Intended for healthcare professionals

Rapid response to:

Papers

The timing of the “fertile window” in the menstrual cycle: day specific estimates from a prospective study

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7271.1259 (Published 18 November 2000) Cite this as: BMJ 2000;321:1259

Rapid Response:

Disservice to Women

I have worked for many years as a women’s reproductive health care
provider and I am continually dismayed by patients’ and other health care
practitioners’ misunderstanding of fertility. While I appreciate that
your article points out some of these myths, its fails to mention that
there is a way for women to know when they are fertile, and use this
information to achieve or avoid pregnancy. While the rhythm or calendar
method, as your article points out, is not very effective due to the
unpredictability of ovulation and the accompanying fertile phase, “natural
birth control” or “fertility awareness methods” are not based on
predictions. They are based on scientifically proven ways of observing
fertility and then following particular guidelines. Cervical mucus, if
observed everyday, is a very reliable marker of fertility.

What frustrates me is that this information is not shared with women.
It is far easier to give women pills or to tell them to use condoms every
time they have sex than to explain the menstrual cycle and how her own
body can inform her of her fertility. Even if a woman has irregular
cycles she can use this method because it is based on asking the question,
“Am I fertile today?” It is irrelevant whether she was fertile this time
last month.

As someone who works directly with women in a sexual health clinic, I
know that if you tell a woman you can get pregnant at any time in the
cycle, this can work as a scare tactic which can be disempowering.
However, if it is also explained how the menstrual cycle works and how she
can use this information, she is likely to have a better awareness and
understanding of her body and thus be more confident and able to manage
her fertility.

Competing interests: No competing interests

25 November 2000
Lisa Rizikov
Clinical Coordinator (and NFP Teacher)
Hassle Free Clinic, Toronto