A Guide to Understanding Fertility 

Understanding fertility is important for all women. Fertility is defined as the ability to conceive a child (1). Being able to identify the fertile window within the menstrual cycle is important in order to time sex correctly for conception (2). The ability to recognise this fertile period within the menstrual cycle is known as fertility awareness (3). This awareness can be used not only as a way to achieve pregnancy, but as a natural contraception or even as a way to monitor menstrual health. Despite its importance, fertility awareness is often misunderstood (4, 5).

 

Sadly, in Australia, infertility is common with 1 in 6 couples being affected (4). Infertility is defined as being unable to conceive after 12 months of regular unprotected sex (1). As mentioned, being able to identify the fertile time during the menstrual cycle is key to timing sex correctly when trying to get pregnant (2). However a study has found that even though many women believe they are timing sex within their fertile window, most were found to have a low knowledge of their fertile time (5). Of 204 infertile women attending two IVF clinics in Australia and seeking help with getting pregnant, 68.2% of women thought they had mostly timed sex within their fertile window (5). However, it was found that only 12.7% of those women were accurately pinpointing their fertile time (5). These numbers are despite 86.8% of women having tried to gain more fertility awareness knowledge through various sources, such as information on the internet (5). This indicates that low fertility awareness knowledge could be playing a role in some couples’ infertility and that the sources women are seeking for this information may be of low quality (5).

 

It is important to seek help from someone who is trained to provide this information in order to ensure accuracy (5). This is one of the roles of Natural Fertility Educators and they could provide an important missing link in the conception journey for couples. GP’s are commonly the first point of contact for couples who are having difficulty conceiving, however most GP’s do not have training in fertility awareness methods and are unable to provide this information (5). Couples are often referred directly to a fertility specialist without first exploring the couple’s knowledge of the fertile window (5).

 

Getting pregnant is only possible within a short time frame each month and timing sex to coincide with this window is the key to getting pregnant naturally (2). The body produces indicators of fertility in response to the hormonal changes that take place throughout the menstrual cycle (6). There are three main fertility awareness methods used to identify the fertile window: rhythm, mucus & temperature (3).

 

The rhythm method (also known as the calendar method), is an outdated way of tracking fertility (6). It uses the length of a woman’s previous menstrual cycles to predict the fertile window (7). As the menstrual cycle varies, even for women with a regular menstrual cycle, it is not an accurate indicator of fertility (2). Many fertility tracking apps use this method to calculate its user’s fertile window which is something to be wary of.

 

The cervical mucus method (also known as the Billings ovulation method), is an accurate way to identify a woman’s fertile window (4). Women make daily observations of their cervical mucus by noting the sensation of the cervical mucus at the vulva (the skin outside of the opening of the vagina) (8). Cervical mucus changes in response to the hormonal changes that occur throughout the woman’s menstrual cycle (8). On average, fertile cervical mucus occurs for 6 days prior to ovulation (4). When fertile cervical mucus is present, it is possible for sperm to survive for up to 5 days (6). Fertile cervical mucus also provides channels for the sperm to safely make their way to the egg (9). Fertile cervical mucus can be identified by the presence of a slippery sensation at the vulva (8). The final day of this sensation is known as the Peak day and the most probable day of ovulation (8,9). The sensation of the cervical mucus outside of the fertile window will be a feeling of either dryness or slight moistness (8). 

 

The temperature method uses the basal body temperature (BBT) to determine ovulation in retrospect (4). Basal body temperature is the body’s lowest natural temperature which usually happens after a minimum of 6 hours undisturbed sleep (4). When ovulation occurs, the basal body temperature rises by 0.3-0.6°C (6). This occurs because soon after ovulation, when the egg is released from the follicle (the sac where the egg comes from), it transforms into a gland called the corpus luteum (10). The corpus luteum starts to secrete a hormone called progesterone (10). The progesterone then communicates with the part of the brain that controls the body’s temperature (the hypothalamus) and tells it to increase the body’s basal temperature in preparation for possible pregnancy (11). 3 days of temperatures higher than the previous 6 temperatures are needed to confirm ovulation (4). If pregnancy has not occurred, the temperature remains elevated until the next period (4). 

 

Due to only being able to determine ovulation in retrospect, it is preferable to combine the mucus method with the temperature method (4). This is known as the symptothermal method (4). Practicing this method may be particularly useful for women with irregular menstrual cycles (4).

 

Whether trying to get pregnant, avoid getting pregnant or monitoring menstrual health, learning fertility awareness provides valuable knowledge and is a way for women to feel empowered about their body.

 

Every woman deserves access to reliable information about their fertility. Although there is a lot of information available on the internet, learning the cervical mucus method or symptothermal method through a trained teacher, like myself, is important to ensure correct application of the method. For more information or to work with me, visit joeybegent.com.

 

References

 

  1. Borght, M., & Wyns, C. (2018). Fertility and infertility: Definition and epidemiology. Clinical Biochemistry, 62, 2-10. https://www.sciencedirect.com/science/article/abs/pii/S0009912018302200
  2. Wilcox, A. J., Dunsen, D., & Baird, D.D. (2000). The timing of the “fertile window” in the menstrual cycle: day specific estimates from a prospective study. BMJ, 321(1259). https://doi.org/10.1136/bmj.321.7271.1259
  3. Hampton, K., & Mazza, D. (2015). Fertility-awareness knowledge, attitudes and practices of women attending general practice. Australian Family Physician, 44(11), 840-845. https://pubmed.ncbi.nlm.nih.gov/26590626/
  4. Hampton, K., & Newton, J. (2016). Assisting women to conceive: a clinical update on fertility awareness. Australian Nursing and Midwifery Federation, 24(1). https://pubmed.ncbi.nlm.nih.gov/29236432/
  5. Hampton, K., Mazza, D., & Newton, J. (2013). Fertility-awareness knowledge, attitudes, and practices of women seeking fertility assistance. Journal of Advanced Nursing, 69(5), 1076-1084. https://pubmed.ncbi.nlm.nih.gov/22764878/
  6. Pallone, S. R., & Bergus, G, R. (2009). Fertility awareness-based methods: another option for family planning. The Journal of the American Board of Family Medicine, 22(2), 147-157. https://www.jabfm.org/content/22/2/147.long
  7. World Health Organization and Johns Hopkins Bloomberg School of Public Health. (2018). Family planning a global handbook for providers. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/260156/9780999203705-eng.pdf?sequence=1
  8. Billings, E., & Westmore, A. (2011). The Billings Method (9th ed.). Melbourne: Anne O’Donovan Pty Ltd.
  9. Odeblad, E. (1994). The discovery of the different types of cervical mucus. Bulletin of the Natural Family Planning Council of Victoria, 21(3), 1-34.
  10. Stocco, C., Telleria, C., & Gibbori, G. (2007). The molecular control of corpus luteum formation, function and regression. Endocrine Reviews, 28(1), 117-149. https://doi.org/10.1210/er.2006-0022
  11. Steward, K., & Raja, A. (2020). Physiology, ovulation and basal body temperature. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK546686/

Dear Body

Nicole Yarham

We live in a world where comparison is the norm.  We compare our jobs, our hobbies, our weekend events, our holidays, our friends, our incomes and more shockingly our bodies.  Most of us struggle with, or have previously struggled with, body dissatisfaction, poor body image or body comparison in some way, robbing us from leading a life full of joy. This needs to stop.

 

Australia’s National Eating Disorders Collaboration defines body image as the perception that a person has of their physical self, but more importantly the thoughts and feelings the person experiences as a result of that perception.  They believe that there are four aspects of body image:

 

1. The way you see yourself (Perceptual)
The way you see your body is not always a correct representation of what you actually look like. For example, a person may perceive themselves to be fat when in reality they are underweight.  How a person sees themselves is their perceptual body image.

 

2. The way you feel about the way you look (Affective)
There are things a person may like or dislike about the way they look. Your feelings about your body, especially the amount of satisfaction or dissatisfaction you experience in relation to your appearance, weight, shape and body parts is your affective body image.

 

3. The thoughts and beliefs you feel about your body (Cognitive)
Some people believe that they will feel better about themselves if they are thinner. Others believe they will look better if they develop more muscle.  The way you think about your body is your cognitive body image.

 

4. The things you do in relation to the way you look (Behavioural)
When a person is dissatisfied with the way they look, they may employ destructive behaviours such as excessive exercising or disordered eating as a means to change appearance. Some people may isolate themselves because they feel bad about the way they look.  Behaviour in which you renege as a result of your body image encompasses your behaviour body image.1

 

With this in mind we can clearly see that as we begin to compare ourselves to others we risk affecting our thoughts, emotions and behaviour. We can easily become fixated on trying to change our body shape and get caught up in feelings of guilt and low self-esteem.  This can lead to a heightened risk of developing an eating disorder or poor body image and body dissatisfaction as we engage with unhealthy practices with food and exercise in hope of alleviating these negative feelings.

 

However we need to remember that there is no right or wrong when it comes to body shape or appearance.  Yes that can be hard to accept, however challenging the acceptance of our body shapes and limiting the comparison of ourselves is a crucial step towards feeling positive about our weight, shape, size and appearance.1

 

Having previously suffered from an eating disorder, body acceptance has been a real challenge.  I find it hard at times to love myself, limit comparisons and accept my body – imperfections and all.  Therefore I decided that something had to change.  I needed to change the way I viewed and thought about myself as well as my negative self-talk in order to have a positive effect on my thoughts, emotions and behaviour.  For that reason I decided to write a pledge not only for myself, but for all women struggling with poor body image and body dissatisfaction in hope that it would remind us to accept our true selves.

 

Dear Body,

 

I’m sorry I’ve treated you unkindly and poorly in the past.

 

You were never a problem.

 

I’m sorry for letting what other people think colour my judgment of you.


There is nothing wrong with your size, your curves, your scars, your flaws, your stretch marks or you.

 

I know you are subjected to comparisons, daily put downs and even put through pain in hopes of looking like the people on my Instagram account or Facebook newsfeed. However, it’s not your job to look “pretty” because you’re good enough already!

 

So this year instead of working against you, I will work with you.

 

Instead of going on crash diets, skipping meals, binging on junk food and sacrificing on exercise and sleep, I will try to keep you healthy and happy.

 

I know our relationship in the past has been very unstable, abusive and at times irrational and crazy but I promise to love you and be more thankful for all that you do for me and allow me to do.

 

I promise to take responsibility for why you might be feeling unwell, sluggish, lethargic and rundown and not lay the blame unfairly on you.  I promise to invest in self-care and treat you to the occasional massage or pedicure.

 

This year I promise to remind you daily that you are good enough and full of worth.  And when I look at you in the mirror I promise to silence your haters and look at you with loving eyes.

 

I will stop taking out my stress on you by abusing you through my lifestyle choices.  I will cherish you, stick up for you, encourage you, motivate you, celebrate you and embrace you because whether we like it or not, we are in this together – daily – every day – for the rest of our life.

 

With love and gracious kindness,

 

Me.

 

Take some time today to appreciate and celebrate all the amazing things that your body does for you and let these mindful words empower you to accept yourself just as you are.  Then take some time to practice self-care and say some loving words to yourself as you learn to work with your body rather than against it.

 

References (check them out for more information):

 

1. National Eating Disorders Collaboration. 2011. Body Image Fact Sheet. [ONLINE] Available at: http://www.nedc.com.au/files/logos/Fact%20sheet_Body%20Image_2013.pdf. [Accessed 22 February 16].

Are You Emotionally Fit?

– Bianca Rea

 

 How do you measure emotional fitness?

 

Mental and emotional fitness, much like physical fitness, is measured by recovery rate. How quickly are you able to bounce back from a setback, rejection or negativity? We all experience this at some point in our lives. The quicker you are able to bounce back, then the fitter you are emotionally.

 

We’ve all heard about the Mind-Body Connection, the better you look after your body, the better the mind is. Physical activity increases the flow of oxygen to the brain, and boosts endorphins (feel-good chemicals) in the brain. It’s no surprise then, for this reason that people that are in good shape have a higher level of mental agility.1

 

While exercise is good for the brain, so is the ability to decompress and chill out. Failure to do this can result in stress, which can turn harmful if not managed.

 

Stress is a normal physiological reaction, which was developed in our ancient ancestors in response to danger and other threats. These days, it’s unlikely that we will face those dangers that our ancestors did, but we do face many challenges that cause our body to react in the same way. Meeting deadlines, studying, paying bills, all of these issues we face turn on the fight or flight response – boosted heart rate, increased energy, increased blood pressure etc. to enable us to deal with these problems.

 

Chronic stress relates to how we manage these problems. The longer our stress periods last, the more damage it does to our mind and bodies. Stress can also make our existing problems worse. Studies show that unmanaged stress can cause heart attacks, arrhythmias, and even sudden death.2

 

So how can we reduce or even fix stress?

 

It’s not an easy quick fix, but there are steps we can take that will go a long way of repairing the damage that has been inflicted on ourselves.

 

Identify what’s causing you stress: Being mindful of what is actually causing you to stress out will give you a strong clear pathway on how to reduce it. This also compartmentalises these issues, making it easier to plan your attack.

 

Reduce caffeine and sugar: The temporary “highs” caffeine and sugar enables you with, usually end in a deep crash, which results in lack of energy and mood swings. Reducing or avoiding these foods altogether keeps you better equipped to deal with situations and help you sleep better.3

 

Get enough sleep: Sleep is most important. Adequate sleep fuels your mind and your body. Failure to get enough quality sleep can cause you to think and act irrationally.

 

Be present: Focus on one behaviour with mindfulness. Whether it is showering and feeling the water hit your body, or listening to the water splash on the tiles. When you spend time in the moment, and focus on your senses, then you can feel less tense.

 

Be kind to yourself: Having compassion for others makes them feel better. So why not show a little compassion for yourself? Putting great pressure on yourself can only exacerbate the problems you are facing. So make sure you take some time out for yourself and let yourself get a little silly – if you feel like being completely lazy for a day and not do anything at all except watch Netflix and eat chocolate ice cream for a few hours, then let yourself. It’s this downtime that gives you an opportunity for your mind and body to rest and to avoid adrenal fatigue.

 

Learn how to say no: Know your limits and stick to them. Biting off more than you can chew is a surefire way to induce unnecessary stress in your life. Distinguish between the “shoulds”, “musts” and don’t be afraid to just say “no” when things get too much to handle.

 

Progressive muscle relaxation: This exercise shows you how to tense and relax different muscles in your body, so that you are aware of what a tensed muscle and a relaxed muscle feel like. You then become more mindful of the physical sensations. You start off by tensing the muscles in your toes and then working your way up the body till you get to your neck and head. Tense the muscle groups for five seconds and then relax for thirty seconds. Rinse and repeat. Avoid people who stress you out: If someone consistently causes stress in your life, then take steps to reduce contact with them. Limit the time you spend with them, or just end the relationship.

 

Ask for help: A problem shared is a problem halved. Don’t be afraid to ask for assistance on a problem that is bothering you and causing you unease. They don’t even need to help you fix the problem; they just need to be a good listener. Asking for advice from a friend or family member also strengthens healthy relationships so you’re getting a two-for-one discount with this one.

 

Take control: If watching the news stresses you out, turn off the TV. If you can’t handle the crowds in the supermarket, then do your grocery shopping online. Taking control of the situation

can help you in feeling like you’re managing the problem.4

 

Let us know what works for you in the comments below!

 

Written by Bianca Rea

References (check these out for more information!):

 

1. http://www.healthline.com/health/depression/mental-fitness#54

 

2. Krantz, D.S., Whittaker, K.S. & Sheps, D.S. (2011). “Psychosocial risk factors for coronary artery disease: Pathophysiologic mechanisms.” In Heart and Mind: Evolution of Cardiac Psychology. Washington, DC: APA.

 

3. http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/relaxation-technique/art-20045368

 

 4. http://www.helpguide.org/articles/stress/stress-management.htm

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