Fertility is one of the main concerns I hear about from women with PCOS. Not many women clearly understand their fertility cycles and even fewer feel like they have any control over them. Fertility expert Hannah Ransom visited the PCOS Diva podcast this week to share information with other women with PCOS that want to take more control of their fertility using fertility planning and awareness methods.
Listen as we discuss:
- The difference between natural family planning and fertility awareness
- How to use fertility awareness as a birth control or family planning method
- The best time to test for pregnancy or progesterone levels
- What your cervical fluid is trying to tell you
- Using fertility awareness to make your cycles more regular
- Helpful fertility apps
Hannah Ransom is a certified fertility awareness educator that helps women figure out exactly when they are fertile for use as an effective natural birth control method. She is the creator of the HER fertility program and teaches women all over the world how to use their cycles to their advantage.
Amy: Hello and welcome to another edition of the PCOS Diva podcast. Today we’re going to be speaking with Hannah Ransom. Hannah is a certified fertility awareness educator. I invited her onto our podcast because a lot of people with PCOS take the pill for therapy or have taken the pill and I’m certainly one of them, but if you’ve taken the pill you’re also at risk for things like heart attack or stroke. Women with PCOS are at elevated risk of blood cloths. The pill can lower levels of valuable nutrients, it can lower libido, it increases insulin resistance. It can kill off friendly bacteria in your gut. There’s a lot of downsides to taking a pill.
I know that when I was trying to get pregnant obviously I came off the pill, but then went back on it for birth control and my body just couldn’t tolerate it. I decided there had to be another way that I could manage my fertility, but also feel better with PCOS and manage it in a more natural way. I actually use natural family planning and fertility awareness methods and I wanted to bring on fertility awareness expert on the podcast. Hannah could share some information for other women with PCOS that want to take more control of their fertility using fertility planning and awareness methods. Hannah, welcome.
Hannah: Hi, thanks for having me.
Amy: Let me just tell everyone a little bit more about you. As I mentioned, you are a certified fertility awareness educator and you help women figure out exactly when they’re fertile to use it as an effective natural birth control method. She is the creator of the Her fertility program and you teach women all over the world how to use their cycles to their advantage. Tell us Hannah how we can go about starting to use fertility awareness as a birth control method.
Hannah: I guess I’ll start a little bit with what fertility awareness actually is because a lot of people get it confused with the rhythm method or something else. People hear fertility awareness and they’re like, “Oh yeah, I know what that is,” but really when I start questioning people more, no idea. Fertility awareness is all about using your bodies actual day to day signs that it gives you, telling you what’s going on with your hormones. Those signs are actually a really reliable indicator of when you are actually fertile and not fertile.
It’s really great because you’re getting that fertility window with these signs regardless of whether your cycles are regular, irregular and also because these signs are based off of what’s happening with your hormones in your body. You’re getting an idea of what is going on with your hormonal health. If you’re still trying to figure out, “Hey, what kinds of natural things help me to have my PCOS under control more,” you’re getting cycle by cycle data from your body just by charting your cycles and saying, “Hey, this seems to be regulating things in a really good way,” or, “This doesn’t really seem to be doing anything.”
That’s one of my favorite things about fertility awareness, is all of the information that you get from your body. Then of course it’s great as a birth control method which can be really effective as long as it is used well or used correctly and learned well and also to help you get pregnant, especially if you have irregular cycles. You’re never really sure when you’re ovulating or you have a really short fertile window.
Amy: When I was first diagnosed with PCOS it was a result of using the Creighton model of fertility awareness. I’m not even sure if you would consider that fertility awareness. Is that natural family planning technique?
Hannah: Natural family planning and fertility awareness are really similar. They’re both basically umbrella terms for any kind of method that uses either periodic abstinence or periodic use of barrier methods, if you’re using fertility awareness and using a barrier method. A natural family planning tends to be when you hear natural family planning most of the time that is taught by Catholics and they teach abstinence only during the fertile phase. They just have this specific moral and ethical code of the Catholic church whereas fertility awareness is often taught secularly. A lot of times if you’re taking fertility awareness class your teacher can discuss with you other methods using during your fertile phase, stuff like that. That’s the difference.
Amy: The teacher that taught the Creighton method was really the one that diagnosed me with PCOS based on my fertility charting. Once I started to learn more about my cycles it was so empowering. I think that’s a big part of being a diva, a PCOS diva, is taking control of your health and realizing that knowledge is power. Charting your cycles is such, like you said, key information and really gives you wonderful feedback on how your lifestyle’s working for you.
Hannah: Yeah, definitely.
Amy: Can you really use it as a birth control method for women with PCOS? Our cycles tend to be longer, irregular. Tell us a little bit more, whether it’s really a viable method for us.
Hannah: The beauty of fertility awareness is that it’s effective whether your cycles or irregular. It can be used with PCOS sometimes because there’s a couple of things that people have a tendency towards with PCOS in their cycles. This isn’t everyone necessarily, but a lot of times there will be longer cycles. That’s because ovulation is delayed. You’re having a longer pre-ovulatory time. Then also during that pre-ovulatory time a lot of times there’s also a lot more cervical fluid than normal. Instead of five days you might have ten days. Cervical fluid is actually the sign that is telling you, “Hey, ovulation might be coming up.” Cervical fluid is the thing that is actually making sperm be able to survive inside of you because normally your vaginal environment is very acidic and sperm dies off very quickly.
Cervical fluid alkalizes your vaginal environment and provides nourishment for sperm. It works in this perfect system where your estrogen levels are increasing, which is what signals the cervical fluids to start and the estrogen level start increasing when your egg starts maturing. It’s working in this perfect system where that happens right before ovulation and you’re knowing, “Okay, ovulation’s coming up and sperm can survive inside of me.” With PCOS a lot of times estrogen levels can be a little bit higher and you can have more follicles maturing and they can be doing so for a while without one actually dominating and ovulation happening.
Sometimes, and this is for some people, you’ll have an increased amount of cervical fluid, so your fertile window can be longer artificially kind of, even though you wouldn’t have necessarily been fertile that whole time in retrospect you can be like, “That was a lot of extra cervical fluid way before I ovulated.” Sometimes one of the frustrating things can be that you can have a longer fertile window which can be hard, but in terms of efficacy, you’re not losing efficacy. If it’s something that it’s like, “Okay, I would really love to do fertility awareness so that I can start really understanding what’s going on in my body right now, start figuring out what kind of natural methods are working for me and really get my cycles more regular,” which I’m assuming most of the listeners here are in that situation.
That’s something that’s really cool about fertility awareness and you can still use it as a birth control method, but it’s going to get a lot better to use as a birth control method as your cycles regulate because most people are going to end up having a shorter fertile phase. It’s just not as frustrating because when you have a really long potential fertile phase it can be frustrating because you’re like, “Wow, I’m barely having any time that I can actually have unprotected intercourse.”
Amy: Really, I think for those that are trying to conceive, when you feel like it’s … sometimes can be so frustrating, out of your control. By being able to be an active participant by knowing what your cycle is doing, I think it gives you a little bit more peace of mind I guess.
Hannah: Definitely. Especially when you’re not sure when you … If you’re just going off of calendars or something like that for ovulation, you could easily be missing it. Also, trying to conceive, there are so many little things that can give you peace of mind with fertility awareness. You know when you actually ovulated. You know when’s going to be the best time to actually test to see if you’re pregnant. If you’re doing any kinds of tests in terms of actually going to the doctor and getting progesterone level tests, you’re timing those tests correctly for your cycle instead of just going in on day 21 when you may not even have ovulated and your doctor’s like, “You’re in ovulatory because I see your progesterone levels are this low.” There’s so many advantages really for both, but it can definitely be a frustration as a birth control method if you still have really irregular cycles.
Amy: I ended up getting pregnant using fertility awareness. It was hard. It was hard for me to, at the time, my cycles were not as regular as they are now. Of course I have a wonderful blessing of a daughter, but I think … It becomes more of a challenge for women with PCOS and they need to have a teacher or a mentor that they can really rely on. I know that you offer several different ways that women can work with you as a fertility awareness educator. For somebody that’s thinking, “This is something that I want to start to take control of,” what is the first step? How can women get started?
Hannah: You can learn more. I do have, if you’re just like, “Let me just dip my toes in. I just want to learn more about fertility awareness and see if this is something that might be right for me.” I do have a free program called the Her Fertility Mini School. That basically goes over, there’s documents on if fertility awareness is for you, how to talk to your doctor and partner about it, more about exactly how fertility awareness works and what it is. More about all of the other non-hormonal birth control methods too just so that you can see if it’s a birth control method you’re looking for, what the differences are and what works best for you. There’s a lot of different information in there that’s really helpful. That is free. You can sign up for that course. That is at HerFertility.com/join-free. I always want to forget to say that hyphen.
Then my fertility awareness courses, those I have a couple of different levels. Both of them are definitely, I like to be really high contact with everyone that works with me. Both of them have access to a Facebook group where you can get your questions answered and office hours. Then I also have an option where you can do built in one on ones via Skype and email and text support. If you want a little more personal support, you just really like having that one on one, that is a really good option as well. Both of those include the core, everything about learning fertility awareness. They have core video modules. They have an eBook.
They include a cervical fluid master class which cervical fluid, it’s one of the most important pieces of fertility awareness. They have a little hormonal health module too for things to do. Basically, one thing is looking at your charts and figuring out what’s healthy and what’s not and then also some of the basics of good hormonal health. Those courses are jam packed with lots of stuff. They’re definitely really helpful for anyone learning fertility awareness and wanting to use it for monitoring hormonal health, birth control or even getting pregnant. There’s specific getting pregnant courses in there too.
Amy: I love that you have this master course of cervical fluid. It’s a difficult topic to learn by a book or looking at pictures. It’s great that you have that kind of support. I was just wanting to mention that there’s a lot of new research coming out for women with PCOS on different supplements that increase fertility. Ovasitol is one of those. It’s a combination, myo inositol, D chiro inositol products that help women with PCOS on a variety of different ways with ovulation. I think that knowing how to monitor your cervical mucus and cervical fluid, you’re right, you can get a sense of whether, if you’re on a new supplement, if it’s making a difference in your cycles.
Hannah: Yeah, because cervical fluid is one of the biggest things with people with PCOS. Very commonly, not always, but very commonly people with PCOS have increased amounts of cervical fluid. Not only are you able to see … everyone’s able to see, “My cycle’s …” long cycles are another common thing, or “My cycles are getting closer together.” That’s something that even if you’re not charting or … you should be paying attention I guess, but even if you’re not charting everything, your temperature, your cervical fluid, you’re still able to see that.
What’s really great about doing everything using the cervical fluid, the temperature, is you’re able to see when your hormone levels are getting more regulated. It’s really, I think, an invaluable thing to have in your skillset when you’re working on your hormonal health. It’s just really, really informative. That was something that surprised me when I started using it because I started using it as a birth control method. It woke me up to a couple of things that weren’t so great with my hormonal health. It was really, really awesome to have that, it’s just this extra bonus of using this method.
Amy: It definitely made me feel more empowered over my health; especially as a woman with PCOS you just really do feel so out of control. It was something that I felt like I could play a part of. It was great to see as my lifestyle changed, my cycles changed for the better. It’s really a rewarding outcome.
I do have a question about charting. When I was doing fertility charting on a really daily basis, I was using a little sticker chart. I know we’ve come a long way from sticker charts. Are there any apps or other charting vehicles that you like to use?
Hannah: The apps are really neat. There’s tons of them now. One thing that I’d like to mention about apps is that they are a tool. It’s not something like, “I want to do this fertility awareness thing. Let me just download an app and I’ll figure it all out.” Apps are really great charting tool, but you definitely want to have that base education and then use the apps as something to chart instead of using the apps to interpret everything for you and to just try to learn based on what they’re telling you their little tips which usually are incorrect. I was taking screenshots of apps that I’ve used and they’re telling me like, “You ovulated yesterday,” and I’m like, “No, I didn’t.”
It’s definitely not good to rely on the apps, but they’re really cool to use as a tool to chart. There’s a few different options. You can use sticker charts like you said. You can chart on paper. I love charting on paper, personally. It’s just my personal preference. Then there’s also a bunch of apps. There are some that are better than others. I think that some really good ones are Groove, Kendara. Overview is okay. You have to be really careful about interpretations on that one. You just have to ignore the ones that do interpretation for you because they’re usually wrong. Especially if you have anything a little bit different about your cycles which you’re likely to if you have at all imbalances in your hormones.
Those are some of my favorite. Groove doesn’t do interpretations and Kendara mostly doesn’t do interpretations. I think that they’re really nice because a lot of people just want to keep everything in their mobile devices. It’s just something that for some people, it makes charting a little bit easier. Because for some people, looking at a piece of paper, they’re just going to forget about it or it’s going to be inconvenient for them. Having the ability to have different ways to do it is really great. There’s all kinds of technology around charting now which some of it might be better than others, but there’s all kinds of app integrated thermometers and just lots of stuff that is coming out. You want to be careful about what you use and really make sure there’s science behind it and that there’s a reason to use it.
Amy: I have to ask you, do you have any tips for women who are charting on a daily basis to stay on track? How do you avoid missing a day and saying, “Oh my gosh, I forgot to chart yesterday. I forgot to check my cervical mucus.” How do you stay on track?
Hannah: The way that I teach cervical fluid is different than some people, but there are some people who will teach, check it at least three times a day. I don’t teach that way. I actually teach a similar way to what you might be familiar with with Creighton, but I teach people to check with toilet paper because it’s really easy to remember when you are noticing the difference of how toilet paper feels when you’re wiping because you can tell sometimes. People who have never even charted out there, they’ll probably be like, “Oh yeah.” Sometimes you’ll wipe and it’ll be drier, sometimes you’ll wipe and it’ll be more smooth or slippery. You can go, “Oh yeah, I think I have cervical fluid.” Look at the toilet paper and there it is.
It’s really easy to remember once you get into a few days’ habit. Sometimes it does take a little bit of time to get into the habit. Generally most people don’t have very much problem with, especially cervical fluid, at all. Temperature is also easy once you get into the habit because when your alarm goes off you just take your temperature. For people who don’t ever use an alarm, some people just start using an alarm or some people are able to remember and take it anyway. It works out that checking the things works into your daily routine in such a way that you don’t usually forget a lot once you get into the habit.
In terms of actually remembering to chart most people as long as they pick for one thing a good way that they like. For instance, some people it’s going to be really easy to remember to use an app and enter in their data. For some people it’s going to be really easy to use a piece of paper because they’ll see it, they’re sitting on their night stand and they’ll be like, “Oh, let me just chart.” I’ve had days that I’ve forgotten and one of the cool things about charting is that you are … The next day you can still write in what you had if you remember. You can’t go a million days, but it’s not like, “I need to do this at exactly 12:00 pm every day” like you have to do with taking a pill. There’s a little give in there. I personally think that it’s pretty easy once you get into the habit. Did you have a pretty easy time?
Amy: Yeah, you’re right. It’s just getting used to taking those steps, to take the daily observations. Then it becomes like second nature.
Hannah: Totally second nature.
Amy: It might seem really overwhelming at first to take this step and start a fertility awareness program. Certified educators like you have broken it down to very doable steps and make it what can seem like an overwhelming idea really digestible and easy. I encourage people who are thinking about it. I can tell you coming off of the birth control pill was one of the best things that I did for my health. I’m just so happy that I made that decision. I know it’s not the right decision for everyone, but it certainly was for me. If you’re thinking about doing it and are a little concerned about tracking fertility I highly recommend that you check out Hannah’s site, HolisticHormonalHelath.com. Just tell us again the name of your free resource.
Hannah: It’s the Her Fertility Mini School. It’s at HerFertility.com/join-free.
Amy: Thank you Hannah so much for coming and sharing your knowledge and being with us today.
Hannah: No problem. Thank you so much for having me.
Amy: Thank you everyone for listening. Just so you know, PCOS Diva Podcasts are now on iTunes. Please go and rate our podcast today and please subscribe. We have a lot of other fantastic guests on the horizon. Thank you for listening and I look forward to being with you again soon. Bye, bye.