complete fiction. So if the above sounds familiar to your experience, Taking Charge of Your Fertility will be a revelation.
Key learning points from this book
That I have PCOS. Who would have thought it? Not the NHS, no Sir. It took 3 years of pondering and prevarication before the NHS concluded that I was possibly on the PCOS spectrum but that it’s all a bit tricky isn’t it so let’s put you down as ‘unexplained infertility’. Cheers. My IVF clinic diagnosed PCOS and confirmed my strongly held view, formed 2 years previously as a result of reading this book, that PCOS was indeed my allocated lot in life. Without this book I would have taken my GP's advice that 'whatever is normal for my cycle is normal' and not realised that taking more than 35 days to ovulate is not 'normal' or 'healthy'. Due to the learnings from this book I was able to clearly see the issues with my cycles and make dietary and lifestyle changes to dramatically improve my health, tracking the improvements in my cycles, month on month (against my better judgment on maintaining some privacy during my pursuit for fertility, I have posted a year's worth of charts showing my improvements and how I achieved them).
Just some examples of the numerous things that a fertility chart can show you (that you may not know otherwise) include the following:
Are you ovulating? - your temperatures should rise by a certain amount and for a certain period of time post ovulation. Cycles can look nice and regular, every 28 to 30 days a period arrives, and yet you are not ovulating. How is a girl to know?
Is your progesterone too low? - shown by a short luteal phase (the phase post ovulation) which may prevent implantation of an embryo and therefore pregnancy. A short luteal phase has plagued me from the start.
Are you pregnant or at risk of a miscarriage? - your charts can indicate a pregnancy before urine tests can detect it and low temperatures following a positive result can indicate that the pregnancy will not be sustained. Charting post receiving a positive pregnancy test result must be incredibly daunting, inducing panic at every temperature reading that is slightly lower. I don't know whether my heart could take it.
What do you need to implement the learning in the book and start charting your cycles?
1. A digital thermometer - I use a Braun Digital Thermometer which records my temperature to one decimal place and gives a useful yet irritatingly loud beep to let me know that the temperature has been taken successfully. It can be used orally or under the arm pit (I wouldn't mix the two, gross). There are plenty of other body temperature thermometers available online and they are not too expensive, under £15. A top tip: place the thermometer in your mouth for 5 minutes to let is adjust to the temperature before turning it on and taking the reading. Otherwise, the results can jump about a bit on a trampoline of inaccuracy.
2. A fertility chart - I use the (free) Kindara app from the app store to note my information and it automatically creates the fertility chart, like the ones available on my monthly results page. It also provides access to a knowledge base with questions, answers and example charts as well as an excellent community of like minded and supportive fertility charters, many of whom are trying to conceive.
3. The Fertility Friday Podcast - Listening to the (free) Fertility Friday podcast helped me to get to grips with concepts of fertility awareness. The rational voice of Lisa leads the listener through interviews on topics such as coming off the pill, irregular periods and unexplained infertility. The first few episodes of the podcast in particular focus on the basics of fertility charting and are definitely worth a listen.
4. Help with your charts - Some fertility signs and charts are more difficult to interpret than others. I have always been lucky that mine are as clear as day. Totally dysfunctional, but clearly so. If you struggle to get to grips with charting you can always seek help from a FAM expert. Justina Thompson from Nourish Fertility is one such expert who I have consulted with in the past. She is excellent and can provide consultations via Skype.
How long did it take me to read?
Well, I still haven't read every word and never will, as not every section is applicable to me. It is a textbook rather than a page turning beach read and it is there is to dipped in to for reference. If you read it all, cover to cover, my hat goes off to you.
That said, it is very readable and insightful. Never have I flipped through the pages of a text book with such glee, like a child excitedly opening the next present on Christmas morning. I was enthralled, fascinated and hooked on reading about how menstrual cycles should work and was desperate to start the tracking my own. Admittedly I held an unwavering conviction that my body was an exception and that the inbuilt evolution of the female cycle would not be applicable in my case. I was wrong, obviously. And a moron for thinking that despite women's cycles following a pattern since the dawn of time, I, little me, would be the exception to the rule. An ego like that deserves to be bashed.
If there is one fertility book I'd recommend above all others, it is Taking Charge of Your Fertility. It is the foundations upon which to build any dietary changes, lifestyle investments or fertility tests. Without the understanding in this book how do you know what is wrong with your fertility and whether any steps you are taking are working? Whilst waiting months in-between medical appointments and years in-between fertility treatments, this book empowers women to understand their bodies and take back control of their fertility. I would have been lost without it and I will ensure that it forms compulsory reading for any young women in my family. And I don't care if that makes me 'boring Aunt Amber', probably a title I will acquire anyway so they may as well benefit. They will thank me for it when they try to have a baby...