Toni Weschler, author of Taking Charge of Your Fertility, wrote the foreword of Lisa Hendrickson-Jack’s book, The Fifth Vital Sign: “This book is a gold mine of practical advice for women wanting answers to a myriad of questions that usually arise around fertility and the menstrual cycle.” If Toni, author of what I consider to be the vagina owners manual, gave The Fifth Vital Sign such an incredible review, I knew I needed to interview Lisa Hendrickson-Jack!

Taking Charge of Your Fertility was one of the first books Lisa read and opened her eyes about FAM and fertility in general. After being on the pill for period pain as a teenager, she decided to come off the pill when she became sexually active and switched to condoms because she trusted them more. She soon after learned about fertility awareness and felt more in control as she began charting and learning about her cycle.

After taking a training program about FAM, she started teaching women about charting their cycles and still continues to educate about fertility awareness today.

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The indoctrination and fear around fertility is so real. The more cycles that you go through the more you see and begin to understand ovulation, etc and that helps you build up your confidence in your ability to understand when you can and cannot have unprotected sex without getting pregnant.

Charting can be very empowering. Becoming familiar with your own body and your cycle means having the information available if something does go wrong. You can go into your doctor’s office knowing you have a short luteal phase, or you’re not ovulating regularly, or even that your cycle is 32 days and not 28. It really empowers you to be the expert on your own body.

Charting connects you to what’s happening in your body in a completely different way.

Women come to charting often for a reason – either they want to get pregnant or they’ve had a  bad experience with hormonal birth control. What happens is they come for the reason and then stay because they gain body literacy. Charting just begins the realization that everything you do in life impacts your cycle – how you eat, your sleep habits, everything which is why the menstrual cycle is a vital sign!

Even seeing a specialist we’re often told the only way to “regulate” our cycles is with the pill.  Whatever is happening with our bodies-it’s outside of our control. Whatever is happening is just happening.

It’s so frustrating too because medical professionals use the terms “regulate your cycle” when in reality it’s actually overriding and obliterating your cycle. There is no cycle on hormonal birth control. They say “regulate” and it sounds really safe and reassuring, but it’s not real.

The message is “you have no power.” The only thing we can do is medication, something that’s outside yourself. Charting helps women understand that there is A LOT you can do to help manage, ease and regulate their menstrual cycle and symptoms! What you eat, how you sleep, your stress levels, your lifestyle all have an effect on your menstrual cycle and whether or not you ovulate, how long your luteal phase is, your cervical mucus quality, how heavily your bleed, etc.

Lisa teaches the thermo-symptal method of charting which is observing symptoms like cervical position and fluid and charting temperatures every morning. Progesterone has a thermogenic effect on the body, so your entire body temperature rises after ovulation because your body is making more progesterone. You have these physical signs of ovulation.

It’s actually so simple. We often picture charting as difficult or cumbersome, when really it’s a simple as taking your temperature every morning, observing your cervical mucus when you wipe while going to the bathroom and writing these things down (or logging them on an app!) Checking cervical position isn’t even necessary, it’s typically considered a secondary sign. All of this is just basic information that we should all know!

I’m just such an advocate for getting comfortable with your own body and I absolutely understand that some people are not there yet. I think charting is such a safe great way to start down this path of learning about your anatomy and about your vagina and the inside of your vagina.

Our sex education had huge gaps in understanding the menstrual cycle. It was explained solely as a period and that’s it – no explanation of ovulation, cervical mucus, etc. Learning about all of these things will only help strengthen your relationship with your body. 

One thing that’s helpful about charting is that it allows you to form a baseline for what’s normal.

Knowing what’s normal for your own body is so important because so many things happen with our menstrual cycle. A typical cycle looks like menstruating for 3-7 days, a few “dry” days, or days that you’re not observing cervical fluid and then cervical fluid days for 5-7 days. Ovulation should then occur, then cervical fluid should dry up, and then you should have dry days again for the rest of your cycle until you menstruate again. You should not have discharge every single day, it should not have a strong odor, it shouldn’t be yellow or gray or green. And the many days of your cycle should be dry.

Constant wetness or gushing, discolored discharge, strong odors, are all signs of possible problems. Knowing what’s normal for you and observing these symptoms can help you diagnose problems before they’re serious.

Long term pill use has been linked to chronic HPV. Women catch HPV all the time, most bodies can fight it off. Pill use depletes folate making it difficult for you body to fight off HPV, creating a chronic infection that can lead to cervical cancer.

If you’re on hormonal birth control and you develop an unusual condition that doesn’t make sense, be the first to point the finger at the birth control and ask “could my birth control be causing this?” And that may mean doing your own research, tracking down the information pamphlet the birth control came with and pressing your doctor to investigate because they aren’t typically quick to blame the birth control. There are downsides to hormonal birth control that we just aren’t talking about.

My biggest problem with hormonal birth control is the lack of informed consent.

The manufacturers don’t really hide that there’s problems, but they use minimizing language. Instead of saying “may cause depression or anxiety” they say “potentially causes mood disorders.” And very few women’s doctors pull out the insert and review it before starting birth control!

Lisa has an entire series dedicated to the harmful effects of hormonal birth control where she’s interviewed women about their experiences.


So many women experience anxiety, depression and low-libido. The challenge is that we already culturally have the stereotype of women as being non-sexual, emotional and mean. So if you’re on the pill and you go to your doctor with these symptoms you’re much more likely to be prescribed additional medication to manage these problems rather than your doctor saying “you know what, we know that the pill causes all of these problems, maybe we should make some changes to your birth control, instead of giving you additional serious medications.” But that’s not typically what happens. 

In order for the pill to work, it has to shut down ovulation. In order for it to shut down ovulation, it has to suppress ovarian function so it disrupts communication between your hypothalamus, pituitary and ovaries.  Because it suppresses normal ovarian function, you no longer produce normal levels of your natural estrogen, your natural progesterone and your natural testosterone. It also increases your production of a protein called sex hormone binding globulin, which attaches to your free testosterone. So women that are taking hormonal birth control have 50-60% less testosterone than those that aren’t. This isn’t a side effect that happens to some people, this is how the medication works. Hormonal birth control works by completely overriding what your body would do naturally and turning it all off.

All people on birth control are going to have these depressed levels of testosterone, what that lack of testosterone can make you feel is what can vary.  Some will have less energy, some will have less libido, some may have painful sex, how it plays out is up for debate.

We can approach the pill very differently. We aren’t talking about the side effects enough. And we need to acknowledge it as a MEDICATION – it’s not a vitamin or a mineral. When our doctor asks if we’re on any medication, do we always think about the IUD in our uterus, the implant in our arm or the pill we’re taking every day? We need to demystify how the pill actually works because understanding the huge effect it’s having on our overall health is part of informed consent.

Starting hormonal birth control at a young age before you really know yourself and suffering from the side effects like anxiety, panic attacks and depression could lead you to believe that that’s who you are and those problems are yours and not caused by the birth control you’re taking. The efficacy of the birth control is often prioritized over anything else, especially for teens, even if it’s causing these side effects.

Women are not stupid and we don’t need doctors making our decisions for us. We need the information because we’re adults. We need to have informed consent.

I just want informed consent with all medical care.

Talk to 5 women that have come off the pill. They’ll tell you the difference living without it. They’ll tell you about depression, low-libido, anxiety those are all common, but many can tell you about strokes, deep-vein thrombosis and blood clots.

We need to push doctors to be very open about possible side effects and to be well educated BUT we also need to be more responsible about it ourselves. That’s the hard part. Look up the drug name and do the research about what you’re putting in your body and what it’s doing. Reddit, Facebook, hashtags on IG or Twitter will always have information and stories of people taking your the same medication. It’s common for concerns and symptoms to be gaslighted downplayed by your doctor – come in armed with information.

Don’t downplay your intuition. Listen to your body and your inner voice.

Let’s talk actionable steps. Where do I start? How do I learn about my cycle? How do I start charting?

  1. Get a copy of The Fifth Vital Sign and Taking Charge of Your Fertility. Even if you’re not wanting to use FAM as birth control, both of these books are easy reads and IMPORTANT reading for anyone with a vagina!
  2. Listen to Fertility Friday Podcast.
  3. Start getting educated and gathering information before quitting your birth control. Don’t feel like you have to do everything at once.
  4. Start observing your cervical mucus when you go to the bathroom – it’s as simple as mentally noting what your discharge looks like each time you wipe.

The important take-away is that it does work and you can use fertility awareness. It isn’t for everybody, and may not be right for every stage of life AND THAT IS OK. That’s why conversations like this are so important – we need to know what all of the options are and what is going to work best in each season.

When you’re learning to chart and you want to use an app, turn off all the “predictor” settings. Do everything manually so that you’re listening to your body and not being influenced by what the app thinks (it’s still learning your cycle too).

It’s important to keep educating yourself and keep learning so you can get to a point where you trust your body. You can do this – thousands upon thousands have done this before you. Fertility Awareness is one of the few methods of birth control that has zero side effects, but it is 100% dependent on you. If your interest is peaked, you CAN DO IT!

Lisa, how do you like to manage your period?

Meluna Cup. She’s been using menstrual cups for 20 years and this is her current favorite.

Lisa can be found:

Fertility Friday Podcast

The Fifth Vital Sign

Fertility Awareness Mastery Charting Workbook: A Companion to The Fifth Vital Sign

Fertility Friday Freebies Page

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