Blog of the Society for Menstrual Cycle Research

Stopping Depo-Provera: Why and what to do about adverse experiences

April 11th, 2013 by Laura Wershler

Laura Wershler interviews Ask Jerilynn, clinician-scientist and endocrinologist

A screen shot of comments to Laura Wershler’s blog post of April 4, 2012: “Coming off Depo-Provera can be a woman’s worst nightmare.”

With 250 comments – and counting – to my year-old post Coming off Depo-Provera is a women’s worst nightmare (April 4, 2012) I thought it was time to revisit this topic.

That blog post has become a forum for women to share their negative experiences with stopping Depo-Provera (also called “the shot,” or Depo), the four-times-a-year contraceptive injection. (Commenters reporting positive experiences have been extremely rare.) Many women have experienced distressing effects either while taking Depo and/or after stopping it. They report that health-care professionals seem unable to explain their problems or to offer effective solutions. What is puzzling for many is why they are experiencing symptoms like sore breasts, heavy and ongoing bleeding (or not getting flow back at all), digestive problems, weight gain and mood issues when they stop Depo.

This post aims to briefly explain how Depo works to prevent pregnancy, its common side effects and, most importantly, why and what to do about adverse experiences when stopping it.

What follows is my interview with Dr. Jerilynn C. Prior, Society for Menstrual Cycle Research board member, professor of endocrinology at the University of British Columbia, and scientific director of the Centre for Menstrual Cycle and Ovulation Research (CeMCOR) Section 1 explains how Depo-Provera works and what causes its side effects. Section 2  explains the symptoms women are experiencing after stopping the drug.

1) Taking Depo-Provera: How it works and established side effects

Laura Wershler (LW): Dr. Prior, what is Depo-Provera® and how does it prevent pregnancy?

Ask Jerilynn: The term, “depo” means a deposit or injection and Provera is a common brand name of the most frequently used synthetic progestin in North America, medroxyprogesterone acetate (MPA). Depo is a shot of MPA given every three months in the large dose of 150 mg. Depo prevents pregnancy by “drying up” the cervical mucus so sperm have trouble swimming, by thinning the endometrium (uterine lining) so a fertilized egg can’t implant and primarily by suppressing the hypothalamic and pituitary signals that coordinate the menstrual cycle. That means a woman’s own hormone levels become almost as low as in menopause, with very low progesterone and lowered estrogen levels.

LW: Could you explain the hormonal changes behind the several established side effects of Depo? Let’s start with bleeding issues including spotting, unpredictable or non-stop bleeding that can last for several months before, in most women, leading to amenorrhea (no menstrual period).

Ask Jerilynn: It is not entirely clear, but probably the initial unpredictable bleeding relates to how long it takes for this big hormone injection to suppress women’s own estrogen levels. The other reason is that where the endometrium has gotten thin it is more likely to break down and bleed. These unpredictable flow side-effects of Depo are something that women should expect and plan for since they occur in the early days of use for every woman. After the first year of Depo (depending on the age and weight of the woman) about a third of women will have no more bleeding.

LW: What about headaches and depression?

Ask Jerilynn: It is not clear why headaches increase on Depo—they tend not to be serious migraine headaches but are more stress type. Perhaps they are related to the higher stress hormones the body makes whenever estrogen levels drop. Unfortunately, headaches tend to increase over time, rather than getting better as the not-so-funny bleeding does.  Continue reading...

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Posted in Amenorrhea, Birth Control, coming off the pill, Dysmenorrhea, Health Care, Hormones, Menorrhagia, Menstruation, Ovulation, Perimenopause | 20 Comments »

I am a pro-choice menstrual cycle advocate

January 9th, 2013 by Laura Wershler

As 2013 begins, I give thanks to each and every one of my colleagues at the Society for Menstrual Cycle Research and all my blogging buddies at re:Cycling. Without them I’d feel left out in the cold.  

Are menstrual cycle advocates left out in the cold? Photo by Laura Wershler

I’ve been a menstrual cycle advocate since 1979 when, during a year of post-pill amenorrhea that totally freaked me out, I began to research the ill effects of hormonal contraception. It is not an understatement to say that reading  Barbara Seaman’s national bestseller Women and The Crisis in Sex Hormones changed my life. It started me on a path of self-discovery, and commitment to the idea that healthy, ovulatory menstruation is integral to women’s health and well-being. If you don’t know about Barbara Seaman and her work in women’s health activism, please read about her.

My menstrual cycle advocacy took what could be considered a counter-intuitive path. I aligned myself with the pro-choice sexual health community, committed to comprehensive access to sexual and reproductive health information, education and services. I’ve been as much a contraception and abortion rights advocate over the last three decades as I’ve been a menstrual cycle advocate. But I was a successful user and ardent advocate of the fertility awareness method long before I became a board director at the pro-choice Calgary Birth Control Association in 1986. I went on to serve 10 years on the board of Planned Parenthood Federation of Canada and worked for six years as executive director of Planned Parenthood Alberta, which became Sexual Health Access Alberta in 2006. I’m currently on the board of Canadian Federation for Sexual Health, the former PPFC.

I stress my pro-choice credentials because I think I’m often suspected of being anti-choice. Surely any woman who advocates for healthy, ovulatory menstruation and speaks out against the health concerns inherent in hormonal birth control methods must be anti-contraception and anti-choice. I am neither. More broadly, I’ve written and talked a lot about the value of body literacy for women’s health and well-being.

I wonder sometimes why I’ve stuck it out with the pro-choice sexual health community. While many have been open to my ideas, I have seen little effort to learn about the health benefits of ovulatory menstruation or acknowledge the need – let alone act – to better serve women who want to use non-hormonal contraception. It’s frustrating to be a lone voice, but I keep talking.

It took me over 20 years to find the community that serves and appreciates my menstrual cycle advocacy. I attended my first Society for Menstrual Cycle Research conference in 2005, and that’s how I came to belong to this diverse group of academics, medical professionals, researchers, activists and artists committed to advancing knowledge and awareness of the menstrual cycle. We come from different perspectives, we ask different questions and we focus on different aspects of women’s menstrual lives. But we all hold true to the same idea: #menstruationmatters.

Menstrual cycle advocacy can be lonely and oh so frustrating. Chris Bobel’s recent post about how difficult it can be to help others make the menstrual connection included this quote from me:

Caring about menstruation and the menstrual cycle makes me almost a freak in the pro-choice world. I get ignored or criticized a lot because people don’t want to ask or answer some of the questions I keep trying to pose about choice around non-hormonal contraceptive methods. 

Thanks to SMCR and re:Cycling, I’m not going to stop asking hard questions, or challenging the ignorance and avoidance that many in the mainstream sexual health-care community demonstrate when it comes to ovulation, the menstrual cycle and fertility awareness. I’ll keep chirping and chipping away.  Continue reading...

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Posted in Activism, Amenorrhea, Birth Control, Communication, Health Care, Menstruation, Ovulation | 15 Comments »

How to Make Sure Your Period is Never “Late”

November 20th, 2012 by Kati Bicknell

Have you ever been concerned because your period was late? I know I have. But I’m not anymore! And you don’t have to be either! And since I’m sure you’d rather not spend several days every month nervously pacing and counting dates backwards on your hands while glaring at the general vicinity where you guess your uterus is, I’ll tell you how.

It’s simple:

LEARN ABOUT YOUR BODY!

Your period is not a Rolex watch; it was not specifically crafted in Switzerland to accurately tell time. A woman’s reproductive system is designed to … wait for it … reproduce! It takes into account all kinds of things when determining whether or not “now” is a good time to try and have a baby, and not ONE of those things is what day it is.

“Oh rats! I’m late for … uh … me ….”  This is something your period will never say. Think about it for a second. Your period is late? For what? For itself? Do you see how insane that is?

Whether or not, and when, a woman gets her period each cycle depends on a slew of hormonal events, which can be influenced by many things, such as diet, environmental and emotional stress, and on and on.

So let’s take things from the top and see why you think your period is “late,” shall we?

To begin, there is a theory that all women used to cycle with the moon. They would ovulate at the full moon, and they got their period with the new moon. But there is some evidence that suggests that the amount of ambient light in your bedroom while you’re sleeping at night can influence your cycle, in the same way that the moon supposedly did.

So if we are basing the notion of a “standard 28 day cycle” off when we used to cycle with the moon, we’re all pretty much screwed! Think of your bedroom — your alarm clock, a charging cell phone, a streetlamp, a light from under the door because your roommate is on another ‘Friday Night Lights’ bender: most of us do not sleep in a room where the only light is moonlight.

To further confuse matters, women who are on the pill “get their period” at around the same time every month, but anyone who knows anything about the pill knows that is not an actual period. It’s a bleed caused by the body’s withdrawal from progesterone on the week of placebo pills.

So we’ve got these two things that mislead women into thinking that their cycle should be 28 days.  One of my colleagues who has been teaching the Fertility Awareness Methodfor years says that she’s never had a client whose cycle was the same exact length every single time.

Sample chart for Example 1
© Kindara, used with permission


Period not arrive when you thought it would? Let’s take a look at your chart, it could be several things:

If you actually learn about what is going on in your body each cycle, and chart your fertility using the symptothermal method, you will be able to see and understand what is actually happening with all your heretofore “mystery bits.”

1. You haven’t ovulated yet, which means that a period is a ways off.  You might experience breakthrough or withdrawal bleeding later, but this would not technically be a true menstruation.

 

Sample chart for Example 2
© Kindara, used with permission

2. You ovulated and are currently in your luteal phase, which appears up until now, to be of a normal length.  Depending on how long your luteal phases typically are, you could have a better idea of when to expect your period, and if that day passes with no period, let’s see what’s behind door number 3.

 

 

 

 

3. You ovulated and are currently in your luteal phase, which appears to be longer than normal, which could indicate pregnancy.  (Or in very rare cases, a luteal cyst.)

Sample Chart for Example 3
© Kindara, used with permission

You see, there is always a reason that your period has not come yet, if you’re waiting on it. Certainly, you could say I’m just arguing semantics, but the truth of the matter is that your period is never “late,” it is doing exactly what your body is telling it too. The trick is to understand your body, rather than blame it and stare wistfully up at the moon, hoping it will work its sweet, sweet magic on your uterus.

 

Chart your cycle, and you’ll always know what the deal is.

Doooooooo it.

Editor’s note: Click on images to view at full size.

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Posted in Fertility, Menstruation, Ovulation | 3 Comments »

Fertility Charting Is the Way of the Future!

August 29th, 2012 by Kati Bicknell

The Quantified Self is the idea that by tracking things about your body you can live a happier and healthier life. Hardware devices like the Fitbit and Withings scale measure your daily activity and weight respectively so people can set and reach activity and weight goals. Apps like Lose It are tapping into this idea using a software-only approach: Lose it helps you lose weight, not by putting you on a diet, just by having you keep track of everything you eat. Every day you enter all the foods you eat into the app, and it tells you how many calories you consumed. You can also put in how much, and what type of exercise you did each day, and Lose It tells you how many calories you burned.  The result is you can see the amount of calories you burned, relative to the amount of calories you took in.

I have several friends who swear by this app. Lose it isn’t telling you anything you don’t know (eat less, and exercise more if you want to lose weight), but what it is doing is making it very easy for you to see how your actions are affecting your weight in a specific way on a daily and even moment by moment basis. In addition to achieving goals, quantifying the self leads to a sense of confidence and control where before there was confusion. And in doing so it makes us feel better.  This is the crux of the quantified self movement. Recording and analyzing everyday data can help us win at the game of life!

As my friend Lauren Bacon has pointed out, fertility charting fits right in to the Quantified Self movement. Women who chart their fertility record their waking body temperature, cervical fluid viscosity, and other data each day, and over the course of each menstrual cycle get a detailed picture of their reproductive health, and sometimes more!

Kindara Screen Shot © Kindara 2012

Cervical fluid viscosity is a proxy for estrogen level. Basal body temperature is a proxy for progesterone.  And as any high school student can tell you, hormones are powerful influencers of how we feel, think and act, and why our bodies do the things they do.  Just imagine if your menstrual cycle, and all the fluids, feelings and fluctuations that went along with it were no longer a mystery.  Imagine knowing just what was going on, and why.

By recording your daily fertility signs a whole world of possibility opens up for you! While it’s true that fertility charting can be, and often is used to achieve or prevent pregnancy, the benefits of it don’t stop there. Fertility charting can answer important questions about our ovulation, luteal phase, cycle health, thyroid function and more.  I have friends who have finally figured out the root of several food allergies, from charting their fertility.  I myself have learned that a diet high in animal fat keeps my cycles regular. One reason I’m so excited about what we’re doing at Kindara is that as more and more women start quantifying their fertility, we’ll start to generate new knowledge about fertility for the benefit of humankind, creating a virtuous feedback loop that will help each woman feel calm and confident with her fertility in her specific situation.

I envision a future where more and more women are taking an active role in their own health care with fertility charting.  How about you? If you’re currently charting your cycle, tell us in the comments what you’ve learned so far, and how it’s changed your life!  Continue reading...

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Posted in Fertility, Menstruation, Ovulation | 17 Comments »

In a fertility flap? Five things you need to know

August 22nd, 2012 by Laura Wershler

Your fertility is not a deep, dark mystery only your doctor can unravel. It’s yours to own, understand and manage. Forget the ticking biological clock, it’s the wrong metaphor. Fertility ebbs and flows, like the phases of the moon. It’s about the cycle – not the clock.

Are you wondering about your fertility status? Will you be able to have a baby when you want to?

Seems these questions are on the rise for 20- and 30-something women who are finally getting the message that putting off motherhood may not be a good idea. Recent news stories report that young adults don’t know the facts of fertility decline and overestimate the success of reproductive technologies.

But as the message gets through, the response makes my eyes roll.

Judith Timsom, one of my favorite columnists, recently pondered the fertility fears many young women are having.  Among them:

A third woman, turning 30, with a committed partner and a great job, made fertility sound like the new “f” word as she glumly remarked to a friend ,“My doctor told told me my fertility just dropped 50 per cent. Crap.”

This is crap. It misrepresents how fertility works. Timson writes that “young women – and men – are crying out for more factual, emotionally neutral information on how their fertility works.”  Forgive me if I, and at least 700,000 others – the number of people who have purchased Toni Weschler’s  Taking Charge of Your Fertility since it was first published in 1995 - shake our heads in frustration.

What women need is body literacy, the know-how to observe, chart and interpret our menstrual cycle events so that we – not the doctor, not the lab tech – can confirm our fertility status. Yes, it’s called fertility awareness, and, since the late 60s, millions  of women world-wide, including me – a bonafide pro-choice feminist, have used this life skill to both avoid and achieve pregnancy.

If you’re worried about your fertility, here are five things you need to know:

  1. You can learn to observe and chart three key signs of fertility: a) fertile cervical mucus b) basal body temperature shift  c) adequate luteal phase, or number of days from ovulation to next period.
  2. If you use hormonal contraception (HC), you have been infertile for as long as you’ve been using it. When you stop HC, your body has to establish healthy ovulatory menstrual cycles before you become fertile. Health and environmental factors may impact this process. Factor recovery time into your baby plans.
  3. If you began using HC as a teenager for heavy bleeding, painful periods  or irregular cycles chances are your reproductive system has not fully matured. When you quit HC this maturation process will resume. Depending on the method you used, it could take months before you have ovulatory, fertile cycles. Be patient. Holistic Reproductive Health Practitioners can assist in recovering fertility.
  4. If you began using HC for PCOS or endometriosis, expect symptoms to resume when you stop. The Centre for Menstruation and Ovulation Research describes treatments that manage PCOS  and endometriosis while helping to preserve fertility.
  5. Fertility is individually, not statistically, determined. It can ebb and flow from cycle to cycle. Diet, stress, travel and trauma can result in anovulatory, or infertile, cycles. When it comes to getting pregnant, the more you know about your own menstrual cycle, the better.

Fertility awareness is empowering, but Toni Weschler says that in her decades long experience she has repeatedly seen the sense of excitement that women feel evolve into anger. “Women want to know why they weren’t taught this when they were teenagers.”

The young women Judith Timson writes about have yet to acquire this knowledge. When they do, will they be angry enough to teach their own daughters? Weschler has a book for them, too - Cycle Savvy: The Smart Teen’s Guide to the Mysteries of Her Body.  Fertility isn’t a mystery if you know where to look for the clues.

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Posted in Birth Control, Fertility, Menstruation, Ovulation, Pregnancy, Reproduction | 2 Comments »

Bring on the Fat!

July 31st, 2012 by Kati Bicknell

I’ve been doing research on my own menstrual cycle for almost four years, charting my cycle using the Fertility Awareness Method.

 

Photo by Pete&Brook // CC 2.0

My cycles have always been wacky. I got my period when I was 11  but bled only a couple times a year, until, at my doctor’s suggestion, I went on the pill at 18, to “regulate” my cycle.  At 26 I learned that the birth control pills didn’t actually regulate my cycle, they just covered up the real issue.  I was determined to let my body find its own natural cycle, so I went off the pill. I wanted the option to have my own children someday, and with my dubious state of fertility, I needed to give myself a head start on having a healthy cycle.

I didn’t find much information about cycle health for a while, but when I was finally introduced to Toni Weshler’s book, Taking Charge of Your Fertility, I felt that  I had found the key!  I was fascinated to learn that with just a few simple actions each day I could get a clear picture of my cycle health. I started charting right away and did my best  give my body a shot at having a “normal” healthy cycle, exercising, eating healthy, trying different herbs and foods. But nothing seemed to make a lasting difference.  I would still only get around four periods a year.

This year in February I went to China, so Kindara could take part in the Haxlr8r start-up accelerator program. I was shocked when within two weeks of arriving in China, I ovulated, after not having my period for six months. I don’t generally ovulate in the winter, so I thought maybe this was just the end of that drought, being as it was March. But then I ovulated again in April, and in May, and in June.

The only thing I could point to that I was doing differently from what I had ever done before was eating lots of weird meat. In China it seems that no part of the animal is wasted. I had countless meals consisting of mostly bones and/or animal fat. In fact the regular “meat” that I was used to in the States didn’t seem to exist.  Everything was either bones, organs, or fat. This was pretty unnerving to me at first, but I slowly got used to it. So I kept it up. When we came back to the states in mid-June I made an effort to eat meat at least several times a week, the fattier and weirder the meat, the better!  And that’s hard to find here. But my efforts seem to be working, I ovulated in July as well!  This makes five months of regular cycles, for the first time in my life.

This is incredible, and I never would have had such a front row seat on the action if I wasn’t charting my cycle. I seem to have cracked the code on what my body was missing. And this means that I should have an easier time getting pregnant, if and when I decide I’m ready. My procreative power is now in my own hands, and I love it!

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Posted in Fertility, Ovulation | 13 Comments »

Politics and Sex Education Make Strange Bedfellows

June 6th, 2012 by Elizabeth Kissling

Guest Post by Lisa Leger

Yesterday (June 4) on MSNBC-TV, my girl Rachel Maddow interviewed New York Times columnist Gail Collins, author of the new book, As Texas Goes. The book criticizes the state’s politics and morality laws and their impact on the rest of the country. Now, I’m all for slagging the state of Texas for its abstinence-only sex ed policy, and I look forward to reading Collins’ book (which Maddow called “the funniest political book of the year”). However, my problem started when Maddow read a quote that seems to mock a piece of sexual health information that is actually correct.

The statement in question is “if the woman is dry, the sperm will die” , followed by the interpretation that it is some sort of colonial-era notion relating to the woman’s enjoyment or collusion in the sex act. Of course, the quote refers to fertile mucus and not lubrication or ejaculate, as the rather garbled interpretation seemed to imply. It’s a shame that a piece of perfectly useful information about fertility is confused with some arcane puritanism to make the [valid] point that abstinence-only sex ed is backward. I’m also disheartened [and vindicated] to see my assertion that mucus is either left out of sex education or inadequately taught being demonstrated once again.

In this story, though, my concern is not for the un-informed teens I champion in the blog linked here — but for the many adults who worked with Collins on her book and with Maddow on her show who let that reference get by them. Are we to assume that none of them ever learned to chart their cycles? Could there be no one on either staff trying to get pregnant? How can not a single one of the likely dozens of professional writers, fact checkers, and other staff members not have noticed that the reference they chose to hold up to ridicule is actually valid information about sperm survival in mucus?

A “Strange Bedfellows moment” for me as a Fertility Awareness Method (FAM) teacher is when what we teach is lumped in with what abstinence-only courses teach.  Another example would be finding oneself in favor or opposed to something like hormone pills for entirely different reasons.  As a Justisse Method teacher for 20 years, I’ve watched how charting is portrayed as some sort of Vatican roulette and how mucus is hidden away even more than menstrual blood is. I wince when I see perfectly good educational opportunities go by the wayside like that. How do the biological facts of fertility (sperm need mucus to survive) become invalidated simply by being taught from an authoritarian religious perspective?  I usually see the humor in a strange bedfellows moment, but hearing an evangelical Texan being mocked for teaching kids some mystical version of what I teach — this one stings a bit.

Lisa Leger is a member of the Society for Menstrual Cycle Research and a Justisse Fertility Awareness teacher on Vancouver Island.

 

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Posted in anatomy, Birth Control, Ovulation, Television | 2 Comments »

Coming Off The Pill: A Mind Map Guide

March 7th, 2012 by Laura Wershler

Everybody can use a good map to help them get to where they’re going. Why not women heading to the land of non-hormonal contraception?

In my post on January 11, 2012 I asked if coming off the pill was a growing trend. I proposed to write a series of posts about the issues associated with the decision to stop using hormonal birth control.  For the purposes of this discussion assume that “coming off the pill” refers to quitting any method of hormonal contraception including the pill, patch, ring, shot, implant or Mirena intrauterine system.

As I was preparing a list of possible topics, I realized that one way to represent the complexity of issues involved in this decision is with a mind map: “a diagram used to represent words, ideas, tasks, or other items linked to and arranged around a central key word or idea.” It also occurred to me that readers could then add to this schematic, filling in important points based on personal or professional experience. So I got out my colored markers, did a little brainstorming and came up with Coming Off the Pill: Mind Map 1.0. I invite readers to comment, offering additions under the key headings I’ve noted and suggesting other categories that should be included.  Could this become a talking, planning or process guide for women considering the transition to non-hormonal birth control methods?

If you’ve thought about or been through the experience of quitting hormonal contraception, or if you’ve helped others through the experience, please contribute to the development of Coming Off The Pill: Mind Map 2.0 by posting your comments and suggestions. (I’ve already thought about other headings I could have included.) Besides providing me with a guide for writing future posts, what other ways can you imagine this mind map might be used?

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Posted in Activism, Amenorrhea, Birth Control, coming off the pill, Communication, Dysmenorrhea, Health Care, Hormones, Menorrhagia, Menstruation, Ovulation, Pharmaceutical, PMS, Reproduction | 10 Comments »

Sex Ed for Teens: Where’s the Mucus?

February 24th, 2012 by Laura Wershler

Guest Post by Lisa Leger

Teen girls are getting pregnant, in part, because they don’t understand their menstrual cycles. It’s time for sexual health educators to step up and teach girls the primary sign of fertility.

A recent report by The Centers for Disease Control and Prevention (CDC) on teen pregnancy in the U.S., based on a survey of close to 5,000 young mothers who got pregnant unintentionally, found that half of them had not used birth control.  When questioned further, a third of those said that they didn’t think they could get pregnant. Their reasoning ties in with previous research findings that girls who get pregnant in their teens have misconceptions about their menstrual cycles. They don’t seem to understand how ovulation works and are failing to correctly identify the fertile days in their monthly cycles.

Photo by Acaparadora // CC-BY-SA-2.5

My colleagues in sexual and reproductive health education should take notice. These findings reveal a knowledge gap in sex education: Teens don’t know about the easy-to-spot sign of fertility that precedes ovulation – cervical mucus secretions. Let’s fix it by adding one simple phrase to our sex ed classes: “When you have mucus, you can get pregnant.”

We would also need to explain the ovarian cycle, how estrogen promotes cervical mucus production, the role of mucus in sperm survival and how to check for it. This is arguably among the most useful information young women and men could receive before leaving high school.

If girls had this knowledge then I believe that at least some of them would more accurately identify fertile days in their cycles and at least some unintended pregnancies would be prevented. When a girl knows that mucus on the toilet tissue means she is fertile and able to get pregnant, she may be empowered to avoid intercourse, insist on a condom if she has sex, or know if she needs to seek out emergency contraception. Or she may decide to just hang out with her girl friends. I’m not saying that fertility awareness is a magic wand. Of course, many factors influence our decision-making. But teens are capable of making wise choices when they have accurate information on which to base them.

I’ve talked to many public health nurses throughout my 20-year career as a fertility awareness instructor. They usually quibble about the effectiveness of fertility awareness as a birth control method and seem reluctant to mention the existence of cervical mucus for fear that “a little bit of knowledge is a dangerous thing.” They worry that some students, if taught fertility awareness, might screw it up, thinking they were “safe” when they were not. But the CDC report tells us that garbled understanding about how ovulation works is doing more harm than good.

I hasten to reassure my public health colleagues that I am not proposing we teach teenagers natural birth control. What I’m proposing is the awareness part, that we correct this critical gap in teenagers’ knowledge by explaining that mucus is an obvious sign of fertility.

I won over my local sex educator to this idea by showing her the evidence-based Justisse Method of Fertility Awareness User’s Guide. She now teaches the meaning of mucus in her ovulation lessons.I predict her students will benefit. When they feel that slippery wetness when wiping, they will remember that it has something to do with being fertile. When they see clear, stretchy mucus on the tissue, they will know it’s a fertile day. It seems obvious that reducing confusion about the fertile phase would result in fewer unplanned pregnancies among girls who are currently confused about when they’re safe and when they’re fertile.

Instead of withholding useful information about what cervical mucus means, let’s tell teens that avoiding sex when they observe mucus can prevent pregnancy.

SMCR member Lisa Leger teaches the Justisse Method of Fertility Awareness & Body Literacy and is a Natural Health Consultant on Vancouver Island.

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Posted in Activism, Birth Control, Girls, Menstruation, Ovulation, Reproduction, Sex | 15 Comments »

Is Coming Off the Pill a Growing Trend?

January 11th, 2012 by Laura Wershler

The Internet abounds with articles, posts and forum discussions about coming off the birth control pill. Women are looking for information and advice. Many are trying to get pregnant, others are just done with hormonal contraception.

It’s a topic that interests many of us connected to the Society for Menstrual Cycle Research (SMCR) because of

Created at an a menstrual arts and crafts event, Andrea, 25, said this piece depicts the multiple emotions she feels around menstruation. Photo by Laura Wershler

how the pill and other forms of hormonal contraception impact the menstrual cycles of the women who take these medications. Some of us are experts in menstrual cycle function and dysfunction, most are advocates for healthy, positive menstrual cycle experiences from menarche to menopause.

A recent blog post at nomoredirtylooks.com on the topic of quitting the pill caught our members’ attention.  Re: Cycling blogger Elizabeth Kissling included the post in Weekend Links on November 19.

A young woman in Paris was looking for advice and comments from other blog readers about how to manage the effects of coming off the pill. Siobhan O’Connor, the blog co-editor, shared Paris girl’s story with a graceful, inclusive invitation to readers:

There’s no judgment—implicit or explicit—on anyone who is on or has been on birth control pills. Some people love them, some people have to take them for medical reasons, some people abhor them. Here, we want to talk candidly about what happens when you go off them. Because, whoa. That can be hectic.

The post drew over 80 comments, with a few coming from SMCR members. What struck me was how many women:

1)  had already ditched the pill or were planning to
2) expressed a desire for the return of regular, normal menstrual cycles
3)  were concerned about their skin (it often breaks out after quitting the pill).

SMCR member, endocrinologist and guest blogger Dr. Jerilynn Prior answered the concerns about acne and bad cramps in a comment posted on November 22, and included a link to Centre for Menstrual Cycle and Ovulation Research website where readers can find information about all things related to menstrual cycle health.

Holistic Reproductive Health Practitioner Geraldine Matus, another member, commented on November 26 that it was concerns and experiences like those expressed by posters that prompted her and colleague Megan Lalonde to write the guide: Coming Off the Pill, the Patch, the Shot and Other Hormonal Contraception.

I invited No More Dirty Looks readers to visit this blog to learn more about the menstrual cycle and the issues raised by their online discussion.

Regular visitors to re: Cycling know that we cover a broad range of topics, but bloggers frequently address hormonal contraception as it relates to women’s health issues.

Check out this sampling from the re: cycling archive:

Several of the women who responded to the Paris girl post at nomoredirtylooks.com expressed eagerness to reclaim healthy, ovulatory menstruation and a willingness to learn how to  manage their fertility without the aid of hormonal contraception.  Continue reading...

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Posted in Birth Control, Health Care, Menarche, Menopause, Menstruation, Ovulation | 6 Comments »

I’ll read for the cure, but I won’t drink the pink Kool-Aid

October 19th, 2011 by Laura Wershler

OPINION

Every October it’s the same thing:  Buy pink, think pink, drink the pink Kool-Aid.  All in pursuit of (mostly) the cure for breast cancer.

Forget the cure. I’m much more interested in preventing the disease. As such, I’ve refused for years to walk or run for the cure to breast cancer. Not only am I concerned that too little of the money raised by such events is being spent on prevention research, I also don’t like what can only be called the commodification of breast cancer.  For more on this check out thinkbeforeyoupink, a program of Breast Cancer Action.

In addition to these concerns, I find some of the breast-cancer fundraising and awareness-building activities being promoted this year to be nothing short of cringe-worthy.

I certainly won’t be attending boobyball 10 next month.  This auspicious event is put on by Rethink Breast Cancer, a Canadian non-profit geared to building awareness in the under-40 crowd. Too bad Rethink’s booby fetish seems more appropriate for the under-12 set.

And I won’t be wearing an “I love boobies” bracelet anytime soon.  Nor will students at a middle school in Kelowna, British Columbia, where the bracelets were recently banned because the message was deemed “offensive.” I’d ban the $3.99 over-priced plastic wristbands just for being silly.

The bracelets, along with other silly “I love boobies”  promotional products, are sold by keep-a-breast.org, the mission of which “is to help eradicate breast cancer by exposing young people to methods of prevention, early detection and support.”

Although I’m sure both of these organizations mean well, I want to scream, “Enough already!”  I know I don’t fit either org’s demographic, but still, enough already.

What I will attend, this evening, and with some hesitation, is the inaugural Read for the Cure event in Calgary.  For $90 I’ll enjoy wine and nibbles, hear three Canadian female authors read from their work, and take home three books by these featured writers.

Marina Endicott is one of three featured authors at Read for the Cure in Calgary, Alberta on October 19.

Read for the Cure is a Canadian endeavor launched in Toronto in 2006 by two women from the same book club who had recently completed treatment for cancer.

“Acknowledging the important role of reading in their lives, and the wonderful support they had received from their fellow members during their treatment, they saw an opportunity to harness the energy of enthusiastic book clubs and readers to raise funds for cancer research.”

I love books, I love my own book club, and I’m going to the event with a dear friend whose mother died of breast cancer.

While breaking my self-imposed boycott of cancer-related fundraising events, I plan to ask a few questions of my fellow attendees:

What’s your take on the mammography screening controversy?

Are you aware of the connection between healthy ovulatory menstruation and breast health?

What do you know about vitamin D and cancer prevention?

I’m also hoping to engage representatives from the Alberta Cancer Foundation and the Cancer Research Society — the two recipients of the event’s proceeds — in discussions about the current research projects they’re funding.  Do they know about the Breast Cancer Prevention Study being conducted by Grassroots Health to explore the association between vitamin D levels and breast cancer?

Tonight, my drink of choice will be red wine. Here’s to a fun evening.

 

 

 

 

 

 

 

 

 

 

 

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Posted in Activism, books, Communication, Health Care, New Research, Ovulation | 2 Comments »

Hold the Eggs When Ovulating

August 11th, 2010 by Elizabeth Kissling

Fascinating new research from the National Institutes of Health finds that women’s cholesterol levels correspond with cyclic changes in estrogen levels. Total cholesterol levels can vary by as much as 19% over the course of the cycle.

The researchers found that as the level of estrogen rises, high-density lipoprotein (HDL) cholesterol also rises, peaking at the time of ovulation.

In a typical cycle, estrogen levels steadily increase as the egg cell matures, peaking just before ovulation. Previous studies have shown that taking formulations which contain estrogen — oral contraceptives or menopausal hormone therapy — can affect cholesterol levels. However, the results of studies examining the effects of naturally occurring hormone levels on cholesterol have not been conclusive. According to the NIH’s National Heart, Lung and Blood Institute, high blood cholesterol levels raise the risk for heart disease.

. . . .


In contrast, total cholesterol and low-density lipoprotein (LDL) cholesterol levels — as well as another form of blood fat known as triglycerides — declined as estrogen levels rose. The decline was not immediate, beginning a couple of days after the estrogen peak at ovulation.

These findings provide another reason for girls and women to learn to track their cycles, so their blood tests can be interpreted more precisely.

It also gives more weight to the frequent assertion of members of the Society for Menstrual Cycle Research that menstruation matters — and is worthy of our study — in part because it is not an event isolated in the uterus and vagina, but a complex part of the endocrine system that has effects on health and well-being throughout a woman’s body.

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Posted in Health Care, Menstruation, New Research, Ovulation | 1 Comment »

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Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.