As a general disclaimer, the content found within this article was intended for informational & educational purposes only and should not be interpreted as medical advice. If you have a medical concern, please seek care from your primary physician or medical professional. The content found within this article is intended to motivate readers to make educated decisions about their health after consulting with a qualified health care professional. No information found on this article should be used to diagnose, treat, prevent or cure any diseases or conditions.
Did you know that in 2015, the American College of Obstetricians and Gynecologists suggested that the menstrual cycle should be viewed as a vital sign?
This makes sense, as menstrual health is directly related to systemic health & function.
In fact, if paid close attention to, dare I say the menstrual cycle could even be used as a diagnostic tool. (Please see disclaimer above)
Whether you are a practitioner looking to support your female clients in their hormone-balancing & cycle-healing journeys…
Or if you’re a womxn who’s looking to understand your body on a deeper level so you can decode what your menstrual cycle could be telling you…
This article will teach you the basics of how to achieve an inside look on a womxn’s health through using the menstrual cycle as a vital sign & diagnostic tool.
The Menstrual Cycle as a Whole
Before we dig into how to use the menstrual cycle as a tool, you must first understand that the menstrual cycle & menstruation are two entirely separate things.
The menstrual cycle consists of a month-long process beginning with the first day of the period, to the day before the next period. It can be broken up into 4 distinct phases, each consisting of different metabolic processes such as specific hormonal fluctuations, the buildup of the nutrient-rich endometrial (uterine) lining & of course, the most important event of them all, ovulation. Read more about the menstrual cycle phases & accompanying hormones.
At the end of the month, hormones drop to their lowest points triggering the uterus to contract and shed the blood & nutrient-rich endometrial lining, resulting in menstruation.
As you can now see, the menstrual cycle is way more complex than simply getting a period once every 28-or-so days.
Contrary to popular belief, periods are not meant to be painful or symptomatic. The level of pain & symptoms a womxn experiences with her period is highly associated with her systemic health, inflammation levels, hormone balance, nutrient status and more.
Understanding how the menstrual cycle is translating systemic dysfunction in this way, is key to utilizing the menstrual cycle as a vital sign & diagnostic tool.
Interpreting The 5th Vital Sign
To use the menstrual cycle as a vital sign & diagnostic tool, you must first be able to identify the difference between a normal, healthy menstrual cycle & a dysfunctional, symptomatic cycle.
A healthy period should ideally:
Dysfunctions in menstrual health may appear as:
Although cycle symptoms may be statically “normal” or common amongst menstruators, they are definitely not biologically normal, and are typically a sign of systemic dysfunctions like elevated inflammation, hormone imbalances, nutrient deficiencies, chronic stress & more.
It can be helpful to keep track of symptoms throughout the menstrual cycle to get a big-picture look at what can be considered normal or what may be a sign of dysfunction.
Charting the Menstrual Cycle
By observing cyclical patterns within the menstrual cycle, you can clearly see what the underlying issues and/or dysfunctions may be triggering a womxn’s symptoms.
Utilizing information in this way allows womxn to get an inside look on their health so that they can seek the support they need to balance their hormones & optimize their reproductive health.
I recommend suggesting to your clients that they keep detailed track of their symptoms throughout their entire cycle and during their period.
For an advanced level look into the menstrual cycle, you could also suggest they keep track of their basal body temperatures and cervical mucus patterns throughout their cycle.
They can do this by charting their observations on paper, or through using a detailed charting app like Kindara or Read Your Body.
Observing Cervical Mucus Patterns
It is normal to experience fluctuations in vaginal secretions throughout the menstrual cycle, specifically within the fertile window, which occurs roughly 5-6 days before ovulation.
In response to rising estrogen levels in the follicular phase, the cervix produces fertile-quality cervical mucus. The mucus may appear sticky, or tacky at first and should evolve to become creamier, with more water concentration the closer to ovulation you get, eventually turning into a very slippery, egg-white quality of cervical mucus.
The presence of fertile-quality cervical mucus is a sign of optimal fertility and is very different than vaginal discharge. Occasionally womxn may observe fluid secretion outside of their fertile window, but in this case, it would be considered vaginal discharge and not cervical mucus. This may be an indicator of hormone imbalances and/or infection and should be examined by a qualified medical professional.
Abnormal vaginal discharge that appears grey or greenish in color, has a foul odor, or is accompanied by itching or irritation is a sign of imbalance or infection and should also be examined by a qualified medical professional.
Observing Basal Body Temperatures
Keeping track of basal body temperatures can be an easy way for womxn to observe their menstrual cycle from a birds-eye view.
To track basal body temperatures, you would need a basal thermometer, or a thermometer that records temperatures to at least 1/100th of a degree.
Instruct your clients to take their temperature first thing, at the same time every morning upon rising. They will want to ensure that they take their temperature before moving or getting out of bed, before taking a sip of water and before looking at their phone or engaging in conversation or sexual activity.
Temperatures in the follicular phase should ideally rest somewhere between 97.0 to 97.7 degrees Fahrenheit or 36.11 to 36.5 degrees Celsius.
After ovulation occurs, they should see a sustained rise in temperature at least 2/10s of a degree above the average follicular temps. Postovulatory temperatures may rise to 97.8 degrees Fahrenheit or 56.55 degrees Celsius and stay elevated until the next period arrives.
The thermal shift is a result of progesterone production after ovulation, which has a thermogenic effect, stimulating thyroid hormone, thus, increasing basal body temperatures. A sustained temperature rise is one way to confirm an ovulatory cycle.
If your client cannot determine if they experience a sustained temp rise, they may not be ovulating consistently, which could be an influencing factor in their cycle symptoms. Or, they could be taking their temperatures inaccurately. If you suspect the latter, recommend they visit a certified Fertility Awareness Educator to have their charts thoroughly inspected and to learn more about how to chart their cycles accurately.
Keeping track of basal body temperatures can give you insight on not only if your client is ovulating or not, but also the status of their thyroid health & function, adrenal health & hormonal status.
Interpreting & Monitoring Progress
Through keeping track of menstrual cycle symptoms, cervical mucus patterns & basal body temperature, one can use the menstrual cycle as not only a vital sign measurement, but also (dare I say), a diagnostic tool.
This is because when observed strategically, the menstrual cycle can provide great insight into a womxn’s health on multiple levels.
Not only can her period symptoms provide insight on her hormonal status and levels of inflammation, her menstrual cycle charts can help to confirm whether or not she’s experiencing hormone imbalances, adrenal dysfunction, thyroid dysfunction, and more.
The tangible data that comes from cycle charting is absolutely invaluable information for a womxn to have, as it is a completely free way that she can monitor her own health status & progress.
The good news is that the menstrual cycle is malleable. It can be heavily influenced by the quality of a womxn’s nutrition, environment, sleep patterns, stress levels, & exercise routine. This means that through making simple, strategic nutrition & lifestyle adjustments, the menstrual cycle can change & improve over time.
A womxn’s period gives her the opportunity once per month to pause, check in with herself & reflect on her progress. It is her internal report card, a vital sign, showing her precisely where she needs to make adjustments in order to experience a healthier, symptom-free cycle.
Embracing The 5th Vital Sign
I firmly believe that now, more than ever, womxn need access to quality information about their reproductive health & how they can use their menstrual cycle to their advantage in these ways.
The more practitioners are familiar with this vital information, the more accessibility there is for womxn of this world. Through teaching them how to utilize their menstrual cycle as a vital sign & diagnostic tool, we have the power to take back control of our bodies & reclaim our reproductive health once and for all.
Resources available upon request
Why Hormonal Birth Control is So Popular
The pill (also known as hormonal birth control - HBC) is a commonly used & prescribed medication that introduces synthetic hormones to a womxn’s reproductive system.99.9% of the time HBC successfully prevents unwanted pregnancies. It does so by interfering with the natural hormonal cycles, inhibiting ovulation and creating an inopportune environment for fertilization & pregnancy to occur.
Hormonal Birth Control is favored not only due to it’s effectiveness at preventing pregnancies but also for its ability to relieve hormonal-based symptoms such as period cramps, PMS, cycle irregularities & hormonal acne. Depending upon the HBC of choice, womxn are even able opt out of getting their periods all together.
In the United States, on average, 98% of sexually active womxn have used birth control at some point in their life, and nearly 62% of womxn in their reproductive stages currently use birth control. However, the usage of birth control for managing cycle symptoms averages nearly 58% of overall users, meaning that only about 42% use birth control for preventing pregnancy alone. This means that over half of birth control users are using it for reasons other than contraceptive purposes! Not only is hormonal birth control prescribed for numerous womxn’s health issues, it is also utilized as a treatment plan for more serious conditions like PCOS, endometriosis, fibroids, cysts, etc.
These numbers are quite outstanding, however they are not surprising. These numbers have accumulated over time and are continuing to rise due to the nature of the womxn’s reproductive healthcare system in America. HBC usage is widely accepted as normal preventative care and is frequently encouraged by many doctors & OB/GYNs in the industry despite whether or not it is the best option available for womxn’s overall reproductive health.
The History of Birth Control Usage
The history of how the pill came to fruition is based upon a past of feminism & reproductive freedom, but overtime its usage has only led to further oppression of womxn’s reproductive health & rights. As a preface, I acknowledge that this topic is quite controversial in the world of feminism, but I encourage you hear me out first before clicking away!
Contraceptive methods have been known to be used since 3000 BCE and have evolved greatly overtime (thankfully). However, the first oral pill contraceptive, Enovid, wasn’t invented until 1960 when womxn were tired of relying on less effective barrier methods and spermicides as the only contraceptive options available. Enovid was created through a mixture of synthetic hormones similar to natural progesterone and estrogen. It was found that introducing these synthetic hormones suppressed natural hormone production resulting in temporary infertility. Its invention ultimately sparked feminist conversation around womxn’s reproductive rights & body autonomy as it gave womxn the opportunity to be freely in control of their reproductive choices, making a huge step in the evolution of feminism.
Fast forward to our present day and age, many womxn (even feminists) still view the usage of HBC as an act of womxn’s liberation & sexual reproductive freedom. I can definitely understand this thought process, however, with the knowledge we have today about womxn’s reproductive health & the technology that’s available to us, there are plenty of healthier & just as effective alternative options available for womxn. I believe that is a disservice to womxn for health care providers to not offer up other available options outside of HBC, especially when it comes to managing cycle symptoms.
The problem lies not solely within the product itself, but also with the reproductive healthcare system incessantly promoting its usage whilst not disclosing the true function of the pill and the disruptive effects that synthetic hormones have on womxn’s reproductive health, not to mention the added risks & side effects that can accompany it.
What HBC does to your body & potential risks/side effects
The pill may be an effective way to prevent undesired pregnancies, but it only does so at a great cost to your overall hormonal and reproductive health.
The synthetic hormones (typically progestin & estradiol) found within hormonal birth control work to inhibit the body’s natural hormonal fluctuations which prevents pregnancy through a combination of ways. Stopping the cyclical fluctuation of natural hormones can interfere with ovulation, and without ovulation, pregnancy cannot occur. The synthetic hormones also create a thick mucus plug within the cervix making it difficult for sperm to swim up into the uterus & fallopian tubes. Finally, by suppressing natural hormones like estrogen, HBC has the ability to thin the uterine lining to an extent that makes it unfavorable for implantation of any fertilized eggs (this part is also what contributes to a lighter, more ‘manageable’ period when on the pill).
It’s important to note that a period on the pill is not a real period. According to definition, a true period only exists after the occurrence of ovulation. HBC inhibits ovulation, thus, the ‘period’ that comes from using the pill is technically considered a breakthrough bleed and is triggered by the controlled decrease of hormones from using the pill. This is why you must take HBC at the same time each day and why there are often ‘sugar pills’ included in the packaging.
HBC not only interferes with your hormones, but it can also lead to other serious health issues like nutritional deficiencies (commonly in B vitamins, Vitamin C, Vitamin E, Magnesium, Zinc & Selenium), and an increased risk for blood clotting, heart attack, stroke & cancer.
Many womxn experience complications & adverse reactions from taking hormonal birth control. Symptoms like, mood swings, depression, nausea, headaches, weight gain, decreased libido, etc. However, instead of recognizing these symptoms as serious signs that the body is reacting adversely to synthetic hormones, many physicians opt for offering a different type of hormonal birth control like the IUD, injection or the patch.
Most womxn prescribed HBC are not fully disclosed about the potential risks & side-effects involved. Some doctors even refuse to believe that the pill can do more harm than good! When womxn are ready to come off of the pill (whether that be to achieve pregnancy or for personal reasons) it is quite common for it to take time for their natural cycle to return. In some cases it can take up to 6 - 12 months to regain a healthy period, however, many physicians will advise staying on HBC until you are ready to conceive, assuming that everything goes back to normal immediately after discontinuing the pill. Of course this can be true in some cases, but it is definitely common in a high amounts of post-HBC users for it to take time to regain their hormonal balance. Unrealistic expectations like these can set couples up for unnecessary infertility diagnoses & a lot of frustration.
For those who take HBC to manage cycle symptoms, coming off the pill can trigger the return of symptoms (and often with a vengeance). This is because despite what other people may say, HBC does not ‘manage’ cycle symptoms, it only suppresses them. If your cycle symptoms were caused by a hormone imbalance in the first place, using HBC as a treatment can potentially make matters worse on the inside by not correcting the underlying issue. On top of that, suppressing natural sex hormones through HBC usage can tigger thyroid issues and increase sex hormone binding globulin, which can lead to a host of other complications in various areas of your body resulting in more undesired symptoms. The only way to truly manage & overcome cycle symptoms is to work on supporting hormone balance. There are a variety of provenly effective approaches, however, utilizing a functional nutrition approach to balance hormones is the method I am most familiar with as a functional nutrition professional.
Finally, the last point I’ll touch on is that HBC usage disrupts the cyclical nature of the natural feminine experience. Hormones are designed to fluctuate throughout the course of a womxn’s monthly cycle, which gives rise to ebbs & flows in a womxn's energy, mindset, productivity, creativity & sensuality. HBC usage has led many womxn to being out of touch with the natural order & wisdom of their feminine existence. This aspect is not well considered in scientific literature, but there is a lot to be said about the beauty of a natural female cycle without synthetic hormones. Click here to read more about getting in touch with the wisdom of your menstrual cycle.
Thankfully, there are plenty of less-invasive alternatives to hormonal birth control usage that are very effective at managing symptoms AND preventing undesired pregnancies. Thus, whether you use (or are thinking of using) the pill for preventing unwanted pregnancies or for managing your period symptoms, there are indeed other alternatives for you to consider.
Alternatives to Hormonal Birth Control
Many womxn use HBC as an effective method for preventing undesired pregnancies. As successful as this approach may be, it definitely disconnects us from our natural fertility & reproductive potential.
Did you know that you are only fertile for 5-6 days out of your entire monthly cycle? It’s true! This is a well-known, well-researched & proven fact. So this means that in total, there are roughly 20 or so days within your cycle that it is physically impossible to get pregnant. I bet no one ever told you that, huh?
Of course there are other options for birth control methods such as condoms, cervical caps, diaphragms, withdrawal, spermicide & sterilization but each of those may be risky if you are unaware of when exactly you're in your fertile window.
Introducing the Fertility Awareness Method of Natural Birth Control. By tracking your body’s fertile signs (cervical mucus, cervical position & basal body temperature) it is possible to identify your fertile window (and avoid sex within this time frame or use a barrier method) and confirm ovulation to know when it is safe to have sex without getting pregnant. Many womxn use this method of non-hormonal birth control effectively and it can even have up to a 99% success rate when used perfectly. I have used it myself to successfully avoid pregnancy for 4+ years now.
When it comes to managing cycle symptoms, there are many non-invasive approaches to balancing hormones naturally. Click here to read more about how to balance hormones naturally.
Working with a qualified functional nutrition professional can help you to identify the root of your hormone imbalance and support your reproductive health through nutrition, lifestyle & key supplementation. Click here to learn more about the programs I offer.
Coming Off HBC & What to Expect
If you have decided to come off hormonal birth control (good for you!) there are a few things to consider beforehand.
For one, expect that it may take time for your body to adjust to not having hormones readily available to it. It may take time to regain your period and hormonal stability. Because of this, it is advised to come off of HBC roughly 6-12 months before planning to conceive.
In some cases, womxn experience what’s been termed as post-birth control syndrome which can result in symptoms such as cramping, acne, headaches, hair loss, depression & anxiety for a period of time until hormones level out.
Now, I don’t want to scare you! If it eases your mind at all, not all womxn will experience symptoms of post-birth control syndrome. It really depend upon what type of birth control you were on, if you had any underlying symptoms or issues that were suppressed from HBC usage as well as the status of your overall health and ability to adapt to the hormonal changes from discontinuing the pill.
It’s hard to know what to expect until you make the leap. However, there are ways in which you can support your body to have a healthier transition.
I’d recommend taking a high quality multivitamin and to ensure that any nutrition deficiencies are addressed before coming off of the pill. Eating plenty of nutrient-dense foods as well as finding ways to support your digestive health can all help to ease the process. I also recommend reading Dr. Jolene Brighten’s book ‘Beyond the Pill’ as it has some wonderful information and insight on how to support yourself if you do experience post-birth control syndrome. In general, working with a qualified health practitioner who is well versed in these areas may also help you in your transition off of hormonal birth control.
In conclusion, it is your body, your choice. It is your right to be informed of the benefits vs. risks/side effects of HBC usage. A part of having the reproductive rights that we do today is that we have the ability to decide what’s going to be best for ourselves and our reproductive health. Whether or not your physician agrees with your decision is another story. I advise you to seek out a health care team that supports you in your choice to come off of the pill and find ways in which you can learn more and make an informed decision before doing so. Reading this blog post was definitely a good start in the right direction! If you’d like to learn more about how I might be able to support you in your reproductive health journey, click below to book a free discovery call.
Article sources available upon request
Ashe Milkovic, NTP is a Nutritional Therapy Practitioner, Womxn's Health Specialist & Hormone Expert focusing in the field of womxn's reproductive health.