Latest / The Lila Rose Show / E13: Hormones, Health and Fertility with Dr. Marguerite Duane

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E13: Hormones, Health and Fertility with Dr. Marguerite Duane · The Lila Rose Show

0:01
Welcome to the Lila Roe Show. So excited you guys are
0:04
listening. Today we are tackling a topic
0:07
that I am very passionate about and we have a fabulous guest who
0:10
will be joining us to discuss this very important topic.
0:14
The topic has to do with understanding our bodies,
0:17
especially our fertility. And today I'll be interviewing
0:20
Dr. Marguerite Duane, who's an adjunct associate professor at
0:24
Georgetown University, and she's also the executive director of
0:27
FACTS, which is a fertility awareness organization.
0:32
She's board certified in family medicine, and this is one of her
0:35
areas of expertise. So, Doctor Duane, thank you so
0:38
much for coming on to talk about this.
0:41
Thank you so much for having me. I'm delighted to be here.
0:44
So first of all, you've got an impressive resume.
0:46
I've I've been familiar with your work for quite some time
0:49
and I've actually benefited from learning about more about
0:52
fertility awareness from your work.
0:54
But how did you get involved in this?
0:56
What got you interested in fertility awareness and why,
0:59
Why? And tell us more about facts to
1:01
what? What is facts?
1:02
This organization that you're that you're the head of.
1:05
Sure. Well, FAX is an organization
1:07
that I cofounded with another family physician doctor Bob
1:11
Motley, and it stands for the Fertility Appreciation
1:15
Collaborative to teach the science.
1:17
And our mission at FAX is to educate the next generation of
1:21
healthcare professionals, doctors, nurses, midwives,
1:24
pharmacists, etcetera, about the science supporting fertility
1:29
awareness based methods, the evidence underlying their
1:32
effectiveness, whether it's from a family planning perspective or
1:35
from health applications perspective.
1:38
So our goal is to educate the next generation of medical
1:40
professionals so they in turn can educate and empower women
1:45
and engage men in the care of their fertility.
1:49
And then what? So you're also a Co founder So
1:51
what inspired you to start this? Well that's great question.
1:55
So for me personally, I never heard the term fertility
2:00
awareness or charting the female cycle or NFP any term related to
2:05
this until I was actually in my first year of my family medicine
2:09
residency training. I was a 29 year old woman at the
2:13
time, having graduated from medical school with an ND after
2:16
my name and never heard anything about this.
2:21
At the time, I was passionate about woman's health.
2:23
As a family physician, I plan to prescribe the full scope of
2:27
family medicine care, including prenatal care and deliveries.
2:31
And so I was quite shocked and dismayed that I had never heard
2:35
about fertility awareness. And it simply happened to be.
2:39
I was on OB call one night getting my postpartum patients
2:42
ready for discharge. And at that time, one of my
2:45
senior residents shared with me about charting the female cycle
2:50
and how women could use this from a family planning
2:52
perspective. And I was shocked.
2:55
I'm like, why didn't I learn about this in medical school?
2:58
This seems like such basic information that not only every
3:02
woman should know, but every doctor that provides women's
3:04
healthcare should know. So I first heard about it myself
3:08
in 2000. Flash forward a decade later, I
3:11
was on the faculty at Georgetown and had been invited to
3:15
volunteer to teach a small group class to medical students.
3:18
And I thought this would be a great opportunity to introduce
3:21
even a small group of first year medical students, the science
3:26
supporting fertility awareness based methods.
3:28
And so I recruited some volunteers, some experts in the
3:31
field, founders of the various methods, natural methods of
3:35
family planning to teach this course.
3:37
And the students, students feedback was so overwhelmingly
3:40
positive. They're, you know, they, their
3:42
comments were this is basic women's reproductive Physiology.
3:46
Why aren't we learning this in our first year classes?
3:49
This is the most clinically applicable information we've had
3:52
so far. This is the best class I've had
3:54
at Georgetown. This is something every medical
3:56
student should learn. And it was that last comment in
3:59
particular that I really took to heart.
4:01
And I thought, yes, this is something every medical student
4:03
should learn because this is the basis of Women's Health.
4:07
And if we really want to provide, you know, true
4:10
comprehensive women's healthcare and really give women options
4:14
when it comes to family planning, we need to understand
4:17
the basics of how their body works and how women can learn to
4:20
chart their cycle and use this information depending on their
4:24
health or family planning goals. Well, it's so interesting
4:28
because I, you know, coming from the pro-life movement and also
4:31
just being a woman, 31 years old woman who's I'm also pregnant
4:35
with my first child. And there's so much conversation
4:38
about reproductive healthcare, both in politics and then also
4:42
just culturally sex education, the importance of sex education.
4:46
And it's really striking to me that so many women, young women,
4:50
teen girls, they've never really are given that education about
4:54
how their bodies work, how their fertility functions and how
4:57
essential their fertility is and how it inter work.
5:01
You know, it's, it's inter workings with the rest of our,
5:04
our body and all the other systems that we have.
5:06
I've even heard fertility described as our 6th vital sign.
5:11
You know, how, how we're doing. So can you talk, explain that a
5:14
little more to the listeners here, what exactly fertility
5:18
awareness this term means and why it's important for women,
5:23
young girls, we'll talk about men in a minute too.
5:25
But why it is so important for us as women to understand not
5:29
just that we have are the parts that we have, but how they work
5:32
together in our fertility? Right.
5:34
That's a great question. And I should say right off the
5:37
top that I am very passionate and strongly promote the idea
5:42
that girls should learn to chart their cycles as soon as they go
5:45
through puberty. I really see this not simply as
5:49
a form of family planning, but really we, I like to use the
5:53
phrase fertility appreciation. Appreciation takes it one step
5:57
further than awareness. Awareness is, Oh yeah, I've got
6:00
this body, but an appreciation is really understanding and
6:03
appreciating how it impacts your overall health.
6:06
So the female cycle really is an intricate interplay of the
6:10
woman's hormones. And through fertility awareness,
6:15
women can learn to observe very specific physical signs that
6:20
reflect the internal hormonal changes that are happening in
6:25
her body that reflect this intricate orchestration of
6:29
hormones that allow for ovulation to occur.
6:33
Ovulation is really a sign of how and if a woman is not
6:37
ovulating, that's a sign that somewhere, somewhere along the
6:41
line, something is not working. You know, perhaps it's an issue
6:45
with her hormones, perhaps there's a a physical issue, but
6:49
if she's not ovulating and she's not able to observe specific
6:53
signs, that's a sign that something could be wrong.
6:56
But when women learn to chart their cycle, it gives them so
7:00
much information about their overall health and their
7:04
well-being. And in fact, we often refer to
7:07
the female cycle as the 5th vital sign.
7:10
And I would say many women don't really learn about this because
7:13
unfortunately, most doctors are are not familiar with this.
7:17
The good news is, is that ACOG, the American College of
7:20
Obstetricians and Gynecologists, as well as the American Academy
7:24
of Pediatrics have both said that the female cycle really
7:28
should serve as a vital sign. Because when women can learn to
7:31
chart specific signs or biomarkers like cervical fluid
7:35
secretions, basal body temperature, or urinary hormone
7:39
measurements, they can have a better understanding of what
7:42
their cycle looks like. And then at AX, we will teach
7:47
medical professionals how they can learn to read the chart of
7:51
the female cycle just like they learned to read an EKG.
7:55
They go through it in a very systematic manner to look at the
7:57
overall cycle length, the menstrual cycling, the cervical
8:00
fluid cycling, the luteal phase length to see is it normal or is
8:05
it not? And if it's not normal, help
8:07
them think through what might be some of those underlying
8:12
abnormalities that they may we need to further investigate and
8:16
do more targeted diagnostic work up to better treat the
8:20
underlying causes. So could you unpack a little bit
8:23
this idea of charting our cycle? And obviously we're talking
8:25
about our menstrual cycles as women.
8:28
And you know, if you're listening, it's like, oh, we're
8:31
talking about periods, yes. And because it's essential to
8:34
our health and not just our physical health, but I would say
8:36
our emotional well-being, our mental health.
8:39
So walk us through what that actually means to chart your
8:43
cycle because a lot of girls today, they think, OK, my period
8:46
comes about once a month if it's regular around this time.
8:49
So maybe they have a sense for when their periods come.
8:52
But why is it important to chart our cycles?
8:55
What does that mean? And I do want to bring in the
8:58
men because there are men that listen and I hope they're not
9:00
tuning out because this is important for men, especially if
9:02
you want to be married one day or have it, you know, a woman in
9:05
your life. This is this is something that's
9:07
essential to the, you know, how human beings are even created.
9:11
Procreation happens. But but first start start with.
9:14
What does it mean to chart our cycle?
9:16
Sure, and it goes for the men. It certainly goes well beyond
9:19
just procreation. It goes to the heart of
9:22
understanding the woman that you're with and where she is in
9:25
her cycle. At Facts, we often interview
9:28
couples or feature blog posts about the the couple's story or
9:33
the woman's story or even the man's story.
9:34
And men often say by understanding their partner's
9:38
cycle and where she is in her cycle, it gives them a much
9:41
better appreciation and understanding and how to better
9:43
relate to them. But the other thing.
9:45
At Facts, we offer a webinar for women and men called The Signs
9:49
of the Female Cycle Explain to help unpack it in more detail
9:53
with pictures. But to give you the basic
9:56
introduction, you know at women we are so much more than our
9:59
periods. The period is called a period
10:03
because it actually marks the end of your previous cycle.
10:07
And after your period ends, you begin a new cycle.
10:10
In the first few days, women may not notice anything other than
10:13
some some dryness, but they may not notice anything in
10:17
particular with regards to their cycle.
10:20
But then a few days after their periods and women, if they're,
10:23
if they're taught and they learn to pay attention to their
10:26
bodies, they may notice some cervical fluid secretions or
10:31
vaginal discharge and that's a sign that their estradiol may be
10:35
rising. Estradiol or estrogen is one of
10:39
the female hormones that is very important in terms of our not
10:42
only our reproductive health, but in terms of our overall
10:45
health. When our estrogen is rising, our
10:47
energy levels go up, our extroversion becomes more
10:52
pronounced. For those of us that are
10:53
extroverts, it becomes easier to relate in a social situation.
10:57
Our libido is higher, our physical attractiveness to our
11:01
male partners is higher when our estrogen is rising.
11:05
And this is also when our cervical fluid secretions are
11:08
more pronounced. And it's also when we're most
11:11
fertile. And so when women learn to chart
11:14
that they can understand when they're entering that fertile
11:17
window. And what most people don't
11:19
understand is as women, we are only capable of getting pregnant
11:24
about three to six days every cycle.
11:27
Unfortunately, a lot of girls grow up thinking if I look at a
11:29
guy the wrong way, I'm going to get pregnant.
11:31
But we're actually only capable of getting pregnant for less
11:34
than one week out of the cycle, and that's when our estrogen is
11:37
rising. Then once ovulation occurs
11:41
again, if everything is working properly and she ovulates, then
11:45
the estrogen levels drop and the woman's progesterone rises.
11:49
And progesterone, if you listen to the name, it's about pro
11:52
gestation. It's about preparing for
11:55
pregnancy. Progesterone is the hormone that
11:57
is very high during pregnancy, and this causes a rise in the
12:01
woman's basal body temperature. So she can note that ovulation
12:05
has occurred, and she's moved into the second-half of the
12:07
cycle. If you think about, you know,
12:10
progesterone or pregnant women, you know, at that point in a
12:13
woman's life, she's really kind of focused on internally and
12:16
nesting. And so this is when women tend
12:18
to be a little bit more focused inward.
12:21
And men may notice that, you know, their wife wants to spend
12:25
a little bit more time nesting or at home.
12:28
Her energy levels might be a little bit lower, but she'll
12:32
also notice some dryness if she's checking her cervical
12:35
secretions. If pregnancy has not occurred,
12:39
then what happens is the progesterone levels will start
12:42
to drop. And women will often notice this
12:44
because, you know, their energy levels really drop.
12:47
This is when we start to see some of those mood changes where
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she might be more irritable or her patience is a little bit
12:53
less. You know, my husband personally,
12:56
when he knows where I'm, when I'm at that stage of my cycle,
12:59
he's like, well, this is a good day for me to take the kids out
13:02
and we'll spend the day at the zoo and let leave you to have
13:04
your time to just kind of focus inward.
13:08
But that's a sign that the woman cycle is ending.
13:12
And you know, the new cycle will will soon begin after she gets
13:16
her period. But again, a woman's energy
13:18
level or her ability to focus her libido so much will change
13:25
throughout the course of her cycle.
13:27
And it can be directly related to the hormones.
13:30
And women who chart their hormones and chart their cycle
13:33
may begin to detect patterns, and this can help them better
13:36
plan their lives, plan their activities.
13:38
Like, I know if I've got a big project and I got to devote a
13:41
lot of time to it, I tend to want to do that in the first
13:44
half of my cycle when I know my energy levels are going to be
13:46
higher. Whereas the second-half of my
13:48
cycle, I may not plan to do as much or I may plan to do some
13:53
more of that, like solo work that doesn't require as much
13:56
that interaction with others because that's just where I am
14:00
more my skills are at are at their at their best at that
14:04
point. So there's tremendous advantages
14:06
and we really encourage women to learn to chart so much more than
14:09
just when they have their period, but really learn to
14:12
chart the signs of your fertility as well as the
14:15
symptoms associated with that. And again, our science the
14:19
Female Cycle webinar is a great introduction and overview.
14:23
But if you really want to learn to chart your cycle, we strongly
14:26
encourage women to learn one of the modern evidence based,
14:29
natural or fertility awareness based methods of family planning
14:32
that are available and where you can find more information about
14:36
them on our facts website at Facts about fertility.org.
14:39
And that, I mean, this is so helpful.
14:42
I remember for me when I first really understood that there was
14:46
more to my fertility or even more to my cycle than just when
14:49
my period happened. And that there was so much going
14:51
on that the more I learned about it, the more I can understand
14:54
mood changes and energy changes and even my sleep cycle and so
14:58
many things that interplayed with just my everyday life.
15:02
A lot of people listening. There are certainly married
15:04
people listening, people who are, there are lots of young
15:07
people listening though, teenagers who are, you know,
15:10
they're, they're not in a relationship.
15:11
They're not looking to get pregnant or avoid pregnancy per
15:14
SE. They're they're just, you know,
15:16
in school or whatever. Students, why is this important
15:20
for us to no matter our age, especially when we're younger,
15:25
when we're when we're, you know, post puberty teens, young adults
15:29
in college and high school. What are the benefits for us to
15:34
learn about our cycles, to learn to track our cycles long before
15:37
we're married or or thinking about starting a family?
15:41
Well, I think purely from a health perspective, it's really
15:45
valuable because a lot of young girls and women may experience
15:49
symptoms associated with their cycle.
15:52
You know, they may experience premenstrual syndrome or PMS
15:55
symptoms. They may experience severe
15:57
cramping associated with their periods and it may be a day or
16:01
to it may be quote UN quote normal.
16:04
But if you are aware when it's going to happen and you can plan
16:06
for it, you're more likely able to handle it better.
16:10
You know, for me personally, and part of what sparked my own
16:13
interest was my own personal experience.
16:15
I think like most college kids, I was struggling with symptoms
16:19
associated with my period, severe cramping.
16:21
And when I went to the student Health Center, the the option
16:23
that was offered to me was the birth control pill.
16:25
I was told take pill. This will be great for you.
16:28
It'll make your periods lighter. It'll make your cramps less.
16:32
And while that was true, it certainly did improve my period,
16:37
my cramping. It also had serious side effects
16:40
for me. I started to lose my hair.
16:42
And at 21, you know, any 21 year old woman is not going to do
16:47
well if she's starting to develop bald spots.
16:49
And I remember going back to the student Health Center and
16:51
calling them up and saying, oh, yeah, hair loss.
16:54
That's normal to have a little bit of hair loss when you're
16:56
taking the pill. And I said to the woman, but I
16:58
have a bald spot the size of a baseball.
17:00
That can't be normal. And the doctor's response was,
17:04
well, we'll send you to a dermatologist and they can do
17:06
steroid injections so your hair will grow back.
17:09
And I thought to myself, wait, there's got to be something
17:12
better. But at that point, they didn't
17:14
offer me anything else for my severe period cramping.
17:18
Later on when I learned about charting my cycle, I realized,
17:21
and this is true for any woman you know, if you know you suffer
17:25
from cramping or severe menstrual cramps, if you can
17:29
identify when your period will start and you can take a non
17:33
steroidal anti-inflammatory medication like ibuprofen or
17:38
Aleve a day or so before that can actually short circuit the
17:43
the pain that you have. And so that was life changing
17:47
for me. And so I'll tell young women, if
17:49
you chart your cycle and you can start to identify when your peak
17:53
day is and that time between your peak day and the first day
17:56
of your period is pretty consistent.
17:58
So you can plan for when you're going to get your period.
18:01
Even if you don't get cramps or you don't have mood changes or
18:05
acne associated with the onset of your period.
18:07
Nobody wants to be surprised when they get their period.
18:10
I mean, they don't want to be, you know, at a volleyball
18:12
tournament for the weekend and get their period and they
18:14
weren't expecting it. So for young girls, I think it's
18:17
so helpful to understand. For mothers of young girls, I
18:21
think it's really helpful to understand where your daughters
18:23
are in your cycle so that and they may be a little bit more
18:26
irritable or struggling. You can be a little bit more
18:28
sensitive and supportive and not so irritated with the why are
18:31
they being so harmful? You can understand like, oh,
18:35
this is where she's in her cycle and this is normal.
18:38
Some adolescents, both men and women experience acne that's
18:43
hormonal related. And again, for women to be able
18:45
to understand like, oh, this part of my cycle, my acne really
18:49
flares and I need to be more careful about, you know, what
18:51
I'm eating and washing my face better.
18:54
Again, they can just be more proactive in terms of caring for
18:58
their overall health. So I think it's really, really
19:01
beneficial again, for every woman, regardless if she's
19:04
single or married or planning to have children, you know, in a a
19:08
year or ten years from now, understanding your cycle is a
19:11
window into your overall health. And it's something that I think
19:15
every woman should learn to do because unfortunately, if they
19:19
don't, you know, and they're like me or like many other women
19:23
as medical professionals, when women come to us with issues
19:26
with their cycle, painful periods, regular cycles,
19:30
oftentimes doctors first response is, well, we'll put you
19:32
on the pill because that will quote UN quote regulate your
19:35
cycle. Well, it doesn't.
19:37
The birth control pill or hormonal contraception does not
19:40
actually regulate the woman's cycle, but it suppresses her
19:44
normal hormones and causes her to have a withdrawal bleed.
19:48
But it might not get out. What are the root causes of your
19:51
painful periods or your irregular cycles?
19:54
For young girls 12/13/14 who have just started getting their
19:57
period in the first in the last couple years, it may be totally
20:01
normal that their periods come anywhere from three to five
20:04
weeks. And you know, it may not be
20:07
abnormal. But if she's not charting her
20:09
cycle, and if her doctor isn't trained in these methods, they
20:12
may not know better and simply offer the pill as an option.
20:15
And when it may not actually be be necessary.
20:18
So I really believe that for women to learn to chart their
20:21
cycle not only educates them about the way their body works,
20:25
but really empowers women to care for their health.
20:29
I do see that as really problematic.
20:31
And I've, I've heard so many stories, Doctor Duane from other
20:35
women, young girls and, and, and you know, women in their 20s or
20:38
30s, but who were put on the birth control pill when they
20:42
were teens. And it's, it seems like such a
20:46
common practice in medicine today.
20:48
And also, you have, you know, talking about groups like
20:52
Planned Parenthood, which, you know, we've talked about in the
20:54
podcast before, the biggest abortion chain, but they're also
20:57
one of the biggest promoters of birth control pills and hormonal
21:01
contraception. And there's a lot of this
21:03
recommendation to give it to teen girls, not just to
21:07
potentially deal with other side effects of their periods, but
21:10
also to work as a contraceptive for them.
21:13
Because that's just the the idea of girls are going to have sex
21:16
anyway. So we better just give them
21:18
contraceptives, which I think is really insulting, quite frankly,
21:21
to teenagers. It's like you're an animal.
21:23
You're not going to have self-control.
21:24
You don't have a moral compass. You can't make good relationship
21:26
decisions. So here's some, you know,
21:28
artificial hormones. What do you think about this
21:31
kind of phenomenon? I would consider it that because
21:35
these are cancer causing agents. I mean, the World Health
21:37
Organization has named it a Group 1 carcinogen birth control
21:42
pills. We know there's a long list of
21:46
real side effects. You mentioned getting a bald
21:48
spot as a 20 year old. But there's, I mean, women who
21:50
have died from, you know, strokes and the cancer causing
21:55
agents in these drugs. So talk to us about why has this
21:58
happened there in healthcare today and women's healthcare
22:02
there? It's just like there's no
22:04
questions even hardly asked and birth control is prescribed.
22:09
Most women don't understand their cycles and how they work,
22:11
and that's just kind of how it is for us.
22:14
Right, right. I mean, I think when birth
22:17
control first came on the market in the early 1960s, I mean, it
22:20
really was seen as as liberating for women.
22:24
And it became, it became the default for for doctors.
22:30
And I will tell you as a physician, when I went through
22:32
my training, the way we were trained to address most Women's
22:36
Health issues was through using hormonal birth control.
22:40
And it's important to keep in mind that hormonal birth control
22:45
are powerful steroid hormones. And these are not the same
22:49
hormones that your body produces.
22:51
These are synthetic versions of the hormones that your body
22:55
produces. So it's not as if you're
22:57
replacing the estrogen that your body produces with another
23:00
estrogen. You're you're replacing it with
23:02
a synthetic estrogen or a synthetic progestin.
23:06
And the way these powerful steroid hormones work is to
23:10
suppress your body's normal hormones.
23:12
And I do think it's ironic that we that are as a society, we
23:17
strongly encourage and push young teenage girls to use these
23:23
powerful synthetic steroid hormones, whether it's to
23:26
regulate their cycles and, or quote UN quote, vote and, or to
23:29
treat Women's Health issues. And on the other hand, we
23:33
strongly discourage young men from using steroid hormones, you
23:37
know, specifically anabolic steroid hormones, because we
23:40
recognize, you know, the potential harm with that.
23:43
But you are correct. I mean, the reality is, is that
23:48
conventional forms of hormonal birth control that contain
23:51
synthetic estrogens, synthetic hormones can affect a range of
23:58
can affect the woman's body throughout.
23:59
I mean, there's been research recently that has shown a
24:02
documented increase in depression, especially in
24:06
adolescent girls that use conventional birth control.
24:10
As you noted, the world's Health Organization does classify the
24:16
combination birth control pill, estrogen and progestin as a
24:19
Group 1 carcinogen because the documented increased risk of
24:23
breast cancer, cervical cancer and liver cancer.
24:26
There is an increased risk of blood clots and heart attacks
24:29
and stroke. And for better, for worse, I've
24:32
had the honor of meeting families who have lost sisters
24:38
and daughters and wives due to the side effects of birth
24:42
control. So the side effects are real.
24:44
Now, the serious side effects may be rare.
24:48
It may only affect, you know, less than 1% of women might
24:52
suffer a serious or fatal injury from birth control.
24:55
But when more than 10 million women are given birth control,
24:59
that number in hundreds or thousands of women.
25:03
And the the reality is, is the literature shows, the medical
25:06
literature shows that nearly 2/3 of women will stop using the
25:11
birth control pill, for example, within the first year because of
25:15
side effects. So women really need to be given
25:19
the full information so they may make a truly informed decision
25:23
when it comes to their family planning options.
25:26
In fact, our goal is to educate the medical professional
25:29
community about fertility awareness space methods so that
25:33
we can actually offer more comprehensive and targeted
25:37
approaches to women's healthcare.
25:40
Let me just give you a perfect example.
25:41
One of the number one reasons I think women are given birth
25:44
control, especially in adolescents, you know, painful
25:48
periods, oftentimes the pain can be severe, debilitating.
25:52
I was one of those women that would miss classes for two or
25:54
three days. That doesn't really work well,
25:57
you know, if you've got a job or you're trying to get through
25:59
college. But, you know, why is a woman
26:03
having painful periods? I mean, you know, is it just,
26:07
you know, a mild association with her period or is there a
26:10
more serious underlying disorder?
26:13
You know, if you have really bad headaches, you might take
26:15
Tylenol. But if you keep taking Tylenol
26:17
or Advil and it's not getting better, you want to look at what
26:21
is the cause? Why are you having severe
26:23
headaches? For many women who are having
26:25
severe period pain or cramping, they may take the birth control
26:30
pill and that will suppress the pain.
26:33
But what is the underlying cause?
26:34
And what we're finding is that a lot of these women may suffer
26:37
from a serious condition such as endometriosis.
26:41
And with endometriosis, the research shows that using the
26:45
combination birth control pill, while it can temporarily
26:48
suppress the symptoms of the pain, does not actually stop the
26:51
disease process. And as a result, many women will
26:56
take more than a decade, more than 10 years, before they
26:59
actually receive a diagnosis of endometriosis.
27:03
And that's a shame. I mean, as women, we deserve
27:06
better and we deserve to be getting the appropriate
27:10
diagnosis and treatment to treat the underlying causes of our
27:14
issues. Again, birth control can help
27:16
with the symptoms, but it doesn't necessarily get at the
27:19
root cause. I mean, in the case of
27:21
endometriosis, really the best and most appropriate way to
27:24
treat it is to surgically remove it.
27:26
The reality is, is right now, women can get birth control for
27:29
free, but surgery is very expensive.
27:32
So it's easy to just keep taking the birth control pill.
27:35
But what happens when they want to go off the birth control pill
27:38
and they want to? What happens when women want to
27:43
go off the birth control pill because they want to, you know,
27:46
have a family or they're tired of the side effects?
27:49
Well, if they've been taking it for addition, like
27:51
endometriosis, the symptoms may come back with a vengeance.
27:55
And, you know, they may still be suffering.
27:58
And so I think as medical professionals, we really need to
28:01
learn to work with our women and with our female patients to
28:07
better diagnose and better treat these conditions.
28:12
Do you think I love what you're saying?
28:15
That women deserve better? Because that's my, my mantra
28:19
with this, with birth control and with just understanding our
28:22
fertility, knowing our bodies, we deserve to know.
28:25
It's something that's so basic and fundamental.
28:27
And yet it's so it's so out of reach for so many women in just
28:32
what they're being given, you know, by the educators that they
28:34
know, you know, in the school system or by the health
28:37
professionals that they do interact with.
28:39
And you know, you mentioned endometriosis and you know,
28:42
those, these things can have devastating impact if it's just
28:45
covered up by birth control pill.
28:46
Like they're like you said, symptoms are alleviated, but the
28:48
root cause is not addressed later on.
28:50
It's going to have an impact. If that woman wants to then
28:53
start a family. All of a sudden she's like,
28:55
shoot, I was, you know, ingesting first of all, this,
28:59
these these drugs, which can be cancer causing agent so that I
29:02
could have other health issues because of it.
29:04
And on top of it, I have endometriosis, which was never
29:07
addressed and maybe has gotten worse affected my fertility.
29:11
So it's just really personally, as a woman, frustrating for me
29:15
to see so many other women not being given and girls not being
29:19
given the education that they deserve, the information that
29:22
they deserve. What do you think, Doctor Duane,
29:25
are the biggest forces against facts and fertility awareness
29:31
and education here? Because I think they're
29:33
absolutely groups and, and, and whether it's on purpose or it's
29:38
just accidentally the way they're structured that are
29:40
really working against Women's Health in this way.
29:43
Right, right. I mean, personally I believe the
29:46
the number one rate limiting step or the number one barrier
29:51
is the medical community and it's because we are not educated
29:55
about these methods. So sad.
29:57
There was a study a few years ago that showed only three to 6%
30:02
of family physicians and OBE kind are familiar, knowledgeable
30:07
with modern fertility rainy space methods.
30:09
That's incredible. Yeah.
30:11
At Facts, we did a survey of the Women's Health faculty at family
30:18
medicine residency programs. So these are the faculty members
30:21
responsible for training future family physicians about Women's
30:24
Health. And the overwhelming majority of
30:27
them were not at all familiar with modern FABMS.
30:30
The method they were most familiar with was the rhythm
30:33
method. And what I'd like to say to my
30:35
colleagues is the rhythm method was developed in the 1920s and
30:38
the 1930s, before World War 2, before the 1st antibiotic was
30:42
developed. And this is what you're familiar
30:45
with. This is the latest evidence that
30:47
you're working off of when other methods such as the Billings
30:51
method and the Crate model and the Central thermal and
30:53
Marquette methods have all been developed in the last 50 years.
30:57
And yet less than 10% of the physicians know about these
31:01
methods. And, you know, I think that is a
31:03
tragedy. And why do I think most doctors
31:06
don't learn about these methods? Unfortunately, you know, for
31:09
better or for worse, these methods really rely on women
31:15
learning how to make these observations.
31:17
It really puts the control, the locus of control or the power
31:21
back in the hands of the woman, right?
31:23
As opposed to like when I play, you know, if a medical
31:25
professional places an IUD, the doctor is in control and putting
31:29
in the IUD and taking the IUD out.
31:31
But when you're teaching a fertility awareness based
31:33
method, it's the woman and the couple that has the information
31:37
and uses that information to make the choices that they're
31:39
going to make with regards to their family, family planning.
31:42
The other issue is it's just it's a money thing.
31:45
I mean, the birth control industry is a $4 billion
31:48
industry in the United States alone.
31:50
And women are being given birth control not only for family
31:53
planning, but also to address up, quote UN quote, a whole
31:56
range of Women's Health issues. With fertility awareness based
32:00
methods, there's not a lot of money to be made because there
32:03
are no drugs that are being prescribed.
32:06
And unfortunately, it takes doctors more time to explain to
32:10
women how to observe and chart cycle than it does to, you know,
32:15
prescribe a birth control pill or place an IUD.
32:18
So it's much more profitable for the medical professionals to
32:22
simply prescribe birth control or place IUD's.
32:24
And so as a result, medical professionals are not learning
32:28
about these methods. I think honestly, to be to be
32:31
fair, another big barrier is many people associate natural or
32:35
fertility awareness based methods with faith and with
32:39
people of faith. And I think this is due in part
32:41
because for the last 50 years, the Catholic Church has been the
32:44
one organization that has consistently promoted natural
32:48
methods of family planning. But the reality is, is fertility
32:52
awareness based methods or natural methods of family
32:54
planning are based on science. And I always like to say
32:57
nobody's overs or Catholic as women, you know, our hormones
33:01
should all function the same way.
33:03
And this information should be available to every woman,
33:06
regardless of her faith, or even if no faith of all at all,
33:10
because this is where bodies are designed to work, and women
33:13
deserve to be educated and empowered with information about
33:18
how their bodies work. Absolutely.
33:20
And something a couple, I mean some, a couple of the things you
33:22
said are just so crazy that that this is the situation we're
33:26
dealing with. But you mentioned that 3 to 6%
33:28
of family physicians and OBGYN's are even familiar with fertility
33:32
awareness and are able to be equipped to teach it to
33:36
patients. And also the fact that, you
33:38
know, I remember this was I think just last year, Planned
33:42
Parenthood's CEO at the time, this was before their last CEO
33:45
who they fired because she wasn't in support of abortion
33:48
enough. And then they're the one before
33:50
that was Cecile Richards. And she was in an immediate
33:52
interview and she was, she was mocking fertility awareness
33:55
based methods. And she said it's the rhythm
33:57
method. You know what I call that?
33:58
She basically said it, that means you're going to get
34:00
pregnant. She was totally ignorant,
34:03
completely ignorant of all the different science based methods
34:06
that have been developed in the last 50 years, Like you just
34:09
named many of them the Marquette method and so, so many different
34:13
ways to understand our bodies because the science has
34:17
developed. We've, we've come to, we have
34:19
more information now about our bodies than we've ever had.
34:23
And, and you know, the rhythm method is not, this is not the
34:26
rhythm method. This is not just knowing kind of
34:29
a sense for when my period might come the day and then kind of,
34:32
you know, going back 56715 days to kind of guess that when I
34:36
might be fertile. This is really understanding
34:39
through my hormones and through potential, like you said, you
34:43
know, maybe taking your temperature, but also there's so
34:46
many different ways to understand our fertility,
34:49
markers for our fertility. I often Lila, I often ask the
34:54
question, well, how do modern methods of fertility awareness
34:58
differ from the rhythm method? And I think it's very simple.
35:01
With the rhythm method, women use data from their 6 to 12
35:06
previous cycles and specifically the length, how long were there
35:10
six previous cycles to try to predict their future window of
35:16
fertility. So they're using historical data
35:19
to try and predict what's happening in the future.
35:22
With modern fertility around a space method, women use data in
35:26
real time to identify their likelihood of being fertile
35:31
today based on their observations that they're making
35:34
today. And why is that important?
35:37
Well, there are a lot of things that could affect a woman's
35:39
fertility. Perhaps, you know, she had a
35:41
really stressful experience, was in a car accident, you know, and
35:44
that created a great deal of stress.
35:46
Perhaps, you know, she was really sick and that affected
35:49
her cycle in real time. So there are different things
35:52
that can affect a woman's fertility.
35:54
And when you're using daily observations of biomarkers that
35:58
you're checking on a day-to-day basis to predict your fertility,
36:02
that is so much more effective than using historical data.
36:06
It's like, you know, it's, you know, like I tell people as an
36:09
example with the weather, I mean, it's Labor Day weekend.
36:12
Last year, Labor Day weekend of Florida, Florida might have been
36:15
beautiful and sunny. And but if you go to Florida
36:17
this weekend thinking, well, last year Labor Day was a
36:19
beautiful, great weekend. I'm going to use last year's
36:22
data to make my plans. You're going to be sorely
36:25
surprised when you know, you get there and there's a hurricane
36:28
because when you go in real time and look, well, what is the
36:31
weather show today? You know, it's so much more
36:34
effective to use information in real time.
36:36
And that's a modern fertility awareness base.
36:38
Methods differ. They teach women to make
36:41
observations in real time to identify their likelihood,
36:44
opportunity, utility. When the rhythm method was
36:46
developed in the 1920s, it was a major scientific advance.
36:50
But again, that was nearly 100 years ago.
36:52
The sciences advance, the research is advanced, and in
36:56
fact, our mission is to educate the medical professional
36:59
community about all of these methods.
37:02
So we do this through webinars where we introduce them both my
37:05
family planning perspective as well as if it's vital sign.
37:09
We also now have an online elective for medical students,
37:12
nursing students, any health professional student or resident
37:15
can take online to learn about all of the methods.
37:19
And we're doing conferences. We have a one day continuing
37:22
medical education conference that will be offering in Dallas
37:25
on Saturday, October 12th to learn about using fertility
37:29
awareness based methods to address PMS, using fertility
37:32
awareness based methods to address infertility.
37:35
And then we have a conference in November on fertility awareness
37:38
and fem tech and that's going to be on Sunday, November 3rd in in
37:42
Lancaster, PA. But our goal is we want to get
37:45
this information to the medical community because we want
37:48
doctors to be able to offer the full range of options for
37:53
women's healthcare because all women deserve this information.
37:56
They deserve full information to truly make informed choices.
38:00
And when one other question on this, which we we've touched on
38:04
a little bit, but is also a huge interest to a lot of people that
38:08
have reached out to me, people who listen to this podcast, but
38:11
is achieving pregnancy, dealing with infertility.
38:15
I mean, that's a huge cost that unfortunately so many women
38:19
endure today and and so many men.
38:21
And could you just speak to how fertility awareness too?
38:24
It's not. It's not only understanding our
38:26
cycles to be healthier, our bodies to be healthier and even
38:29
to be able to maybe avoid pregnancy for periods of time
38:32
naturally, but also to be able to treat infertility and be able
38:37
to achieve pregnancy. Right.
38:39
Absolutely. And sometimes, Lila, it can be
38:42
as simple as explaining to a woman how her body works.
38:45
For example, when I was medical, when I worked at a community
38:49
Health Center, federally qualified community Health
38:51
Center here in Washington, DCI had a young couple come to me
38:56
for care. They were trying to get
38:58
pregnant. She was 27 years old, he was 31.
39:01
So they were young. I mean, certainly not of
39:03
advanced maternal age, but they have been trying for over a
39:07
year. So they technically met the
39:09
definition of fertility. And when I did her history, she
39:12
described her cycles the way she described her cycles.
39:15
They sounded totally normal and healthy.
39:19
And as she was giving me her history, she then remarked,
39:21
like, yeah, occasionally I get this discharge.
39:23
And so it's not every month, but a lot of months I get this
39:26
discharge. And so whenever I have this
39:28
infection, you know where this discharge and make sure not to
39:31
have sex with my husband because I do don't want to give him
39:35
whatever it is that I have. And as she described this, and
39:38
when she described in her cycle and the way she described this
39:41
quote UN quote discharge, which she presumed was an infection
39:45
was actually her normal fertile cervical discharge that
39:49
indicated she was entering her window of fertility.
39:52
So, unbeknownst to her, she was deliberately avoiding having sex
39:58
when she was fertile and. And he did a full exam and was
40:02
able to reassure her she did not have any sexually transmitted
40:05
diseases or any infections that she would, you know, pass on to
40:08
her husband. And I encouraged her the next
40:11
time you have this, quote, UN quote discharge, have sex with
40:14
your husband. The only thing you're going to
40:16
give him is a baby. And they came back two months
40:19
later pregnant. And he thought I was a miracle
40:21
worker, but literally all I did was help them understand that
40:24
this is the way your body works. You know, unfortunately, as
40:27
women, we're often given this message that whatever comes out
40:31
down there, whether it's our cervical fluid, our period or a
40:34
baby, it's a bad thing. And so it needs to be avoided at
40:37
all costs. But the reality is, is, you
40:40
know, many of this, many of these signs are signs of help,
40:43
you know, but I've also had a couples with recurrent
40:45
miscarriages, you know, who suffer from low progesterone.
40:49
And, you know, I have a patient who tried had two miscarriages
40:53
left last year. And, you know, thanks to the
40:55
work that I was able to do with her to help supplement her
40:58
progesterone levels, she has a baby that was born in May very
41:01
healthy. You know, I, my heart actually
41:03
honestly went out to doctor Lena when the the former president of
41:07
Planned Parenthood, you know, when she talked about her
41:09
miscarriage. You know, as women get older and
41:12
you know, and unfortunately, we think of women over the age of
41:14
35 being advanced maternal age, but you know, it is not uncommon
41:18
that our body doesn't produce as much progesterone.
41:21
And, you know, so in cases like that, that sometimes those women
41:24
can benefit from supplemental progesterone when they're
41:27
working with trained physicians, you know, to, to receive this.
41:32
And in fact, there was just a research article that came out
41:35
in the last year specifically looking at this.
41:38
So I often times will see patients like this.
41:41
But then I had another patient with really, really irregular
41:44
cycles, polycystic ovarian syndrome, another condition very
41:49
common in women. Women are very commonly given
41:52
birth control, to quote UN quote, treat the polycystic
41:55
ovarian syndrome. But again, it doesn't actually
41:57
treat the syndrome, but it can potentially make it worse.
42:01
But I had a woman like this. We were able to work with her to
42:03
get her to lose weight. Her cycles went from 60 to 70
42:07
days long to 30 to 40 days long, but still really long.
42:12
She conceived on day 27 of her cycle.
42:15
So we often think of like, oh, you're going to ovulate on day
42:18
14. This woman literally ovulated on
42:20
day 27 and was able to conceive that cycle and gave birth this
42:25
past May. But when I was working with her,
42:27
I explained to her based on when you concede, based on charting
42:30
your cycle, your due date is May 5th.
42:33
Your period will give you a due date of April 27th of April 24th
42:37
I think. And sure enough when she had her
42:40
ultrasound it showed her due date was consistent based on
42:43
what her cycle showed. So helping achieve pregnancy is
42:47
a really important aspect of using these methods as well.
42:50
And again, there are many factors that can affect it.
42:53
Unfortunately, there are so few physicians that are trained in
42:57
these methods that can really help women.
42:59
But there has been research, there have been two large
43:02
studies in particular of the Cretin method that have shown
43:06
live birth rates using Creighton and natural procreative
43:09
technology. These studies have shown live
43:12
birth rates that are comparable with conventional approaches to
43:15
assist the reproductive technology.
43:17
So I strongly encourage women if you're looking, if you're
43:20
struggling, you know, e-mail us at info@factsaboutfertility.org
43:25
so we can try and connect you with someone in your area and
43:28
work with us to help educate your medical professionals.
43:32
At FAX we have a folder specifically for the medical
43:35
professional community called Share the Facts with your
43:37
Physician or medical Professional and it provides
43:40
information about the research supporting fertility awareness
43:43
based methods. So we encourage you to make a
43:45
donation of facts so we can share those with you to share
43:47
with your medical professionals. So women can have medical
43:50
professionals that are educated and able to support them in the
43:54
use of fertility awareness based methods.
43:57
This is so Doctor Dwayne, this is such life, literally life
44:00
changing information. And I know from women who have
44:03
gotten the proper fertility education and then working with
44:07
doctors who understand fertility to achieve pregnancy to deal
44:10
with infertility or just girls learning about their cycles and
44:15
then learning how to deal with some of the painful maybe
44:17
symptoms they're enduring in a natural way, not just being
44:21
prescribed birth control. So this is just incredibly
44:23
powerful information for women, for girls, and for men to be
44:27
aware of because this is the, you know, half the half the
44:31
human race are your sisters, your mother's, your, your wives,
44:35
your girlfriends, whatever, who there's a whole world of
44:38
healthcare for us that we really need access to that.
44:41
I think, you know, you're doing groundbreaking, pioneering work
44:44
in you've mentioned a few resources throughout this
44:47
interview, which have been awesome.
44:48
Can you just list a few more? If someone's listening, they
44:50
just want to learn more. They want to go to a website.
44:52
And then also, you know, most folks listening are not medical
44:56
professionals themselves, but and, and maybe they're looking
45:00
to connect with medical professionals that will give
45:02
them better treatment. Sure.
45:05
Yeah. So like I said, our website is
45:07
facts about fertility.org. We do have a webinar called the
45:11
science of the Female cycle that is perfect for the non medical
45:15
professional, just for the general audience to learn more
45:18
about the female cycle and the various fertility rena space
45:21
methods that are out there. Under our what is charting
45:24
section, we have information about all of the evidence based
45:27
methods both in English and in Spanish.
45:31
If you'd like your doctors or midwives or nurse practitioners
45:34
to learn more, you know certainly refer them to our
45:36
website and or consider making a donation to fax to receive one
45:40
of our share the fax folders to give to your medical
45:44
professional to help them understand more.
45:46
For the medical professionals and students, we do have the two
45:49
upcoming conferences, one in Dallas on Saturday, October 12th
45:53
and that's approved for seven continuing medical education
45:57
credits on the early early bird registration deadline for that
45:59
is September 13th, so we encourage people to register
46:02
soon. And then our conference on
46:04
Sunday, November 3rd in Lancaster, PA on fertility
46:07
awareness and FEM tech. At the moment there is not a
46:12
universal database of medical professionals or educators that
46:15
are trained in various methods at fax.
46:17
One of our goals is to create that, you know, once we're able
46:20
to get the funding to do so. But if people want to e-mail us
46:24
at info@faxaboutfertility.org we can try and help you locate a
46:28
medical professional in your community.
46:30
The good news is as many doctors and medical professionals and
46:33
educators are now offering sessions online.
46:35
So even if there isn't 1 local, we may be able to help you find
46:38
somebody that you can work with online to address address your
46:42
your concerns or your issues. Thank you, Doctor Dwayne, super
46:47
helpful. Please everyone check out.
46:49
You can go to itsfactsaboutfertility.org.
46:51
Is that right? Correct.
46:53
Awesome. And then there's conferences
46:55
coming up. Obviously those are 2019
46:57
conferences, but I'm going to guess you'll have conferences in
47:00
2020 as well and in upcoming years.
47:02
And thank you so much. I so appreciate you willing to
47:06
ask the extra questions. You know, as a young medical
47:09
student, young doctor, and now starting this amazing
47:12
organization and helping elevate women and empower us to get the
47:16
the resources that we really need about our bodies and our
47:18
fertility. Thank you so much for joining.
47:20
You're welcome. Thank you so much for having me,
47:22
Lila. Thank you for listening to this
47:26
episode of the Lila Rose Show. We talked about body awareness
47:29
and fertility awareness and how important it is for everyone.
47:32
If you enjoyed what you listened to, please share it.
47:35
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47:36
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47:39
reach more people. You can give it five stars and
47:41
leave a review. We love getting your reviews and
47:44
thank you all so much and have a wonderful rest of your evening
47:47
or wherever you are. Thanks.