Blog of the Society for Menstrual Cycle Research

A doc about birth control, #LiveTweetYourPeriod, and other 4th of July weekend links

July 4th, 2015 by Laura Wershler
  • It’s old news that men find women’s faces more attractive when they are fertile, but the facial cues to explain this have eluded researchers. A new study from the University of Cambridge, as reported in the Science Daily, shows that women’s face skin gets redder at the point of peak fertility. However, as this change in face redness is too subtle for the human eye to detect, skin colouration has been ruled out as the reason for this “attractiveness effect.” Dr. Hannah Rowland, who co-led the study, said, “Women don’t advertise ovulation, but they do seem to leak information about it, as studies have shown they are seen as more attractive by men when ovulating.” The mystery continues.

When Elynn Walter walks into a room of officials from global health organizations and governments, this is how she likes to get their attention:

“I’ll say, ‘OK, everyone stand up and yell the word blood!’ or say, ‘Half of the people in the world have their period!’ ”

It’s her way of getting people talking about a topic that a lot of people, well, aren’t comfortable talking about: menstrual hygiene.

Changing Attitudes on Menstruation in Australia

February 10th, 2015 by Saniya Lee Ghanoui

Guest Post by Rosie Sheb’a

Many questions have come up recently about why my focus is on Australia, when there are so many places that appear “worse off” than we are that I could be focussing my attention on. You may have seen the recent media coverage (Huffpost, Upworthy and the likes) about the great stuff happening with menstrual cups in Africa. These posts get so much attention not only because they are in popular media, but because they give the reader that “feel good” sensation that there are people doing worse than them, and that someone is out there helping them. However, I feel that here in Australia, in the area of menstruation and women’s knowledge of our own bodies, we are actually doing pretty abysmally.

Most women I speak to (who haven’t used a cup) don’t even know what their cervix is, let alone how to find it. Many Australian women don’t know that if they tense their body in fear, or lie really still, it makes cramping worse. Women haven’t been told that opening up the pelvis, and moving around while breathing deeply and slowly out is a really good way to release period pain. Until I started using and researching menstrual cups, I didn’t realise myself just how amazing periods can be, and how important it is to understand how our bodies work. One of the biggest barriers I have come across with women using menstrual cups, is their fears of what can happen. “What if it gets lost?” The impossibility of this due to the vagina having an end is not understood. Many Australian women don’t realise their vagina has muscles that they can use to push things out with.

We have an epidemic in Australia. It is the fear of the uterus, vagina and their inner workings. We treat it with The Pill. We treat it with Nurofen, Paracetamol, and Codeine. We treat it with Implanon, white bleached tampons and pads, and most of all – we treat it with silence. We leave the room, or tell our friends to keep their voices down if they dare speak about it in a public place. We shield our children from the topic, and we make up names to cover up the shame of speaking about something that without it, none of us would be here. Europe is years ahead with “period positive” talk and action, so is Canada, America is catching up, and even in parts of Africa the women know more about their bodies than we do. It’s time Australia woke up too.

This is my mission with Sustainable Menstruation Australia. To open the conversation about menstruation. To share knowledge, and learn from our friends, colleagues, families and lovers. To move from a culture of fear, shame and taboo, to one of celebration for the beautiful and powerful ability we have as human beings who menstruate. Menstruation is not just about reproduction. When we get in touch with our cycles, it becomes a powerful tool to use in our lives every day. We know when we are likely to be feeling certain ways due to the cocktail of hormones (or lack thereof) coursing through our veins. We learn that certain times of our cycle are going to be really awesome for networking, making connections and growing projects and plans. Other times are going to be great for self-reflection, reassessing our lives and taking good care of ourselves. Our cycles give us a brilliant road map to help our lives. And when we release the fears and tensions associated with menstruation, the pain starts to ease. We can participate in swimming, sports, work and other areas of our lives that felt impossible. Pain, fear, shame, and the copious amounts of waste through disposable products and menstruation are not Sustainable. Not for ourselves, our communities or our planet.

There is light at the end of the tunnel. That light is in the form laughter, liberation and learning. Our bodies can be celebrated, not feared. We can use products that don’t pollute our planet or make a large dent in our budget. We can love our bodies, relax into them and honour our cycles. We can use this knowledge to become more powerful and in control of our lives. There is a revolution afoot, and Australia is getting on board. It’s learning to love our bodies again. Our cycles. Our selves. Our planet. Let’s celebrate.

Women’s Need for Accurate Information About Birth Control Gets Lost in Controversy over Zimbabwe Official’s Speech About Dangers of Birth Control

July 18th, 2014 by Saniya Lee Ghanoui

Guest Post by Carol Downer

One side of the population controller establishment, the “pro-natalist”, says they’re concerned about our health, when, in reality, they just want us to have more babies; the other side, the “anti-natalists”, says they’re concerned about our health when, in reality, they want us to have fewer babies. Who’s “facts” do we believe?  Or, whether we believe their facts or not, do we believe they’re concerned about our health, or that they’re cloaking their national and international policy debates about the impact of birth rates on national aspirations or economic growth in the neutral garb of a discussion about women’s health.

A recent flurry of supposedly neutral health discussions and commentary was provoked when a pro-natalist Zimbabwean official told his countrywomen “to multiply” in order to be a “superpower” and warns that birth control can cause cancer, a supposedly objective “fact checker group”, Africa Check, rushed to allay women’s fears about oral contraceptives and cancer, and Bustle.Com chimes in support.

Africa Check wrote a critical article about two main assertions by Zimbabwe Official Tobaiwa Mudede on May 25 at the celebration of Africa Day. It ignored his first assertion that the promotion of birth control is a ploy by western nations to retard population growth in Africa, and then it found that when he says that contraceptives can cause cancer, his facts are right, however his advice to women to stop using contraceptives were “misleading and alarmist”.

They rely on WHO’s cancer and research agency, the International Agency for Research on Cancer (IARC), who confirmed that there can be a link between the use of oral and injectable hormonal contraceptives and particular types of cancer, increasing the risk in some cases and lowering it in others. Dr. Elvira Singh of IARC concluded that Mudede’s comments are “alarmist”.

Shortly thereafter, Abby Johnston of, sums up the WHO’s position as “the benefit far exceeds the risks” with contraceptive use, and mis-quotes Africa Check in saying that “the higher the birth rate in a country, the higher the maternal mortality rate”. Fact? Africa Check said that the UN only said the dangers of having more children could result in increased mortality rate. Johnston reveals her true concern, which is that African women are having too many babies in her statement, “Access and education on birth control is particularly important in areas facing overpopulation.”  She presumably means Africa. African women, just as much as other women, need to have an unbiased comparison of all methods of birth control;

Methinks that the reason that Africa Check didn’t check the facts concerning Mudede’s allegation that “there are those in the West that push birth control is because they fear population growth in Africa” is based on fact, as the article reveals.

There isn’t much written about or by the population control establishment for the general reader. (There is an extensive scientific literature published by demographers -demography is the study of populations, including birth control, migration and immigration). I urge supporters of women’s reproductive rights to read “Quiverfull” by Kathryn Joyce, a contributing reporter for Nation Magazine. Joyce gives a road map to the Christian Patriarchy Movement” in America that forms the popular base for the pro-natalist politicians. Given the tidal wave of T.R.A.P. laws (Targeting Abortion Regulation Providers) in various states, and the recent Supreme Court decisions that promise to sharply restrict accessibility of abortion, I think it is important for us to face the influence of the growing pro-natalist movement in the United States. At the same time, I think we need similar research and analysis of the antinatalist movement, both national and international, who oppose it. My review of Quiverfull is at

Save the Date! The Next Great Menstrual Health Con

June 16th, 2014 by Chris Bobel

Depo Provera and menstrual management

April 8th, 2014 by Holly Grigg-Spall

Melinda Gates speaking at the London Summit on Family Planning; Photograph courtesy Wikimedia Commons

A few weeks back I did an interview with Leslie Botha regarding the distribution of Depo Provera to women in developing countries. Recently Leslie shared with me an email she received from someone working in a family planning clinic in Karnataka, India. He described how he was providing the Depo Provera injection to women and finding that, after they stopped using it, they were not experiencing menstruation for up to nine months. He asked for advice – “what is the procedure to give them normal monthly menses….is there any medicine?”

I have written previously about one potential problem of providing women with Depo Provera – the possibility of continuous spotting and bleeding that would not only be distressing with no warning that this might happen and no medical support, but could also be difficult to navigate in a place with poor sanitation or with strong menstrual taboos. As women in developed countries are so very rarely counseled on side effects of hormonal methods of contraception, it seems unlikely women in developing countries receive such information. As we know, some women will instead experience their periods stopping entirely during use of the shot and, as we see from this email and from the comments on other posts written for this blog, long after use.

In this context I find it interesting that the Gates Foundation’s programs for contraception access have a very public focus on Depo Provera. The method was mentioned again by Melinda Gates in a recent TED interview and when she was interviewed as ‘Glamor magazine Woman of the Year’ the shot was front-and-center of the discussion of her work. Yet the Foundation also funds programs that provide support for menstrual management and sanitation.  Continuous bleeding from the shot, or cessation of bleeding altogether, would seem to be an important connecting factor between these two campaigns.

Much has been written on the menstrual taboo in India and how this holds women back. In the US we have come to embrace menstrual suppression as great for our health and our progress as women. We see menstruation as holding women back in a variety of ways. However, in India could lack of menstruation also be seen as a positive outcome? Instead of dealing with the menstrual taboo with expensive programs that provide sanitary products and education, might suppressing menstruation entirely be seen as a far more cost-effective solution? It may seem like a stretch, but I am surprised this has not been brought up during debates about the need for contraceptive access in developing countries. Yet of course, the menstrual taboo may well extend to absence of menstruation – a woman who does not experience her period might also be treated suspiciously or poorly.

When Melinda Gates says women “prefer” and “request” Depo Provera I always wonder whether that’s after they’ve been told how it works (perhaps described as a six-month invisible contraception) or after they’ve had their first shot or after they’ve been on it for two years and then, via FDA guidelines, must find an alternative? How much follow up is there? As the self-injectable version is released widely how will women be counseled? Gates argues that the invisibility of the method is part of the draw as women do not have to tell their partners they are using contraception, but what happens when they bleed continuously or stop entirely?

It seems to me like there might be a real lack of communication – both between medical practitioners and their patients, drug providers and the practitioners, and those who fund these programs with everyone involved. It is often argued that the risks of pregnancy and childbirth in developing countries justify almost any means to prevent pregnancy – including the use of birth control methods that cause health issues. How much feedback are groups like the Gates Foundation getting on women’s preferences if they seem to be so unaware of the potential problems, even those that would greatly impact their wider work?

Choice, Fertility, and Menstrual Cycle Awareness

April 2nd, 2014 by Laura Wershler

Guest Post by Lisa Leger

Photos courtesy Lisa Leger

Posing while pregnant in my pro-choice T-shirt in 1993 was a political statement, one I made with a huge sassy grin on my face. When I recreated the pose recently on my daughter’s 21st birthday, I found it easy to reprise the grin. First take, in fact. My choice tee is well worn; it’s a house/jammy shirt that my daughter has seen me in her whole life. Little does she know that she’s had her nose wiped by a piece of Canadian history.

I bought the choice tee at a fundraiser in Toronto when the Ontario Coalition for Abortion Clinics was helping Canadian abortion rights crusader Dr. Henry Morgentaler with legal expenses when he was forced to defend in court his practice of providing safe abortions in a free-standing clinic. At the time, abortion was legal in Canada, but only if approved by a Therapeutic Abortion Committee and performed in a hospital. I was 27 years old, fresh from university, and a legal abortion had allowed me to finish my degree unburdened by an unplanned pregnancy, but I supported fewer restrictions to access.

Like most twenty-somethings, I had a long history of contraceptive use. I’d tried the pill, an IUD, and even the rhythm method, a fuzzy grasp of which I probably had picked up in a public school health class. I had a rotten attitude about my fertility, saw it as a huge hassle, and had no interest whatsoever in becoming a mother. My social and political opinions about the right to reproductive choice were fully formed when I bought this T-shirt for the cause I so ardently supported.

I was 32 years old when I posed in it while pregnant. By then I’d been charting my menstrual cycles for enough years to have improved my attitude about fertility dramatically. I’d met Geraldine Matus in the late 80s and learned to use the Justisse Method for Fertility Awareness that she developed. It changed my life forever; not only did I gain body literacy, develop a healthy relationship with my cycling body, and break free from contraceptive drugs and devices forever, I also gained a cherished mentor in Geraldine, and a career path as a Justisse fertility awareness educator that has sustained and gratified me for the past 25 years.

I took that picture in my choice T-shirt in 1993 because, for me, it says “I’m choosing to be pregnant.” I grinned because it was my choice to have Clair; I wasn’t scared or forced or coerced into that pregnancy. It was entirely my free will to lend my body to the great task of having a child and I made that choice because of the healing that had gone on over the years of charting, coming into relationship with my body, and learning to appreciate the awesomeness of my pro-creative power. Now that my daughter is 21 years old, I think about the freedom and choices she has as a Canadian woman in 2014, and feel sadness for those who don’t have that choice. I reflect on what a shame it is that these battles over reproductive choice, human rights, access to birth control, stigma, and power seem never to be put to rest. On Clair’s birthday, I posed in my choice T-shirt for my family archives and for those who still do not have choice.

Lisa Leger is a Holistic Reproductive Health Practitioner (HRHP) and women’s health activist on Vancouver Island. She serves on the board of the Society for Menstrual Cycle Research.

Is the birth control pill a cancer vaccine?

March 11th, 2014 by Holly Grigg-Spall

I’d given up reading the comments on online articles for the good of my mental health when a small slip last week steeled my resolve. In response to an article exploring the arguments made by “birth control truthers” a concerned father decided to have his say, taking the defensive arguments put forward by those in opposition to these “truthers” to their only logical conclusion:

“Perhaps we should market contraceptive pills as hormonal supplements to reduce cancer risk instead of as “contraception”? After all, it is only in modern times that women have hundreds of menstrual cycles throughout their lives. Even up until 1800 it was common for women to be either pregnant or lactating throughout much of their short lives.

The body simply wasn’t built to handle so many menstrual cycles, which raises the risk for cancer.

Who could argue with taking supplements to prevent cancer?

This may sound strange, but I am seriously considering putting my 11 year-old daughter on the pill (with no placebo) just for the health benefits. I just have to convince my wife first who is a little shocked by the idea…”

I cannot count how many times I have heard that the birth control pill “prevents cancer” – specifically “preventing” ovarian and endometrial cancer.  In the last few months I have seen references to this benefit explained less and less so as a “lowered risk” and more and more so as a “preventative” action.  I think this is significant as the word “prevent” suggests that the pill guarantees you will not get these forms of cancer. And yet, to remark that the pill is counted as a carcinogenic substance by WHO – due on the increased the risk of breast and cervical cancers – will get you tagged as a “truther.”

What is interesting, of course, is that despite the “cancer protecting” benefits of pregnancy, and early pregnancy at that, we do not see women encouraged to get pregnant in order to lower their risk of ovarian cancer.  Criticism of child-free women does not generally include comments about their lax attitude towards their own health. The risk goes down further with every pregnancy and further still with breast feeding, especially breast feeding for a long period of time after birth. Women who have children young, and multiple children, have a lower risk of breast cancer than women who have no children or children after 30. Yet we see more talk of women having “too many” children at an age that is “too young” – in fact I was contacted via Twitter by someone who read this piece and who saw, in the comments, that one woman who uses natural family planning admitted to both liking the method and having 14 children. This admission disgusted the person who contacted me, even when I pointed out that it seemed the woman had very much chosen to have those 14 children.

It seems the people who are advocating prescription of the pill for cancer prevention purposes are not advocating women have children earlier, more children, or consider breast feeding for the good of their own health – in fact two of the loudest critics of my “birth control truther” book are vehemently against pregnancy and breast feeding being part of women’s lives (Amanda Marcotte and Lindsay Beyerstein). The risks of the pill are frequently compared to the health risks associated with pregnancy and child birth,  but we don’t often hear women say they are choosing to not have children to avoid putting their health at risk for nine or so months.

Which leads me to this article in the LA Times that suggested nuns should also be on the birth control pill for its cancer-protecting abilities:

“And are the pills really unnatural? Our hunter-gatherer ancestors had their babies four or five years apart, because of long intervals of breastfeeding. As a result of that and their shorter life spans, they had as few as 40 menstrual cycles in a lifetime, while a modern woman can have 400. Though we can’t claim that today’s pills are perfect, their use is certainly less unnatural than enduring the hormone turmoil of hundreds of menstrual cycles.

This brings us back to the Colorado nuns, the Little Sisters of the Poor. Nuns have a substantially higher risk of reproductive cancers than women who have children, in part because of their celibacy, which means a lifetime of uninterrupted menstrual cycles. In 2011, my wife and I attended an obstetric conference in the Pontifical University of the Holy Cross in Rome. The keynote lecture there recommended that nuns use oral contraceptives for two or three years after taking their vows, in order to benefit from a long-term reduction in reproductive cancers to which nuns are otherwise exposed by their celibate life.”

Of course, no one would suggest nuns should give up on God and get pregnant, despite the fact that their increased risk comes from not having children or breast feeding, anymore than the father of that 11 year-old would likely encourage his daughter to have multiple children before she hits 30.

The Big, Fat, Menstrual Untruth in Cameron Diaz’s The Body Book

February 5th, 2014 by Laura Wershler

I was curious. If Cameron Diaz’s purpose in writing  The Body Book: The Law of Hunger, the Science of Strength, and Other Ways to Love Your Amazing Body was empowerment, helping women to understand how their bodies work, would she include information about the menstrual cycle?

There was no way of knowing from her Jan. 22, 2014 radio interview with Jian Ghomeshi on CBC’s Q. I listened to Diaz explain that conversations she’d had and overheard in the last few years made it clear to her that women are completely confused about their bodies. She said this had her thinking, “Wow, that’s such a crazy thing that after so many years of living in your body that you actually don’t have an understanding of it.”

Then she revealed her intention in writing the book – to empower women to make “informed decisions about their nutrition and their physical activity.” Judging from this comment, the book’s subtitle, and the fact she did not mention menstruation during the interview, I wondered if the menstrual cycle would even be mentioned.

I sought out The Body Book at my local bookstore and quickly scanned the table of contents and index. I found myself smiling, thinking about Betty Dodson, author of Sex for One: The Joy of Selfloving, and how she revealed in Chapter 1 that whenever she gets a new sex book she “immediately” looks up “‘masturbation’ to see where the author really stands on sex.” Whenever I see a new book about women’s health I look up “menstruation” to see what the author really knows about the menstrual cycle. Turns out Diaz, and/or her co-author Sandra Bark, know both a lot and not so much.

In Chapter 21, Your Lady Body (the book’s introduction starts with the salutation Hello, Lady!), she presents a fairly accurate endocrinological description of the three phases of the menstrual cycle: follicular, ovulatory, luteal. So far so good. But then, in the last paragraph of the luteal phase section, comes the big, fat menstrual untruth, the implication that whether you use hormonal birth control or not, this is how your menstrual cycle unfolds. It’s an absolute falsehood, and one that many women in this age of burgeoning body literacy are sure to see through.

Photo Illustration by Laura Wershler
Note: This is the only reference to contraception in The Body Book

The last paragraph of this luteal phase description (page 182) is ridiculously misleading. If a woman’s birth control method is the pill, patch, ring, implant or (Depo-) Provera shot, the synthetic hormones each contains will shut down her normal menstrual cycle function. She most definitely will not experience a cycle with follicular, ovulatory and luteal phases. Hormonal contraception does not “protect” her eggs. She will not ovulate, therefore the egg will not die. She may have a “withdrawal bleed” but it is not a true period. This is the truth.

I can understand, possibly, why Diaz made this egregious implication. What were her choices? Open a can of worms? State categorically, as every description of menstrual cycle function should, that you don’t ovulate or experience a normal menstrural cycle while taking hormonal contraception? 
Maybe something like this?

Hey Lady! If you use hormonal birth control none of this fascinating menstrual information applies to you. Wish I could tell you what this means for your health and fitness but, sorry, that’s beyond my area of expertise.

If Diaz’s intention for this book is to empower women to better understand their bodies, then she failed when it comes to the menstrual cycle. I hope she’ll correct this big mistake in any future editions.

Food. Fashion. Blood?

January 10th, 2014 by Laura Wershler

A month ago I was musing about what it might be like to blog about fun stuff like food, fashion or travel – you know, topics not quite so “fraught” as the menstrual cycle. Sometimes it feels like just so much work sharing facts and opinions about why body literacy matters, why knowing how our cycles work and how ovulation impacts our health can lead us into meaningful, self-determined relationship with our bodies and ourselves.

But in the days leading up to Christmas, I was reminded by two young women, both of whom I’ve known since they were babies, daughters of friends, one in her late 20s, the other in her early 30s, why I do what I do.

Photo by Laura Wershler

The younger had contacted me last September, at the suggestion of her mother, with questions about switching birth control methods. She was fed up with the Pill, wanted to quit, was considering the Mirena IUD, told me about her history with ovarian cysts, irregular cycles. In a stable relationship, she hadn’t thought much about children. We talked about options. I assured her there were effective non-hormonal methods she could use, that by doing so she could assess her fertility, get her cycle functioning normally before making a decision about the Mirena. I sent her information about treatment – not involving hormonal contraceptives – for ovarian cysts; I asked a medical colleague questions on her behalf. She was thankful, emailing me that she had “some heavy thinking to do, including my actual timeline for children.”

I hoped to see her at her family’s annual Christmas party. We greeted each other briefly when I arrived, but not until the house was teeming with guests did we have the chance to talk privately amidst the holiday din. She told me she’d stopped the Pill three months before, could hardly believe how much better she felt, even though she’d yet to have a period. She thanked me, again, for validating her desire to quit the Pill. It so happened she had an appointment the next day with her family doctor; she knew what treatment she would request to help get her cycle started.

It did not go well. Her doctor, like so many I’ve heard about, was not interested in the menstrual cycle research she had done or the choices she wanted to make about her reproductive health. Quite the contrary: her doctor was hostile. It was disheartening for her, maddening to me, but not surprising.

A day later, at another holiday gathering, the other young woman stopped me in the hall to ask what I thought of the Mirena. She’d made the switch from the combined Pill (estrogen/progestin) to a progestin-only version to help with migraines. She offered that she and her partner had not yet decided about children, but she was concerned about leaving it too late. I told her the Mirena was intended as a five-year method, and if she was thinking she might want a child, it was a good time to stop hormonal contraception and assess her fertility before making a decision, either way.

I forwarded both women links to a naturopath skilled in menstrual cycle and fertility issues, and to a fertility awareness instructor who’d just announced her 2014 Eco-Contraception Program. The decision about what to do next, of course, will be theirs.

I sense both young women are searching for new, mindful connections to their bodies. Even if all I ever do is help a few such women find the support they need to make this connection, then to hell with food and fashion, I’ll keep writing about the menstrual cycle.

Why the “pullout generation” is a sex ed fail

November 13th, 2013 by Laura Wershler

Questioning and quitting the pill are current hot topics, fueled in no small part by Holly Grigg-Spall’s recently released Sweetening the Pill Or How We Got Hooked on Hormonal Birth Control. Her book has drawn ample backlash, brilliantly addressed by re:Cycling blogger Elizabeth Kissling.

Adding to the media clamour was Ann Friedman’s New York Magazine online piece No Pill? No Prob. Meet the Pullout Generation which explores how and why women she knows are ditching hormones and depending on withdrawal and period tracking apps for birth control.

Black Iris by Georgia O’Keeffe, photographed by Laura Wershler
at The Metropolitan Museum of Art

Both writers, along with Toronto freelancer Kate Carraway, recently discussed the topic Rebelling against the pill: ‘Pulling-Out’ of conventional birth control on CBC Radio-Canada’s The Current.

Listening to Grigg-Spall, Friedman, and Carraway discuss the pill rebellion affirms that while many young women are through with hormonal birth control, their transition off the pill, etc., is not without risk-taking and pushback.

Grigg-Spall nailed the pivotal point when she said “It’s a provider issue.”

The rise of the “pullout generation” is proof that sexual health-care providers and educators, among whom I count myself, have failed on two counts:

1) We’ve failed to address a key aspect of contraceptive use: how to transition successfully between method groups, in this case from hormonal to non-hormonal methods. We’d rather present the so-called “latest and greatest” hormonal methods and say – earnestly, pleadingly – try this! The CBC panelists provided strong anecdotal evidence that more and more women are having none of it.

2) We’ve failed to adequately acknowledge and serve women who can’t, won’t or don’t want to use hormonal methods. We are NOT providing across-the-board support and programs that include easy access to diaphragms or certified training in fertility awareness based methods (FABM), either onsite or through collaborative referral strategies.

For over 25 years I’ve advocated for increased access to information, support and services for women who want to use non-hormonal methods of birth control. It’s self-evident such services must include access to qualified instruction to learn FABM that have effectiveness rates over 99%. This is not to say there isn’t a place for withdrawal as an effective back-up. Check out this confessional how-to post by fertility awareness instructor Amy Sedgewick.

As Friedman said on The Current, women are intimidated by the idea of learning fertility awareness. I believe this is mostly because mainstream sexual health-care providers have never fully educated themselves about FABM or fully committed to presenting these methods as viable options to drugs and devises. Do they think that most women can’t or don’t want to learn fertility awareness skills? That would be like thinking most girls can’t or don’t want to learn to read.

As I’ve written elsewhere: “Fertility awareness, like riding a bicycle, is a life skill.”

If you can learn to swim, ski or snowboard, knit a sweater, read a balance sheet or master Adobe InDesign, you can learn to observe, chart and interpret your menstrual cycle events. We can all acquire body literacy.

Until sexual health educators and care providers develop programs to fully serve women who won’t use or want to stop using drugs and devises for birth control, we will continue failing to meet the growing “unmet need” for effective non-hormonal contraceptive methods.

The reign of hormonal birth control as the top-of-the-contraceptive-hierarchy gold standard appears to be coming to an end. The pullout generation represents just one thread in this transition. The questions is: Are sexual health educators and care providers paying attention and, if so, what are they going to do about it?

Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.