F R E Q U E N T L Y   A S K E D   Q U E S T I O N S

Learning the Method

How to Locate a Fertility Awareness or Natural Family Planning Teacher

Before I answer this question, let me clarify that Fertility Awareness teachers tend to have a secular, feminist orientation; teachers of Natural Family Planning tend to offer the method in a Catholic framework. The medical information offered by these groups can be identical, although the Ovulation Method involves mucus-only observations; and the Sympto-Thermal Method involves mucus, cervix changes, and waking temperature.

The FERTILITY AWARENESS NETWORK (FAN) provides a list of FA teachers in the U.S. and Canada and occasionally other countries. FAN also offers classes and consultations in New York City. Teachers of FA tend to work from a secular, feminist orientation; they teach the Sympto-thermal (mucus, temp and cervix changes) and/or the Ovulation (mucus-only) methods. For a list of teachers, send a check for $5 to FAN, PO Box 1190, New York, NY 10009. 800.597.6267; 212.475.4490; www.fertaware.com/fan_resources.html.

The BILLINGS OVULATION METHOD ASSOCIATION (BOMA) offers classes, conferences, teacher-training and research in the Ovulation Method of Natural Family Planning. While their orientation is Catholic, BOMA's classes and conferences are open to people of all faiths. BOMA-USA, PO Box 16206, St. Paul, MN 16206; 651.699.8139; www.boma-usa.org.

The COUPLE TO COUPLE LEAGUE (CCL) teaches the Sympto-Thermal Method of Natural Family Planning. The League offers classes, training, and conferences. Their materials are available in Spanish. The mission of the CCL is to promote marital chastity through th teaching of NFP in a Christian context. PO Box 111184, Cincinnati, OH 45211; 513.471.2000; www.ccli.org.

The Best Books About Fertility Awareness and Natural Family Planning

The Garden of Fertility by Katie Singer includes chapters on gauging gyn health by your fertility signals, breastfeeding and FA, common products that can be hazardous to reproductive health, and nutritional strategies and night-lighting techniques for strengthening your reproductive health. It introduces women conducting research on their own fertility charts. You can purchase the book here.

For more books on Fertility Awareness and related topics, please check out our resource section.

Teaching the Method

If You Want to Teach Fertility Awareness or Natural Family Planning

In order to teach Fertility Awareness (FA) effectively, you need to know and present FA's core material simply and clearly. What's the core material? It's a solid grasp of:

• female and male reproductive hormones and anatomy
• the physiology of the menstrual cycle
• how conception and pregnancy occur
• how to observe and chart fertility signals
• the rules for preventing pregnancy
• timing to enhance one's chances of conceiving
• using charts to help identify trends in a woman's gynecological health
• Fertility Awareness and breastfeeding

Besides clarity, warmth and humor are also helpful in presenting this material. I've found that information about the menstrual cycle is best heard when it's presented as a story. What parts do you emphasize? What can you leave out? What details are crucial to the whole? All of these questions need to be thoroughly examined while you train--and regularly re-examined.

Whenever Fertility Awareness is taught and another woman begins using what she's learned to prevent or achieve pregnancy, the method's reputation is on the line. Also, whether they want FA for birth control or to become pregnant, many women's charts indicate possible health problems. The teacher needs to be able to help them interpret their charts and to find options for strengthening their menstrual cycles.

Often, when a woman begins to chart her fertility signals, questions arise about life and death, previous sexual experiences, identity, and so much more. Fertility issues are universal and deeply personal. Again, the FA teacher needs to be prepared to offer this woman and her partner options for strengthening her health and emotional wellness.

I began teaching Fertility Awareness in 1997. About 25 percent of the women who take my classes are not ovulating and/or their charts indicate thyroid problems, PCOS, or progesterone deficiency. All of these problems can lead to more serious health risks. An FA teacher needs to be able to define and describe these conditions, and to respond to questions like, What causes this condition? What does it mean for my overall health? What are my options in addressing it? What should I ask my doctor? Where do I go for more info? Are there support groups of women with this condition? The teacher needs to respond to these questions as an educator, not as a physician. She may need to provide her students with referrals of health care providers whose medical practices compliment Fertility Awareness.

Familiarity with FA's core material comes from reading extensively over at least 12-18 months; from observing at least two teachers' classes; from raising questions about your own charts and researching answers for your own situation. Teacher-training also includes a comprehensive, open-book exam that can serve as a guide while you study and as a reference when you begin to teach. Also, you need to present 3-5 workshops to friends who are new to FA while an experienced teacher is present. Effective teaching requires creating a clear structure for your classes, including handouts that have been approved by a senior teacher with editorial skills.

FA offers a new view of the menstrual cycle and a way for every woman to observe trends in her own health before serious problems arise; it encourages informed health care. It presents a cooperative method of natural birth control, and a way to identify your fertile days when you want to conceive. It encourages a fresh dialogue between women and men!

"If you are interested in becoming a Fertility Awareness Teacher I recommend the following resources:

1. I have posted a comprehensive Study Guide for people who want to teach the method. It's available via PayPal for $35.
2. I highly recommend Geraldine Matus' teacher training program: visit www.justisse.ca to learn more.
3. If you are comfortable with a Catholic orientation, I recommend training with the Couple to Couple League (www.ccli.org) or the Billings Ovulation Method Association (www.boma-usa.org).

Most people require at least a year of study and training to become a Fertility Awareness teacher. As an alternative, or before you qualify to teach, you may choose to be a Fertility Awareness Advocate.

POSSIBLE ACTIVITIES OF FERTILITY AWARENESS ADVOCATES:

• You chart your fertility signals!
  
• Bring your charts to appointments with health care providers, along with your observations and questions--and be prepared to explain what Fertility Awareness is and how you learned to chart.
  
• Share your enthusiasm for charting with friends, family, health care providers. Give books about Fertility Awareness as presents at graduations, weddings, when a new relationship begins, when a pregnancy is announced.
  
• Write papers about Fertility Awareness in biology, Women's Studies, psychology, pre-med, religion, and political science classes.
  
• Ask bookstores, herb shops, natural food stores, and doctors' offices to stock books about Fertility Awareness.
  
• If you're in practice as a midwife, acupuncturist, chiropractor, herbalist, homeopath, naturopath, nurse practitioner or physician, sell books about FA in your office, be prepared to help your clients locate a teacher, encourage women to chart their fertility signals and read these charts well enough to talk about their findings.
  
• Research your own cycles!! And share what you learn with your sisters, cousins, daughters, friends, and health care providers.

Viva la Fertility Awareness!!

Reproductive Health Problems

PCOS / Ovarian Cysts

Q: I'm 23 and I have ovarian cysts. My doctor gave me two options: I can have surgery to remove my ovaries, or I can take a medication that'll put me in menopause for three months. Any suggestions?

A: First, please read chapters 1, 6 (especially pages 105-108 and 115-116), chapters 8, 10, 11, and 12 in my book, The Garden of Fertility. This'll take time, and it's a crucial first step to learning what happens during a typical menstrual cycle and what ovarian cysts are. To make informed decisions about our health care, we need to know how our bodies work!

Ovarian cysts are thought to be related to insulin resistance and estrogen dominance. Adjusting your diet could help direct your hormones toward more normal functioning. For examples, decreasing or eliminating sugar, white flour, soy, trans fats and caffeine and eating nutrient-dense foods like organic butter, free-range eggs, cod liver oil, and plenty of greens could help decrease estrogen levels. My chapter on food (chapter 11) describes this info in more detail. The best cookbook I know for a nutrient-dense kind of diet is Nourishing Traditions by Sally Fallon. Sally is also the president of the Weston A. Price Foundation. Their website, www.WestonAPrice.org, lists local chapters that can help you find nutrient-dense foods in your area.

Daily exercise is also important: exercise and a healthy diet can help get good circulation going to your ovaries. You might talk with your doctor about experimenting with a nutrient-dense diet and daily exercise for 3-6 months, then returning for a check-up to see how or if your situation improves.

Acupuncture may also be helpful.

Last, http://health.groups.yahoo.com/group/PCONatural/ is a wonderful site for women who want to address poly-cystic ovarian syndrome naturally.

Low Progesterone

Q: I'm wondering about the connection between the thyroid and adrenal glands. I know that they are both endocrine glands that emit hormones, and that women with low temperatures may have low thyroid hormones and sluggish energy. Is there any reading you could recommend to help me get clear on this?

A: Please visit www.DrRind.com, the website of Bruce Rind, MD. Dr. Rind explores the relationship between the thyroid and adrenal glands and estrogen dominance; he also lists natural remedies for addressing a sluggish thyroid and adrenals. (Chapters 6 and 12 in The Garden of Fertility can give you introductory information about thyroid problems.) Dr. Rind explains that if a person has a sluggish thyroid (hypothyroidism), s/he typically has sluggish adrenals (hypoadrenals) as well. He finds that estrogenic foods and pharmaceuticals (i.e. sugar, soy and the Pill) can contribute to estrogen dominance, which in turn can contribute to hypothyroidism and/or hypoadrenals. Soy is high in phyto (plant-based) estrogens, which deplete thyroid hormones and can also offset the balance of estrogen to progesterone. When sugar is consumed, it's a "shock" to the bloodstream; this can elevate cortisol levels..and in turn deplete progesterone levels, and in turn lead to estrogen dominance. All this stuff is worth exploring!!

Birth Control and Fertility Drugs

Stay tuned for Katie's insights on this topic.

Breastfeeding

Q: I'm 15 weeks postpartum, nursing every one and a half hours during the day, and four to six times each night. During the day, I usually carry my son in a sling. I've been sleeping in the absence of light (even covering my clock) for several months. My cervix is always low, firm, and tilted, suggesting that I'm infertile. But my cervical fluid almost always "glistens." I am therefore nervous that I could ovulate at any time. It's against my religious practice to use condoms or other barriers, and I don't want to take the Pill. But I'm not ready for another baby now. Is there something I could do to dry up my mucus and confirm that I am in fact infertile?

A: First off, I congratulate you for how much you're doing right with breastfeeding your baby. Second, given how often you're nursing, including how often you're nursing at night, your chances of conceiving in your baby's first six months are 2%.

Meanwhile, I very much appreciate that you'd like your mucus to dry up to confirm that you're not fertile now. My first suggestion is to nurse a little more frequently. Offering your breast to your baby even for 30-second nips could help your mucus dry up. Taking a 20-minute daily nap with him could also help.

You didn't mention whether you're using pacifiers (other than your breasts) or employing babysitters. These can actually encourage the production of cervical fluid.

Your continuous "glistening" cervical fluid could indicate elevated estrogen levels. What is your diet like? Sugar, white flour, soy and trans fats can elevate estrogen levels. Cod liver oil and organic butter (along with plenty of healthy greens, free-range eggs, perhaps raw milk cheeses) could help you create hormone levels that are less estrogenic. Read my chapter on food in The Garden of Fertility; check out Nourishing Traditions by Sally Fallon or www.WestonAPrice.org for other ideas. Bruce Rind, MD's website, www.DrRind.com, has excellent info about estrogen dominance.

And do keep nursing!

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