LISA HENDRICKSON-JACK

Jessica [00:00:02] Hi everyone. Jessica here. If you’ve been following our Leiamoon page for a while, you know very well that we are passionate about empowering women to better know and care for their bodies. In our research we came across the work of likeminded expert Lisa Hendrickson-Jack, who I have the honor of interviewing today to share with you, our audience. 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.

[00:00:35] In her new amazing book, The Fifth Vital Sign, Lisa debunks the myth that regular ovulation is only important when you want children. We are recognizing that the menstrual cycle is a vital sign. She draws heavily from current scientific literature and presents an evidence based approach to fertility awareness and menstrual cycle optimization. She also hosts the amazing Fertility Friday podcast, which is a weekly radio show devoted to helping women connect to their fifth vital sign by uncovering the connection between the menstrual cycle, health, fertility and overall health. Lisa, thank you so much for being here and for all that you share.

Lisa [00:01:13] Thank you for having me. I’m excited to be here.

Jessica [00:01:17] So can you start by just introducing yourself, telling us about your background and how you came to write this book?

Lisa [00:01:24] Yes. I mean with my story–my experience with fertility awareness is unique in that I discovered it when I was really young. So I was just out of high school, I think my first or second year of university when I discovered fertility awareness; so I was about 18 or 19 years old. Like many women, I’d been put on the pill for painful, heavy periods in high school. I mean, I didn’t really know how else to handle it and I probably said three words to the doctor and he was like already writing the prescription. So I wasn’t using the pill for birth control, I was using it for pain management. And every time I would come off of it for whatever reason, just to take a break or something like that, the pain would be there and it would be the same or worse. Also, because I wasn’t using it for birth control, I wasn’t always taking it at the same time every day, but I was always the nerd that I am, so I had read the entire inserts and I knew that if you weren’t taking it the right time it wouldn’t be as effective and I felt like I would always be nervous about whether or not it was working when I actually did need birth control.

[00:02:30] Around the age when I actually did need birth control, I was kind of like, okay, so if I don’t fully trust the pill, I’m always going to use condoms. Then I was like, but if I’m always going to use condoms why use the pill because I was also kind of nervous about my fertility in the future, like I didn’t want kids at 18. But I knew I wanted them at some point and I had some reservations just about–I saw some of the members of my family have challenges with fertility, I knew I had these really heavy painful periods. My mom had struggled with fibroids for years and ended up having a hysterectomy and I kind of just had the sense of like, this isn’t normal and I really want a different future, like I want to figure out what’s going on.

[00:03:10] So it’s right around that interesting time of contemplation of what am I going to do that I discovered fertility awareness. So for me, that was the first time that I had ever learned that I wasn’t fertile every day. So I distinctly remember in my junior high school education class that the teachers told us there were no safe days, we could get pregnant as women every single day regardless. So I just left that at that age and stage of my life feeling really terrified, scared that I could get pregnant at any time, not really understanding why there was this imminent threat but I didn’t understand it. Then when I discovered fertility awareness it was like okay, there’s only a short window of fertility, you can identify it by tracking your mucus and your cervical position and your temperature and you can use it as birth control and it’s evidence base, there’s science behind it, it’s up to 99.4% effective. So I was like, yes that is what I want to do. .

[00:04:05] I like to share that because I was a young woman; I was in my late teens, early 20s and so I ran up, taking charge of your fertility. I also happen to live in Edmonton Alberta and that’s where Justice Health Works for Women was located physically. So it just so happened that on my university campus there was a group of women who were trained teachers and were running monthly workshops. And so I attended and never stopped attending and eventually trained and started teaching; it’s like they couldn’t get rid of me. But that basically was my kind of window into this.

[00:04:44] And so fast forward a decade, I had used fertility awareness to avoid pregnancy throughout my entire 20s successfully, so I like to say that too because it works. When you learn how to use it correctly and you follow the rules and you continue to chart, it is an effective method of birth control as effective or equally to the pill. Then when my husband and I decided we wanted to start a family, we basically flipped the switch and had sex all the other days, had unpredictably sex. But basically just around that time, I was in my early thirties and I kind of looked around and realized that even though I had known this information all these years and had the privilege of teaching it to women, the average woman still has no idea how her cycle and body works, that she’s not fertile every single day every cycle. And a lot of women are struggling to conceive and still not understanding even just like how to time sex accurately. So I felt this obligation to spread the word and out of that came the podcast and now the book. And so it’s a really long answer to your question.

Jessica [00:05:54] No, no it’s great. It really is amazing that at such a young age you have the foresight to research just a bit further or that maybe it was just this fateful event that on your college campus you also had the opportunity to connect with women that were teaching fertility awareness. So remembering on my college campus I think birth control pills were free and I remember my roommates being like, “Oh, we have to go down to the health center so we can get our birth control on our condoms.” And I also had never really heard of the pill before that. And it just feels like it’s so quick to be given away and prescribed to women at such a young age before we really have the right information about our bodies to make an informed decision. So it kind of feels like it’s this intentional thing where they’re like, okay here you go, get into this stuff because this will be the rest of your life. And so it feels like the work that you’re doing is really trying to turn that on its head now and give women options without feeling like this is the only solution.

Lisa [00:06:55] It feels like there’s this–kind of an addition to what you said, it’s like this fear of–it’s like if we tell women what’s really going on then they’ll know. So even among women who learn and understand the fertility awareness method, there’s often this question of, should we be teaching it to teenage girls? How young should we be teaching it to them? And it’s kind of like this fear that if we teach them that they’re not fertile everyday, they’re going to go and have sex. Well newsflash, they are already having sex. Right.

[00:07:24] But it’s really just interesting this notion of wanting to suppress that truth because really, when you have the information, you’re able to make better choices. So I’m with you, I don’t really understand the hesitation of just making this information more accessible to women.

Jessica [00:07:42] Can you explain to us what fertility awareness method is and how do we do this?

Lisa [00:07:48] Yeah. In the most basic sense, fertility awareness is developing an understanding of your cycle so that you can identify which days of your cycle are fertile and which days are not. And then when you have that basic understanding of okay, this is how my cycle works, this is when I’m fertile, then you can choose whether you want to use that information to help you to avoid pregnancy naturally; so as an effective method of non-hormonal birth control. Or, if you’re trying to conceive then helping you optimize, have sex at the correct time of your cycle. For some women who are trying to conceive, just by understanding the correct time will help them to conceive. Obviously fertility is complex, so it’s not always that simple. But for a certain percentage of women, it’s literally like, let’s get the dates correct and they’ll be able to conceive. And then a third, just in general, because your menstrual cycle is connected to your overall health, you can also chart your cycles just to get a sense of what’s happening health wise. And as you make different changes, diet, lifestyle, different things, you can actually see that reflected in your cycle if you’re on the right track. So for some women they’re just going to follow their cycles for health reasons.

Jessica [00:09:00] The title of your book The Fifth Vital Sign is basically saying that our menstrual cycle is a vital sign. Can you break that down a bit more? What are more typical vital signs and what makes a menstrual cycle also a vital sign?

Lisa [00:09:15] Well I mean there’s a growing number of health care practitioners who are acknowledging that the menstrual cycle is a vital sign. Essentially a vital sign is a measure of how your body is functioning. The most common vital signs that we’re familiar with are say, your blood pressure, your heart and respiratory rates, how many breaths that you take each minute and your body temperature as well. So those would be the most common. We all have a general understanding that there’s a normal range of each of these signs and if you were to go to your doctor and one of those signs either too high or too low, not only would it give the doctor specific information that there’s something wrong, but it would also give a specific indication for the doctor of like okay, typically when the blood pressure is elevated it could be these things. So then it gives a roadmap as to, we should be looking here. So the menstrual cycle does very much the same thing. When you’re working with a person who has that insight of how the menstrual cycle could be related to help.

[00:10:22] Typically when I talk about the menstrual cycle, a lot of women just think you’re period, right. So when I talk about the menstrual cycle as being a vital sign, I mean the whole thing. So it’s not like you just have your period and then fast-forward and then the next one. In a healthy cycle, just to kind of take you through, the first day of your cycle is the first day of your period, your true flow. So I always say like when you actually have to get something to deal with it. So if you have a couple of days of spotting before your period starts then we wouldn’t count those as the first day; we’d count the first day as the first day of flow. So, the whole menstrual cycle you have your period typically lasting anywhere from three to seven days. Then, as your period comes to an end you typically have a few days before you start to see your cervical mucus. So cervical mucus can either look like creamy white hand lotion or sometimes it can look like clear stretching kind of like raw egg whites or you go to the bathroom and it feels really slippery when you’re wiping.

[00:11:22] But as you approach ovulation you would typically expect to see about two to seven days of cervical mucus. In a healthy cycle you would ovulate. So that’s a really important aspect of it. Then after ovulation you would expect your period to come in 12 to 14 days or if your period doesn’t come you would be pregnant. So there’s basically two options there. So if I break that down into what happens in the preovulatory and post ovulatory phase, within each different aspect of that we can gain information about overall health. So if we look at the period, if the period is extremely heavy and painful you know that can give us some important information that could indicate a problem that we should be looking into. If your period is too light, that could indicate a hormonal imbalance or something like that. If you don’t ever see cervical mucus at all that would indicate a potential issue with your cervical health. If you see mucus every single day, that could be an indication of something as simple as yeast infection or something more serious. Even abnormal cervical cells can come up with consistent water discharge throughout the cycle. If you’re not ovulating that would give us an indication of something that’s happening and also even just the length of your luteal phase, if you see spotting throughout your cycle. So it’s just helpful to have that understanding of there is a normal and healthy cycle and there are normal and healthy parameters of that. If you’re a cycle or certain aspects of your cycle regularly fall outside of that, I think that’s important as well because every woman will have the occasional kind of random thing that happens in their cycle, so we can’t necessarily say that if once you have some spotting that that indicates a huge problem because a lot of people will have spotting one. But if you look at the consistent patterns throughout your cycle, for many women especially women who are charting and pay attention to these things, there’s many cases where those subtle changes in your cycle can be the early indication even before you would think that there’s something wrong somewhere.

Jessica [00:13:27] What are the biggest disruptors then to what the normal cycle would be for a woman?

Lisa [00:13:35] I mean if you think about the menstrual cycle as a reflection of overall health then there’s a lot of different aspects of just life that can affect it. So it could be something like stress. Chronic stress even can affect the cycle a bit differently versus acute stress. Then when I say stress, we often think of like bad, horrible boss or something but it could be even going on a vacation. If you get on a plane your body’s all of a sudden 4000 feet in the air so your ovaries are kind of like what’s up. So that could be a stress even though it’s not ‘bad’. So if you experience some sort of acute stress prior to ovulation it’s really common for ovulation to be delayed a little bit if you have a health issue. So for example women with PCOS, PCOS is characterized by insulin resistance inflammation and that can disrupt ovulation, which is why women with PCOS, the characteristic PCOS cycle has a delayed ovulation. So women who fit that description typically have longer cycles. So it can be something like stress that can be something like a health condition that’s happening in your body.

[00:14:47] When I’m working with women, I’ve seen women who have got issues. So for instance if a woman has some degree of IBS and she had some food sensitivities or allergies or something like that and she exposes herself to those foods that can affect her cervical mucus production. So I’ve seen women who, let’s say, they have a sensitivity to like dairy, let’s pick on dairy for example and they eat the dairy and they have the sensitivity to it, they have some degree of mucus throughout their cycle. Then if they stop consuming it for a while, they might see that shift back to a more normal mucus pattern. So those are just a few examples and I really could go on. If a woman has endocrine issues, thyroid issues, issues with the conversation that goes on between your hypothalamus pituitary ovaries, so HPO access to this regulation. It’s just really interesting. And so you can’t necessarily look at the chart and say okay, this is exactly what’s going on, right. We can’t make like a quote unquote diagnosis. You need your doctor to do the test to make an accurate diagnosis. But you can get those subtle and kind of specific indicators that would let you know, okay, you should look here to see if there could be something wrong or you should look at this or this isn’t normal. You should know that that’s not what we would expect to see .

Jessica [00:16:08] Some when your menstrual cycle is off, which you can tell by regular tracking, that’s an indication that there might be some other aspects of your health that is out of whack and doesn’t necessarily mean it’s only a reproductive system that’s misbehaving. It’s more of a response.

Lisa [00:16:26] Well yeah. I think that one of the myths just in general as women that we’re working to overcome at this interesting phase–because right now it’s a really great time for periods. Within the year there’s been–I don’t even know all the books that have come out about periods. But even just within the year there’s a lot of women talking and writing about it. Periods, it feels like they’re getting their moment and we’re starting to really recognize that the menstrual cycle is important. But there’s this myth that your cycle only matters when you’re trying to have kids and it’s really only related to reproduction. So if you’re not actively trying to have kids today who cares, you can shut down your cycle with hormonal birth control. It won’t have any effect on your body and all that kind of stuff.

[00:17:10] My analogy for that is if you or I were to go to the car dealership, so we wanted to buy a car or something like that, I could get the car with air conditioning or I could get it without air conditioning or I could get it with heated seats or without heated seats and it wouldn’t affect engine functioning. And somehow, we think of our ovaries that way. We think that we can turn them on and off with hormonal birth control or if our cycle stop for whatever reason, we kind of think that it doesn’t affect our regular functioning because we kind of think that our ovarian function and our menstrual cycle is only related to having kids. But when you look at what happens when you interfere with normal ovarian function–so when women have disrupted cycles such as is the case with PCOS and they have really delayed ovulation.

[00:18:01] So a healthy cycle you would expect it to be somewhere between about 24 and 35 days with an average of about 29 days. So in that type of cycle you would expect that the first half of the cycle, your ovaries are producing estrogen, so your first half of the is characterized by a higher estrogen production. Then after ovulation you produce progesterone and so it’s not like a perfectly equal balance or anything, but you would expect to have about as many days where you’re producing significant estrogen as you would where you’re producing significant progesterone and these hormones have different roles and they work together. Progesterone mitigate some of the negative effects of estrogen, estrogen is characterized by cell proliferation. I mean I could go on. But an example of PCOS for example, then a woman would typically have cycles that are longer. So if her cycles are 45 days or– I actually spoke to women yesterday who told me that when she was trying to conceive, her cycles were like 75 days kind of on average. So that would mean in a 75 days cycle you would potentially have like 63 days of preovulatory, because your period comes after ovulation and the second half of your cycle is typically about two weeks long. So 62 days let’s say of estrogen dominance and then you have 12 to 14 days of progesterone. So women with PCOS for example are at an increased risk of developing endometrial cancer because they’re just exposed to estrogen for such a long period of time.

[00:19:36] So it’s just to show that there’s more to your cycle than just your ability to reproduce. And another example I’ll share is hypo so I make a memory. So that is a different situation where–so typically women with hypothalamic amenorrhea, it just means that they’re not ovulating and so they’re not menstruating. And it’s typically related to a combination of over exercise, undernutrition and stress. So basically something is happening where the connection between the brain and the ovaries is not happening. And when women lose their periods for say six months or more and this continues–so they’re just not ovulating, they’re not menstruating, they’re at an increased lifetime risk of developing osteoporosis. So it turns out that our ovarian cycle is related to how we develop and maintain bone mass. And so obviously my bone development is not related to my ability to bear children. So it’s really helpful to get out of this myth that our cycles only matter when we’re trying to have babies and understand that they’re important outside of that.

Jessica [00:20:46] So then that’s amazing. Of course it’s all connected. So I guess even in your book the way that you frame what synthetic hormones and birth control pills do to what we believed we’re regulating our cycle are making it actually sort of mute in the way it communicates with the rest of our body. So maybe you can speak a bit more on that because what you’re just describing, how all of these different systems within our bodies are communicating with each other, just like the car dealership analogy, like what happens when he just decides to a la carte pick and choose which systems we shut down.

Lisa [00:21:33] Well I mean, I feel like a lot of what I do is myth busting. And so when I was writing the book, I did some research just into the history of the pill just to kind of be able to explain it in a concise and accurate way. And so as I was looking at the research, when the pill was first developed before, they brought it to the market they did some testing So just picture it’s the late 50s, there’s never been a pill on the market before. So the women have no precedent for this. So in one of the early iterations of the pill, the individuals who created it, they gave the women the pill but they hadn’t created the withdrawal bleed yet. So there was no break. They just took the pill and they just stopped menstruating.

[00:22:17] So one of the myths about the pill and other types of hormonal birth control is that it regulates the menstrual cycle. So if your cycles are irregular you can take this pill and then magically your cycles are just regular now. But what the pill does is actually suppress ovulation in most cases, so when you’re not obviating you don’t have a period. So the women in the late 1950s and that early kind of pill development phase, some of those women were actually trying to conceive. So when they were creating this drug, they were also trying to kind of maybe kick start the cycle. So there were women in there who were actually trying to get pregnant. So when they saw that their periods weren’t coming, they thought they were pregnant and then the doctors were like, no you’re not pregnant. This was because of this pill that you’re taking. But the women, there was no precedent for this. So they were like, I don’t know what you’re talking about, I’m pregnant. The only reason I wouldn’t have my period is either because I’m pregnant, sick or breastfeeding and so I must be pregnant. So yeah, the women were absolutely devastated and when they actually discovered that it was the drug that was causing them not to have their period.

[00:23:27] So what happened was, from the very beginning of when the pill was first released on the market in 1960, what they did is that they created that fake 28 day cycle. So you know, any woman who’s ever taken pills out of a pack will know that you take it maybe for 21 days or the number of days might be a little bit different. But you take it for 21 days and then you get seven days of a sugar pill or just seven days of not taking it and then you get this bleed. So that’s how from the very beginning basically women were lied to about how the pill works and told that it was regulating the cycle and what it’s really doing is halting your cycle completely so you don’t have one anymore. Then when you stop taking the synthetic hormones–so the synthetic estrogen, progestin and the pill are not the same as what’s in our bodies. So even when you hear someone saying, oh it’s just estrogen and progesterone in the pill, it isn’t. In order to patent and sell drugs you have to create hormones that are similar enough to our natural hormones estrogen and progesterone to fit into our receptors, but different enough so that you can patent them and sell that right.

[00:24:37] Basically, from the very beginning we were told that this is what’s happening and even to this day when I try to bust some of those myths and create posts and post them and talk about this, there’s always a lot of women that–because we’ve never been told this, so there’s always a lot of women who are like, what do you mean? You know, my whole life I thought that this was regulating my period. I thought this was the solution to my irregular cycles and I’m bleeding, so how is this not a real period. And so you only have a true menstrual period after you ovulate about 12 to 14 days later.

Lisa [00:25:14] Fascinating. And same with IUD then too. I mean I guess most IUD eliminate the period altogether. Women are celebrating that and it’s also advertised in such a way where it is like this miracle thing, and I think the research that you’re presenting is that this is not healthy for us. It’s really hard to convince a great population of women now that feel like this is a victory, that it’s actually disrupting so many other pieces of our whole being that are shutting down now. So what would you say to those women?

Lisa [00:25:57] Well I just want to mention with the IUD, so there’s different types of formulations. So the most common and widely used types of birth control, whether it’s the pill, the patch or the ring are typically a combination of synthetic estrogen and progestin that work primarily by suppressing ovulation. But when you look at the research, ovulation isn’t necessarily suppressed 100% of the time. So the three main modes of action would be; (a) suppressing ovulation. So shutting down ovarian function and basically interfering with the normal function of your endocrine system because that’s what you need to do to prevent pregnancy right. If you stop ovulation you can’t get pregnant.

[00:26:39] But in addition to that, one of the other modes of action is to prevent the production of fertile quality cervical mucus, so when you’re on the pill or other types of hormonal birth control, it actually fills your cervix with a thick mucus plug, which you would naturally produce that outside of your fertile window. But basically the pill just prevents that from changing. So it’s just always like that. Then the third mode of action would be that when you’re using hormonal types of birth control, the uterine lining–so if they measure the thickness of your uterine lining via ultrasound, it’s very very thin. So in order to get pregnant your uterine lining has to be a certain level of thickness and so these drugs prevent the lining from ever fully forming. Even if, for example you’re using a type of birth control and you don’t ovulate, there would still be these other two backup measures to really reduce the chance of you getting pregnant and having a successful pregnancy.

[00:27:35] With the IUD there’s two main types of broad categories. There’s hormonal and non-hormonal. And typically the hormonal IUD are progestin only. So there’s no estrogen, so they don’t always suppress ovulation. I think the myth though is that you get to keep ovulating and have your normal cycle. So when you look at the research about hormonal IUD there is a percentage of women who continue ovulating, there’s a percentage of women who stop ovulating and there’s a percentage of women who ovulate more sporadically. So maybe they ovulate every once in a while. So with the IUD one of the primary modes of action, the progestin releasing IUD, one of the primary modes of action is to prevent that uterine lining from ever fully forming and then there’s other protests. So I just wanted to clarify that because I know I often get questions about that because there are women who choose the IUD, for instance, the hormonal IUD because they’re able to continue ovulating. So it’s helpful to clarify that it doesn’t mean that everything is happening normally because you are still getting a dose of hormones and often those IUDs are promoted as low dose. And it’s interesting, you can call it what you want, it has to have enough hormones to prevent you from getting pregnant, so we can call it high dose or low dose.

[00:28:50] We can look at the doses but it has to be enough to disrupt the normal system enough to prevent you from getting pregnant. And also with IUD, I hear a lot of women talking about how it’s like localized. So you have like a circulatory system, so it’s not like the progestin just stays in your uterus, it moves around.

[00:29:12] But you asked a question. I kind of went on a tangent about IUD but you had asked a question about how–maybe refresh me.

Jessica [00:29:20] Well I was just kind of curious because there are so many different types of contraception now that deals with hormones and some are kind of sold in a way that makes it seem like your cycle is still functioning as normal and like you answer the question. I mean it really was understanding which aspects it does sort of target to prevent pregnancy, which there is a spectrum of but what it’s doing is it’s shutting down pieces of what would naturally occur. So the fertility awareness method that you’re talking about charting, that seems to be the one way that we can prevent pregnancy if that’s the goal without disrupting all these other parts of our bodies. And that it’s still how effective?

Lisa [00:30:09] Well, I mean there’s been research done. So one of the research studies that I quote in the book if the Frank Herman study. In that study they had women, they tested the sympto thermal method of birth control so I teach a version of the sympto thermal method.

[00:30:24] All that means is that you’re combining the symptoms, so your cervical mucus and your cervical position observations with the thermal, the temperature charting, so you’re using both. And in that particular study they had women who were taught a specific method of charting by train instructors. The effectiveness when you teach yourself, I don’t know that that’s been studied necessarily in a scientific reliable way. But when these women who we’re taught a specific method and they were following and accurately [charting] the effectiveness rate was 99.4%. So that’s with correct, perfect use.

[00:31:00] So there’s a difference between what they call user failure and method failure. Then there’s a difference between like using the method correctly and not really charting and getting pregnant but you weren’t really charting. So I think that it’s helpful just to know that the user failure rate is different with any contraceptive methods. So even with the birth control pill the perfect use effectiveness rate is like 99 point something percent. But with the typical use it’s more like 92% even with the birth control pill.

Jessica [00:31:36] Do you encourage your clients to use the fertility awareness method like other apps that you recommend? How do you get people to really commit to this?

Lisa [00:31:46] Well I mean, women who come to me they’re typically like ready to go. By the time you get to me you’re like on board. So the way that I think of it is that charting isn’t for everybody, just like condoms aren’t for everybody. Like everybody doesn’t love [condoms]. It’s like this dirty little secret, people don’t want to talk about it. The pills isn’t for everybody, the IUD isn’t for everybody.

[00:32:09] So there’s a reason why we have all of these different options when it comes to managing our fertility. And so I’m the first to say, and it might seem strange as a fertility awareness educator to be like, no charting isn’t necessarily for every woman or for every point in your life. So for some women charting might be really appropriate at one stage of their life but at another stage of their life they might opt for a different method of birth control. So I think that that’s just really important, I’m assuming we are all adults here or at least close to, so having the ability just to have that openness in terms of that conversation. Because charting your cycle, that appeals to a certain type of woman. This appeals to someone who’s really interested in what’s happening with her cycle, who is actually on some level really fascinated by it, she is highly motivated to not use hormones. And so for some women, there’s some women who’ve had a really negative effect on birth control. There’s a long list of side effects associated with hormonal birth control that we can go through, and not every woman has the same experience. Some women use it and really don’t notice a lot of difference so maybe they notice after they come off the difference in how they feel, and their mood and energy and stuff like that. But other women they go on it and they immediately have a negative reaction. They are some women that just can’t use birth control because it just causes such a negative reaction for them.

[00:33:29] So the type of woman who is interested in fertility awareness is often very motivated to do it. So I don’t have to try to get women motivated because when they come to me, they’re already motivated, they want to do this. And so really what it comes down to though, it sounds like a lot of work you know. Like you’re checking for cervical mucus every day, you’re checking your cervical position if you choose to, you’re taking your temperature every day, you’re writing it all down, you’re interpreting the data, you’re modifying your sexual activity. God forbid, what I mean like on some days you have to use protection, on some things don’t. So there’s all of these factors and so it can sound like it’s really, really complicated. But what I always say is like, did you brush your teeth this morning? I’m guessing you did. And did anybody have to tell you? Did somebody have to harass you? You probably just picked up the toothbrush and did it because you’ve been doing it for so many years that you’re just in the habit of it.

[00:34:25] So when you start charting part of the challenge is to develop those habits. But once you start charting your cycles, it’s very similar to any other habit like brushing your teeth, where you’re not going out of your way to check for cervical mucus. Like, I’m sure that everyone watching this went to the bathroom at some point today. Like no one had to tell you to wipe yourself. So you’re just like paying attention when you wipe yourself, taking your temperature in the morning. It can be an inconvenience for some women, but for others it’s literally just put the thermometer in there before you get out of bed. So it doesn’t have to be this big crazy thing, it’s literally just developing a habit. And so for the women who are interested in fertility awareness and feel that this is the right birth control method for them they just do it.

Jessica [00:35:13] Do you feel that the more data you get about your own cycle, the more you start to really appreciate it and enjoy it. There is this shift happening right now it seems and like the wave of women embracing their menstrual cycle and period and really appreciating the significance of seeing it.

Lisa [00:35:34] I think so but I think it can be–so one of the things that I see happening, when you discover that your cycles are more than just about having babies and you discover that your cycles are reflecting your health and that you can actually tell when you’re fertile when you’re not, it’s obviously really exciting and something that most of us haven’t been told. So we kind of get into this romanticized notion of this is amazing and beautiful, wonderful but not everyone’s cycle looks like it does in the textbooks. So when you learn about fertility awareness, so if you read my book or you read Taking Charge of your Fertility or devour whatever resources on fertility awareness, you’ll typically see like this picturesque 28 day cycle, ovulation happening around day 14. And a lot of women get into what I call rhythm method thinking, where they really think that they should be able to anticipate when ovulation is going to happen and think their cycles should be looking about the same all the time. But as we’ve talked about the cycles reflecting your overall health, there’s a lot of women out there struggling with different challenges, whether it’s hormonal imbalances, endocrine and gut issues. There’s just a lot of different things that women are struggling with these days and any number of those things can cause you to see different patterns in your cycle. So I do think that what happens when you start charting, especially for women who continue and they chart for several cycles.

[00:36:59] Any woman who’s charted her cycles for six months, a year or more, in my case almost 20 years, you start to see patterns but you also start to see that you have a lot more impact on your cycles and your health than you thought. So if you’re charting your cycles let’s say for two years or more or less, I’ll just throw random number out there, then you’ve probably made a few changes here and there. Maybe you tried a different thing with your diet, maybe you added exercise took it away, maybe you started sleeping better or worse or you went through a stressful time or something like that. You really start to see how these things impact your cycle. And the term body literacy, that’s a term that I became familiar with when I learned to teach women how to chart and became a fertility awareness educator. And I believe Laura Wersher was the first to–she coined that term of body literacy. In the general sense that just means having that awareness of your cycle, how it works, how to identify when you’re fertile and also how the different things can affect your cycle. So the more you chart, the more you develop that body literacy. And it’s very empowering because you start to realize that–I mean there’s a lot of women who have had the experience of, I think there’s something wrong with my cycle. I don’t think my period should be this heavy, I don’t think they should be this this way. I’m seeing this weird stuff but I don’t think I should be seeing and you go to your doctor and you’re either told go on the pill, there’s nothing wrong with you, everything’s fine whatever. You kind of dismiss this whole theme of the way medicine treats women a lot of the time. Hopefully that’s changing but for now that seems to be the experience of a lot of women.

[00:38:39] When you start charting and you start to see, oh wow, if I drink wine a lot this is what happens, oh, if I kill myself at the gym for seven days straight every week, this is what happens to my cycle. Oh, if I had like a raging thyroid disorder, this is what happens to my cycle? Like if you start to see these things and then also if you start to make positive changes and you start to see your cycles get better, then all of a sudden you realize that you actually have the ability to impact your cycles in a positive way to impact your health. I feel like for a lot of women that’s what they come to and that’s why this can be so empowering and powerful for women, because it really kind of puts that power back in their hands where it belonged in the first place, to be able to really impact their own lives in a positive way if they want to.

Jessica [00:39:28] I really like the way you said that. Even just knowing that there is a normal cycle that we all aspire to, but that’s not going to look the same for everyone and some people are in such difficult situations with their health that their cycle is just typically very painful and they hate it. So it’s sort of through this method, being able to start to make those tiny steps and adjustments to make it just that much better, even if it’s just by a percentage of the degree, that is really empowering to feel like you are the one that’s in control of understanding how to make these positive impacts in how your menstrual cycle feels every month. I think we need more space to be able to experiment with that in our lives. And it’s hard because I think the easy fix is to be taking more medication but it doesn’t really get at the core issues that you’re talking about.

Lisa [00:40:26] Even when you mention like painful periods, I think because sometimes it’s just helpful to have somebody say out loud that although it’s really common for women to have pain with periods it’s not normal. So this is something that I say to a lot of my clients, it might not have been coming from one specific client experience. But I remember having conversations with one of my clients or several and checking in about the pain, like what is your period like, how painful is it on a scale of 1 to 10. And it was kind of like, you know, five or six and I’m like that’s pretty significant. Well no, you know, my friend throws up when she has her period so it’s totally fine, right. Because this is what we do, we downplay–I know somebody who was way worse than me. Mine is nothing. And then I kind of said well, what if your male partner had that degree of pain in his penis for a couple of days every month, how do you think he would feel? And of course she was like, Oh. And sometimes we need to throw it out of that context so that we can understand.

[00:41:27] Outside of menstruation, pain is typically considered to be a problem and considering that a huge percentage of women with severe period pain have underlying endometriosis, which can be an extremely debilitating condition that can really interfere with your day to day life and functioning and future fertility because it’s associated with infertility. We should be actually paying attention to things like that and we shouldn’t continue to perpetuate this idea that it’s just normal for women to just have these miserable debilitating crippling periods and we should just be tolerating it. And for the record, I mean for a lot of women they find some relief with the birth control pill and with heavy medication. And obviously if you’re in that type of pain you’ve got to–I’m not a proponent of using medicate, I’m just not a proponent of suffering. I had extremely painful periods for a long time. I remember before I had children and I had these horrible periods, I remember thinking to myself, it would just be like this all day thing, at the end I would be exhausted because it hurt so much. If I didn’t take the medication in the window I was just out for the count.

[00:42:39] Eventually I would just like pass out and then wake up and the medicine–like it was literally ridiculous. And I remember thinking after waking up and being exhausted, all this pain and I’m like rolling around. I’m talking about it flippantly but it was really bad. I remember feeling like, I feel like I went through later and there’s no baby. So it’s like pointless pain for a reason and then now I do have two children so I’ve been through labor twice. The first time I went into labor. So with my eldest son, I literally didn’t know I was in labor all day because I was like, it can’t be labor my period pain hurts more than that. With labor I had these contractions and then I had like a break. Now I know that they were contractions before I didn’t know that.

[00:43:24] This is the kind of thing that as women we actually just tolerate and think is normal. I’ll never know if I have a touch of Endo because I mean when I describe I’ve described that to people a number of times even the health professionals, naturopaths and alternative health care professionals who are like, Lisa that sounds like it’s pretty bad.

[00:43:43] I suppose the good news is that you can improve it. Pain, especially with menstruation is a sign of increased inflammation. If you look at the research women that have significant pain have a higher degree of the markers of inflammation like prostaglandins. And there’s a lot of research to show that if you reduce the prostaglandins, if you think about all the things that could contribute to inflammation and actively work on reducing your exposure to those things and also address the inflammation specifically you can make a really significant impact on your pain. But I guess for me it’s like bring it back to–it’s really helpful I think for people to say out loud, look it’s not normal to be in that much pain you know. Even if you’ve been in that pain every cycle for the past 10 years and you’ve just accepted it as part of life, I feel like it’s always necessary for someone to stand up and say actually no, you shouldn’t have to suffer like that.

Jessica [00:44:41] I think so many women have been told like, oh this is just the burden of being female. It’s like part of your life now which is like a really sad way to look at it. And I think now that we’re equipping ourselves with so many more tools to be able to manage it and really pinpoint what it is that’s causing the pain and finding relief even if it’s not instantaneously like shutting it down in the immediate sense. Just getting those little subtle cues of feeling a little bit better your next cycle and even better the next cycle, that is really empowering as well.

Lisa [00:45:14] Well, and just to kind of put it out there, again another thing that should be said is that if you look at your menstrual cycle as a vital sign and you take period pain for example, that’s an indication of a deeper underlying issue. In that case it’s likely inflammation. A lot of new research is coming out about endometriosis and how it can be related to immune dysregulation and it’s obviously an inflammatory disorder where you have endometrial tissue developing in areas where it shouldn’t be developing. Depending on where it develops it may or may not cause pain because not all women with endo have pain. But if you think about it like that, the pain is a sign of something else and so it’s important to have relief so however you get relief in the temporary sense is helpful. So I don’t want to downplay the importance of that.

[00:46:00] But know that taking the pill doesn’t solve it, it doesn’t cure it, it doesn’t fix it. It stops the menstrual cycle and then a lot of women may experience some–but not even all women experience a complete resolution of the pain on the pills, to put that out there too. But it’s just important to recognize like there’s a difference between treating symptoms versus actually trying to figure out what’s the underlying factor in addressing it.

Jessica [00:46:27] I am segueing into vaginal steaming of course since that is what we focus on a lot a Leiamoon. At what point in your research did you come across vaginal steaming?

Lisa [00:46:41] Well I mean I came across steaming in a really interesting way early on. So I’ve been podcasting and I started the Fertility Friday podcast which will be five years this December. So yeah! And I remember I posted this article on Facebook and it was like Gwyneth Paltrow is telling everyone to steam their vaginas or something. Of course I’m paraphrasing, I don’t remember the exact name of the article. I was like, great, now we have to steam our vaginas now. What’s next?

[00:47:11] We were talking about this before in our pre-chat and I had never heard of it before and I kind of thought that it was an extension on like vaginal rejuvenation. I thought it was like a negative, like your vagina smells and you need to clean it. And so I really just didn’t know about it and I just assumed that it was not a good thing. But I remember and I’m very thankful and our vigo practitioner checked me right there. She made a comment on the post and she’s like actually Lisa, it’s a real thing you should look into it. I think you should interview Dr. Rosita Arvigo, and I was like, huh, alright then. So very early on in the podcast, so going back to the archives, episode 18 I think it is. I remember it because I referred to that one so many times. But I interviewed her and in that interview she was the first to really explain virginal steaming to me and also of course the audience and the implications. Then much later on I interviewed Keli Garza on the podcast Steamy Chick and she shared even more information and so steaming has an interesting history and it’s associated with a lot of different things. For the women who I’ve worked with, [steaming was] particularly helpful.

[00:48:33] So I’ve had a number of clients who–I think as women we just have an intuitive sense of like, if you have your period and it’s dark, it looks black or oxidized or if you use a menstrual cup and you’re bleeding and it’s like molasses…. Many women find steaming [to be beneficial] and it seems too simple!

[00:49:11] I think that when I talk about steaming some of the myths that come up for people, because there’s always people that are like adamantly like, no steaming is bad and you’re burning your vagina and all that stuff. So steaming feels like a warm bath for your vagina. It’s not painful and the steam is never–if you are actually feeling any type of discomfort, you’re not doing it correctly and the steam is too hot. It quite literally feels–the same way you would go into like a steam room or sauna or like have a nice bubble bath or something like that, it feels very comfortable, very nice as I’m sure you talk about all the time. But basically with the steaming it seems so simple because you’re just sitting there, not a whole lot happens, it just feels warm in your lady parts. But by steaming over the course of several cycles many women notice incredible shifts in the quality of their menstruation and it’s something that I’ve seen time and time again.

Jessica [00:50:05] Why do you think that happens? I mean just as somebody who’s really well studied in like the science-based evidence world?

Lisa [00:50:23] Well I think that as women we haven’t had as much of an opportunity to connect with our physical bodies and it’s easy to forget that our uterus is an actual organ inside of our bodies. So I’ve had a number of interviews with different practitioners of abdominal massage therapies. So my conversation with Dr. Rosita Arvigo. I recently released a podcast interview with Dr. Jennifer Mercier, founder of Mercier Therapy. I had an interview with Claire Blake, founder of Fertility Massage Therapy and I’m probably forgetting somebody. And even, I’m thinking of Isa Herrera, she wrote the book Female Pelvic Alchemy.

Jessica [00:51:07] Ending Female Pain.

Lisa [00:51:09] She wrote like four books. But anyways, those types of conversations always ground me in the very physical nature of our bodies…. We tend to gravitate to this concept of taking pills and drugs, and it doesn’t necessarily occur to us that… potentially, the blood inside of the uterus hasn’t fully been expelled…. What a lot of people don’t know as well is that your uterus is really an interesting and dynamic incredible organ. It’s really fascinating and over the course of your menstrual cycle your whole uterus actually changes its position.

[00:52:03] So when I’m teaching about fertility awareness and teaching how to identify the changes in your cervical position, one of the things I teach my clients is that the uterus actually changes position and the cervix tilts and it’s in a different position during your fertile window versus outside of it. But your uterus has to have that freedom of motion to actually move around during your cycle. It’s not like walking the town or anything. So this is always my little example of the uterus. I teach with my hands, all my clients are laughing. But if this was your uterus and this was your cervix, during your cycle as you start your period it might be more like in this position and it tilts facing backwards. As you approach ovulation it actually moves. And so the tilt and position of your cervix changes but your uterus has to have the freedom of motion to be able to move around essentially.

[00:52:52] So if you… have old blood and tissue and [your uterus] hasn’t fully emptied, then it would make perfect sense that…if you work with somebody who is trained in abdominal physical therapy, you hear them talk about how they can actually palpate your abdomen…. It’s not necessarily like the same as getting a regular massage, but they have to kind of get in there… and move everything around. 

[00:54:11] If you think about the concept of physical physiotherapy or if you have a knot in your back and somebody rubs it out or if you are really, really tense and you’ve worked out a ton and you’ve just got a lot of tension, and you have a massage and you do a steam room or something like that, that’s the answer to your question. Of course it could potentially have this incredible impact on women because we are talking about our physical bodies here and sometimes we quite literally need some physical manipulation.

Jessica [00:54:41] That’s such a good example actually, even doing that–.

Lisa [00:54:43] You like when I do this?

Jessica [00:54:48] But I mean, I think that makes sense too even thinking of the laws of gravity when our cycle is trying to sort of shed our uterine lining every month, but the actual physical positioning of that organ is tilted in such a way… having that physical maneuvering would be really helpful. And the uterus… is literally physically trying to move old bloo, or old lining or old tissue that doesn’t serve anymore out so that it can re prepare for the rest of the cycle… and to accept life if that’s what it chooses to do. So it makes sense that the physical positioning of that organ is really critical to how it’s able to expel each month as you said.

Lisa [00:55:39] Just imagine if it was kind of like a standard of care. So this conversation I’ve had with a number of practitioners in these types of fields…Imagine if it was just standard of care to have an assessment, have somebody who’s trained in that area to basically do an assessment of her abdomen to find out if [where the] uterus aligned… [and do a] series of sessions or whatever in combination potentially with steaming or castor oil packs… If that was just the standard of care, how different the world would be. Cause it’s kind of blows the mind because it’s a non-invasive type of–there’s no surgery. We’re not talking about surgical, we’re not talking about medication, we’re literally just talking about like this very basic non-invasive type of activity.. I mean there’s limited research but it’s coming more and more.

[00:56:54] In my interview with Dr. Jennifer Mercier, she talked about basically a study that she did with her patients who were undergoing Mercier Therapy and the success rate that she talks about is really high. But it’s hard to I suppose–I don’t know, the drug companies aren’t interested in funding a study that doesn’t involve medication, like you can dispense this, so that has something to do with it. But I think it kind of is hard for us to wrap our head around it because… we’re just so ingrained the thing drugs and pills.

Jessica [00:57:37] Yes, it’s such a basic kind of first step you would think to be like, okay, well where is my uterus located and how is it sitting. Also, the way it…

Lisa [00:57:44] Like it didn’t occur to me until I had these conversations. It just never did….  It never occurred to me until I had those conversations.

Jessica [00:57:55] And of all our organs, it just seemed like the uterus, the way it’s held in place is so tenuous and nuanced with just these ligaments kind of suspended between your bladder and your rectum. It makes sense that it would potentially get moved around and that these non-invasive ways are things that we can do for ourselves, on our own at home, on our own terms. I mean there’s certainly several amazing therapists out there that are great guides for it, but ultimately it could be something so basic if we had our own sort of techniques that we were taught. Which I think Arvigo Maya abdominal therapy, they do self…

Lisa [00:58:38] Yeah, you have the session with the practitioner and they teach you how to do self care. It feels like the uprising of the kind of feminine wisdom. It feels like we’re at a time where we’re starting to kind of bring this back and it’s so necessary. To me it feels like women supporting women in the ways that would make sense for women.

[00:59:03] I remember I felt like that when I first used menstrual cups. So the first cups that I used, keeper back in the day, like the year 2002, circa 2000 before–throwback. Now there’s like 100 companies that make menstrual cups but before that there was like two. And I remember like the first time I saw this and used it, I was just like wow, this is what happens when like women solve problems for women, like it just makes more sense.

Jessica [00:59:36] The cup was such a revolution too. Like even what you’re talking about, being able to see your blood and assess it and know like when it’s off or when something weird is going on, the cup is like kind of the first wave where we could actually like hold our periods. And even that was like really revelatory to be able to like hold this cup of your own blood in your hands. Like really investigated because for so long we’re kind of conditioned to use tampons, plug it up, like don’t look, hide it in the trash bin. Andrew is commenting right now.

Lisa [01:00:17] This is literally like throwback to year one university. But on my university campus there was a women’s center and they had all these really great speakers series things and presentations and I went into this one and they were talking about the issue with conventional pads and tampons and how they’re laced with synthetic chemicals and dioxins and all that kind of stuff. And I remember they put, like they just took a glass of water, very much like this glass of water, except this is lemon water, they took a tampon and put it in the glass of water and you saw how it would expand. Then after they pulled it out the water you saw the little synthetic fibers in the water. If you ever want to do that you’ll be grossed out forever. But when you actually have your period as a woman it’s not blue liquid, it’s not water, it is blood and tissue. And so having the cup was one of those kind of revelatory moments, like this actually addresses what I actually have, it’s not uncomfortable. If I have a lighter day, it doesn’t leave me feeling really dry and uncomfortable when I pull it out. Like I’m not necessarily dissing any type of products except for the ones laced with the chemicals and the dioxins. But really I just had that moment of like this is made for women by women. This is what happens when women create solutions to the problems based on what we feel would intuitively be better.

Jessica [01:01:38] And if we aren’t talking about being able to assess the result of your cycle each month, that’s a great way to really get in there and understand what’s going on. And sometimes I really just feel like having that understanding is what’s making our cycles better in a way. It’s sort of like, look at me, I’m trying to communicate something to you… And you can physically see it in a way and I think that acknowledgement is already helping women understand it, and what might have even been translated as pain before might actually not be now, if it’s connected to some new logic that you’re able to find as a result of really seeing your cervical music, music and mucus and your menstrual blood.

Lisa [01:02:26] Well and the way that I’ve looked at it over the years kind of like the way I joke about it is, because I’ve been charting for so long, I can’t really go off the rails. Like I can’t really go on like a crazy three month sugar binge and like drink all the alcohol and like never sleep and like, I can’t really do all that stuff because when you’re charting you actually see how it quite literally affects your cycles…. So my cycles have always helped me to stay on track. It gives me an indication of what I do with my body, how I take care of myself all of these things, why it matters and why it’s always good to go back to the basics.

[01:03:24] A lot of us want to really think, oh I have to take all these supplements, I have to do all these things, I have to completely change everything I’m doing. But often it starts with like getting enough sleep and sleeping in the dark and not eating all the sugar. It can be really a lot easier or a lot more straightforward, a lot more basic in many cases, at least in the initial stages than we often think.

Jessica [01:03:51] Sure, and I think that is part of why I really appreciate vaginal steaming because it kind of gives you this ritual or marker–I mean it depends on when you steam but I usually was steaming before I got pregnant, just a few days after my cycle as a way to kind of reflect on what happened, like what did I do over the course of the month that might have [affected] my cycle. And even in just steaming myself…. So even that combined with tracking your cycle is a really good sort of consistent time to spend giving yourself that assessment.

Lisa [01:04:37] Well, when you’re tracking your cycle, so for instance, if you ever make it shift, so if you start steaming, if you pay attention just to a few things. You can pay attention to the length of your period, the color of it, the quality of it… whatever the case is, but you can kind of take note of the things that are important to you and that’s what’s really helpful as well by having a record of it. Because we really quickly gravitate to the new normal and often forget where we came from. So if you have that record of several cycles and then you can say, okay I started steaming in January now it’s April, and you can actually kind of take a look at the changes that you experienced. It really gives you a good indication of whether or not you’re on the right track and if what you’ve been doing has been helping you.

Jessica [01:05:27] So much. Well I don’t want to keep you too much longer which is very easy to do. But thank you so much Lisa. I really appreciate all your wisdom and everything that you share encouraging us to embrace our hormonal changes and know them individually as a true indicator of our overall health.

[01:05:45] Everyone please check out Lisa’s book The Fifth Vital Sign. It’s pure gold especially if all this information is new to you. There it is.

Lisa [01:05:55] This, I asked my ask my designer, I said I wanted it to look like a vulva but not like a vulva. I was like, I want it to look like a vulva in an arty way. So how did you do it?

Jessica [01:06:05] It’s beautiful. Turn to nature, nature always provides. The flower.

Lisa [01:06:10] Whatever I show it to men they’re like, I see it.

Jessica [01:06:15] I mean even just like that, like all the content is broken down in such a clear palpable stylish fun way that I highly recommend giving it a read. And if you head to fertilityFriday.com you can see more about Lisa and what she has to offer. She has consultations on her website and again her podcasts Fertility Friday is the best. I love it. That’s how we found her. And for those of you who haven’t signed up yet head over to our site Leiamoon.com to reserve your home electronic vaginal steam seat. We’re getting closer to our countdown of launching our kick starter. So stay tuned and stay in touch. Lisa thanks again. It was really a pleasure and a privilege to spend the afternoon with you.

Lisa [01:07:00] Thank you. This was so much fun. Thanks so much for having me.

Jessica [01:07:03] You’re very welcome. Bye everyone.