- From adolescence through middle age, women are simply not taught much about their reproductive health, which is intricately tied to their overall health. Tweet This
- Hormonal birth control does not “regulate” one’s cycle; it overrides and suppresses it entirely, acting as a band-aid solution for common reproductive issues. Tweet This
- The more we learn about women’s health, the more it becomes apparent that women need to experience healthy menstrual cycles for proper development and good health. Tweet This
In my experience as a fertility awareness advocate and instructor, I have found that what women do not know about their bodies (and the myths they believe about their fertility) could literally fill books. And yet, this ignorance is typically no fault of their own. From adolescence through middle age, women are simply not taught much about their reproductive health, which is intricately tied to their overall health.
In fact, this is precisely why issues with one’s fertility often manifest in systemic effects. For example, it’s why those with endometriosis often have digestive issues, or why those with polycystic ovary syndrome (PCOS) often have severe cystic acne. It’s also why—no matter how many times pharmaceutical companies tweak the dosage or the precise molecular makeup of the synthetic estrogens and progestins found in birth control—women using contraceptives still experience a broad range of side effects that, to the untrained eye, seem wholly unrelated to one’s menstrual cycle. In truth, we do women a great disservice by keeping them in the dark about their fertility health, which too often leads to years of unnecessary physical and emotional pain, as well as confusion about how best to address infertility issues and achieve the families they desire.
In this article, I’ll discuss the top five myths (as I see them) that far too many women believe about their reproductive health. It’s my sincere belief that if we were able to correct these myths on a societal scale, the health and well-being of girls and women would vastly improve.
Myth #1: You can get pregnant any time, at any age.
I want to discuss this myth first because it gets to the heart of the misinformation girls and women are fed about their reproductive health. It’s the source of two equally pernicious beliefs: 1) That a woman’s fertility is something wild and unpredictable that needs to be controlled in order for women to have any meaningful agency over their lives, and 2) that there is no biologically-imposed time limit upon a woman’s ability to get pregnant when she chooses.
Women’s fertility is actually cyclical, and pregnancy is only possible when one has intercourse during a defined window of time during each cycle, namely in the days leading up to and immediately following ovulation–which is when a mature egg is released from an ovary. Each woman and each cycle are different, but on average, this means that a woman is only fertile for roughly 6 days each month—and a woman is capable of discerning exactly when these fertile days are, if she diligently tracks her menstrual cycle via observation of one or more various fertility biomarkers, such as basal body temperature or cervical mucus.
Additionally, this healthy, predictable, observable pattern of fertility (and therefore the time of most ease in achieving a healthy pregnancy) is most readily seen in women of prime childbearing age, which is roughly the late teens through the late 20s. Indeed, age is one of the single biggest factors affecting fertility, with a decline beginning as early as age 30. At 35, fertility begins to decline even faster. By their mid 40s, (on average) many women are in the thick of perimenopause, where changing hormone levels can result in menstrual cycle changes, making natural pregnancy difficult to achieve (although not unheard-of). However, by late 40s or early 50s, many women have reached the late stages of perimenopause, where ovulation and periods become sporadic for several months until stopping completely. Once a woman has gone 12 months without a period, she is considered to be in menopause, and pregnancy is no longer possible. Men, by contrast, constantly produce sperm from puberty until death, although sperm count and quality (and therefore fertility) diminishes at a slow decline as they age (40+).
Despite the significant impact of age upon fertility, research shows that lay-people and healthcare practitioners alike are misinformed about age-related declines in fertility, and they consistently overestimate the success rates of having a child via artificial reproductive technologies (ART), such as in vitro fertilization (IVF). It takes 3 cycles, on average, for women under 35 to conceive via IVF, with success rates declining with age. Each IVF cycle, on average, costs $15,000-$30,000.
Myth #2: Periods are unpredictable, and if a woman wants any kind of control over her life, she needs to “regulate” her period.
Just as a woman can track her cycle to know when she is fertile, she can also track her cycle to know when she'll experience her next period. What’s more, it is only by knowing when she ovulates that a woman can know fairly certainly when she will get her next period. This is because the time between ovulation and the start of the next period—a phase of the cycle known as the luteal phase—is nearly always the same number of days each cycle. While the day of ovulation can change based on a number of factors (stress, illness, etc.), the length of the luteal phase stays fairly consistent for each woman.
Armed with this knowledge, a young woman need not be taken unawares by her period or feel the need to “regulate” her cycle via hormonal birth control. However, as mentioned above, some variation in ovulation date can be normal, especially in teens who are just beginning to cycle, those who are sick/under stress, and women in perimenopause.
Myth #3: Birth control is the only solution for reproductive problems like Endo and PCOS, which are some of the most common causes of irregular periods.
Birth control is often prescribed (off-label, in many cases) to “regulate” unruly cycles that do not fit the textbook 28 days each and every month, or cycles that are accompanied by heavy bleeding and/or pain. But hormonal birth control does not “regulate” one’s cycle; it overrides and suppresses it entirely, acting as a band-aid solution for common reproductive issues. By releasing a constant, steady dose of synthetic estrogen and progesterone (known as progestin), hormonal birth control causes a woman’s body to suppress its natural production of endogenous estrogen and progesterone, preventing her from ovulating and menstruating. The bleed that a woman on birth control experiences is merely a withdrawal bleed, as a woman takes her week of sugar pills, free from the synthetic hormones found in the rest of the pack. This will lead her to have a regular, predictable bleed each month (except for the intermittent spotting that is common with some types of birth control, or the prolonged bleeding that is typical with placement of a new IUD), but it is inaccurate to call this a “cycle,” or to call that regular monthly bleeding a “period.”
Better treatments for painful and heavy periods exist (the source of which is typically an underlying issue like endometriosis, polycystic ovary syndrome, uterine fibroids, etc.), and it starts with an actual diagnosis. For far too many women, the solution proposed by most doctors is simply to start hormonal birth control to offer some physical relief, without any further digging into what the underlying issue might be. This leads to the unbelievable reality of women spending the better part of a decade searching for a diagnosis for what are profoundly common issues.
We do women a great disservice by keeping them in the dark about their fertility health, which too often leads to years of unnecessary physical and emotional pain, as well as confusion about how best to address infertility issues and achieve the families they desire.
Myth #4: IVF and other forms of Assisted Reproductive Technology (ART) are the best (and only) solutions for infertility we have.
Endometriosis, PCOS, and uterine fibroids are some of the leading causes of infertility in the U.S. and developed countries around the world. Authentically treating the root cause of these issues often restores fertility for a woman who may be struggling to conceive. Rather than forcing a pregnancy or circumventing an issue (as ART does), restorative reproductive medical (RRM) providers get to the heart of why a reproductive system is not functioning as it ought to (whether it is poor ovarian functioning, issues with the endometrium, and more), and in restoring health to that system, overall health is often improved, including often fertility.
Research is increasingly finding that ART carries significant medical risks for moms (and their babies, but the good news is that effective, holistic alternatives exist that view a woman’s reproductive system as integral to the rest of her health.
Myth #5: Birth control only affects the reproductive system, and nothing else.
A woman’s reproductive health is inseparable from her overall health. This is evident in the systemic effects that can be seen from issues like PCOS and endometriosis, and likewise, in the changes in mood, energy, and appetite that a naturally-cycling woman experiences over the course of her cycle.
Just as a woman’s natural cycle plays a role in her overall health, shutting it down via hormonal birth control produces effects that can be seen across the entire body. Not only does hormonal birth control cause an ever-growing list of risks and side effects, but in preventing women from cycling, it prevents them from reaping the benefits of a healthy menstrual cycle, with implications for bone density, heart health, brain development, and more. The more we learn about women’s health, the more it becomes starkly apparent that women need to experience healthy menstrual cycles for proper development and good health (in the present and future). It is folly to believe that the effects of the synthetic hormones found in hormonal birth control are limited to the reproductive system alone, just as our natural, endogenous estrogen and progesterone affect all of our bodily systems.
And we are only now beginning to reckon with the effects of long-term exposure to these synthetic hormones on individual bodies, our society, and our environment. For example, this March, the University of Oxford published a new study showing that any form of hormonal contraception (whether combined or progestin-only) is not only associated with a slightly higher risk of breast cancer for current users but also for "ever users" of these drugs.
Girls and Women Deserve the Facts
If we could get this myth-busting information into the hands of girls and women across the country (and truly, the globe), imagine the difference it would make in empowering women to better care for and appreciate their reproductive health. Imagine if more women, understanding the truth about hormonal birth control, demanded better care and solutions from doctors and health researchers. The truth about the goodness of the female body—including our fertility—is written in a way we all can see, if only we are taught to read it.
Grace Emily Stark is a writer, editor, and speaker with published work in multiple outlets, including Natural Womanhood, where she is the Editor. She is a current Ramsey Institute Fellow at the Center for Bioethics & Culture, and a former Novak Alumni Fund Journalism fellowship recipient. Grace holds a M.A. in Bioethics & Health Policy from Loyola University Chicago, and a B.S. in Healthcare Policy from Georgetown University.
Editor’s Note: The opinions expressed in this article are those of the author and do not necessarily reflect the official policy or views of the Institute for Family Studies.