August 10, 2023

The Impact of FABMs on Quality of Life

By: Mia Terrana, DO

Director’s Note: Mia Terrana, DO, shares an enlightening interview with a patient, Jessica,* that explores the connection between physical symptoms and menstrual irregularities, as well as the role a fertility awareness-based method (FABM) can play in pinpointing the cause. Jessica’s story highlights how charting the female cycle can serve as the fifth vital sign by enabling a woman to identify the link between her symptoms and her cycle. Unfortunately, even after Jessica heard about FABMs, it proved challenging to find a physician trained in the methods. When she did, she ultimately received a diagnosis and treatment for underlying endometriosis. Through the FACTS elective, we hope to train the next generation of physicians to fully appreciate the value of charting the female cycle with FABMs, so they may better serve their patients.  Your support is critical to our success, so please make a gift today.

 

Fertility awareness-based methods, or FABMs, serve to empower women to more clearly understand their menstrual cycles and overall health. These methods can be used throughout a  person’s life for different purposes to more precisely work towards their goals, such as achieving or avoiding pregnancy. FABMs use different markers of a woman’s fertility — including cervical mucus, basal body temperature, and urinary hormones — to provide guidance to women about what is happening and where they are in their menstrual cycle. By learning from and working with professionals trained specifically in these methods, women can use this information about their cycles to answer questions and make decisions.

“FABMs use different markers of a woman’s fertility – including cervical mucus, basal body temperature, and urinary hormones — to provide guidance to women about what is happening and where they are in their menstrual cycle.”

To better understand how FABMs can empower patients, I had a conversation with Jessica,  a woman in her early 30s who has been using FABMs throughout different stages of her life. Her journey to tracking her menstrual cycles with FABMs began with a simple goal to “be healthy.” Jessica has been working in a demanding profession over the last decade, and she was desperate for a solution to the painful, heavy, and irregular menstrual periods that often interfered with her work schedule and sense of well-being. She had tried different types of hormonal birth control over the years without any significant relief of her symptoms, instead experiencing various bothersome side effects. When she finally discovered FABMs through a faith-based organization, she felt that these methods were most aligned with her personal values and desire to use a natural method to better understand her body.

Jessica began working with a Creighton-certified teacher through her doctor’s office to learn to track her cycles with the Creighton Model, which focuses on monitoring cervical mucus throughout the menstrual cycle. She gradually became more confident in her use of Creighton and after about a month, she felt that charting had seamlessly become part of her daily routine. Once she began to observe clear abnormalities in her cycle, she sought out a physician experienced in reading, diagnosing, and treating patients utilizing data from her chart. Unfortunately, finding a physician trained in Creighton or any other FABM proved to be one of the more difficult parts of her journey.  She rarely felt understood and supported by various healthcare providers.

“She gradually became more confident in her use of Creighton and after about a month, she felt that charting had seamlessly become part of her daily routine.”

Jessica eventually connected with a physician certified in NaPro technology, or Natural Procreative technology, which prioritizes a restorative approach to women’s reproductive healthcare and works cooperatively with the natural menstrual cycle. She believes her present relationship with this physician was indeed worth the wait, as it finally led to the diagnosis of endometriosis. After years of physical symptoms and menstrual irregularities, she had an answer to why she had painful, heavy, and irregular menstrual periods. Following a laparoscopic laser vaporization procedure to remove the endometriosis, she experienced a significant reduction in her symptoms, and this was reflected by the normalization of her cycles on her Creighton charts. After treatment and equipped with a better understanding of her cycles, Jessica was able to achieve two healthy pregnancies. Now, in the postpartum period, she has been experimenting with different FABMs, including the Marquette Model, which uses a urinary hormone monitor to measure estrogen metabolites and luteinizing hormone in the urine throughout the cycle. She is grateful that a myriad of methods are available for the varying stages in her life, and she would encourage women interested in using FABMs to remain hopeful that there is a method suited to their individual needs.

“She is grateful that a myriad of methods are available for the varying stages in her life, and she would encourage women interested in using FABMs to remain hopeful that there is a method suited to their individual needs.”

Jessica’s experience with FABMs demonstrates that there is no one-size-fits-all approach to reproductive healthcare. The pros and cons for each method can vary from patient to patient and requires a deeper, more intentional understanding of a patient’s life. Jessica’s story also highlights the need to advocate for and partner with our patients to help them find resources for the type of family-planning method they feel is best for them. My experiences as part of the FACTS About Fertility elective have inspired me to begin having more open conversations with patients about their goals for health and family planning. Jessica was powerfully and positively influenced by encountering a physician who made her feel understood and heard, and I hope to be this source of encouragement for patients in the future. As for Jessica’s wishes for healthcare professionals, she hopes that they too can remain open to the valuable role of FABMs in comprehensive patient care.

*Names have been changed to respect the privacy of the interviewee. All information is shared with permission.

ABOUT THE AUTHOR

Mia Terrana

Mia Terrana, DO is a recent graduate of Philadelphia College of Osteopathic Medicine in Philadelphia, PA. She completed her undergraduate education at the University of Miami in Coral Gables, FL. She plans to pursue a career in Family Medicine and has particular interest in women’s health, adolescent medicine, and preventive care through lifestyle and nutrition. She enrolled in the FACTS elective to expand on these interests and develop a deeper understanding of how to empower patients in discussions about reproductive health.

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