The Fifth Vital Sign | Periods & Fertility


The Fifth Vital Sign | Periods & Fertility

Did you know your period is considered the 5th vital sign? The color, amount, length, and frequency can tell you a lot about your health. Lisa Hendrickson-Jack, author of the Fifth Vital Sign shares the details on all things periods, reproductive health, and fertility.

Lisa Hendrickson-Jack

Lisa Hendrickson-Jack

Author of The Fifth Vital Sign

Lisa Hendrickson-Jack is a certified Fertility Awareness Educator and Holistic Reproductive Health Practitioner who teaches women to chart their menstrual cycles for natural birth control, conception, and monitoring overall health. In her new book The Fifth Vital Sign, Lisa debunks the myth that regular ovulation is only important when you want children by recognizing the menstrual cycle as a vital sign. Drawing heavily from the current scientific literature, Lisa presents an evidence-based approach to fertility awareness and menstrual cycle optimization. She hosts the Fertility Friday Podcast, a weekly radio show devoted to helping women connect to their fifth vital sign by uncovering the connection between menstrual cycle health, fertility, and overall health.


Maria Marlowe: [00:00:33] Welcome back to the Happier and Healthier Podcast. Today, we’re talking all things period’s reproductive health and fertility. with Lisa Hendrickson Jack. I’m so excited to bring her on the show as I somehow stumbled across her book, The Fifth Vital Sign. And I absolutely loved it. I feel like I learned more in the first two chapters about my period than I learned the entire 30 years of my life. Lisa is a certified fertility awareness educator and holistic reproductive health practitioner who teaches women how to chart their menstrual cycles for natural birth control, conception and monitoring overall health. In her book and in her work, she draws heavily from the current scientific literature and presents an evidence based approach to fertility awareness and menstrual cycle optimization.

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Maria Marlowe: [00:02:35] Lisa, thanks so much for being here.

Lisa Hendrickson Jack: [00:02:38] Thank you for having me. That felt like a mouthful.

Maria Marlowe: [00:02:42] I had to get it all out and I really, really did enjoy your book. Honestly, I feel like I learned so much. So to kick it off, I feel like there’s just so much we don’t know about periods that we’re not taught. And woman’s reproductive health. So what are some of the top things that you think most women don’t know and are really important that we should know about our reproductive health and reproductive organs?

Lisa Hendrickson Jack: [00:03:05] Well, that is a good question. That’s kind of like where do we start? But I think from the most basic and general sense as women, we should know that we’re not fertile every single day of our menstrual cycle, because that is the thing about when you start, you know, in my position educating women about the menstrual cycle and fertility awareness. That is the number one thing that I hear from women all the time, which is, you know, nobody told me I wasn’t fertile. Every single day, most of us had subpar education in junior high that consisted of basically like terror and fear. Like, you know, you could get pregnant every day of your cycle. And that really sets us up to choose a birth control method that protects us from pregnancy 24 hours a day, seven days a week forever, when really there’s only a short window of time each menstrual cycle and pregnancy is possible. So I would say that’s number one. And then, you know, to build on that, when we learn more just about how the menstrual cycle works.

Lisa Hendrickson Jack: [00:04:06] So to understand that the menstrual cycle is not just your period, you know, you have your period and then you typically have a few days before you start producing cervical fluid, which is intertwined with your fertility. So the days of cervical fluid before ovulation are your fertile days because it’s your cervical mucus that allows the sperm to get to where it needs to go so that you can get pregnant. So really starting to understand like this happens before ovulation and then after ovulation, you would expect your period about two weeks later. So having that general information about how it all works and even for teenage girls, understanding that your cervical fluid. So for anyone who’s listening, who isn’t really familiar, it can look like creamy white hand lotion. It can look like raw egg whites like this kind of stretchy between your fingers. And so even just for any teenage girl to understand that when you see those signs, it’s tied in with your ovulation. When you when it goes away, like when it dries up, then you can expect your period about two weeks later. I mean, what teenage girl wouldn’t want and not be surprised by her period and have the ability to to know in advance when it’s coming or even when you’re pregnant.

Maria Marlowe: [00:05:15] I mean, that was pretty groundbreaking for me to learn. I had no idea that when you have cervical mucus, that that is a sign that you’re fertile. Yeah, but that was mind-blowing. And, you know, just talking about it. Reading about it. Amy Schumer, the comedian. I love her. She did a standup bit on it. And she was saying, I think most women don’t really know what it is. And she was remarking something about how she looked in her underwear and it looked like she blew snot in her underwear. I think most people. But that’s as far as they know. Like they don’t really know what it’s there for or why it’s there. Is it normal? Is it not normal? All of that. So just even learning about that was really interesting when it’s such basic.

Lisa Hendrickson Jack: [00:06:00] Once you learn about it and for any woman who charts her cycles and monitors her fertile signs. Once you start doing that, it’s really basic. I mean, yeah, we can go into lots of complexity. Right. Although like 40 pages worth of cervical mucus discussion that I have the book. But at the end of the day, the basic concept is very straightforward. And it’s something that we could educate every single teenage girl and woman about. It’s very straightforward. Like when you have this cervical fluid for you, obviously in your cycle, it just means that you’re fertile in those days, you know? And I think there’s a couple other important myths to bust the myth that ovulation always happens on day 14. And the myth that the menstrual cycle is always 28 days long. I mean, that’s a pretty basic one as well. But a lot of women with pretty normal, typical healthy cycles think there’s something wrong with them. If their cycles, they are run like thirty two days or like twenty seven. Because we’ve been so ingrained that 28 is the only, quote unquote, healthy option. And it hurts women when they’re trying to conceive in many ways, because for many women, if they’re trying to get pregnant and it doesn’t happen right away, they may go to their doctor and then are told, OK, we’ll just have sex on day 14 or have sex on every other day until the end of time or whatever they’re being told. And what happens is, if you’re not timing to your mucous, it’s very possible that you could just have a shorter cycle or a longer cycle and be mis timing it based on that false information. So I feel like that’s the tip of the iceberg of the basic information all women should know.

Maria Marlowe: [00:07:33] Yeah, I mean, like. Weren’t we taught this in middle school or high school? This is just mind blowing.

Lisa Hendrickson Jack: [00:07:39] Well, and many doctors aren’t taught it in med school to the same degree and level. It’s just not a standard part. I mean, the female body and how it works in this way, in this very specific way. It’s just there’s a much deeper question to answer in terms of like, why weren’t we taught this?

Maria Marlowe: [00:07:57] Yeah, I think there’s a lot of things that we’re not taught. And a lot of things I wish were taught. That’s a whole other thing. You know, I think there’s just a lot of confusion around what a normal or healthy period looks like. So can you explain what does a healthy period look like?

Lisa Hendrickson Jack: [00:08:13] So a healthy period. First of all, in order for it to be a true menstrual period, it has to happen after you’ve ovulated. So first and foremost, in order to have a healthy period, ovulation would have had to happen about 12 to 14 days before that. So for women who are on the birth control pill or other hormonal contraceptives that allow for a regular bleed, it’s important to know that that is not the same thing as your period. It’s withdrawal bleed. And so the difference being that if you’re on a hormonal method of birth control, it suppresses your ovulation. So you’re not ovulating. In most cases. And then the bleed that you get, it’s just it’s because you kind of take your sugar pills for seven days. And so that the drop in the artificial hormones is what causes this bleed. But it’s not the same as your period. I think this isn’t news to me because I’ve been in this field and in this knowledge for about almost 20 years. So there’s a part of me that’s like we still have to go over this.

Maria Marlowe: [00:09:12] But yeah. So let’s this as any women who don’t know this yet. Let’s just to clarify. So essentially what you’re saying is that if you’re on birth control, when you get your period for those few days a month, it’s not actually your period.

Lisa Hendrickson Jack: [00:09:28] Like we it’s like air quotes period. So, I mean, there’s blood there. But in order to have a true menstrual bleed. So in a healthy normal ovulatory menstrual cycle, you know, you have your period at the beginning and then you move towards population.

Lisa Hendrickson Jack: [00:09:44] And so we talked about cervical fluid that you’d see as you approach population. And during that time you’re producing estrogen and estrogen, stimulate cedar and lining and helps it to develop and build up. So that kind of replenishes. So every time you have your period, it shuts aligning, obviously. And then when you obviously in a true menstrual cycle, you produce progesterone and then progesterone helps to continue building the lining, but it also helps to mature that lining and prepare it for pregnancy so that, you know, and then if you don’t get pregnant, if there’s no fertilization, then 12 to 14 days later, you’d have what we call a true menstrual bleed.

Lisa Hendrickson Jack: [00:10:19] So when you’re on birth control, you’re not producing your natural estrogen at the same level. You’re not producing your natural progesterone because you’re having this influx of artificial hormones. So, you know, they call it estrogen and progesterone, but it’s not. They make those hormones in a lab and they are similar to our natural hormones, but not the same. So back to your question about what’s a healthy period. So the first thing is that it happens after ovulation and a healthy period can last anywhere from about three to seven days. So the average is about five days. And in a typical period, we would expect it to start off either moderate or heavy and then gradually decline. So for any woman who’s been off the pill for a while and has had, you know, relatively normal periods, you typically bleed the most during the first one to three days. And so when, you know, of course, I looked into research about it. So we typically lose up to 70 percent of our bleeding within the first two days, 90 percent in the first three days. So it’s very common to have like a heavier start and then to have some kind of and trail and bleeding for a couple of days after. So the problem would be if you’re bleeding is like two days or less, then we would know from my perspective, I would be asking, you know, did you awful late? Is this the true menstrual period? Could this be spotting like if it’s really less than three days and then if it is a true period, then you know what’s going on hormonally, because that’s depending on the volume of bleeding that you’re having.

Lisa Hendrickson Jack: [00:11:50] And then if it’s going on and on and on. So seven days, eight days, nine days, 10 days are if you have your period and then you just continue to have spotting throughout your cycle, it’s really important to know that that is not normal. A lot of women have spotting, so it’s not completely uncommon. But if you’re regularly experiencing several days of spotting, you know, in the middle of your cycle and then maybe a bunch of days of spotting again before your period starts, it’s something that we should know that it’s outside of what we would consider to be optimal. And so there’s more.

Lisa Hendrickson Jack: [00:12:22] I think it’s really important just to mention that although it’s very, very common for women to experience pain during that period. So varying degrees of pain, some women experience some mild discomfort. And many women experience like moderate. Heavy pain where they have to take medication just to get through the day. So I think it’s really important to make the distinction, although it’s very common for women to experience pain with menstruation. That doesn’t mean that it’s optimal and it doesn’t mean that it’s something that the way that I discuss it with clients and just in general. It’s that outside of your uterus and periods, there is no other situation that I can really think of where we actually think pain is like totally fine. Like I’ve really tried to think of. And if you can think of an example I would love because I’ve really tried to think of an example of like what is a situation where we would actually consider it to be just fine. I experienced like horrifying period pain as a teenager and in my early 20s before I figured out how to kind of rectify it and adjust it. And so I can speak from that experience is now I’m a mom of two. So now I’ve been through labor twice. And I can say that some of those periods that I had, the pain was worse than the early stages of labor like that severe pain. I feel like I’ve had women describe the on the severe and it’s like someone stabbing while simultaneously setting them on fire. I had to describe it as if some somebody went into her uterus and it was like wrenching it back and forth, like wet laundry. And I personally have described it as if someone reached up my anus and squeezed as tight as possible. So that is like we have to, first of all, recognize that pain is a sign of a problem. When we look at what the science says, women who experience period pain, they can measure certain markers of inflammation.

Lisa Hendrickson Jack: [00:14:11] So prostaglandins and lipids are associated with muscle contraction. And so in a healthy period, we actually produce these prosthetic gladdens. And that helps our uterus to contract to really, you know, release the blood. So it’s a normal part of this process. And menstruation is actually an inflammatory process. However, when we have too much inflammation, when this normal process goes awry, then we end up with too much inflammation, which then can cause more pain. So women who experience moderate to severe period pain have been shown to have four times the levels of prostate glands than women who don’t.

Lisa Hendrickson Jack: [00:14:49] So for anyone out there, that’s like it’s totally fine and it’s totally normal and this is just the way it is. I think it’s important to bring it back to the science and say, well, look, we can identify some differences in the women who have severe pain. And it shows that they have more inflammation. So we should really be looking at pain as a problem. Right. And then take that and start learning about ways to reduce that inflammation. Understanding that it could be a sign of something more serious, like the new trio says a large percentage of women who have really severe pain do have the materials. It’s not all women who have endometrium that’s have severe pain, but this is a conversation we should be having about periods.

Maria Marlowe: [00:15:31] Yeah, I think I know when I was growing up, Mydol was advertised pretty heavily in all of the teen age magazines and shows and all of that. And I did think that PMS was just a part of being a female. Every month you would get your period and you’d get PMS Like I just thought that was a thing. Not realizing. No, actually you don’t have to have pain. And personally for me, when I started changing my diet, I grew up on a very unhealthy, inflammatory pro-inflammatory diet. And when I changed it for other health reasons, I realized, oh, well, the PMS actually went away like completely like zero pain, like nothing. And yeah, I think it’s just something that we’re not taught. But it definitely we shouldn’t feel pain. Anytime you feel pain. The only thing I could think of when we think pain as a good thing is after a workout.

Lisa Hendrickson Jack: [00:16:22] That’s a good or a good one. But other. That’s true. Yeah. But with that said, right when you work out, it’s it’s a pain that doesn’t leave you breathless. It’s a pain that. Yeah, you might be a little sore so that it’s a little bit harder to walk, but it’s not like you can’t get out of bed right now for sure. That’s totally different. Yeah. So that’s a really good example of like culturally, this is what we consider to be normal in terms of pain and any woman who’s experienced. So, you know, moderate to severe period pain, we’ll say that it’s a lot, you know, when when I can exercise hard. But it’s never got to the point that I was laying on the ground like moaning and couldn’t get up. But my periods have done that to me many times in the past.

Maria Marlowe: [00:17:09] You mentioned inflammation as a reason, as a potential reason for this severe pain. So what are some changes that people could make that may help reduce that inflammation?

Lisa Hendrickson Jack: [00:17:21] Mm hmm. There’s quite a few, I think that I often resist the idea that there’s a magical supplement that’s going to fix everything. And I think it’s it can be challenging because it often involves. Several changes in your diet and the different things that you’re exposing yourself to. So just to kind of go down the list of some of the things that we can do or the things that we should be watching for. So I’m not anti dairy, I think, but dairy is known to be a contributing factor. So the way that I look at dairy, I kind of break it down into what is it about dairy that contributes to this inflammation? And so there’s a few points of it. But basically when you go to the grocery store and you just buy regular milk depending on which country you live in. You know, the dairy farmers may be allowed to give their cows growth hormones that cause them to produce more milk. So, you know, regular conventional dairy may contain additional growth hormones that are put into the milk. Conventional dairy operations source Holstein cows, because those are the cows that make the most milk. And there is a protein that Holstein cows produce called a 1 beta casein. Who wants to know? I talk about this more in the fifth vital sign if anyone wants to nerd out on the dairy a bit more. But basically there’s a protein that’s been linked to all kinds of inflammatory conditions and other related conditions. It’s been linked to schizophrenia and ADHD and even autism.

Lisa Hendrickson Jack: [00:18:53] And so there’s all these studies about this A1 protein and how it causes all these problems for you. So for some women, literally just the type of milk itself could be contributing to these problems. In addition to that, you know, conventional dairy operations, often the cows are fed grass, they’re fed grains, and often those grains are corn and soy and maybe genetically modified and heavily sprayed with pesticides. So there’s a lot of issues with conventional regular dairy. And for that’s part of the reason why a lot of women when they switch either to goat’s milk. So if you’ve got you know, we’ve all heard of kids that have cows milk, but they can have goat’s milk. So goat’s milk has a different protein, a protein which many women or many individuals can tolerate better. So some women find that if they switch to a different type of milk, it can help or if they switch to organic or if they switch to like a less highly processed option. So organic, not homogenized or whatever the case is. So if you have moderate to severe period pain and you regularly consume, you know, regular conventional dairy, that would be something to definitely look into, even though it can be challenging, you know. But there’s now that we’ve gotten to this different place of health, regular health, food stores and things are starting to carry organic milk and things like that. So it’s actually getting a lot easier to find.

Maria Marlowe: [00:20:19] Yeah, there’s plenty of alternatives. As an Italian woman who has given up dairy 10 years ago, I can assure you that there are plenty of options and you get used to it. Just that initial switch period, as you know, takes a little takes little time to get used to. But once you do, you don’t even miss the old stuff.

Lisa Hendrickson Jack: [00:20:40] Yeah, well, and the reason I kind of talk a lot about it is because I find a lot of people just throw it all out. So it’s like all dairy is horrible. And I think it’s really important to make those distinctions. For those of us who because for me, I tried to give up dairy and looked at different alternatives. And what ended up working for me was finding different sourcing my dairy directly from farmer and knowing that it’s, you know, eating grass. And so but that may not work for everybody. So that’s one thing to look at dairy also looking at conventional meat. So some similar idea that depending where you live, the meat may also contain those growth hormones. Conventional meat on a feedlot is given is fed to grains. And there’s science behind this when you feed a cow grains. When they look at the meat, it has a much higher ratio of omega 3 to omega 6 fatty acids or a much higher ratio. Sorry, it will make a 6 to omega 3. So the conventional meat is we know that it’s a lot more inflammatory compared to grass-fed meat. So if you have an issue with period pain, again, that’s something just to look at to see what can you do to source better meat.

Lisa Hendrickson Jack: [00:21:51] And it’s a huge issue in terms of cost. And so if you had to choose, like, where to put your money, it would likely you know, my my suggestion would be like the dairy and the meat if you consume those to put your money into better quality, because that can make a significant impact. So now that we’ve kind of talked about some of those other offenders in general, it’s looking to reduce your exposure to various toxins and chemicals that can disrupt your endocrine system. So as a woman, every product that is marketed to us and available anywhere, unless we’re looking specifically for non-toxic alternatives, contain all kinds of zeno chemicals, zeno estrogens. And basically that’s a word to say that the chemicals have a structure similar enough to our natural hormone estrogen or natural hormones, that our bodies men when, you know, they may get into our estrogen receptors and trigger these responses. So even though it’s not you’re not like when you spray perfume on yourself, it’s not like your spraying hormone, but it’s acting like a hormone in your body. And that can really disrupt your menstrual cycle. It can disrupt your periods and can contribute potentially to period pain and different issues. And that goes for months for products too.

Maria Marlowe: [00:23:08] Menstrual products and the body care products that make sense. But I think sometimes people don’t realize the scented candles and air fresheners and those sorts of things also contain these chemicals.

Lisa Hendrickson Jack: [00:23:20] Yeah, it can be really overwhelming. You know, I’ve had clients in my programs, so at varying stages, some women come into the program and they’ve already, you know, done everything for their house. But I’ve had women who come in. You know, they’re like 20 years old and they’re just like, holy cow. Because really, anything with the scent. So that includes your cleaning products, your laundry, your fabric softener in your sheets. I’ve tried not to use the brand name, but like your fabric sheets. And. And that’s a good place to start laundry because you wear it clothes all day.

Maria Marlowe: [00:23:52] And you’re sleeping in your sheets all night

Lisa Hendrickson Jack: [00:23:56] So that can be it’s everything with the scent. It’s everything and all the whole beauty care industry, you know, they tell us we need to have 15 products just to live our lives. So we’ve got the hair, got the shampoo, the conditioner, we’ve got the body lotion, the body wash, the you know, shave gel, the like, everything. And all of them have a scent and all of them are exposing us to different chemicals. And I’m a black woman. And I mean, I wear my hair in a way now that doesn’t require a lot of chemicals. But I’ve done a couple of episodes about the products specifically marketed to black women are all the different ways that we wear our hair and that can really be an additional exposure to these chemicals. So it’s a huge but important thing. It’s not about being perfect. And the way that I always talk about it is that we all start somewhere. The goal is not to ever like we’re never going to be toxin free, like, sorry to break it to you. But even if you get everything, quote, like air quotes perfect in your house, you start to walk outside and like breathe air and the air is polluted. So there’s no perfect here. We’re just trying to reduce exposure.

Lisa Hendrickson Jack: [00:24:57] And many women find that by making certain shifts like switching from the regular tampons that are bleached and are have been shown to contain dioxins. So, you know, there was again, this is all in the research and things. So we know that they contain these chemicals. So there are women for whom they switch from their regular, you know, tampons and pads to organic or they switch to something else like a months or cup or washable pads, etc.. And some women, not all, obviously, but some women find that out. My period pain either went was a lot lower or it went away after switching to a different type of product. So these things it’s important to think about this in stages. So kind of stage one is looking at your exposures to these different things and starting to reduce them if you’re able to then look at, So we talked about the meat and dairy. If you’re able to look at your foods and look at, you know, how much the pesticides like, it’s not realistic necessarily for everyone to buy organic. It’s not necessarily it’s not always necessary to buy everything organic. You can look at the environmental working groups, Dirty Dozen or Fifteen Dirty Dozen. But it’s all again, it’s all about reducing bad exposure.

Maria Marlowe: [00:26:13] Yeah. And I think I always say that baby steps lead to big results. You don’t have to necessarily do everything overnight. But when you’re cleaning products or an out in your detergent runs out, choose a healthier, non-toxic option or on scented option when your body care products turn out, choose, choose, better, healthier ones, non-toxic ones. And it’s just these little steps over time. It makes it less overwhelming with the tampons. That’s a big one. Definitely choosing organic or some sort of non-toxic option. So cleaning supplies, body care, what else? The food with organic. Just a tip to save some money on organic frozen frozen produce. Organic produce is typically 30 percent cheaper and just as nutritious as fresh. So that for anyone who wants to buy more organic but is on budgetary constraints, that’s something to look into. Even with meat and seafood, if you buy them frozen there, again, typically just as nutritious. Really no difference, but they are quite a bit cheaper.

Lisa Hendrickson Jack: [00:27:16] And depending on where you live, it isn’t always necessary to get everything like certified organic, for example, where I live. There are farmers who have their animals on pasture, but for whatever financial reasons they don’t go ahead to. This organic certification. So if I go to a farmer’s market, I can talk to the farmers and find out if I’m comfortable with the way that they kind of run their situation. So, you know, a lot of the meat that I buy isn’t necessarily certified organic, but it’s coming from local farmers. So I can kind of trace where it’s coming from and I can feel comfortable enough in how those practices are that I don’t need that label. So that may not apply to everybody depending on where you live. But it’s just look what you have locally. There’s so many where I live there. You know, you live a certain part. I live in Ontario, just outside of Toronto. And so, you know, there’s tons of farmers here that two tons of farmer’s markets and every little pocket of the city. And so there’s a lot of ways for me to get fresh local produce. Whether or not it’s certified organic, but knowing that it’s at least far less heavily laden with pesticides, even if they use some natural, because we all have this lovely notion that, you know, everything can just be come by on whatever. When you’re actually a farmer out there growing vegetables, there’s you know, you’ve got to figure out a way to manage the path.

Maria Marlowe: [00:28:36] Yeah. Even organic, that is a misconception. Actually did a whole interview with Max from Living Maxwell on organics. And there is this misconception that organic produce has no chemicals on it. But that’s not actually true. There are certain chemicals typically naturally derived that farmers do use on their crops that are less toxic than the conventional ones. But there there’s still on there for sure. And for anyone who’s trying to find a farmer’s market by them, there’s this great website. Well, there’s to a local harvest stock or you can type in your zip code and you’ll find your closest farmer’s markets anywhere across the US and maybe Canada. I’m not actually sure if that’s on there. And there’s another website called Eat Wildes. I believe it’s Eat Wild dot org that will show you which local farms that may not be at a farmer’s market, but that have organic pasture raised meats. So it’s a great resource.

Lisa Hendrickson Jack: [00:29:32] Hmm. And it’s such a great way to get a little bit more edge, even just a little bit of conversation that we had about understanding the general process of farming. It was brought to my attention when I had this like wonderful notion of growing kale in my backyard. And I thought I would just be like planting, like dropping seeds on the kale would just grow and I would just be eating salads all summer until I had an encounter with the slugs and the earwigs. And then it was this whole thing. So, you know, it’s helpful to just learn a little bit more about where our food comes from and going to your local farmer’s markets. If you have the ability, not even necessarily all the time, but even just making a point of having those conversations can help you to understand where your food is actually coming from and the process involved in all of that.

Maria Marlowe: [00:30:15] Right. So we’ve touched on birth control a few times throughout. And I’d love to discuss this a little bit more. So what are your thoughts on birth control? And what are some of the the dangers or side effects of birth control that many women may not be aware of?

Lisa Hendrickson Jack: [00:30:34] Well, that’s a good question. I just wanted to say one thing for the listener who like has really horrible period cramps and is thinking to themselves. So they’re just saying, I need to make two dietary changes and everything’s going to be amazing. In the book, I list a number of other like it’s not just that and it’s gonna be amazing. I just wanted to say that because there are women who struggle so much with period pain. And I just remember when I was really struggling with it, I would read things and sometimes I’d be reading a book and the person be like, oh, you know, just I was having emotional issues and I like said some prayers or whatever and like did a meditation. And then I didn’t have period painting. I just I felt don’t feel discouraged. Yeah. You feel discouraged? Are you kidding me? This is a real problem, though, for women who are really, really struggling. Also considering working with functional practitioner in addition to their doctor, someone who can help to target some in addition to all of the dietary and lifestyle changes that we were talking about, to really look at some targeted supplements and some other ways to really get at that pain. I think it’s really important.

Maria Marlowe: [00:31:34] It’s always good to remember that everyone’s body is different. So there is no one universal remedy or protocol that’s going to solve your chronic ailments. There might be some similarities, but it is really important to get to the underlying root cause of what’s causing that issue for you in particular, and then remedy it accordingly.

Lisa Hendrickson Jack: [00:31:58] And as we go into talking a little bit about the pill, I get a lot of lasts a couple of months. I was posting a lot about period pain and I did. I always get pushback from women who have had horrible experiences with their periods, who basically say, like, the pill is the only thing that ever helped me. Like, basically, like, you know, like screw you and your opinions here. You’re my idol, right? So I think it’s really important to acknowledge that. And so for many women, the pill to date has been the only thing that has ever brought them relief. It doesn’t mean that there couldn’t possibly be other ways. But for many. Women, that’s the only thing. And so if for the listener who is on the pill because she had horrible pain and the thought of coming off the pill terrifies her. I’m gonna go back there. These are the things that we talk about and all. You know, in addition to the other tactics that you can implore, you can do that while on the pill for several months to kind of get your body, you know, organize before you think about coming off of the pill. If you have those types of concerns. So I just wanted to, like, shout out to the women with the horrible periods because I’ve had them. I’ve had them, too. I can’t say I’ve had I don’t think I’ve ever had the worst that I’ve heard. But I had I would categorize them as like eight or nine out of ten. So I do have a lot of empathy because it’s just horrible.

Lisa Hendrickson Jack: [00:33:10] So your question about the pill. What are some of the basically the side effects that women don’t know about? I mean, there are quite a few I think that I remember back when I was really young because I took the pill when I was a teenager, because I had the pain and I didn’t know how to deal with it. And back then, I really thought that the only side effects were like the bad one. So I was like, okay, stroke, pulmonary embolism, blood clots. But of course, no one ever thinks that that could happen to them. So I just remember thinking that there was nothing else. And so the most common side effects that women experience on the pill are depression and other mood changes like anxiety, panic attacks, as well as low libido. So those are some of the ones that many women experience, but not all women would necessarily know that the pill was causing them. So one of the concerns that I have with women, especially younger women, you know, young teenagers, like when I think I was about 15 or 16 when I was put on it, I mean, I was a child. I didn’t know myself well enough. So if I started feeling anxious or depressed or having panic attacks, I wouldn’t think that it was the pill that would cause that. I probably would just identify as an anxious person. Like, I have anxiety,.

Maria Marlowe: [00:34:33] You would blame yourself. You would think your mood or your personality. Yeah.

Lisa Hendrickson Jack: [00:34:39] Well, especially because most women that I’ve spoken to over the years, when they were put on the pill, there was very there was either no discussion of side effects or at best very little. I’ve spoken to maybe one or two women over the course of my entire life whose doctor sat down with them with the insert and help them to kind of read through it like one or two. So it’s the more common experience to just not be aware that this could be a thing. So then it sets you up for if you do experiences things, you don’t necessarily think that it’s the birth control. And what’s interesting about it as well is that some women go on birth control and then they immediately will have these like anxiety, mood, kind of altering experiences and then they come off of it right away. But other women will go on it for years and then start developing panic attacks like eight or nine years in. That stop after they come off, so I think that it’s really just important to know that that is a thing. And some women describe having like they don’t have the highs and lows anymore. It kind of makes them just feel kind of numb. So that’s the thing. And then low libido. There’s some scary studies that have been done on the pill where they actually measure the volume of the clitoris and the vulva tissues so that the tissue around the vaginal opening.

Lisa Hendrickson Jack: [00:36:03] And so hormonal birth control has been shown to shrink the clitoris and reduce the volume of the tissues around the vagina. I think it’s important to point this stuff out because many women may have experienced issues with libido on the pill and either they knew or they didn’t. That either way, they’re still experiencing it. And often it’s kind of like it’s thought of as like an emotional issue like that, like you need therapy and counseling. But if it causes a physical response, a physical change to your actual vulva, vulva tissues, we should know about that because it’s not in our head. You can measure it. It’s happening. So for some women, though, some women do experience painful sex in addition to a low libido. And one of the reasons for that is, you know, could be that since the hormones are thinning the tissue around the opening of the vagina, then obviously that could make the physical act of sex more painful. And I’ve interviewed a few women who did have that experience where sex was very painful for years, but they had no idea that it could be related to the pill. And I shared the real story of one of the women with her permission in my book.

Lisa Hendrickson Jack: [00:37:15] And in her experience, she had no idea she went to multiple doctors before she was even given the diagnosis of vulvadynia which is painful sex. And then one, she had a consultation with a surgeon who then surgically removed identified the parts of the vulva that were painful and had it removed. And the pain didn’t even go away until she used progesterone in the area. So or testosterone. That was a mistake. So but testosterone. So that’s just something to keep an eye. I mean, these are some of the like you could say, the worst case scenarios and obviously not a women experience that degree of pain. But what the pill does across the board is prevent pregnancy. So how does it do that? It suppresses normal ambulatory function. So if you are not ovulating, you actually can’t get pregnant. There’s no egg. There’s no pregnancy. So one of the main functions of the combined hormonal birth control, so whether that’s the pill, the patch, the ring and also the depo shot and the implant, to some extent suppress ovulation and also make your uterine lining really thin. So prevent theatre in lining from fully forming so that if there was an egg to escape, it wouldn’t have anywhere to implant.And it also thickens your cervical mucus. So the cervix is blocked with a thick mucus plug.

Maria Marlowe: [00:39:45] And in the book, you talk about alternative, an alternative to taking the pill, which is charting a much lower risk, many less side effects. So can you tell us a little bit about that? Yeah.

Lisa Hendrickson Jack: [00:38:31] And so there’s those three main modes of action. And so when you suppress normal ambulatory functions, basically shut down the ovaries. One of the effects that happens is that testosterone production goes way down. And so what’s interesting is that when we talk about the pill, it’s like, you know, did you experience any side effects? So we kind of think that some women experience side effects, that some women don’t. And so I think it’s helpful to know that the way if you understand how the pill works, there are certain things that are going to happen. And every woman. So every woman who takes the pill, for example, is known. It significantly reduces the amount of free testosterone in your body by more than 50 percent. So all women who are taking the pill are going to have at least 50 percent less testosterone than a woman who isn’t on the pill. And so some women are going to experience, you know, an increased rate of depression or low libido. Some women are going to experience painful sex. So how it’s going to play out is going to be different based on those individual differences. But that effect of lowering testosterone is across the board.

Lisa Hendrickson Jack: [00:39:59] So we touched on some of those pieces at the very beginning of our conversation when we were talking about the fertile window and how we’re not fertile every single day. And so essentially fertility awareness charting is it starts by understanding your body, understanding how to know where you are in your cycle, and then using that information depending on what you want to do. So if you’re wanting to avoid pregnancy without hormones, then you would if you if you were so inclined, then you would start charting your cycle to start paying attention to your three main fertile signs. So your cervical mucus, which we talked a little bit about, your basal body temperature, which is essentially taking your temperature first thing after you get out of bed every day. And also cervical position, which is optional. So all three of these signs change depending on where you are in your cycle. So you produce cervical mucus as you approach ambulation, your cervix, which is the lower part of your uterus. It actually changes position depending on where you are in your cycle. So as you approach ambulation, the cervix is in a higher position. It’s open. Many women can feel like what feels kind of like a dimple. And then after you ovulate, the cervix closes and shifts position to more of a lower position that feels more firm. After you ovulate, your cervical meekest goes away and then your temperature rises. So when you put these three signs together, you can identify when in your cycle you’re fertile. And then when you use a specific method of fertility where it is starting, there are rules that we would add to these observations so that you can identify when ambulation took place based on your science confirmed by waiting three days, make sure your temperature stays high.

Lisa Hendrickson Jack: [00:41:43] Make sure your cervical mucus has dried up and your cervix should disposition. And for anyone who is hearing about this for the first time, I mean, it can sound like like this is just the rhythm at that, you know, they’re just going to get pregnant, but there’s a lot of science behind it. So, you know, studies have been done where women are using the specific rules related to the fertility rate as a method following and accurately. And so this method of birth control has been shown to be up to ninety nine point four percent effective when used correctly.

Lisa Hendrickson Jack: [00:42:11] Of course, the big challenge is that fertility awareness is different to the pill like the pill, you’re taking a pill and the pill then is doing its work. So you don’t have to do anything the way that I talked. But it is the pill makes your body resistant to sperm because it stops you from ovulating. It prevents the sperm from gaining access to your uterus. So the pill is basically making your body resistant to sperm. So you don’t really have to do anything except remember to take it. Or if you do another form of hormonal birth control, you don’t have to remember to take it because it’s already there with fertility awareness. Obviously, you have to know what you’re doing. So you have to learn how to chart and you have to actually chart the catch. You can just think about it Maybe write it down or put it in your app and you have to be responsible because there is you like your body is not resistant to sperm. So you have to identify your fertile window and you’re going to have to come up with a way to manage that. And so, you know, typically women who use this method, they’re either going to use a barrier method so like a condom or they might use a diaphragm or cervical cap or something. They might use it together with condoms during that fertile window.

Lisa Hendrickson Jack: [00:43:19] A lot of women use withdrawal. It’s like the dirty little secret that people don’t talk about. But a lot of people use withdrawal and also some women will do alternative sex. So no penis and vaginal intercourse during the fertile window. Keep the sperm as far away from me as possible. And other women will abstain completely. So this obviously is very personal. It depends on your preferences or your partner’s preferences and your preferences as a couple. But what I always say, because there’s a lot of conversation around the fertility awareness method like, oh, this is too hard and you know, it couldn’t possibly work. And almost as if like women are too dumb to figure it out. But the thing is that no one’s forcing anyone to use fertility rates. Women who choose this method self-select. And those are the women who really feel strongly potentially about avoiding hormones. Or maybe they have to avoid hormones because they’ve had a bad experience or reaction to it.

Lisa Hendrickson Jack: [00:44:13] If if anything like me, I mean, I gravitated to it because I couldn’t believe that there was only about a week every cycle that I was fertile. And I thought to myself like, this makes sense. I’m taking a hormone every day and altering my body. So that logic made sense to me. But I was also willing and happy to figure it out, and I didn’t mind modifying my behavior during my fertile window. I’ve used this method since I was like 19, 18, 19, and I never had any issues. With but but it’s different in my case because every relationship I ever entered, like I already wasn’t on the pills, so I only had to negotiate that like once. It wasn’t like we had been together for 15 years. And then I had to negotiate coming off the pill. Right. So I recognize that this is different.

Lisa Hendrickson Jack: [00:45:01] But I just want to give some encouragement, because women who choose to do this, you can be successful. You just have to learn how to do it. Invest some time and possibly money in learning the method. It’s a good idea to work with an instructor, especially if you’re using the method for birth control and you’ve recently come off the pill or something like that. It can be a little bit challenging if your cycles aren’t straightforward, more so challenging for you to understand what’s going on and feel confident and what you’re doing. But it is manageable and it’s extremely effective when used correctly.

Maria Marlowe: [00:45:33] Yeah. I think it’s just important for people to know that it exists. I know that when I was younger, no doctor ever told me that this was even a possibility. And I was actually put on birth control for acne and I ended up not taking it because I didn’t want any of the side effects. And similarly, I didn’t want to be taking the hormone, but I was just never even told that there was another way. And it wasn’t till much later that a friend of mine had mentioned an app that you can chart your cycle. And I had learned about it. But I’ve I’ve just learned so much from your book, The Fifth Vital Sign. And there’s so many questions. I want to ask you two more things before I let you go. One, because the book is called The Fifth Vital Sign. We’ve already talked quite a bit about it. What it can show you what what a normal cycle looks like. But in the book, you also talk about using your period as a diagnostic tool for certain illnesses. So can you just touch briefly on that?

Lisa Hendrickson Jack: [00:46:29] So the reason that I titled the book The Fifth Vital Sign is because a growing number of health professionals are identifying the period as a vital sign. And I guess I should say the period I should say a healthy menstrual cycle, a regular obligatory menstrual cycle. And part of that is because, you know, this is how we make our main hormones, estrogen and progesterone. But part of it is because when you’re in a female like a biologically female body and you’re advocating a menstruating, all of our bodily processes are intertwined with our menstrual cycle when we’re of reproductive age. And for a woman who’s tracking her cycles and paying attention to her ovulation and her periods, if she does have an underlying health issue. Often it’s going to show up in sometimes subtle, sometimes not so subtle ways in her menstrual cycle first. So what I do in the work that I do directly with women is help women and help my clients to look at the menstrual cycle as a vital sign. And as and taking it really looking at it as first possible sign that something’s wrong. So, for example, if a woman has an issue with her thyroid, it can show up in her period, in her menstrual cycle in a number of ways. She might have heavier periods or later periods or delayed ovulation or different signs of low progesterone or signs of stress. I think one of the most powerful, I guess you could say, examples of how the menstrual cycle could be used or just how intertwined it is with overall health is in the case of H.A.

Lisa Hendrickson Jack: [00:48:01] H.A. is when women stop ovulating and so they stop getting their periods altogether. And so we H.A. is characterized by a combination of over exercise, under eating and stress. And it’s commonly seen in women who are really athletic to the point that it’s almost like we think it’s normal for women to lose their periods if they work out too much. But what’s interesting is that in that case, where you’re over exercising, you’re working out a lot or exercising long or you’re not eating enough to support your body and then you have some stress or whatever combination of those three, your body is trying to protect you. So you basically like undernourished, like malnourished. And so reproduction is not no longer hold off on the table because your body’s basically protecting you. Like if you were to get pregnant right now, this would be catastrophic. So when a woman loses her period. What the research tells us is that women who start menstruating rapidly lose bone mass. So there is this association between losing your period and an increased lifetime risk of osteoporosis. And I have worked with women who have lost their period for a variety of reasons, whether it was exercise or whether they had an actual eating disorder and were consuming any food for periods of their lives, who then did develop osteoporosis in their 20s.

Lisa Hendrickson Jack: [00:49:27] So from that standpoint, in that particular example, we can see that a woman’s period is actually reflecting back to us the status of her health. And it’s a wonder then why every health practitioner is like that, why that’s not one of the first. Since that’s ask, what are your periods like, when was your last period or and why? I’ve spoken to so many women who did have this issue and who didn’t have periods for, you know, at various points of their lives for a long time and their health practitioners weren’t even concerned about it. It was like, oh, well, just go on the pill. And yeah, or some bleed every 28 days and everything will be fine. So I think hormonal birth control really has changed the way that we look at the menstrual cycle. It has given us a false sense of security. So for the record, if a woman has lost her period to H.A. and we give her the pill, some women don’t even menstruate when they’re out. They don’t even get the withdrawal bleed when they’re on it. But for those who do, that doesn’t solve the problem, because if the problem is that she’s not eating enough, then she needs to eat. That’s so basic.

Maria Marlowe: [00:50:33] That’s a Band-Aid approach, not actually treating the root cause. Yeah. I think, you know, for me as a health coach, I’m always telling people to monitor their urine and their number two because that also tells you a ton. And it sounds like a third thing that they should be monitoring as really their period and know your cycle, know the color or the length, how strong or weak the flow is. All of these things can be signed. So it is really important that we start to understand what these are all signals of.

Lisa Hendrickson Jack: [00:51:07] Well, and even if a woman doesn’t want to take isn’t ready to go into full on fertility awareness charting and look at all the stuff in such depth. Just grab an app and log in when your periods come and just you know, if you take something from this conversation, just next time you go to the bathroom, just pay attention. And if you do see any of that clear, stretchy or lotiony just market in your app, it really can to start your journey. It could just be as simple as that. Like, it doesn’t have to be difficult. You can find so much valuable information you can have just by tracking when your periods are coming. Do you have a favorite app that you like to use? I mean, I’m not one to recommend one app over the other. I think a lot of my client uses, but there’s a lot of newer apps that are out now for women who are actively using fertility awareness and who are making that a part of their routine. I always suggest to find an app that allows you to turn off the predictors setting so that you can start to just experience your body and understand your cycles and get out of that like 28 day 14, 28 day cycle two ambulation myth. Because often the apps are wrong because they’re based on it. Right.

Maria Marlowe: [00:52:14] And it probably will have you second guess yourself for.

Lisa Hendrickson Jack: [00:52:17] That’s right. It happens every time because then you see mucus early and then it’s like you’re like something’s wrong. But you did see beacons like the actual physical sign trumps it. All right.

Maria Marlowe: [00:52:29] So one last question that I like to ask all of my guests. Is there one tip or one piece of advice? You can leave our listeners to live a happier and a healthier life?

Lisa Hendrickson Jack: [00:52:39] Well, I guess I would just say to just pay attention to your cycles in whatever capacity that makes sense. And just remember that it’s a sign of health to have regular ovulation and healthy periods. So if anyone ever tells you that it doesn’t matter if you ovulate, or women shouldn’t have periods. Just no, just no. Healthy periods with regular ovulation or a sign of health. So just pay attention in whatever way makes sense for you.

Maria Marlowe: [00:53:08] Well, thank you so much, Lisa. And for anyone who wants more from Lisa, you can find her at or under the same name on Instagram. And she’s also the host of the Fertility Friday podcast. So if you want to learn more about your period and menstruation and fertility, definitely check that out. And of course, you can find her book, The Fifth Vital Sign. It’s available on Amazon or ever. Books are sold and I will link that in the show notes. Thanks for tuning in.

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