I was on birth control for ten years. I got on it to regulate pain during my menstrual cycle when I was eighteen. I went to Student Health at the University of Virginia early one morning, in total agony from my period. I was doubled over in pain. The doctor — likely a resident — was nice, and he was a little freaked out. He said that I might have endometriosis. I didn’t really know what that was, except that I knew a girl who had it and was addicted to painkillers. I didn’t think I had something like that. The doctor prescribed Ortho-Cyclen to regulate my cycle and hopefully prevent pain. It did the trick, and my cycles were easy, predictable, and short — for ten solid years. Damn, I can’t believe I was on the pill for that long. Anyway, apparently that little box of push-through pills works quite well to prevent endometriosis. That agony did not crop up again until last year, when I chose to get a copper IUD instead of using hormonal birth control.
Hold up — before I get into all of that story — let me tell you what endometriosis is. It is some gnarly shit. The endometrium is the lining of the uterus. For some women, the endometrium decides to go all out of whack and grow outside of your uterus. According to the NIH, when endometrial cells “…implant and grow outside the uterus, endometriosis results. The growths are called endometrial tissue implants. Women with endometriosis typically have tissue implants on the ovaries, bowel, rectum, bladder, and on the lining of the pelvic area. They can occur in other areas of the body, too.” These tissue implants get especially angry when during menstruation, since the muscles in that region of the body are all contracting, and your hormones and uterus are trying to expel extraneous endometrial tissue. When that junk is outside of your uterus, it can’t be expelled. It sticks with you, and sometimes, it grows. This doesn’t only cause painful periods (and the pain is like WHOA), it causes intestinal cramps, constipation, painful bowel movements, pain during sex, back pain, and even pain during ovulation. I won’t go into incredibly graphic detail, but I’ll just sum it up — it feels as if a knife is twisting around in there. Endometriosis, particularly on the ovaries, can also cause infertility.
So back to the story. After the birth of Sam the Mule, my cycle returned without much occasion (except for an unexplained bout of frantic crying right beforehand, which was then quite well explained). I had already gotten my Paragard, the delightfully non-hormonal IUD that would prevent me from having a baby when Sam was 10 months old. After a couple of months, my period became something I dreaded. I had pain — but not normal pain — curl up in a ball type of pain, can’t sleep type of pain. I chalked it up to my body getting used to the IUD, or perhaps a bit of hormonal stuff that needed to work itself out over time. I decided in August of 2011 to have the IUD taken out, partly because I thought it must be causing the pain, and partly because we wanted to get pregnant again. Unfortunately, my periods continued to be horrible, sometimes even worse than before. I was prescribed mefenamic acid, a strong non-steroidal anti-inflammatory (like Advil, but stronger, and works kinda differently). I was also prescribed some medicine that you snort. I think it dulls your pain receptors. Anyway, I never got that, because my insurance didn’t cover it, and it costed something like $200. My nurse practitioner, probably correctly, hesitated to prescribe any opiate — the only drugs that could have touched that pain.
Finally, I met with my OB in the same practice and told him that something was wrong. It was January of 2012, and we’d been trying (not too terribly hard, but still, trying) to conceive since August of 2011. And each period I had felt like a mini-version of labor. I had also started to have pain during ovulation and during the week before my cycle began. My doctor sent me for a pelvic ultrasound, which freaked me out a bit, but he assured me it was standard procedure. When I went to have my ultrasound (which is a highly unpleasant experience, if you haven’t had the experience of having one), the lady with the magic ultrasound wand kept saying, “Hm,” and taking pictures. I asked her if she had seen anything that wasn’t supposed to be there, and she said she couldn’t say — the doctor would have to evaluate the results. (How reassuring!) I asked her if there were fibroids, and she, kindly, said no.
I brought my CD of the inside of my pelvis, provided by Virginia Hospital Center, to my OB. I had a dermoid tumor (totally harmless) on my left ovary (which I actually knew about through my ultrasounds with the Sam inside), but it had grown to twice its size (not huge, but a few inches of weirdness). My right ovary and parts of my uterus showed calcifications, one of the indicators of endometrial growth. The doctor said he’d schedule me for surgery whenever I wanted. Laparoscopic surgery. Didn’t sound too bad.
I asked my doctor what the recovery time would be, and in his typically positive and unassuming manner, he said, “Oh, no more than one day, my lady. You can return to work the next day if you want.”
I should say this in bold: if your doctor every tells you this about abdominal laparoscopic surgery, he is wrong. It’s not as major as other abdominal surgery — like a c-section — since the openings are tiny, and the surgery is done with a small scope. However, the surgeon fills you up with dry air and pokes around in your innards. The air does something to your diaphragm muscles, and it fills you with pain and rage. According to an article on pelvic laparoscopy, “Some people feel neck and shoulder pain for several days after a laparoscopy as the carbon dioxide gas irritates the diaphragm, a pain which is felt in the shoulder.” Gee, you can say that again.
I scheduled surgery in February, shortly after my thirtieth birthday. I was a little scared going in. But it was okay. Eric was with me when I wore my weird little robe and starved all day waiting for the doctor to get done with his other patients. When they finally wheeled me away and put the ice cold, make-you-forget-and-totally-high medication in my arm, I was ready to be done with all of the crap mentioned above. I was happy. I remember saying to the doctor and the residents looking over me, “Gee, this must be a weird job. You guys come and do surgery on people every day, huh? That’s weird.” I remember them being nice about my random commentary, but I don’t remember what they said.
When I woke up, I puked. My whole body felt like it had been run over by a truck while being stabbed. They immediately gave me two Percocet, which probably made me puke again when I went to the recovery room, and chuck again when we arrived home. Exhausted, I ate a chocolate chip cookie, and I went to bed. The next few days were filled with Law and Order: SVU and a Percocet haze. That would have been fine and dandy except for the pain and swelling that plagued me. Right before I was to return to work, my internal sutures popped, putting me back to that painful place I’d almost escaped.
Little by little, I healed — but not without feeling that there was something broken in my body. I can’t be sure, but I suspect the endometriosis found on my right ovary, and the tumor on my left, were causing me not to ovulate quite properly. I checked for ovulation with Wondfo One Step Ovulation (LH) Test Strips, 50-Count, so I know for sure that an egg was being released each month — I’m just not sure it made it where it was supposed to go, or if the environment of my uterus was just hostile. Now, many women with endo get pregnant just fine, but I’ll always have to know that it might be harder for me. After surgery, I was put on birth control again to let my ovaries heal. I still feel twinges of pain in each ovary at random times, and I just don’t know what it means.
I’ve come to peace with my body. I was angry at it for a long time. Just before I was diagnosed with endo, I had shingles, another blow to the old immune system. I had a bad attitude about my body, and I was pretty disgusted with it. I struggled for months with hating the vessel that failed me and hurt me. It took my brain a lot of persuasion, but I am again at peace. I know it’s what I’ve got, and it gave me a damn beautiful son. Sometimes, when I am driving in my car or sitting by myself somewhere, I thank my body and the universe for blessing me so fully. Damn the endometriosis — I’m a woman who has it all.
I take a regimen of evening primrose oil, 1300Mg and borage oil 1300mg, 60 Softgels to give my body GLA, a fatty acid that can block cramp-causing prostaglandins and reduce inflammation. I also take a high quality fish oil pill, which can also help the inflammatory cells that can make endometriosis flair up. In the week before my cycle, I drink Yogi Woman’s Moon Cycle Tea. I’m not sure if any of it is helping, since birth control fools my body into not producing extra endometria and depositing it on my ovaries. (Since it reduces flow in general, it helps the growth not get out of control.)
I don’t know what happens from here. I know for sure that I will always have endometriosis. It doesn’t just stop, and some women have to have multiple surgeries. Is it life-threatening? No, but it can be debilitating if left untreated, and it can cause infertility. Like many other issues that women have with their reproductive systems, endometriosis is left untouched and largely unexplored by the medical community. When you look up endo in the internets, you’ll find over and over that no one knows why it is caused, and there are few cures, besides endometrial ablation or hysterectomy. Often, endometriosis is left undiagnosed and unaddressed, leaving its victims to suffer in silence. I urge you — if you read this and see symptoms here that reflect what happens to you — see a doctor, and check out what can be done. The surgery sucks, y’all, but it doesn’t suck as much as endometriosis. Get it tended to. It’s the best thing you can do for your own, very beautiful body.
Sam happened magically. Or naturally. It just seems like magically when I think about it. Around the time the boy turned one, we started trying to have another little person. It just didn’t happen. We were not trying long enough to declare secondary infertility or get depressed about the absence of a second pregnancy. I did get checked out, and there were some completely whacked out things about my system. I got surgery (that’s a whole ‘nother post), got on medicine, and since then, we’ve been taking an extended break from trying. We’ve just been focused on Sam the Mule, which is really a pretty wonderful thing. He’s a spirited child (again, a whole ‘nother post), so it’s been pretty great for the whole family that he’s had the lime light only on him for the past two years. Having gotten to know the boy better, I can say with some certainty that he would have clocked a newborn at my breast right on the head. Alternatively, he might have tried to bite an arm or toe off. Depending on his mood, he may have smothered a new little being with too much love. We’re comfortable with our family unit as it is, and we’re very comfortable with Sam being an older Older Sibling.
Along the way, though, I picked up some knowledge. For those of you who know me well, you may remember that I am an obsessive researcher. Obsession and memorization are among my most notable personality traits. I also like to be a know-it-all and proselytize about all of my amazing knowledge. This is clearly the main reason I have a blog.
During the months we were trying for another pregnancy, I did some pretty helpful field research about naturally increasing fertility. I had a whole regimen of supplements in a nice little pill box, and some of them did assist me. Some of them were a bit questionable, but harmless. Some were delicious, if you like celery. Herein, I shall report my findings for your pleasure and perhaps your use.
First, it’s necessary to figure out why you’re having a bit of difficulty getting a bun in the oven. This is worth a trip to a good OBGYN. He or she may be able to diagnose you with some of the more common causes of infertility: PCOS, endometriosis, dermoid cysts, ovarian cysts, anovulatory cycles, short luteal phase, or some other such mumbo jumbo going on with your body that causes you to get antsy and angry at your uterus. Don’t try to guess what is wrong — just go. Keep in mind that it’s quite normal for folks to try for six months or so, or even a year or so if you are over 30. That can cause major unhappiness, but still, it’s normal.
Here are the overall bits of advice that any doctor, midwife, nurse practitioner, chiropractor, or nutritionist will agree on:
1. Eat healthy. Michael Pollan says, “Eat food. Not too much. Mostly plants.” For those of you who know me well, you may wonder if I’m practicing what I’m preaching. I eat a lot of pasta and bread, and I cover it in cheese. This is likely not the best fertility diet. For your ute to work well, you have to have your body the best condition possible. So, the incorporation of lots of green things, lots of unprocessed and delightfully fresh foods, and yummy seasonal and local treats is important. Is it proven that eating broccoli and grapes will get you pregnant? Findings are mixed. However, it won’t hurt you, and it will quite likely help you, your mood, and your belly.
2. Exercise. Duh. It will help, it won’t hurt. If we can readapt Pollan’s motto on food, here it is: “Exercise. Not too much. But just enough.” If you are too too skinny and exercising too too much, you may have anovulatory cycles. Your body may think you are starving, and so it won’t produce eggs. When it does produce eggs, they might not be so healthy. So exercise moderately, eat healthy fats, and don’t stray towards the bottom of your BMI range.
3. If you are overweight, lose weight. I like my women curvy. Too curvy can unfortunately make you have anovulatory cycles. Losing 10-15 pounds can change this almost overnight. I can’t find the exact source but if you google, “Lose weight to increase fertility,” you’ll see that over 3 million results appear. Google is never wrong.
4. Be happy. Stress can cause all manner of ills in your body. It follows that you may not be able to get knocked up if you are completely overworked, overwrought, or totally stressed out all the time. Figure out what you need, and go get it. I recommend keeping a journal, taking a walk, or sleeping in. You may opt for talking to a therapist if stress is completely overwhelming you. It can’t hurt.
As for supplements, it’s pretty clear that some things can help. There is a lot of crazy crap on the internet, so don’t believe everything you read. That means that if you are interested in taking a supplement, research it well, look at medical studies, and figure out when and how you should take it. For instance, some supplements should only be taken in the two weeks before ovulation, and not after. This is because they may cause cramping or uterine spasms, increasing the likelihood of a miscarriage. (Red raspberry leaf and evening primrose oil fall into this category).
First — and I must repeat this — go to your doctor, figure out if you are having an issue with fertility, and what that issue might be. A lot of these supplements are harmless, but some could mess with your hormones in a way you don’t like. So read my snippets of advice, then do some research for yourself, and for heaven’s sake, go to the doc! I didn’t include everything here, but these are some popular supplements you might want to look into.
1. Get a damn fine vitamin. My OB always reminds me to take a prenatal vitamin, but I am lazy and cheap, and I don’t like the giant bottle of Costco vitamins I’ve had on my counter for the past year. So I take Sam’s gummy vitamins. Do as I say, readers, not as I do. Buy a high quality prenatal that is easy on the stomach. I used the Rainbow Light Just Once Prenatal One Multivitamin, 150 tablets, and I loved them. They are just once a day, unlike some other high quality vitamins. They are also easy on sensitive stomachs. If you love the idea of whole food vitamins, check out the New Chapter Perfect Prenatal, 192 Count. I’ve always wanted to try them, but they look a bit hurty for the wallet at three times a day.
2. Invest in a high quality fish oil or DHA/EPA pill. Fish oil is important for your heart, your cholesterol, your skin, your hair, and, quite likely, your fertility. According to the Infertility Awareness Association of Canada, “One study on fish oil and other omega-3 fatty acid food sources (pumpkin seeds, walnuts, chia seeds, flaxseeds) showed improved circulation to the uterus and appeared to increase pregnancy rates for women dealing with infertility.” If you are vegetarian or vegan, you will want to stay away from fish oil. So check out Deva Nutrition Deva Vegan DHA-EPA, 90 Count. I eat the fishes, so I go with Costco fish oil pills with the anti-burp enteric coating: Kirkland Signature Enteric Coated Fish Oil Omega 3 1200 MG Fish Oil, 684 MG of Omega 3 Fatty Acids, 180 softgels. When I was pregnant, I went with the super high quality Nordic Naturals Omega-3 Formula, 180-Count. Either way, you want to take one 1000-1200 mg pill twice a day. Again, it can’t hurt. Even if it’s not proven, it can only help.
3. Vitamin B6 is proven to help luteal phase defects. (Having a luteal phase that is too short can result in early miscarriages, as your body starts your menstrual cycle up before the egg has implanted. Totally not cool.) B6 can also increase cervical mucus, which is essential for conception. Get a great B6 supplement, and take it! It cannot hurt you! Source Naturals Vitamin B-6, 50mg, 250 Tablets.
4. Evening primrose oil is another supplement recommended for fertility. Like DHA and EPA, it increases circulation to your uterus. If you have scant cervical mucus, it can also increase your cervical mucus, which is essential for getting pregnant. (It actually does do this! If you have this issue, also drink tons of water.) Only take this supplement during the first 10-14 days of your cycle, as it can cause cramping and delay or interfere with implantation. 2000 mg per day is the recommended dosage of this wonderful oil. Look on Amazon for a high quality evening primrose oil supplement to include in your routine: NOW Foods Evening Primrose Oil 500mg, 100 Softgels,.
5. Vitex is the next big gun in supplements. Vitex is recommended to women who have irregular cycles or issues with ovulation, as it can regulate levels of prolactin and progesterone. It is supposed to regulate cycles, and it can also help women who do not ovulate to ovulate and produce healthy eggs. Studies on Vitex have mostly been inconclusive, but in my trolling of TTC forums, a lot of women who used it ended up ovulating and pregnant within a couple of months of going on Vitex. Check it out here: Nature’s Way – Vitex Fruit, 400 mg, 100 capsules.
6. Red raspberry leaf is frequently recommended to women with all manner of hormonal issues. It is supposed to provide essential nutrients, which are said to increase the health and thickness of your uterine lining. No studies have conclusively proven this effect, but many women swear by it. This supplement is particularly helpful if you have had early losses. Early losses (before 8 weeks or so) can be linked to having insubstantial uterine lining to support implantation. This supplement is also only recommended during the first ten to fourteen days of your cycle. There have not been conclusive studies on red raspberry leaf, but it won’t hurt you. Here is the RRL I was using: Nature’s Way Red Raspberry Leaves , 480 mg, 100 Capsules.
7. Dong quai is a Chinese herb that is related to celery. In tea, it actually does indeed taste very celery-like. Dong quai is reputed to regulate your estrogen production. I drink it in Yogi Woman’s Moon Cycle Tea to … regulate my hormones, I guess? I got it for PMDD symptoms. I have no reports except that it tastes delicious. Here it is in pill form: Nature’s Way Dong Quai Root , 565 mg, 50 Capsules.
8. Maca has not been proven to assist women in getting pregnant, but it’s one of those herbs that, again, many women swear by. Maca is said to regulate hormones in both men and women, which can be beneficial to those who have irregular cycles or for those who have been diagnosed with conditions like endometriosis or PCOS, which upset the natural balance of hormones in the body. A root common to South America, it is gaining popularity in the US as a miracle supplement similar to acai. This supplement is definitely worth a try for those with irregular cycles, as it is unlikely to do any harm to the body. You can get it in powder form (which is not supposed to taste good) or pill form: NOW Foods Maca 500mg, 250 Capsules.
9. Coenzyme-Q10 (CoQ10) is a found in every cell in our bodies, and it is partly responsible for cell regeneration. Studies have found that CoQ10 can assist in rejuvenation of eggs in women who have unhealthy or weak eggs. Since eggs are single cells, I must say this makes sense. Again, this is one that doesn’t hurt to take. It’s supposed to help prevent heart attacks, lower cholesterol, and even increase your lifespan. Recommended! Doctor’s Best High Absorption Coq10 w/ BioPerine (100 mg), 120 Soft gels is available here.
10. Inositol is another supplement that can help restore egg quality. Inositol has also been shown to increase peak progesterone, which is extremely helpful for women with PCOS or low progesterone in general. Low progesterone can result in early losses or prevention of implantation, so this can be a helpful supplement for anyone suffering from those issues. Look for it here: Twinlab Inositol Caps 500mg, 100 Capsules (Pack of 3).
11. Soy-isoflavones is another supplement that is important for the regulation of estrogen. Don’t take this without first having a conversation with your doctor, as you don’t want to mess up your estrogen levels before or during pregnancy. However, this supplement has been shown to assist in implantation. If you have an issue with early losses, ask your doctor if this might be a good supplement for you. Others swear that this is “nature’s Clomid” (Clomid is a drug that helps women ovulate). Check it out here: Spring Valley Dietary Supplement Soy Isoflavones.
12. False unicorn root (mostly I included this one because of the name) is supposed to regulate hormones and increase cervical mucus production. Some reviews say this is true. However, I would recommend taking the tried and true evening primrose oil, and skip this supplement since it’s a repeat of the same shiz that EPO does.
13. Cinnamon is great for lowering insulin resistance, which can be a problem for women with PCOS. It is also likely to prevent extremely heavy periods, which can worsen endometriosis. Check this link out for more information. Look towards buying cinnamon in bulk at Amazon: Nature’s Bounty Cinnamon 1000mg, 100 Capsules (Pack of 3).
14. NAC (N-Acetyl Cysteine) has been proven to help women with PCOS or with unexplained infertility. This drug, often used in combination with Clomid, can help women ovulate. Here it is on Amazon: NOW Foods Nac-Acetyl Cysteine 600mg, 100 Vcaps. This is, again, a supplement that should be discussed with a doctor.
15. Royal jelly, or bee pollen, is recommended for egg quality as well. It is supposed to help the body regulate hormones and produce healthy eggs that are ready for implantation. Studies on this supplement are inconclusive, so ask your doctor what he or she thinks. Many acupuncturists recommend this supplement for fertility. If you are interested in checking it out, look here: Durham’s Queen’s Delight (Royal Jelly 1000mg, Propolis 600mg, Beepollen 1500mg) in 3 Daily Capsules.
Just in case you don’t believe me, here is an awesome article that lists some of the studies done on these supplements and herbs.
Let me know if you’ve had any experience with these supplements, or if you know of anything else that can be added to the list!
I guess we all know by now how the human body works, at least more or less. And I suppose you can guess exactly what I was doing over Christmas break that got me into this situation. I guess it should make sense to me, but I am still baffled that from two people can come three, and that it all worked so quickly and so well. I am flabbergasted at nature, in all of its strange and swelling glory.
Honestly, I had intended to get pregnant around March. That would put me on maternity leave right at my two-year anniversary with my company. This would give me some sweeter maternity leave, but oh well, that didn’t happen. You see, I didn’t think I would get pregnant so quickly. It took my mom five years of trying, and she suffered from miscarriages before anything actually stuck. I had prepared myself so well for failure that I didn’t even believe it when that second line popped up on the pee stick.
I figured I would share some of the things that really helped me get to this delicate state.
The iPeriod app for your iphone. I’m sure there are similar apps for other smart phones, and probably some great tracking devices or calendars that link up with your email or some such. Either way, track your period — and it works best to do it not just on paper but on a tracking device hooked up to the magical calculators on the internet that figure out, month by month, when you are most fertile. iPeriod works by having you enter the beginning and end of your cycle over several months. After several months, it really begins to figure out exactly what times you’ll be fertile. As you may have figured, this is fabulous for those trying to get pregnant, and those who are trying to avoid getting pregnant. When you enter your period start and end date, it calculates your fertile days for the next month. It shows when you are kinda fertile, and most fertile, and not fertile. It looks something like this:
It’s pretty awesome. The red dot days are your recorded period days, and the light green days are the days leading up to ovulation (potentially fertile), and the greenest day is your exact day of ovulation.
For those of you familiar with the Fertility Awareness Method, this is a kind of dumbed down version of that. It takes out the temperature tracking and so forth, and figures it out for you. That said, it’s probably not as effective as tracking all of your detailed information and watching your temp on a daily basis. But it’s way less annoying!
It seemed to be pretty accurate for me. My cycle got way irregular when I got off BC, and this, after a couple of months, started to predict my period quite accurately … and thus, my fertile days. I am a fan.
The benefit to having this type of calendar on your phone is that you can fill out your days when you’re standing in line at the grocery store, you can check to remind yourself when you are ovulating, and you can calibrate it against any other tracking devices you might have. This particular app also comes with a discreet icon that doesn’t say PERIOD all over it.
I would recommend it to any lady trying to get pregnant, trying to track her period, or using natural cycle birth control. It’s a good idea all the way around. And you can’t beat the price: 99 cents.
Taking Charge of Your Fertility …
So I mentioned the Fertility Awareness Method. What’s that? Well, some of you may know, but I can say that I didn’t at all before I started trying to get pregnant. As it turns out, no one really educates us ladies on what goes on with our bodies during a cycle, and no one really tells us about HOW the body actually manages to get pregnant and stay that way. So, duh, we all know that a sperm fertilizes an egg. But, as it turns out, this doesn’t happen randomly. And it can’t happen at just any old time of the month. Now that seems so simple to me, but before, it wasn’t something I thought about in great detail.
So, if you are interested in fertility tracking, either to get pregnant or to stay not pregnant, I recommend buying Taking Charge of Your Fertility from Amazon. It shows you how to chart your fertility, talks about body temperature and its correlation, and tells you how the body works to get pregnant. I read it from cover to cover. I never really tracked my fertility like it told me to, but I’m so glad I knew all of the info. It worked so well with my dumbed down iphone app, and I didn’t have to do much thinking about it. I won’t get into the gory details on how to tell when you are fertile, but I’ll just say it’s something they do NOT teach you in health class, and it’s not something your mom is going to sit down and tell you about.
I will say that you have to be comfortable with the ins and outs of your body in order to track your fertility effectively. You just can’t be squeamish, and you have to learn how to read the signs that your body is giving you. There’s a lot of talk about … body stuff … and you gotta roll with it.
That said, the information is indispensable.
And we got pregnant two months after we started trying.
For those women who find it more difficult to get pregnant, the FAM method will help you figure out what’s going on. There are several chapters on how to figure that stuff out, and how to proceed. As I said, the information is indispensable.
So, that’s how I got myself into this situation, and I’m glad I educated myself beforehand. Good luck!
Welcome to the Savvy Mom Space
I’m a liberal feminist that believes that liberal, feminist ideals should gel with embracing your gender and motherhood (if that’s what you feel like doing). I support all kinds of moms and dads and parents. Oh and, although I totally love that natural vibe and not harming the environment, I supplement my organic milk and fresh fruits and veggies with the occasional Twix, the frequent Oreo, and the daily Coke Zero. I’m opinionated, not easily offended, and a loudmouth in person and on the internet. I am what I am. Welcome.