By: Kylie Knoles-Barnett
Editor’s Note: During these next two weeks of National Endometriosis Awareness Month, we write about two patients whose diagnosis and treatment of endometriosis was expedited by the use of charting and fertility awareness based methods (FABMs). This interview with a patient is part of our series that highlights the reality of using FABMs, including benefits as well as challenges of the various methods. Kylie Knoles-Barnett, a second year medical student, conducted this interview while on a two-week online elective with Dr. Marguerite Duane, executive director and co-founder of FACTS. This week’s interview illustrates the roadblocks some women encounter as they seek help for persistent symptoms or alternatives to meet their reproductive health needs. Medical professionals with expertise in FABMs have an expanded toolbox to support these women.
Meet Emily
Emily has had painful, heavy periods and acne-prone skin since her youth. While in college, she noticed the symptoms worsened, and attributes this to a poor diet and significantly decreased exercise compared to high school. Emily saw doctors throughout her adolescence and young adulthood and was told these were normal symptoms and not something to worry about. She was offered hormonal contraceptives as a treatment option. Over the years, her trust in doctors and faith in modern medicine declined, and she branched out on her own to find answers to the many questions that remained. Although her trust in medicine was eventually restored, physicians can learn about what matters to patients like Emily by hearing her story.
A Long Journey toward Healing
She first heard about the concept of FABMs from a cousin who wanted to conceive and was struggling with infertility. Emily was intrigued to learn how much more she could know about her body’s natural cycle. She enrolled in a course on the Creighton Model and began tracking her cycle.
A few years later, she moved to an area where people had a more holistic approach to medical maladies. She appreciates holistic and natural approaches to healthcare. She made many lifestyle changes that included avoiding dairy and gluten, exercising and sleeping more, and incorporating meditation and yoga into her life. Through these changes, she feels like she is leading a healthier life.
Emily saw several doctors regarding her more severe menstrual symptoms and was eventually diagnosed with endometriosis and polycystic ovary syndrome (PCOS). A few years later, she traveled to Omaha, NE for a surgical procedure to treat endometriosis. She selected this location because of the doctor’s expertise with this surgical procedure, FABMs, and founding the Creighton Model. After surgery, hormone panels showed all her levels were now within the normal range.
The Versatility of FABMs
After some time, Emily grew tired of the paper charting involved with the Creighton Model and switched to FEMM (Fertility Education and Medical Management). Women who use FEMM may chart their observations on a paper chart or by using the free FEMM app. Emily likes being able to use an app for tracking but feels it is not the best option, and hopes something superior will become available.
For Emily, using FABMs has never been primarily about birth control. Her main goal is to eliminate the negative symptoms she experiences with her menstrual cycle. However, she has used the Creighton Model and FEMM while being sexually active. She describes feeling completely in control of her fertility while using these methods for contraception. She hopes to have children in the future and is very satisfied using these methods to delay pregnancy for now.
Emily has never been interested in taking hormonal contraceptives. She feels confident that when the time is right for her to become pregnant, she will be able to conceive using FABMs. Since she has endometriosis and PCOS, she knows it may take longer than she’d like to conceive, but she has faith it will eventually happen. Her mother had “fertility struggles” and had four children; her sister has PCOS and has a child, and a cousin with PCOS has five children.
What Patients Expect
As a patient, she describes her ideal doctor as an M.D. (medical doctor), one who pursues appropriate testing and presents a diagnosis to the patient. She expects doctors to provide as much education as a patient requests and requires. They also need to review all results and treatment options, including prescription medications and natural remedies when appropriate. She considers knowledge of FABMs a prerequisite for choosing a medical professional.
Emily is very hopeful more medical professionals will learn about FABMs so they can share their knowledge with women who want to know and consider all their options. In particular, she hopes young women and teenagers will learn about FABMs early in life. She has used her “reactive” learning about FABMs to teach her younger cousins proactively about these methods.
Reflections from a Future Physician
I sincerely enjoyed learning about FEMM, Emily, and her journey in reproductive health. Since beginning medical school, I have been intrigued by FABMs for both personal and professional reasons. My goal in taking this selective was to learn more about FABMs to gain greater knowledge about my own fertility and to educate my friends and family. Additionally, I commit to sharing these options with my future patients as a first line treatment for menstrual issues and family planning. I felt very connected to Emily’s goal of teaching young women about these options beyond the typical hormonal contraceptives offered.
I learned truly valuable information from Emily when I probed about what she looks for in medical professionals and why she lost faith in medicine at one point in her life. I am very motivated by her description of the ideal doctor and hope to embody the tenets she described. She reinforced my belief that physicians should do their best to provide patients with as much information about a disease and treatment options as they seek. And by working together as a team with each patient, physicians can help guide people to make informed decisions about their health.
Editor’s Note: One of the benefits of having a variety of FABMs is that women and couples can choose what is best for them based on their desires, needs, and goals in the various seasons of their reproductive lives. Although many different FABMs are now available along with numerous apps for tracking the female cycle, it is advisable to choose evidence-based methods to ensure greater reliability and effectiveness.
ABOUT THE AUTHOR
Kylie Knoles-Barnett
Kylie Knoles-Barnett is a second-year medical student at Georgetown University School of Medicine in Washington DC. She is passionate about women’s health; though her future specialty is yet to be determined, it will undoubtedly include supporting and empowering women in all aspects of their healthcare. She loves spending time outdoors, playing with her dog, and traveling as time permits.
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