Wednesday, May 15, 2013

PCOS & NFP: Jess's Take on STM

Please welcome Jess over to my little corner of the world! Be sure to check out her fabulous blog! 

 Since Aunt Flow came to visit for the first time when I was thirteen, she has kept her distance. It was another six months before I saw her again. She was never consistent, and my gynecologist told me that, as long as I was seeing her four times a year, I was fine.

It was secretly awesome in high school. The irregularity meant that I had no warning prior to her arrival, but avoiding a menstrual cycle when you are a social teen is not world ending. I never gave it a second thought until I went off to college, and she went MIA for another six months. Some friends and I were talking about it one night, and the horrified looks on their faces when I told them how long it had been was the first indication I had that something might be wrong. I really had always assumed I was overly sensitive to stress. If there was an overnight trip planned in advance, it was guaranteed I would need to pack pads instead of a swimsuit. Something big, such as moving three hours away from home and I could just save my money. I went to several different gynecologists in college, and they all said the same two things: four a year was good, but pee on this stick anyway, because I do not believe that you are not sexually active. When I would refuse birth control pills to “even” out my cycles, they were pretty much done with me.

Then I was getting married.  As I am a practicing Catholic and not a fan of pumping my body full of carcinogens, we signed up for an NFP class as part of our marriage prep. CCL Sympto-Thermal Method is what was offered locally, so that is the method we chose. The classes last three months, and at the end of the class, I still had not cycled. My temperatures were all over the place and much lower than the chart allowed (I have since discovered that my base body temp is just lower than average, so a quick edit to the side of the charts helped make my temps visible). My mucus was inconsistent at best, and my cervix was too high for me to check. It made learning how to chart incredibly difficult. I approached our instructors with my charts, hoping to gain a little insight. They reviewed them and suggested that I might have a fertility issue, known as Poly-Cystic Ovarian Syndrome (PCOS) but that I should definitely speak to a physician familiar with both NFP and PCOS.

I’m not going to lie: it was scary to be 21 and think I was barren. I delayed finding a new physician until after we were married. If I were ever to see a professional therapist, I would bet my file would have “USES HUMOR AS A DEFENSE MECHANISM” written all over it in all shades of ink imaginable. When you are newly married, everyone and their dog (Seriously, I think I had three dogs ask me about my fertility or lack thereof.) asks you when you are expecting a bundle of joy. Instead of risking crying and telling all my family, friends, perfect strangers and their pooches about my personal medical history, I opted for the following response:

<Blank stare.> I am a barren wasteland. <Uncomfortable silence.>

Enter Dr. H. I finally did some research. I Yahoo’d “STM gynecologist” and my city, and there he was at the top of the list. I brought in my binder full of charts and brushed up on my story telling abilities for our first meeting. He was kind and genuine in a way that I had never experienced with a physician. Over the course of a few months, he had me complete some blood work, and we went over my charting history.  Soon, he had narrowed down the cause of the sudden weight gain I had experienced my junior year of college, and blood work confirmed insulin resistance. We talked about the various ways to treat this form of PCOS, and with work and fairly regular appointments, I began to lose weight. He also was very positive about our chances of conceiving when we were ready.

We had been on a five year plan. I agreed to it mostly because I did not want to face the thought I might not be able to be pregnant. We finished graduate school, and never spent any period of time trying to avoid pregnancy. My charts showed no signs of ovulating, even if I did feel better. When we were serious about wanted to conceive, Dr. H went over my options.  We decided to try a round of Clomid, and it was successful with the first cycle. I knew I was pregnant long before a test could have told me so. I had never had a temp shift on a chart. I called Dr. H right after I told my husband, and he had me come in for some hormone level checks. My hormone levels were a bit shaky at first, so I was about seven weeks along when Dr. H decided I should start progesterone injections twice a week. Unfortunately, we started them too late, and a week later an ultrasound confirmed that I had miscarried. He spoke to me on the phone and expressed his sincerest apologies. When I met with him in the office to follow up, he handed me a bible verse to look up if I needed some comfort. I was touched: I really did not know physicians like him existed! We talked about our plan of action: give my body a rest, take some time to grieve, recover and I would call him when we were ready to try again.

God’s plan was sooner than I had anticipated. The next cycle, I noticed a temp shift. I was ovulating on my own! During the first ultrasound, the tech had explained that the tenderness I was feeling on one side was ovulation pain, and I was feeling the same tenderness that cycle. We conceived again, sooner than planned. Once again, I called Dr. H right after I told my husband and he scheduled me to come in for hormone level checks and progesterone shots the next day.

I have recently given birth to my third child, and I have not needed to use Clomid again after the pregnancy that ended in a miscarriage. It is as though the Clomid or that first pregnancy woke up my body. I see clear temp shifts in my charting at least every other cycle. We are still open to life and have no reasons to avoid pregnancy at this time, so our children are ages 3.5, 1.5 and a few weeks old. Sometimes I feel as though I have cheated PCOS in some ways, but utilizing NFP charting and physicians that recognize the knowledge that can be gleaned from those charts gave me my fertility (and my health) back.

My experience with having PCOS and using NFP has been different from many, but I have charted evidence of years without ovulation. Without that information (and a physician willing to use progesterone shots without multiple miscarriages) it would have been a guessing game. When I think about this experience, I am really in awe of how amazing our bodies are!

Jess is mom to 3 beautiful children, wife to Matt, and writer extraordinaire at CathoFeminism


  1. Wow, Jess, what a great story!!!

  2. I have a friend that also has pcos and she went years without periods as well. Suddenly she got pg, miscarried, and then like you it seemed to wake up her body. She got pg three times back to back with 3 successful pgs. She has cycled normally since 2007. Our bodies are quite mysterious.