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Justisse
for
Fertility Management
A User's Guide
by
Elaine Matus FMP &
Geraldine Matus FMP
E
l
The
Justisse Method
for
Fertility Management
A User's Guide
by
Elaine Matus FMP &
Geraldine Matus FMP
ACKNOWLEDGEMENTS:
Our appreciation goes out to all the women to whom we have taught
the Justisse Method, as each one has contributed to our greater
understanding of fertility. Appreciation also goes to our sisters, who
have encouraged us in every way to persevere in the development
of Fertility Management Services - the Justisse Method.
We would like to give special recognition to the work of: Dr.
Suzanne Parenteau-Carreau of Serena Canada, Drs. Lynn & John
Billings of The Billings Ovulation Method, and Dr.T.W.Hilgers of the
Ovulation Method - Creighton Model. Their works have been extensively modified to form the foundations of the Justisse Method.
As the content of the following pages will indicate, the Justisse Method involves careful observation and monitoring of certain complex bodily functions.
some of which may not be perfectly predictable in all circumstances. Accordingly, neither Fertility Management Services Ltd., nor the authors, nor their
respective employees, agents, licensees, heirs, executors, administrators, personal representatives, successors or assigns makes any express or implied
warranty about, or assumes responsibility for the accuracy, completeness or usefulnessof any information, methods or products disclosed in this manual.
and neither Fertility Management Services Ltd., nor the authors, nor their respective employees, agents, licensees, heirs, executors, administrators, personal representatives, successors or assigns shall in any way be held liable for any direct or consequential damage suffered by any person as a direct
or indirect result of any use of or reliance upon the contents of this manual. Any reliance placed on the accuracy, completeness or usefulnessof the contents of the manual or the methods described is at the user's own risk.
- TABLE OF CONTENTS
CHAPTER 5
Charting
fertility management
23
mucus definitions
23
the chart
24
sensation
25
25
miscellaneous symptoms
26
CHAPTER 2
Reproductive Anatomy and Physiology
26
cycle variations
charting example
26
ovarian cycle
27
menstrual cycle
ovulation
cervical mucus
CHAPTER 6
Accomplishing Your Intentions with JM
29
nature's gate
fertilitv awareness
29
cervical changes
fertilitv manaaement
29
29
30
31
10
fertilization
11
12
CHAPTER 3
Checking for Mucus
*I"E *-*Mm%i*Y;iw:=
mUaAu-"IF
12
13
-<
14
14
14
CHAPTER 7
Other Chartina Considerations
continuous discharge
36
37
infertility
37
breastfeeding
37
39
39
39
40
CHAPTER 4
Describing Sensations,
Mucus Observations, and Bleeding
15
- menopause
menarche - the first menstruation
15
arousal fluid
observational notations
15
19
sample charts
41
22
CHAPTER 8
Other Natural - zthods of Family Planning
49
calendar rhythn
49
50
50
50
51
bio-self
51
51
References
52
Footnotes
53
climacteric
- SET
40
--
-_
Fertility Management
Fertility management requires understanding of
the reproductive system. It is necessary to have
a fundamental knowledge of reproductive
anatomy and physiology. This guide provides the
necessary information and also explains how to
chart a menstrual cycle. It opens the way to a new
awareness of how your body works in addition to
allowing management of reproduction.
Reproductive Anatomy
and Physiology
In order to use and understand the Justisse
Method you need to have an awareness of how
your fertility works.
fertilization
fallo~iantube
cervix
vagina
Cycle Variations
Your cycle begins with the first day of menstrual
bleeding and ends the day before the next
menstruation. While it has been believed that the
normal menstrual cycle is about 28 days in length,
in fact only 30% of women experience such a
cycle regularly.
Cycle lengths vary within a range of 21-42 days.
A variation of 8 days between individual cycles
is considered regular.
The menstrual cycle is divided into two phases.
Ovulation is the dividing point. From menstruation to ovulation is the preovulatory phase. From
the day after ovulation until the day before the next
menstruation is the postovulatory phase.
The preovulatory phase of the cycle is variable.
You can not predict the exact time of ovulation.
In the preovulatory phase you will experience
menstruation for 3-7 days. The number of dry days
before ovulation will depend upon how early or
late ovulation will occur in that cycle. Several days
prior to ovulation a mucus discharge will be
noticed.
If you have a short cycle (21-26 days) you may
notice mucus on the light and very light days as
menstruation is ending. If you have moderate
length cycles (27-35 days) you may experience
a few dry days before mucus is noticed. If you
have a long cycle (36-60 days) you may experience many dry days or patches of mucus
before ovulation occurs.
menstruation
menstruation drv
mucus
mucus
,,
1
b
vagina
Ovarian Cycle
As your cycle unfolds certain events occur in
the ovaries. This is called the ovarian cycle. The
ovarian cycle occurs simultaneously with the
menstrual cycle. Both cycles occur as a result of
the interaction of the hormones FSH (follicle
stimulating hormone), LH (luetinizing hormone),
estrogen, and progesterone.
The pituitary and hypothalamus glands regulate
the reproductive system. The hypothalmus
corpus luteum
produces progesterone
Mature (Graafian)
developing follicle
produces estrogen
Menstrual Cycle
The endometrium goes through changes during what is known as the menstrual cycle. The
event in the menstrual cycle familiar to all women
is the shedding off of the endometrium - known
as menstruation. The menstrual cycle and the
ovarian cycle occur simultaneously.
Biologically the menstrual cycle ends with the
shedding of the endometrium. The bleeding is
technically the end of the cycle. For the purposes
of fertility management, however, the first day of
bleeding is the recognized marker for the first day
of a new cycle.
menstrual
phase
, , proliferating
'
secretory phase
phase
estrogen
menstrual flow
follicular development
ovulation
luteal development
Ovulation
Cervical Mucus
Cervical mucus appears prior to ovulation. Rising levels of estrogen stimulate the crypts lining
the cervical canal to produce mucus. Estrogen
reaches its peak production around ovulation
day. The estrogen peak corresponds with the
mucus peak. Cervical mucus prepares the way
for sperm, enabling them to live until ovulation
occurs.
Sperm require cervical mucus to survive.
Sperm, in the absence of cervical mucus, will die
within hours or even minutes when deposited in
the vagina. In the presence of cervical mucus
sperm may live from 3 to 5 days and wait for
ovulation to occur. Once ovulation has occurred
the rising levels of progesterone cause the cervical crypts to stop producing mucus, since
sperm survival is no longer necessary.
............
............
progesterone'.
menstruation dry
IUCUS
Nature's Gate
The cervical mucus acts as a gate. The gate
is open when the mucus is flowing, and sperm
can enter the uterine cavity. The gate is closed
when mucus stops flowing and forms a mucus
plug. This blocks sperm entry to the cervix, and
thus the uterine cavity.
When estrogen levels are high the mucus that
is produced is called type E. Type E mucus arranges itself into strands called micelles. These
strands are the channels on which sperm flow
through the cervix. Type E mucus has an alkaline
Ph, which is ideal for sperm survival. Type E
mucus is produced in large amounts so that it
coats the surface of the normally acidic vagina.
In this manner sperm can survive their trip to the
cervix. It nourishes the sperm, and allows only
viable sperm to make the journey.
type G mucus
DRY days
type E mucus
MUCUS days
Nature's Gate
Cervical Changes
By doing self examinations of the cervix a
woman may note changes that correspond to her
fertility.
During the infertile phases of the cycle, under
the influence of progesterone, the cervix is closed, firm and tilted toward the rectum. As estrogen
levels rise and mucus begins to be produced the
cervix opens slightly to allow mucus to flow
through.
after menstruation
closed, firm, tilted toward rectum
around ovulation
very open, very soft, vertical
menstrual
phase
, , proliferating
' ' phase
estrogen
Changes in the
Endometrium
Hormone Changes
I
Mucus Development
BBT SHIFT
Fertilization
Once ovulation occurs, if sperm are present,
they will migrate from the cervical crypts toward
the fallopian tubes. Fertilizationoccurs just above
the fimbriated end of the tube. The sperm meet
the ovum and attach themselves to the cell membrane. This membrane, called the zona pellicuda,
has a hard surface. The first sperm that burrows
its head through the membrane creates a reaction which seals off further penetration by other
sperm. The sperm leaves behind its tail, the
source of locomotion no longer needed.
Once the chromosomal material contained in
the body of the sperm unites with the
chromosomal material of the ovum, fertilization
enlarged sperm
\foreskin
in the
uncircumcised male
I
I
oft"'
S = Sensation: wipe the vulva from the urethra across the perineum to
the anus. Pay attention to the sensation this produces. The sensation will be DRY, or SMOOTH, or LUBRICATIVE. Decide on the sensation before looking at the tissue.
0 = Observation: observe the tissue for the PRESENCE or ABSENCE OF
MUCUS.
F = Finger Test: if mucus is present on tissue, finger test it between the
T
thumb and index finger for COLOR & CONSISTENCY.
Make a decision at each observation and mentally record it.
3 C's of the
Color
Consistency
Change
Sensation
MUCUS'
Describing Sensations,
Mucus Observations
and Bleeding
The words and symbols used herein to describe
mucus are representative of the range of observations. The photographs of mucus on the following pages are a good representation of what you
may observe.
Of all the observations possible, you may experience only some. When you are charting at the
end of the day, pick the description that best
describes your most fertile observation. Use the
list of observational notations on the back of your
chart.
Though you may experience a similarity in your
mucus patterns from cycle to cycle, it is not uncommon for your mucus pattern to change due
to stress, illness, medication, or other variables.
It is best that the mucus pattern of each cycle be
charted and interpreted as seen, not as
anticipated.
I
DRY is associated with
I
I
NO MUCUS
SMOOTH can be associated with
VAGINAL CELL DISCHARGE
NON-PEAK MUCUS
PEAK MUCUS
LUBRICATIVE is associated with
PEAK MUCUS
Observational Notations
Observational Notations are a code system
designed to help you describe your observations.
Choose the notation that best fits your day's
observations.
Describing Menstrual Bleeding
Whenever bleeding occurs it is described as H heavy; M - moderate; L - light or VL - very light.
The flow pattern of menstrual bleeding will climb
a hill and come down. For example, flow patterns
may be as such:
The colors of menstrual flow range from a burgundy to a light red to pink or brown. On the light
and very light days of the flow, the woman makes
observations for mucus, notes sensation and
describes the color as brown, or redlpink.
Describing Unusual Bleeding
Breakthrough or withdrawal bleeding intramenstrually follows a different flow pattern than
menstrual bleeding. It would tend to be just
moderate, light or very light. Women experiencing this type of bleeding will easily identify it as
unusual. The color is usually brown, or pink. There
are special instructions for dealing with intramenstrual bleeding (see Chapter 6). It is very
important with observations of unusual bleeding
that mucus, sensation, and color be charted;
because intramenstrual bleeding may be
associated with ovulation.
Observational ~otations'
On L & VL days of bleeding
mucus & sensation:
H - heavy flow
M - moderate flow
L - light flow
VL - very light flow
Categories of DRY:
0 - DRY
2 - damp without lubrication
2W - wet without lubrication
4 - shiny without lubrication
Categories of PEAK type mucus:
(Sensation of lubrication only nothing can be finger tested)
Color of Mucus:
B = Brown or R = RedIPink indicates the
presence of blood. These colors may be
seen close to ovulation day accompanying mucus, or a day or two before
menstruation begins or as it is ending. If
you see these colors on the tissue on a
L or VL day at the end of menstruation,
and there is no mucus present or lubrication you may consider it a dry day. If you
see these colors anywhere else in your
cycle you must consider yourself of peak
fertility and count 3 days after the last day
brown or pink was seen. This is unusual
bleeding. Consult your Practitioner
whenever there is unusual bleeding so its
significance can be discussed.
C = Cloudy mucus includes white, opaque, or
creamy colors.
CIK = CloudylClear is mucus that is partly
cloudy and partly crystal clear.
K = Clear is mucus that is crystal clear.
---
Sticky Cloudy = 6C
Sticky Clear = 6K
Tacky Clear = 8K
Notation of Cervical Changes: Mark your notations in the space reserved for miscellaneous
symptoms. The cervix is soft and open when you
are fertile. It is hard and closed when you are
infertile. These changes occur gradually over a
number of days, and can help confirm mucus
observations in situations where there is
confusion.
Charting
Charting
Every woman's fertility follows a predictable pattern based on human physiology. Within those
basic physiological parameters your cycle will unfold. Your charts will be a concrete record of your
body's unique expression of its fertility.
Whether you use the Justisse Method as a
health record, or as a means of avoiding or achieving pregnancy, careful and accurate charting are
important for confidence and success.
There are two kinds of mucus you may observe,
peak and non-peak. Both are fertile. It is important to understand their differences for charting
purposes. These definitions are located on the inside of your chart for easy reference. Peak mucus
is cervical mucus. Non-peak mucus is a combination of cervical mucus and vaginal cell sluff.
Mucus Definitions"
Peak Type Mucus is
any mucus discharge that is clear, stretchy
or lubricative.
Non-Peak Type Mucus is
any mucus discharge that is not clear,
stretchy or lubricative.
The Peak Day is
the last day of any mucus discharge that
is clear stretchy or lubricative.
The inside of your Justisse Method chart contains spaces for the date the cycle began, the appropriately colored stamp, sensation, descriptions
of the most fertile observation of the day, and
miscellaneous symptoms, stress, or illness. If you
are recording basal body temperature there is a
special Justisse Method chart that has a graph
for plotting temperatures, and a space to note how
and at what time of day the temperature was
taken.
Day of Cycle
Day 1 of the cycle is the first day of
menstruation.
Day of Month
Underneath Day 1 of the cycle mark the date
menstruation began.
Stamps
There is a place for a stamp on each day.
Choose the stamp that corresponds with your
observations for that day.
Red is for days of bleeding.
Green is for DRY category.
There are also Yellow stamps used for management of continuous discharge. These are given
on special recommendation by your Practitioner.
Yellow represents an infertile mucus
observation based on identification of a
basic infertile pattern (BIP)
Charting
Charting
Sensation
Mark down the most fertile sensation of the day
in the space marked sensations.
D = DRY
S = smooth
L = lubrication
Lubrication is the most fertile sensation. Smooth
may be associated with either the presence or
absence of mucus. If you feel a smooth sensation and there is no mucus present, it has the
same significance as a dry observation. If you feel
a smooth sensation and there is mucus present,
then smooth is considered fertile.
--
Ii
@@
The Count of 3
The stamps used within a count of 3 will be
a white triangle on green, or a white triangle on
violet. The color you use corresponds with that
day's observation. If the observation is dry
category use a white triangle on green. If the
observation is non-peak use a white triangle on
violet.
Ovulation does not always occur on peak day.
In 95% of women ovulation occurs within 2 days
before peak, on peak day, or within 2 days after
peak. In 5% ovulation can occur as late as the
3rd day after peak. For that reason you must count
3 after peak day.
The count of 3 after an unusual bleeding
episode is neccesary because unusual bleeding
commonly accompanies ovulation, or ovulation
may follow very quickly.
It takes three days for the vagina to return from
alkaline to acidic following a mucus pattern. It is
therefore important to count 3 after three days or
more of non-peak mucus. During those three days
there will be sufficient alkalinity for sperm survival.
It is also possible for 3 or more days of non-peak
mucus to accompany ovulation.
Charting
Miscellaneo.usSymptoms
There is space on your chart to record
miscellaneous symptoms commonly associated
with ovulation and/or menstruation.
Mark down any symptoms such as headache,
mood change, abdominal pain, breast tenderness,
libido change, etc. These symptoms can help in
the interpretation of your chart. You may or may
not experience them. If you find any symptom
recurs regularly at certain times in your cycle it
is worthwhile making a note of it.
D
OAD
D
OAD
D
OAD
D
OAD
OAD
Charting Example
In one cycle Sue experienced the following observations. These are the correct stamps and
descriptions she used.
The first five days of her cycle she bled. The first
two days were heavy, the third was moderate, and
the fourth and fifth were very light. On the very
light days her sensation was dry and she saw only
a damp area on the tissue every time she
checked.
Charting
I ovulation
TEMPERATURE
If vaginal temperatures are used, the thermometer must remain in place for 5 minutes. Oral
temperatures may be taken with a glass/mercury
basal body temperature thermometer or a BBT
digital readout thermometer. If the glass thermometer is used orally, it must be left in place
for 7 minutes. The digital thermometer takes approximately 2 minutes. The digital thermometer
will beep when the reading is complete. The digital
thermometer can be used vaginally, though it is
not designed for the vagina.
You take your first temperature of the cycle on
day 5 of your cycle and take it everyday thereafter
until menstruation begins. The day to day
temperature readings are not as important as the
overall picture of the cycle. You are waiting for
your temperature to shift from a low phase to a
high phase. The shift indicates ovulation has
occurred.
0 vaginal
0 oral
(5 minutes)
(7 minutes)
. . ...
BBT shift
The preovulatory temperatures are low, and remain more or less the same. When ovulation occurs the shift in temperature to the higher
postovulatory phase is obvious. When you have
counted three consecutive normal high
temperatures you have confirmation that ovulation has occurred. You are now infertile until
menstruation. Postovulatory temperatures remain
high until menstruation.
L'
BBT thermometer
Charting
Accomplishing Your
lntentions with
The Justisse Method
Fertility Awareness
Fertility Management
If you are using the Justisse Method to either
avoid or achieve a pregnancy then fertility
awareness facilitates fertility management. For
women of normal fertility it is a simple matter of
identifying times of fertility and infertility and using them according to their intention.
Charting is helpful if there is difficulty in achieving a pregnancy. Charting can reveal the reasonls
for subfertility or infertility. Whether the difficulty
is anovulation, limited mucus, tubal blockage,
suspected male infertility, or some other, the chart
is a non-invasive diagnostic tool. It forms a picture that helps to isolate the problem and thereby
give guidelines for regaining fertility. Subsequently
it is a guide to evaluate the effectiveness of any
given treatment.
Avoiding Pregnancy
In order to avoid pregnancy, use only infertile
days for intercourse or alternative sex. The
method is 99.6% effective to avoid pregnancy
when only infertile days are used for intercourse.
Achieving Pregnancy
If your intention is to become pregnant use days
of fertility for intercourse. If you and the man are
of normal fertility, and you use fertile days for intercourse there is a 75% chance of becoming
pregnant in the very first cycle used. There is a
100% chance of becoming pregnant by 6 cycles.
If you or the man are experiencing problems with
fertility, your success to achieve pregnancy varies
depending on the treatability and severity of the
problems.
plishing
Defining Days
of Fertility and Infertility
The definitions for days of fertility and infertility
are outlined to help you accomplish your
intentions.
At the end of Chapter 7 you will find sample
charts entitled "Basic Charting". These charts are
illustrative of how fertile and infertile days are
defined, according to correct use of stamps and
notations.
For easy reference all basic charting considerations are outlined in point form first. A detailed
discussion for each point follows.
2.
Chart daily at the end of your day, and note the most fertile sign of the day.
3.
When starting to chart avoid intercourse and alternative sex until you are
confident.
4.
Times of fertility
a. Moderate and Heavy days of the menstrual flow.
b. Non-Peak mucus days.
c. Peak mucus days.
d. Any days within a count of 3.
e. Any days of unusual bleeding plus count 3.
5.
Times of infertility
a. Light and Very Light days of the menstrual flow when no mucus is present.
b. All Dry days except those within a count of 3.
c. The days following your third normal high temperature until menstruation.
6. "Double Peak
a. When experiencing stress or illness be watchful for a "Double Peak".
b. If your temperature has not shifted after experiencing a Peak anticipate
a "Double Peak".
7.
8.
9.
Breastfeeding
a. When TOTALLY breastfeeding, the first 56 days after the baby's birth are
infertile.
10. A BASELINE may be drawn after observing a temperature shift of 3 consecutive NORMAL high temperatures that are higher than the previous
6 low temperatures. The baseline is drawn one graph space above the
highest normal low temperature. All postovulatory temperatures should
be above the baseline.
31
and accurately.
Your ability to identify the times of fertility and
infertility is directly dependant on regular and
accurate observations. Complacency about the
observational routine interferes with successful
use of the method, and lowers your confidence
and ability to interpret your chart.
A good routine for observations means checking for mucus 100% of the time before and after
urination, before and after bowel movements,
before and after bathing, before going to bed, and
checking if you get up at night to urinate. A good
observation is made by using flat layers of tissue,
wiping from front to back, deciding the sensation
before looking at the tissue, finger testing the
tissue for mucus, and mentally logging it for
reference when charting at the end of the day.
100% regular and accurate observations means
100% confidence.
4. Times of fertility
a. Moderate and heavy days of the
menstrual flow.
It is possible for cervical mucus to already be
present on the moderate and heavy days of
menstrual flow in short cycles. Short cycles do
occur. The endometrial fluid present in the heavy
and moderate menstrual flow looks very much like
cervical mucus, and has a lubricative sensation.
Therefore the endometrial fluid could be confused with cervical mucus if it is present. Because
an accurate observation can not be made, these
days are to be considered fertile in order to err
on the side of caution for those avoiding
pregnancy.
b. Non-Peak mucus days.
The change from dry into non-peak mucus
marks the beginning of fertility. Non-peak mucus
is fertile. Ovulation can be associated with a nonpeak mucus day.
When there are 3 or more days of non-peak
mucus, the acidic environment of the vagina
changes to alkaline, and remains so for three days
following. An alkaline environment enables sperm
survival and transport. Therefore, when the nonpeak mucus returns to dry you must count 3. You
do not have to count 3 after only one or two days
of non-peak mucus.
Accomplishin!
5. Times of Infertility
a. Light and Very Light flow days of the
menstrual flow when no mucus is present.
On the light and very light days the majority of
the endometrial tissue and fluid has been shed,
and now there are only traces left to be discharged. These traces will not produce a lubricative sensation unless cervical mucus is present.
If the sensation is lubricative or mucus is present
during the light and very light days of the
menstrual flow you are considered fertile. If you
are dry then you are considered infertile. Mucus
may be present on the light and very light days
of the menstrual flow in short cycles.
b. All dry days except those within
a count of 3.
lntercourse in the preovulatory phase of the
cycle should occur nights only, as you need the
whole day to determine whether or not you are
dry.
6. "Double Peak"
a. When experiencing stress or illness
be watchful for a "Double Peakn
It may happen that rising levels of estrogen are
inhibited by stress, or illness. When this happens
you may experience a mucus pattern that builds
up to a peak yet ovulation is delayed. Once the
stress or illness is relieved ovulation follows. If you
have not ovulated you will see mucus return. If
you have ovulated you will see menstruation
within 9-17 days, not another mucus pattern.
9. Breastfeeding
a. When totally breastfeeding, the first 56
days after the baby's birth are infertile.
The earliest ovulation recorded in a total
breastfeeding situation has been at 73 days after
the baby's birth (10 weeks). Therefore considering the first 56 days (8 weeks) infertile takes into
consideration possible deviations. Total
breasffeeding is defined as: the baby's only
gratification is received from the mother's breast,
with the occasional sip of water.
The three high BBTs must be normal. Disturbances such as illness, taking your BBT too late,
not enough rest (5 hours minimum), or excessive
alcohol consumption the evening before, can give
a false high temperature. Temperature readings
during a disturbance are disregarded when drawing the baseline. It is important when counting
three high temperatures that disturbances are
taken into consideration. If there is doubt that the
temperature shift is normal, WAIT until the
disturbance has passed before counting three. In
the meantime continue with regular and accurate
mucus observations, as mucus will guide you
through these disturbances. Usually a false high
temperature due to a disturbance will stay high
for only one or two days. The exception to this
is a flu or cold that lasts more than one or two
days.
-er Charting
nsideration:
Other
Charting Considerations
Continuous Discharge
Yellow Stamp Management
Any woman experiencing a continuous
discharge will need special attention. Each
woman in this situation will be unique, therefore
management is based on individual mucus patterns. Experience has shown that by working with
a Fertility Management Practitioner a woman will
be able to confidently identify when her discharge
is fertile and when it is not.
Part of the management for continuous
discharge is the use of yellow stamps. Yellow
stamps are used to indicate discharge that has
been identified as infertile based on a BIP (basic
infertile pattern) within the mucus discharge.
Violet and purple stamps are used for identification of the "true" mucus pattern. The situations
when woman may experience continuous mucus
discharge are: cervicitis, breastfeeding, early
postpartum, and coming off the Birth Control Pill.
Cervicitis and Continuous Discharge
Cervicitis is an inflammation of the cervix. Either
the external area of the cervix or the inner canal
of the cervix may be affected. Most commonly cervicitis is caused by an infection. The infection may
be a sexually transmitted disease, or caused by
other bacteria or viruses. Cervicitis can be either
acute or chronic. Chronic cervicitis results in a
characteristic type of cervical discharge. This
discharge occurs throughout the course of the
menstrual cycle and is not related to fertility.
Sometimes the cervix undergoes other changes
known as ectropion and/or eversion. The tissue
lining the canal of the cervix protrudes into the
vaginal surface of the cervix. When this tissue
makes contact with the acidic fluids of the vagina
the cervix becomes inflamed. This is particularly
true during the infertile phases of the woman's
cycle. During fertile phases, the estrogenstimulated cervical mucus creates an alkaline environment in the vagina, which temporarily arrests
cervicitis. When the vagina becomes acidic again,
during the infertile phases, the inflammation
returns. With ectropions or eversions the cervix
For two reasons a woman may experience continuous discharge during the breastfeeding or
postpartum period: her cervix may still be healing or there may be arousal fluid present. If a
woman's cervix has been damaged during the birthing process it may take several weeks or even
months to heal. Sometimes there is an ectropionleversion or cervicitis present. These conditions generally correct themselves as the cervix
heals. Until then a woman can use yellow stamp
management to interpret her mucus.
Part of the body's response to the suckling action of the baby at the breast is the production
of arousal fluid. Since a child may be nursed many
times a day in the early months it is possible to
mistake this arousal fluid for a mucus pattern.
With the help of her Fertility Management Practioner, she can learn to recognize the difference.
Infertility
Generally infertility is defined as the inability to
achieve pregnancy within one year. Infertility is
a problem that is shared equally by women and
men. The Justisse Method helps to identify the
Breastfeeding
Prolactin is a hormone produced by both pregnant and breastfeeding women. Prolactin levels
increase throughout pregnancy reaching their
highest level just before birth. Every time the baby
is suckled at the breast prolactin is released. Prolactin supresses the production of estrogen,
thereby inhibitingovulation. Without suckling, prolactin levels fall abruptly. With suckling, prolactin levels are maintained. The chance of ovulation occurring is directly related to prolactin levels.
With high levels of prolactin, there is less chance
of ovulation. With low levels of prolactin, there is
a better chance of ovulation. Each woman's
response to varying levels of prolactin is unique,
as will be reflected in her charts. Ovulation may
or may not occur prior to the first bleeding episode
postpartum.
1. Total Breastfeeding
Partial breastfeeding begins with supplemental feeding. When a baby gets nourishment (juice,
formula, solid food) or gratification (pacifier) from
a source other than the breast, even if only occasionally, weaning has begun. With partial
breastfeeding signs of fertility will return sooner
than in the total breastfeeding situation.
If partial breastfeeding is used immediately
postpartum the first 27 days are considered infertile. Charting should begin immediately if a
woman is not totally breastfeeding.
3. Fertility Returns
- Breastfeeding
Climacteric
- menopause
Arousal Fluid
In women arousal fluid is a discharge that
comes from the Bartholin's glands located just inside the vagina. It is produced in response to sexual stimulation. The fluid is designed to facilitate
intercourse and at this point in time has no known
relationship to fertility.
Arousal fluid is usually experienced as a
lubricative feeling with a cloudy or clear color. It
tends to dissipate quickly, lasting only 30 minutes
after sexual arousal ends. If you are confident that
you are noticing arousal fluid you may ignore it.
If in doubt, consider yourself of peak fertility and
count three.
Male arousal fluid is produced by the Cowper's
gland located just below the prostate gland. Male
arousal fluid is also known as preseminal or preejaculatory fluid. It is produced in response to sexual stimulation and is designed to facilitate intercourse and to alkalinize the urethra. Once the
urethra is alkalinized, a favorable environment is
made through which sperm can pass. A man's
arousal fluid is considered fertile, because it may
contain viable sperm.
- SET
Sample Charts
The charts on the following pages are samples
of different types of cycles. Each woman's fertility has a unique expression. The sample charts
are not intended to show what should happen, but
rather what is possible.
Misc.Symptoms;
Stress/lllness:
Stamps
'
'
'
'
'
'
'
'
'
'
'
'
Days from the onset of mucus plus count of 3 from PEAK are fertile.
,
:
,
!
,
:
,
!
,
!
. . . .
;aiaiai.iai.ieie:,eieieje:aja;a;@j@;~;~;~i~;a
;
n ~
Basic Charting
:;
:;
I;
Stamps
Stamps
- -
Basic Charting
Stamps
stamps
;@;@;@;@;@;@;@;@;.;@;@;@f@;@;@;e;@j@;@;@;@
..........................................................................................................................................................
,
,
8
Stamps
~@\@i~i~;@i@ie;@i@i~i@~~~;~i@i$i@i@i@i@;@;ei@
...........................................................................................................................................................
Sensat ion
: S : S : S : D : D : D : D : D : O : S : S :1
L 5 : s : D l O : D : D : D 1D : S : S : L : L : S : S : D : IDD : D 1 D : D : D : D : D: :
:6C: 6C18C '
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6 C ~wD~m4wl
~ ~ ~ ~ o ~ O A6 C~: fk:
O A8ICi
o lj O C i 6 p ~6i ~ ~ p j w D j o L D j o A D j ~
:x2ix2ixI P * ~ ~ O L D ~ ~ * D ~ W ~ D ~ 6c
Q I jxZjx,
~ 1 I0 k:X,
,
,---,---:---:---:---:----I---1---:---,---,---,---:---1---v---8---:---:---:---1---,---,---:---,---,---:---:---:---:---:---:---:---:---:---:
,
,
~3iXZiAX
o I~:AD:YI
--------------;---:---;---)---I---:---:---;---;---%-------;---:---a---a---;---;---;---;---:---;---;---;---;---;---;---:---;---;---;---;---:---:---;---;--,
0
Description
______-_---_--I--_
~OADA
.---;---:---;---*
.---:---:---;--;---:---:---:---;
:16':17 : I 8 :19 :20 :21 :22 :23 :24 :25 :26 :27 :28 :29 :30 :31 :32 133 :34 :35
.....................................................................................................
Day of Cycle : 1 : 2 1 3 : 4 1 5 : 6 : 7 : B 1 9 :10 :11 :12 113 114 :15
.........................................................................
--------------:---:---;---j---;--:---:---.---:---;---;---;---;--:---:---:---.
......................................................................................................
: 1 : 2 1 3 : 4 : 5 : 6 : 7 : 8 :
--------------:---:---'---:---;---:---:---;---.---;---.
Day of Cycle
___-__-_------(
:D:D:
Stamps
:I
.:
9 : l o 111 :12 113 :14 115 :16 :17 :18 119 :20 :21 :22 :23 :24 125 :26 :27 128 129 :3O 131 :32 :33 ;34 :35
,---;---:--7;---;---;-F-;---;---;---;---;---;---;---;---;---.
,---:---;---:---:---;---;---;---;---:---*---. ,
: D : D : O : D : S : S : L : L : 5 : D : b : D : Q ::
,
:
,---:---;---;---;---;---;---.---:---I---I---:---:---:---'---'---.---:-8
rn
. . . . . . . . .
-------------;---:---;---;---:---;---;---;---'---:---'---~---;---'---'---;---'---;---'
Sensat ion
: D : D : D 1 D ~ D : D : ~ : D ~ D : D
,---:---:---;---:---;---:---:---:---;---;---;---;---;---;---;---;---;---.
~ D : D : D : D ; ~ : D ~ D i ~ : D : S ; D : :~ ; : ~ :: s : D : : S: ; :~ ;
..................................................................................................................................
Description
:VL ' V L :
'
:---:---:---:---:---;---:---;---;---;---:---:---;---:
............................................................................................................
Sensation
--------------;---:---:---:---:---;---;---;---;---:---:-------;---;---;---;---;---;---;---,
Infertility
~
,---:---:---:---:---:---;---;---:---:---;---:---:---:---:---:---m
~j
,---;---:---:---;---:---;
j ~j
j ~j
j ~j
j f
stamps
:1
Stamps
: 1 : 2 : 3 :4
--------------;---;---.---:--;--Day o f Month :
:
:
:
Day o f Cycle
--------------:---:---:---:---:---
Stamps
Stamp
i~~@;@i@;@~@:a;aia;~~~j@;@jaja;@;a;@
TEMPERATURE
;bll vaginal
D oral
usual t i m e taken
?:OD
S t amp
--------------;---;---;---;-------;---;---;---;---;---;---;---;
Sensat i o n
:o i
--------------;---:---;---,---,---,---,---,---,---:---:---;-.--:----:---'
~ : ~:
:~
Example # I
Previous Cycle Lengths For 6 Cycles:
27,29,28,28,29,27
shortest cycle = 27
longest cycle = 29
27
29
- 20 = 7
- 10 = 19
28
43
20 = 8
10 = 33
Calendar Rhythm
Calendar rhythm was the first natural birth
control method developed. The independant
works of Ogino and Knaus in 1929130 determined that the postovulatory phase is stable. They
realized that menstruation consistently followed
ovulation by approximately 14 days. Based on that
information they developed calculations to determine probable times of fertility.
The woman needs the length of 6-12 previous
cycles to begin using the method. The formula
to calculate probable times of fertility the calendar way is:
Bioself
Bioself is a small hand held instrument. It is a
combined computer and BBT thermometer, that
keeps track of a woman's cycle lengths and BBT
curves. Using this information it calculates
probable times of fertility and infertility. A small
light flashes red or green to let the w m a n know
what phase of her cycle she is in. The information can be printed out for a permanent record.
It is best used by women who have cycle lengths
that vary no more than eight days from cycle to
cycle, and women whose cycles range from 19
to 39 days in length. For these women, it can be
a reliable means of avoiding or achieving
pregnancy. Women who use Bioself are also encouraged by the dealers to be aware of cervical
mucus symptoms, though there is no Bioself
system for recording them. Bioself can be purchased world wide.
References
References
Adess Nancy et al: Fertility And Pregnancy
Guide For DES Daughters And Sons: DES Actionlcanada, 1983.
@
Billings John J.,M.D.: The Ovulation Method: Advocate Press Pty.Ltd., 1980.
Pfeiffer Regina Asaph & Whilock Katherine: Fertility Awareness, How To Become Pregnant
When You Want To And Avoid Pregnancy
When You Don't: Prentice-Hall Inc., 1984.
@
Roland Maxwell, M.D. editor in chief: International Journal Of Fertility Vol 26:
No.3-lnternation Foundation For Studies In
Reproduction Inc., Scandinavian Association For
Studies In Fertility And International Federation
Of Fertility Societies, 1981.
@
Mishell Jr. Daniel R., M.D., Davajan Val, M.D.: Infertility, Contraception and Reproductive Endocrinology, Second Edition 1986.
@
Footnotes
Footnotes
1 The observational check list, how to wipe
the vulva, 3 steps in checking mucus "SOFT', and
the 3C's in checking for mucus are a modification of the Ovulation Method Creighton Model's,
observational routine, how to wipe the vulvar area,
3 steps in checking for mucus "SOFT', and 3C's
in checking for mucus. The Ovulation Method
of Natural Family Planning 2nd Ed., Tom W.
Hilgers, M.D.: Pope Paul VI Institute, 1983.
@
Notes:
Other Instructions:
Notes:
Other Instructions:
Notes:
Other Instructions:
Notes:
Other Instructions:
Other Instructions:
Notes:
Other Instructions: