Understanding Your Fertility

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Welcome back to the No One Told Us podcast. I'm your host, Rachel, and today I'm speaking with Lisa Hendrickson -Jack, a certified fertility awareness educator and a holistic reproductive health practitioner who teaches women to chart their menstrual cycles for natural birth control, conception, and monitoring overall health. She's the author of three bestselling books and has a new book coming out soon that we're going to be chatting about at the end of the podcast today. Lisa works tirelessly to debunk the myth that regular ovulation is only important when you want children. And she draws heavily on the current scientific literature to provide an evidence -based approach to helping women connect to that fifth vital sign by uncovering the connection between menstrual cycle, fertility, and overall health. Her podcast Fertility Friday is the number one source for information about fertility awareness and menstrual cycle health. And I'm so excited to chat with you. you today, Lisa. Thank you so much for being on the podcast.
Thank you so much for having me. I'm excited to be here.
So the first thing that I'd love to talk about just because I know that we'll probably keep using this phrase is you say that your cycle is the fifth vital sign. So what are our vital signs and why should we consider the menstrual cycle to be one of our vital signs?
Yes, absolutely. I mean, a vital sign is simply a measure of how the body is functioning. And some of the most common vital signs that we're more familiar with would be things like our body temperature or our blood pressure or heart rate or our respiratory rate, like how many breaths we take per minute. And when you think of any of those common vital signs, you know that not only is there a normal range, so if you have those vitals measured,
The doctor can tell you if you're normal or not. But also, if you're out of that range, it also gives your practitioner a short list of some of the issues that could be behind it.
So obviously, if you have a fever, it could mean that you have an infection or that you're ill or something like that. And the menstrual cycle can be used in much the same way because in many ways it is a real -time measure of how your body is functioning. And when we break down the menstrual cycle, it can be used in many ways. cycle into its various parts, when we look at the period, we look at the overall cycle length, we look at the length and quality of the pre -ovulatory phase, your cervical mucus patterns when ovulation is happening, and the length and quality of the luteal phase, the second half of the cycle between ovulation and your next period, there's a lot of different information we can gather from something as basic as you know, if you have a continuous pattern of cervical mucus where you're having kind of like lotiony, creamy discharge all the time, it could mean that you have a yeast infection or another type of infection. So something as basic as that to abnormal or regular bleeding that could be associated with something as serious as uterine cancer.
So it's really interesting when we get into the weeds of menstrual cycle charting, because many of us haven't been taught to think about our menstrual cycles in that way.
It's so true. I remember I tried the natural family planning, you know, method and charting my cycle and taking my temperature every morning and checking my cervical mucus and I was like, "Why did no one ever tell me this? Why did my like middle school and high school, you know, sex ed teachers or whatever not tell us that this is a really good predictor of what's going on in your body. You can just check your cervical mucus. Are you kidding me? It's that simple and it's not that simple. I'm being reductionist. I would love for you to talk more about this, but it really is true that people just don't even understand what's going on in their own bodies.
Well, I mean, it's really interesting because in many ways it is simple, but we can go as deep as you want to go.. I always like these driving analogies. Learning to drive stick, like if anyone drives a standard, it's not like you learn in a day, but at the end of the day, it's not complicated. You just have to learn it, and then once you learn it, you're good to go. And I think that that's similar with charting, where there's all kinds of information. I mean, I had a whole ridiculously long chapter on just cervical mucus in my first book, the fifth vital, but at the end of the day, any woman can... really learn to track her signs.
And I think the answer to the question, at least most of the time for why we weren't taught this, why our teachers didn't tell us is because they themselves didn't know, because this is something that's not yet mainstream. And so I've always taken the approach that, you know, instead of waiting for our educational institutions to catch up and teach us all the things that we just have to jump in and do it and be the ones that are educating our daughters, our nieces, and someone gave me a megaphone. That's my metaphor for having a podcast. And so I think it's really up to us to educate the next generation.
Yeah, to empower ourselves to pass on that knowledge, I think is so, so important. How did you actually get started with this? Like, what was kind of your path to this becoming like your specialty and starting your Instagram page and your podcast? When did that all come about and how did you find this as your niche?
Yeah, it's an interesting story. I mean, it started when I was, you know, a teenager and I got my first period and my first period was painful and heavy. And I was really active. I was in ballet and I was doing track and basketball and volleyball and all the things. And and so it was it was challenging like it would be for anybody to deal with having this period that for a couple days every every month, I would be in pain and that kind of thing. And girls talk. So I learned that the pill could be the solution. So I went to the doctor and asked for the pill. And two seconds later, he was writing the prescription,
I didn't barely even have to say anything.
And so I was using the pill not for birth control, but to manage my so -called air quotes periods for a little while. And being a teenager, I thought I was fixed. I, this is great, my, my so called, you know, I'm using air quotes, but basically my withdrawal bleeds, because when you're on the pill, you're not having a true period because it suppresses ovulation. But these withdrawal bleeds were a lot more manageable. And so every now and then I would come off the pill, because I was fixed. And every time I came off the pill, my periods would come back with the vengeance.
So I share this because then at a young age, I didn't have the language to talk about what was going on. But I did see for myself that whatever was going on with the pill wasn't the same as my periods, and I wasn't actually fixed. And so when I needed birth control, I decided I was coming off the pill. Because also, I had read the insert, and I didn't take the pill at the same time every day, I would forget sometimes, and I would take it 2 the next day. They had instructions for what to do if you forgot it. and all of that kind of stuff. I decided, "Okay, I'm coming off the pill now that I need protection. I'm going to use condoms because I was really afraid of an unplanned pregnancy." It was around that time that I discovered fertility awareness.
It was right around the same time where I had decided I was going to use condoms and then I went to this talk at university and I learned about fertility awareness charting. I ran to the bookstore, bought taking charge of your fertility, started charting, and then very quickly... ended up, there was a group of women on my university campus who were teaching charting. They had the fertility awareness charting circle and so I started attending and very shortly thereafter we took a class together and started teaching. And so in my early 20s there I was teaching women how to chart their cycles on a very grassroots level, you know, we took donations.
That's so cool.
Yeah, it was really really, it was, that's where it all sparked for me because it really, it's life changing information. I mean, I went from being super scared of the possibility of being pregnant every day because I was taught that I could get pregnant all the time to understanding that there's only a short window and feeling really empowered even as a young early 20s, because I was using this method for birth control in my early 20s successfully. And that made a really big difference. And so what led me then to start the podcast and, you know, have the public, you know, page and all those things was when I might when my husband and I had our first son. I mean, I had been using this method all this time. I had taught at the grassroots level.
It really was at that stage of my life that I kind of looked around and realized that I had been taking this for granted for like over a decade here. And the average woman still doesn't know how her body works. And so many women are struggling with fertility challenges. And still the average woman you speak to has no idea about any of this stuff. And so I had this idea that, you know, let me just start the podcast and see if anyone is interested in what I have to say.
And so they were spoiler alert. And it was very well received. And then out of that came the question that everybody asked the question that you asked, you know, why is it that we're not taught this information? And so when I wrote the fifth vital sign, that was my attempt at, okay, like here, this, read this, like,
this is my answer to the question, like, why didn't anyone teach me this stuff? How come I didn't know how my body works? So that's kind of where it all started.
I love that. So, yeah, you really did just, like, kind of take charge and, and give give people what you wish that you had as a teen and I'm just so glad that resources like this are starting to become more mainstream because I have two daughters and like I you know I want them to feel that empowerment about knowing how their bodies work and and yeah. So I would love to go back to something that you said because I think that this is such a common myth because I had a similar story where I got on the Birth Control Pill at 16 and just stayed on it for 10 years because I didn't really know any other option.
And I think it's, it is like a really big misconception that people think, oh, I just get my period on the pill, but it's just lighter. It's just more manageable. So if we're not getting a true period on the pill, then what is actually happening? What is it doing in the body?
Yeah. I mean, the pill, the most common pill or, you know, birth control, hormonal birth control would be the combined oral contraception. And we often hear these things like, "Oh, it has estrogen and progesterone, but really it's a synthetic form of estrogen." So it's not actually estrogen, it's a chemical that resembles estrogen to some degree, and a synthetic version of progesterone. So we have these synthetic estrogens and progestins. And what they do in the body, there's three primary modes of action.
The first thing is that most of these combined oral contraceptives suppress ovulation. So that's their primary job, and that's what you want when you don't want to get pregnant, because if you're not ovulating, pregnancy isn't possible. So when you think about what's happening then, if it's suppressing ovulation, it's actually suppressing that connection between the hypothalamus, pituitary, ovaries, that HPO axis, which is what actually triggers this process of ovulation. And so by doing that, then the ovaries become kind of inactive. And so you go from then producing, because your ovaries in your natural menstrual cycle are producing significant estrogen and progesterone and some testosterone throughout the course of your cycle.

So when you're not on birth control and you're ovulating normally, you're actually benefiting from this hormonal influx, rotating throughout your cycle. But when you're not on, when you're not having... your natural cycle and you're on hormonal contraceptives, your natural estrogen and progesterone production is suppressed because the ovarian function is suppressed. And so you're getting this influx of synthetic hormones, you're not ovulating. And so there are other modes of action.
One of the other main modes of action for hormonal contraceptives is to suppress the true formation of the endometrium. So in a natural cycle, you would have your natural estrogen that causes the endometrium to grow. So after you have your period, that functional layer is built back because estrogen is a proliferative hormone and it causes it to kind of proliferate and grow. But without that, what happens is you have a thin, flat endometrium. So this is something that I've spoken about in both books where they actually do ultrasounds to measure the thickness of the endometrial lining. And women who are on contraceptives, the lining is quite thin. And it's not receptive to a fertilized egg. So even if there was some sort of snafu, you have this backup measure.
And then one of the, you know, the third kind of general way that it prevents pregnancy is by preventing the production of fertile quality cervical mucus. So again, if you're not on contraceptives and you're ovulating naturally, that estrogen is going to trigger the production of this cervical fluid, and that fluid is going to flow from the cervix, your cervix is going to be open, and the sperm would have access to kind of, you know, swim in there and do their thing. So these three modes of actions work together.
And I think what's helpful to know then is that when you're on the pill, it's not a cycle. And one of the, you know, stories that I share is to kind of, of like drive this home is when we look at the very first pill, the very first pill came on the market in 1960. And there's this book called the fertility doctor that I was reading to kind of learn more about what was going on at this time. And I wrote a little bit about it as well. And so before they brought the first pill on the market, they did what I would call a beta trial.
So they took a group of women and some of these women were actually trying to conceive. So it might seem counterintuitive, but I think they were taking the angle that if we suppress ovulation, then once we stop, it'll bounce back and maybe they'll get pregnant. So you actually had women in the group who were actively wanting to get pregnant. So they put them on and when they first did this trial, they didn't actually have the 28 day pill cycle that we are familiar with. So they just went on it continuously. And so what happened is that these women stopped having their periods.
And some of them, they all kind of thought they were pregnant because this was the late 50s. There hadn't been anything like this before. So if a woman stopped getting her period, it's because she's pregnant or breastfeeding or ill. And so the doctors, you know, were kind of like, no, no, this is the pill, but they really didn't get it. And when they realized that the medication had caused them to stop having a period and they weren't pregnant, some of these women were actually quite devastated, you know, especially because some of them had been trying to conceive.
So the doctors then conceived of this solution to the problem, which is to have this cycle where you, instead of having just the hormones all the time,
they give you a little break. You get a bleed. It's not a period. It's a withdrawal bleed. It's a bleed that happens in your body when you stop the influx of artificial hormones. It's kind of like a body resetting itself. Because if you were to just come off of it and not take it anymore, you would have that bleed and then eventually you would resume ovulation. But when you're taking it, you have the bleeding and then you start taking the hormones again.
So what this is, all of this is to say that even the fact that we have these 28 -day pill packs and this situation where it was always intended to kind of mimic what your natural system is doing so that you would feel better about it, so that it felt natural to you. Yeah.
Oh, wow, that's so fascinating. I've never heard that story before. So what is a healthy period then look like? So if you're not on hormonal birth control, whether it's oral contraceptives or something else, what you mentioned that when you first got your period, it was very heavy, very painful. Is that normal or is that something that that is like genetic? What should we be looking for as a sign? Like you said, a vital sign. How do we know that our period is healthy?
Yeah, I mean, there's several parameters we can look at. I think first and foremost, I mean, the period should be anywhere from about, you know, five to seven days. The average is about five days or so. And I always say the period should have a beginning and middle and an end and then it should be over. So typically your period would start moderate to heavy and then it would kind of you know be heaviest within those first couple of days and then gradually taper off. So, you know for anyone who can think about what their periods have typically been like you typically have a couple of days Where you have this kind of active bleeding phase and then you end up having it taper off a little bit.
So I mean You it's not uncommon for women to have have maybe some spotting before their period or after, but optimally, we actually would expect not to have several days of spotting leading up to it. So optimally, if we're thinking about what's optimal as opposed to just what's common, we would expect to actually just start to bleed at the beginning and then go into that.
And like I said, we wouldn't expect it to go on and on and on. We would expect it to end. within that five to seven day time frame. And throughout the menstrual cycle, we wouldn't expect, again, in an optimal scenario to continue to have bleeding. So we wouldn't expect to have, you know, bleeding all throughout the cycle, bleeding here and there. We would expect the bleeding to take place during menstruation.
So in terms of pain, we know that it's very, very common for women to experience pain. And I think even to some degree, it's controversial. to suggest that pain is actually not optimal or not normal. But I would say anything beyond mild discomfort we should be looking at. Not because it's so uncommon because it's very common, but because pain is a sign that there could be something wrong and it could range from something like inflammation to something as serious as endometriosis.
And although this isn't something that we often talk about this way, just picture anyone who's listening or watching. Picture any man you know, anyone. And picture if he had moderate to severe pain in his penis for a few days every month that required him to use medication. And picture him going to the doctor and then just telling him that it's just fine, it's just a part of being a man like this. this is just not a thing that happens. So I think that it's time that we demand a little bit better and start to recognize that pain can be a sign of an issue.
So to kind of go into this a little bit more, when I was writing the Fifth Vital sign, I decided to do some research to kind of learn more about what exactly is happening in the period itself. And, you know, the period when you have your menstruation, it's a normal and inflammatory process. So the process itself is a process of tissue degeneration. So that tissue is essentially, you know, shedding and dying. And as a part of this natural process, our body needs some inflammation and are, we have these lipids, you know, prostaglandins that help to encourage smooth muscle contractions to kind of like get that tissue out.
So this is all part of the normal process. But what's interesting is that when it's happening normally and optimally, when there's not an excessive amount of inflammation or an excessive level of prostaglandins to cause more muscle contractions, you wouldn't actually feel a whole lot of pain beyond maybe some very minor discomfort. So when we actually have the pain, when we look at what the research has to say, women who have muscle contractions can feel a lot of pain in their body. Women who have moderate to severe pain have significantly higher levels of these markers of inflammation, these prostaglandins, upwards of even four times as high as a woman that doesn't have pain.
There was even a really interesting study that I read where they measured the pressure, the uterine pressure of the contractions and they found that, you know, for a really good healthy active labor, they were using, if I remember correctly, a measurement of, like, 90 or so 90 to 100 milligrams of mercury as this measure of pressure for a woman in labor. And can you humor me? How high do you think this pressure measurement was for women who had like moderate to severe period pain? Just humor me compared to labor?
Was it an unmedicated labor? Because I've had three of those so I can very clearly remember
if you had to draw a number. So compared to labor, what do you think?
Okay, compared to labor, like the worst period I ever had was probably like a 30, if labor is a 90.
It was 400. It was 400, so like-- - Oh my God, oh my God. - Yeah, so it was like, obviously, I mean, I've been through three unmedicated labor as well. And so, you know, when you get to the pushing part, you know, period pain, you know, I would say that there's parts of-- of the labor that that, you know, certainly surpassed. But I've also experienced pretty severe period pain as well. What was interesting was I was super annoyed that day. So I was like reading this study. And I'm like reading what their researchers are saying about it.
And they shared this unit, such a big discrepancy. So they're literally saying that when they measured the pain of a period, it was like 400 milligrams of mercury compared to the 90 to 100 in labor. And they were like, so maybe when women say that their period pain is equivalent or worse to labor, maybe there's some truths to that. It was like so cavalier.
Oh my God. I hate that.
Well, yeah, so you can see what I'm doing, right? Like I'm building my case. I'm trying to say that when we shouldn't look at pain as just being normal and natural, we can acknowledge that it's really common. But if it's getting kind of out of control, I think we should look at that again with that vital sign idea in mind where when it gets high, even if it's not endometriosis, we should at least look at it as a sign of inflammation. And we should then start asking the question of what we can do to try to bring that down.
Yeah, I think that's such a good point because I think we are socialized to just accept that like for a week or two out of every single month for our entire, you know, decades of our life, or the middle of our life, like we should just accept this intense pain. And it's funny that you mentioned, like picture any man, you know, so I'm picturing my husband, of course, and he just got a vasectomy a couple months ago. And I was trying so hard to be compassionate until he’d be like, yeah, like like, you know, you should totally rest, take it easy. But in my head, I was just like, you have no idea. Like you, you would die if you were a woman who was going through a period every month or going through childbirth. Like, okay, we're going to be right back and we're going to talk about something that lots of the listeners want to know about, which is fertility around planting pregnancies and maybe subsequent... pregnancies. So we will take a quick break and be right back.
All right, we are back with Lisa and I would love to kind of pick your brain about this next topic, which is first, what is, you know, this idea of tracking our fertility and how do we actually do that?
The fertility awareness method. Fertility awareness method. Thank you.
Thank you. I think. it's kind of like two parts. So what is this method? How do you get started with it? And then is it best to use it for your first pregnancy when you're first trying to have a baby? Is it a method that you could use for a next pregnancy? When is the best time to use this type of method? Or it doesn't really matter?
Well, so I mean, given that I'm in the weeds of this, I would say that there's no one quote fertility awareness method that all, you know, fertility awareness practitioners agree on. There's a variety of fertility awareness based methods, right? So it's a whole, it's a whole situation on its own. So I think what what's most common that people are most aware of is the symptom thermal method, which is when we take that, you know, when we're paying attention to our symptoms of symptom thermal, which would be our cervical mucus and potentially the cervical position as well as as the temperature.
But, you know, in a nutshell, fertility awareness is just understanding what's happening in our bodies, understanding that there's a period of time when we're fertile and we're not. And when we take it into specific cycle tracking and using a specific method of charting, what we're doing is we're learning about these specific signs of fertility, learning how they relate to, you know, our fertile dates, whether you're fertile that day or not, and learning to track, identify, and that in and of itself is simply information. And then you can choose to use that information to either optimize your chances of conception so that you can get the timing right, or you could choose to use it to avoid pregnancy because although it's not necessarily that well known or that common, you can use fertility awareness based methods. and the symptom thermal method when using kind of an evidence -based strategy has been shown to be up to 99 .4 % effective at preventing pregnancy.
So it is actually a contender right up there with the efficacy of hormonal methods when again when used correctly when you're using a specific method and you've learned from an instructor and you understand the rules and all of those great things. There's tons of research behind it so you can, you know, learn a little bit more about it. So that is the method in a nutshell.
And the main fertile signs that we're tracking, as I have already mentioned,
is cervical mucus, basal body temperature, cervical position. And then there are certain methods that will kind of throw in ovulation strips. Or if you want, there's a lot of different tech now that you could use as I would say as secondary signs in addition to the main ones, if you're wanting a different confirmation. And so, you know, your question of, could you use it if you were trying for your first trial? I think it's a great idea to use it because, as you said,
none of us really had the opportunity to learn about this stuff in school. So you learn, I remember these biology classes when we're learning about our eyes and our ears, which are also important, you know, but like the anvil hammer thing in the ear is hardly as practical for me to learn about that my actual menstrual cycle, because this is the the part of my my body, my physique that allows me to build my family.
I mean, what could be more profound than that?
Especially in high school, you think that they'd want to teach a bunch of teenagers like how to not get pregnant?
Well, and I think that there's a lot of like, I would call them strange ideas, but there's a lot of these ideas that, well, we can't teach women that they're not fertile every day because then they'll go out and have unprotected sex and get pregnant." Meanwhile, plenty of women are going out and having them protect and sex and getting pregnant. Anyways, and the research shows that when we teach teens about their bodies and about sexual responsibility and things like that, that the rate of unplanned pregnancy goes down. So, it's really interesting how a lot of women are going out and having them protect of these kind of older old -fashioned I would say maybe ideas permit still.
Yeah, it's so true. So are there, you mentioned tech, are there any apps that you recommend or do you really recommend kind of learning it yourself first and getting really comfortable with it before you rely on an app?

Well, so I think that apps in my perfect world would be used as a tool. A tool to enter your data. not necessarily a tool to teach you or a tool to predict anything. So for somebody who is just tracking their period, and like I think that, you know, whatever is clever. But if someone wants to use fertility awareness as their birth control method, for example, I don't recommend relying on an app to tell you which days are fertile, not before you even learn about what's going on in your cycle.
Yeah. Yeah. Because none of us are really privy to whatever the heck an algorithm is. We use that word, but does anyone really know what that is?
Not really. And so we don't know how they've programmed those devices. Yeah. Like we don't really know what's going on there. And so I would say, you know, when I'm, for someone who's wanting to learn how to chart, wanting to learn how to identify her fertile window, you can predict your period when you're charting because when you can confirm ovulation, typically your period in healthy cycles is going to come 12 to 14 days after. So you can't predict ovulation. I don't recommend for you try to predict ovulation. I recommend for you to understand that your fertile window is associated with your days of cervical fluid, like your days of fertility or like those days that you see this creamy white cervical fluid or the clear stretchy lotion stuff or if you ever go to the bathroom and you feel that slippery sensation when you're wiping that kind of thing.
So when you learn about that part of it, then for someone who really wants to learn charting, I recommend to use the app as a data entry tool, find an app that allows you to take off the prediction setting so that you're not getting confused because I find that women when they're learning the chart,
the app is going to tell them like, okay, You're supposed to be fertile in these days But then if they're not seeing mucus or if it's quote too early or too later That you know different to what they expect it confuses them. So but I'm not anti app I just think they they can be used more effectively.
Yeah, no, I think that's really good advice I remember when I was using the app because I've used this method and have gotten pregnant with all three of my kids this way and But I remember when I was kind of first learning about it and first using the app it would kind of of like change. So I don't know if it was that my cycle wasn't exactly the same every month or like why that was, but yeah, I would like enter data and then all of a sudden it was like
Yeah, it's their mystery algorithm.
Yeah, it was like, I would enter something and it would be like, "Oh, just kidding. We told you the other day that you'd be fertile in this window, but now you're fertile in this window." And it'd be like, "Well, wait, which one is it?" Because this is kind of important. I need to know.
Well, I always say the app doesn't know what's in your panties today.

Yeah, exactly.
So it doesn't mean that it's not right sometimes, but then I mean, I've been teaching this and been in this training space for over two decades. So I do look at it a little bit differently because I know that it can be an extremely effective method of birth control for people who want that. And so for someone who's serious about it, I mean, I host group classes and I can't tell you how many times, like the first session usually, I give everyone opportunity to share a little bit about themselves and so I'm sitting in you know a virtual room with ten you know eight to ten women and some of them are telling me how they went on you know five ten different kinds of birth control they switch from this one to that one they had anxiety they had panic attacks and they couldn't you know desperate night of googling realized it was related.
I mean there's some women obviously this isn't everyone's experience but there are some women who have such a negative experience with hormonal birth control that they're literally like stressed because they need to be avoiding pregnancy, but they feel that they have no options. And that's the kind of, that's one of the types of clients that I work with when they really didn't know they had another option. And so there, you know, there's some women who they really gravitate to fertility awareness, but it's not this thing that they're like for women who are looking to to avoid pregnancy or, you know, maybe even planning pregnancy in the future.

But right now, they need to have a little bit of time before they're ready. This is why I have the strong perspective on the apps, because if someone were to just go without any knowledge and just type in their data and start doing what the app told them to do, it's a recipe for an unplanned pregnancy is really what it is.
Yeah, the stakes are very high, for sure. sure. Okay we're gonna take one more quick break and when we come back I would love to hear about how to track your fertility and plan for another pregnancy after you've had a baby. We'll be right back.
Okay so something that a lot of our listeners wanted to know about was because most of my listeners are already parents right they have maybe a new baby or a toddler and they're wanting to know when does my period come back after having a baby and you know how can I kind of plan for my next pregnancy if I don't yet have a regular period back yet? So can you speak to that a little bit?
Yeah, that's a great question. So when I'm looking at postpartum charting, I usually teach my clients to consider what I call phase one and phase two postpartum. So phase one postpartum is from essentially birth until you have that first ovulation. And so it is possible to use fertility awareness in that phase one. I would say that similar to, you know, anyone else who's wanting to space their pregnancies, or kind of delay a little bit, that you would want to consider working with an instructor. So what's different about that phase postpartum is that a lot of women who have charting experience, you know, they were charting when they were cycling. And so a lot of women rely really heavily, on their temperatures. But during that period of time before you have that first ovulation, your temperature isn't going to actually give you like a heads up or in advance.
So the base of body temperature is a retrospective measure of ovulation, because it goes up after you ovulate in response to your rising progesterone levels. So then when you're in that phase one postpartum, as I would call it before you've had that first ovulation, you're on what I also call mucus watch. You're essentially in an extended pre -ovulatory phase. And so the strategy that I teach my clients in that situation is to chart. Like you have to be really, become really comfortable with cervical mucus charting because it's essentially a mucus only type approach, at least the way that I teach it until you have that first ovulation.
So-- So you're checking for cervical fluid on a regular basis. I encourage external wiping for my clients. And there's a whole specific cervical mucous strategy that we talk about. But essentially, you're checking for mucous every day, and you're identifying what we would call your basic pattern. So outside of that fertile window, most of us have what we call the fertility where this world of... a basic infertile pattern.
And for a lot of us, it's dry. So, you know, if I finish my period, like outside of the postpartum for a second, if I finish my period, typically before I start to see cervical mucus, if I'm checking if I'm wiping, I'm going to see dry, and then I'm going to see the mucus for the window, and then I'm going to ovulate, and then I'm going to go back to dry. So outside of that window, that's what we call our basic infertile pattern. And so for women who are postpartum, The first you know month or so that they're charting before we start relying on the method for birth control you know we need to get a baseline. We want to identify what that pattern is and so for many women it might be dry but because of the increase in hormones and the different things that can happen after pregnancy you know depending on how the birth went if there was Potentially the cervix was disturbed during labor or whatever happened, you might find that your pattern isn't dry. You might find that you have mucus a lot and things like that. So the good news is that it's workable for most women to sort this out, but it is a bit of what we would call an advanced charting situation. I guess the bottom line is that for a woman who is wanting to know when is my period going to come back and what are the factors that contribute to that?
So if you, the biggest factor for women who are breastfeeding is actually breastfeeding. I don't think that comes as a surprise to anybody. What's really interesting is that it's the duration and the length and duration of suckling or the frequency and duration. That's the word I was looking for. So it's not necessarily the amount of milk. I remember when I first had my baby, you kind of think like, if I have a lot of milk, that's what's going to suppress the ovulation. But it's actually how frequently and how long your baby is suckling.

So things to watch out for include when you, when anything changes, like so your baby starts sleeping through the night, maybe you go back to work, maybe you start introducing solid foods, maybe you start pumping more. So anything that is reducing that frequency and duration of suckling that you just want to pay attention. If you're charting your cycle around that time, you want to start paying attention to any shifts. If you start to see more cervical fluid, if you start to notice some changes, even if you start to notice the return of your libido, there's other what we would call secondary signs.
So anyone who's had a baby, you know, after when your breastfeeding, that does have an effect on your overall hormones. I mean, breastfeeding, like I said, the suckling is suppressing that HPO access, and that's why you're not necessarily getting your period, right? And so that also comes with a change in your hormone levels. And so I think it's safe to say that not all women are immediately have their libido back, like the second they have their baby.
Some women do, but a lot of us
can't relate.
And so when you notice the libido coming back, you know, again, paying also. attention to your cervical mucus and other signs as well. That can be one of those things that you pay attention to, but definitely look out for some of those milestones, like when your baby starts sleeping through the night and when you're going in. So it's still variable. Women can get their period back as soon as six weeks if they're not breastfeeding all the way up to, you know, eight to 12 months or more.
And again, there's a lot of very variables there because the women can get their period variable would be like the breastfeeding and how frequently and, you know, for someone who is able to be home with their baby and is, you know, sometimes sleeping with the baby and lots of skin to skin, like, you know, not really doing the bottle thing or the the pacifier thing, like you're the pacifier. So, you know, that in that scenario, there's a lot more suckling. There's a lot more. And so that would potentially be more suppressive of ovulation. So in a scenario like that, it might be that you have a longer time to when you start ovulating again. And then for other women, it might be that babies sleeping through the night, maybe they're pumping a little bit more, maybe,
you know, they take turns with their partner, the partner does some of the nights, you know, checking and things. And so there's not as much suckling. And so, so yeah, it's really interesting.
It's also quite variable because there's also differences between women. So if you talk to enough women, you'll hear someone who did actually breastfeed all the time and got their period back right at four months or right at six months. And then you'll also hear the opposite scenario. But the key thing is that before that first ovulation happens, you would see ideally cervical fluid come back. And if you're checking, you know, on a day to day basis for cervical fluid and you're dry a lot of the time or there's not a lot going on, then when you see that influx of mucus, especially because a fun fact, pregnancy has a rejuvenating effect on the cervical crypts.
So many women find that after pregnancy in their postpartum, they notice more mucus than they did before. Not everybody, but it's certainly a thing because of the high levels of... estrogen and progesterone during pregnancy it's like a second puberty it changes everything so yeah so for a lot like when you are hit to this so now everyone who's listened to this podcast is like oh my gosh now I know so when you're hit to this and you're actually paying attention postpartum you might notice like wow I had a whole lot of slippery stuff today this is crazy and then that's your heads up that either ovulation is imminent or even within the next few months, because it doesn't mean that you have nothing, nothing, nothing, and then mucous, and then you have your period.
Right. It could be that as you're like, as your body's getting closer, you can have ebbs and flows and eventually like some mucous, but you don't ovulate yet, mucous, and eventually you go into that ovulation. So it's very interesting.
Wow, that is fascinating. Is it, is it true too that some people can feel ovulation like some people will say Oh, I could like feel a pang or something on my side and I could tell I was ovulating that day. Is that true?
Absolutely, there's a word for it. It's called mental schmerz and some women track it and there are charts and they'll even track, you know, what side it's on. So for many many years, I always felt ovulation to the point I have a funny story on that to the point that the when I was first kind of ovulating and I would have this pain and it was sometimes a little bit much actually to the point that I went to the doctor this one time because I didn't know what it was I didn't know I was ovulating so the doctor was like oh come back at four and we'll take your appendix out and my mom was like huh and so she took me to my pediatrician in the big city and my pediatrician told me I was ovulating….
oh my god they were just ready to like extract one of your organs just like.
Yeah, it was a small town. I feel like the quality of medical care was not on point. That is insane. That is insane. But yeah, so that's a funny story, a fun story about it. It's not always that dramatic, but absolutely some women do feel it. Yeah, yeah. It shouldn't be overly painful. I think that if it is quite painful, it can be a sign that maybe you need a little bit of support for ovulation. There's a lot of nutrients that are supportive of ovulation, you know, including vitamin D and zinc and iodine.
And so I think that there is, you know, we want to look at that and if it's like really severe pain. But, but yes, many women do feel the pain of ovulation and can when it's fun when you can track it and kind of identify, like, are they all alternating? Like, is it like, left, right, left, right, or is it like, sometimes right, right? Or...
Oh my gosh. Yeah. So interesting. Okay, cool. I'm glad to know that. So you just mentioned nutrition. And before we wrap up, I would love to hear more about that because I know you have a brand new book with the amazing Lily Nichols. Tell us about the book. I'm so excited.
Well, thank you so much. I mean, Lily and I have been friends for a long time, I think, obviously. A lot of our people in our communities were like, "Oh my gosh, we had no idea." And so there's a lot of overlap in our work. And what we were finding was that when I would be working with clients, whether... So, you know, I had a variety of clients, many of whom are preconception clients or clients who are actively trying to conceive.
I also have clients who are not currently actively trying, but plan to, you know whether i a few years or what have you. The nutritional advice in her second book, "Real Food for Pregnancy," is just so on point and it's really supportive of fertility and hormone health and obviously balancing blood sugar and a variety of other topics. I would find myself recommending the "Real Food for Pregnancy" book for my conception clients but also for my non -conception clients and I would say, "Well, I know you you're not currently pregnant, but read this book because the nutritional advice is so sound." And Lily was also finding that when she would be supporting her clients and her fans who were reading her book, she would recommend my book as a way to really encourage and enhance their knowledge of timing and menstrual cycle charting and all those things.
So we conceived of this idea to write this book together so that we could could really give that resource, essentially, that both of our audiences are asking for. And so what this book does, it's not just, I joke that it's like her, but can my book have a baby. But there's a lot of new information in this book, a lot of new research. And essentially, we are wanting to equip women and couples with the knowledge that they need to support optimal fertility. And with that, for a woman who is actively trying to conceive or wanting to conceive baby number two or whatever it is. This book really provides them with the strategy the kind of step by step what to do but also for the woman who's not actively trying even for the woman who's wanting to support optimal hormone health.
I mean the book addresses that need to because once you when you if you if you have menstrual cycle issues, hormonal imbalances, you know, PMS symptoms, whatever the case is, those are signs, you know, of hormonal imbalance. When you follow the same strategy to improve fertility, you naturally improve overall menstrual cycle health. And so that's like a kind of an overview. I mean, I could talk about the book for a long time, but maybe if there's something in particular about the book that you've are curious about, I kid.
Well, I'm excited. I'm excited to get my hands on it for the reason that you just mentioned because I'm done having kids, but it sounds like just such an amazing resource for anyone regardless of where you are in your fertility journey, whether you're planning to get pregnant for the first time or you're maybe between pregnancies or you're done and you just want your hormones to be balanced and to feel good and vibrant. So I'm really excited to read it.
So one last question that I have for you that I ask of all parents that come on the podcast, I know you're also a mom of three. What is something that no one told you before you had kids that you wish you knew about becoming a parent?
Oh, there's so much. Let me think for a moment. Well, I mean, I'll go with two things because it comes to mind. So certainly, given that we were just talking about the book, I think the importance of preparing for pregnancy, not just so that you can have a healthy baby, which is extremely important, but so that you can be a healthy mom. I would say that's something that I didn't necessarily think of until I had children, where even if you were optimally nourished and everything was great you would still be tired, like it would still be difficult. So that's something that, you know, both Lily and I are really passionate about and certainly that comes out in the book.
Another thing that was very personal to my experience was breastfeeding. I had a difficult time breastfeeding with all three. By the third, I kind of anticipated it so I was able to act a little bit quicker. But all three of my children had a tongue tie and I think that as a oh, yeah, isn't it awful and so as a Single person before I had children, you know, I always had this attitude like oh, I'm people, you know Everyone should breastfeed like right like can't be that hard like it's natural like right all that kind of nonsense. But it is natural like it don't get me wrong not knocking breastfeeding at all..
But I didn't have an appreciation for how difficult it could be and why people might actually physically be unable to. And when I experienced this, I know my situation isn't representative of what it does. It's not supposed to be painful. It's not, you know, all that stuff. But it was, for me, it was extremely difficult, very painful. And it's very acute, because you have a baby that needs to eat all the time. And if you, like, don't get a break, you have to feed them every X number of hours and things like that. So that was something I’m not sure exactly what I could have done to prepare for it, but just having maybe even more conversations about that and making sure that the very first time you have resources and just in case it doesn't go well, that kind of stuff.
Yeah, that's such an important point. I know, I had a very similar journey and yeah, I had never even heard of a tongue tie before I had my first baby. I was like, what's that? Yeah, I think more awareness about that topic could be really helpful for a lot of people.
Thank you so much, Lisa, for joining us on the podcast today. Where can people connect with you and find all of your amazing resources?
Well, thank you so much. The new book is Real Food for Fertility. You can head over to realfoodforfertility .com and you can download the first chapter for free. You can also head over to Amazon and you can grab the book. At first release, we are releasing it in the paperback and ebook versions and we do intense to record an audiobook, but that will, we're going to do that a little bit later in the year. So, you know, stay tuned for that.
If you enjoy this topic today of fertility awareness charting and the menstrual cycle is a vital sign, feel free to search Fertility Friday in your favorite podcast player. We're in the 10th year of the Fertility Friday podcast, which is absolutely insane, over 500 episodes. So, lots of great content and resources and information for you there. And on the socials, I'm at Fertility Friday.
And any practitioners who are listening, I have started a practitioner program. I have a really great resource that my team and I have put together called How To Interpret Virtually Any Chart Your Client Throws At You. So any practitioners who are really interested in incorporating fertility awareness charting into their practice, I think will love that. that resource, fertility friday .com /chart.
Okay, awesome. I'll make sure I link all of that stuff up in the show notes for people too, so it's super easy. Thank you so much again for joining. Have a great rest of your day and congrats on the book.
Thanks so much.

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