There seem to be two narratives in medicine. The traditional, white coat, Western route, and the alternative, unconventional (to us Americans, anyhow), Eastern route. Depending on who you talk to one is superior to the other. It’s easy to think that one has all the answers. But when it comes to fertility, is it possible that we’re all just throwing spaghetti at a wall? Sometimes it sticks. And sometimes it doesn’t.
I was staring my doctor in the face (virtually, of course, because #pandemic) and I was trying to let her statement sink in. “You have endometriosis and a mild case of PCOS. Your estrogen is elevated (she points to a chart that shows an ominous line of my estrogen steamrolling exponentially), and we’re going to need to address that before you’ll be able to even consider conceiving.”
After the new year, when we were all still optimistic about 2020, I decided to confront my infertility and see a doctor. I had just undergone rounds of diagnostic tests, ultrasounds, and weeks of bloodwork. I blinked back stupidly. I didn’t say anything, but what I wanted to say was, “That’s impossible. I teach fertility education. My cycles are perfect.”
Ditching the Pill and Learning about Fertility Awareness
Nearly 10 years ago, I ditched the pill and started a love affair with the science of reproductive hormones. (I even made a movie about it.) I discovered cycle charting as an alternative to both family planning and health management. My world of what I thought I understood about my body was flipped overnight. I felt like I had discovered the underbelly of what my OB didn’t want me to know — I didn’t need the pill to manage my fertility. I could cycle naturally and use that to avoid — or achieve when the time came — pregnancy. I checked every book out I could find on the topic, scoured internet forums, and started evangelizing anyone I could on the topic.
I felt like I had discovered the underbelly of what my OB didn’t want me to know — I didn’t need the pill to manage my fertility.
A couple of years later, I graduated film school. I had just gotten married and moved to New York City. At first, I worked on film sets as a production assistant, but I quickly decided to divert my career in another direction. Women’s health.
I trained and certified in organizations dedicated to providing support and education to women about their cycles, like FEMM and Creighton Model of Fertility Care. (I also studied with the Billings Ovulation Method, Sympto Thermal, and Marquette Method of Natural Family Planning. I was a little obsessed.) I got a job at a local wellness center.
After I got pregnant and had my daughter in 2015, I fell in love with maternal health and lactation science (really just another extension of women’s health.) I loved the idea of an uprising against the white coat doctors who had sabotaged birth, quelled female hormones and vitality, and told women that their side effects were “all in their head.”
Infertility and Pregnancy Loss
Fast forward to 2020. We’re in a pandemic, I’d been in denial about my secondary infertility for almost two years, and I’d been through two miscarriages and one chemical pregnancy. But at least now I have an explanation. Well, the beginning of an explanation. Despite being quite common, doctors and researchers have very little understanding of both endometriosis and PCOS.
Despite being quite common, doctors and researchers have very little understanding of both endometriosis and PCOS.
My doctor prescribed a bunch of supplements, bioidentical hormone therapy, and a Whole30 diet. I put my foot down at Whole30. I know many people swear by it, but the two times I have tried it, I almost lost my sanity and a few relationships. I am not pleasant without carbs. I know, I know - this is blasphemous to say. But if I’m going to be indefinitely quarantined with my family, trust me, you want me with carbs. Doc says I can settle for removing gluten, corn, dairy, and soy. I’m not happy about it, but I say I can do it.
Addressing Hormonal Issues with Pharmaceutical Drugs
I’ve been teaching for years that the reasons women are put on the pill are not diseases — but rather symptoms. Irregular, painful, or heavy periods. Hormonal acne. These symptoms point to something much bigger that needs to be addressed. While hormonal contraception works beautifully (for some women) in silencing the symptoms, it doesn’t address the root cause. And how frustrating is it that white coat doctors have little to offer other than this band-aid effect?
I frequently work with women who were put on the pill at age 15 for their irregular or painful periods. The pill worked, because it suppressed her natural hormones all together, and replaced them with a pseudo bleed that was both regular and painless. Problem solved. At the time. Then at age 35, she is ready to get pregnant so she comes off the pill. But the same issue persists that existed 20 years ago. In some cases, it was a missed diagnosis, and, worse, she has now lost 20 years that she could have been trying to figure it all out.
The reasons women are put on the pill are not diseases - but rather symptoms. These symptoms point to something much bigger that needs to be addressed.
But what does “figure it all out” mean? In this case, my case, where Western meets Eastern, there is no easy flowchart — just spaghetti. Maybe cutting gluten will help. Maybe bioidentical progesterone will help. Maybe the supplement that comes from French maritime pine bark (what is that even??) will be the clincher. But ultimately, no one knows. Not my doctor, not my acupuncturist, not even my lucky eight ball.
I have grown softer and more compassionate for both Eastern and Western medicine. We’re all trying to find answers to seemingly unanswerable questions. But just because there’s a little trial and error, it doesn’t mean we should stop asking those questions. We just need to accept our limits. Which is to say, sometimes we’re throwing spaghetti at the wall and seeing what sticks.
As a Fertility Awareness Educator, and someone on the other side of the screen this time, I am incredibly reluctant to tell women that “fixing their hormones” will be as easy as losing some weight and tweaking their diet. Not only are those endeavors incredibly difficult for most women, there’s no guarantee that they will work.
Putting Women before Wellness
Rather than pitting industries against each other and falling for miracle cures sold by Instagram influencers, maybe we all need a dose of humanity. I know “This could work for you but also might not!” doesn’t sell. But the cost? Women feel like failures when their mushroom coffee doesn’t miraculously cure their hormonal acne. Or their low carb diet doesn’t yield a healthy baby. Or worse, they find a low carb diet incredibly difficult, and they can’t stick to it, and so they feel wholly responsible for their fertility, or rather lack thereof.
When we worship “health” as the foundation of wholeness, it sets a lot of women up for failure.
And the science? Super murky. No one actually knows what causes every individual case of infertility because there is just still a lot we don’t know. It’s dangerous waters to wade in. When we worship “health” as the foundation of wholeness, it sets a lot of women up for failure and alienates anyone who isn’t in “perfect” health, which frankly, is ableism. An able (or “well” whatever that means) body isn’t morally better than a disabled (or unwell) one.
I don’t know yet how long I will continue with these pursuits of trying to conceive and “fixing” my hormones. After going through my experiences with infertility and loss, I will inevitably change the way I practice and teach. I won’t sell anything about hormones as “easy.” And most importantly, I want to give women space to be human. Despite modern medicine and science, the body is still largely a mystery. I am thankful for that. It means I’m alive and human. It means we have questions yet. And the right to pursue asking them.