Can You Use The FAM Method with PCOS or Irregular Cycles?
Perhaps my biggest pet peeve as a Fertility Awareness Educator (FAMs Educator) with over 13 years of experience with fertility awareness methods as natural birth control, pregnancy & fertility support, and a holistic cycle wellness tool is when people say to me…
“I can’t use fertility awareness methods because I have PCOS and/or irregular cycles.”
Or
“I can’t track my cycle because I have PCOS and/or irregular cycles.”
This, my friends, could not be more wrong.
You absolutely can, and I would argue should, track your cycle using fertility awareness methods if you have PCOS and/or irregular cycles. It is a great way to understand when and if you’re ovulating, how irregularly ovulation is occurring, what hormonal imbalances may be causing the irregularity in ovulation, and so much more. And, yes, you can even use FAMs methods as natural birth control with PCOS and irregular cycles, too.
In this article, we’re going to talk all about…
> What is PCOS?
> What causes irregular cycles?
> Why doctors automatically recommend hormonal birth control for PCOS and irregular cycles
> Why it’s a myth that you can’t track your cycle with fertility awareness methods if you have PCOS or irregular cycles
> How to track your cycle the right way if you have PCOS or irregular cycles
> 3 Steps for getting started with fertility awareness methods if you have PCOS or irregular cycles
What is PCOS?
PCOS stands for polycystic ovarian syndrome. It is a hormonal and metabolic condition that causes an excess of male-type hormones (like testosterone) called androgens and very often inhibits regular ovulation and therefore creates irregular or absent periods. Some folks with PCOS have random period bleeds throughout the year, others have no periods at all.
If there is one, most important thing that I wish everyone understood about PCOS it’s that PCOS is not a lifelong condition or diagnosis. Instead, PCOS is a temporary condition. Once androgen excess is reversed and regular ovulation is restored, a woman no longer has PCOS.
PCOS & irregular cycles are not lifelong diagnoses. They are temporary states of androgen excess and compromised ovulation.
However, if you choose to cover up the cause of PCOS and simply shut down the menstrual cycle with hormonal birth control to manage the symptoms of PCOS, then - yes, PCOS becomes a lifelong condition of indefinite length.
In my other article How To Manage PCOS Without Birth Control, I talk all about how PCOS cannot be diagnosed solely by the presence of cysts on the ovaries & irregular cycles, how some people with PCOS do not have ovarian cysts at all, and why you may not have PCOS even if you’ve been told that you do.
What causes irregular cycles?
If you have irregular cycles, but do not meet the criteria for PCOS (learn what that is here), there are a few things to understand.
Firstly, unlike with PCOS where many folks are not ovulating at all, those with irregular cycles continue to ovulate - however, ovulation is occurring sporadically and perhaps infrequently.
It is important to note, however, that having long menstrual cycles does not mean that you have irregular cycles. I see this confusion all the time in my clients. A doctor sees their long cycles and, in the absence of detailed cycle tracking charts, assumes that the woman is having irregular cycles when in fact many of these women are having regular, predictable periods and ovulation they are just occurring later in the cycle than would be expected.
For example, if your cycle length is consistently between 38 and 45 days, you do not have an irregular cycle. You have a regular, consistent cycle that is longer than the ideal of around 28 days long. You are very likely ovulating consistently, it’s just occurring up to two weeks later than women with a 28 day cycle.
This is an important distinction because improving a long, but regular menstrual cycle is about boosting already regularovulation whereas improving irregular cycles is about restoring regular ovulation in a cycle where ovulation has been suppressed.
In a cycle that is truly irregular and not caused by PCOS it’s important to identify what is suppressing ovulation. Some common factors include undereating, disordered eating, overexercising, chronically high stress levels, chronic inflammation, autoimmune disorders, thyroid dysfunction, being in perimenopause (when cycle irregularities are normal), being postpartum (again when cycle irregularities are normal), and more. We can see signs of some of these factors right on a FAMs cycle tracking chart - like thyroid dysfunction, signs of perimenopause, inflammation, and more. And, I always recommend working with a naturopathic doctor and appropriate care providers to get appropriate testing, diagnosis, and care in identifying and healing these conditions.
Why do doctors automatically recommend hormonal birth control for PCOS and irregular cycles?
Conventional doctors almost universally recommend hormonal birth control for PCOS and irregular cycles regardless of the underlying causes and how they may vary. This happens for several reasons. The first is that hormonal birth control is the tool that they’ve been given. In the US the “healing” tools of our medical system are pharmaceutical drugs. It is the approach that is taught in medical school where there is very little focus on how to use food, herbs, and lifestyle changes to heal the body.
The second is that the main concern in the medical field around PCOS and irregular cycles is not so much the suppression of ovulation, it is the lack of a regular period bleed. This is a concern because the absence of a regular period means that the uterine lining (endometrial lining) is not regularly growing and releasing. It is, instead, stagnating. This has been shown to increase the risk of endometrial cancer for those with PCOS. (Source)
Hormonal birth control, while it suppresses ovulation which is one of the primary symptoms of PCOS, it does trigger the regular release of the uterine lining which is not happening in folks with PCOS. This can help reduce the risk of endometrial cancer for those with PCOS. It is for this reason that conventional doctors almost universally recommend hormonal birth control for folks with PCOS and irregular cycles. (Source)
I, however, would argue that the more ideal approach is not to continue the suppression of ovulation and artificially manage the release of the uterine lining, but instead to restore regular ovulation by healing whatever is causing the suppression of ovulation so that a regular period is achieved, regular release of the uterine lining is restored, and women with PCOS & irregular cycles can once again reap the many benefits of a healthy, regular menstrual cycle.
I talk all about how to manage PCOS without hormonal birth control here. I even include 3 simple steps for the natural treatment of PCOS.
Why it’s a myth that you can’t track your cycle with fertility awareness methods if you have PCOS or irregular cycles
All this brings me to what I really came here to talk about today… why it’s a myth that you can’t track your cycle with fertility awareness methods if you have PCOS or irregular cycles.
As a yoga teacher of nearly 15 years, it’s like when people tell me that they can’t do yoga because they’re not flexible. While you may do yoga because you already are flexible, it’s most important to do yoga because you want to support and improve your flexibility, among other reasons. It’s the same for cycle tracking with PCOS and irregular cycles. While you may track your cycle because you have a healthy, regular menstrual cycle, it’s crucial to track your cycle to support and improve your menstrual cycle - especially with PCOS and irregular cycles.
Even though ovulation and menstruation are occurring irregularly or infrequently with PCOS and irregular cycles, we can still observe and track our hormones, cervical fluid, temperature, signs of fertility, and more. With each ovulation there will be an influx of fertile cervical fluid and a subtle rise in temperature, just like there is for folks with regular, monthly cycles - even if it only happens a few times a year. We can track these shifts. We can use them to understand when and if ovulation is occurring, if there is any rhythm to it, what the hormones are doing leading up to ovulation, how much progesterone is made after ovulation, and more. We can even use this information to prevent or achieve pregnancy depending on our intentions.
Tracking your cycle with fertility awareness methods if you have PCOS or irregular cycles is a crucial part of the natural PCOS healing protocol that I talk about here because it allows you to really understand what is going on in your cycle as you choose to break free from hormonal birth control and ovulation suppression.
How to track your cycle the right way if you have PCOS or irregular cycles
If you have PCOS or irregular cycles, cycle tracking with FAMs method is very similar to those who track with FAMs method and have regular cycles. You track daily cervical fluid secretions, daily waking temperature, and perhaps daily cervix shifts.
The big difference is that folks with PCOS and irregular cycles will likely have multiple ovulation attempts before ovulation is actually achieved, whereas folks with regular cycles usually only have one ovulation attempt that leads directly to ovulation. What this means is that for folks with PCOS and irregular cycles there will be several build ups of cervical fluid in what is one very long cycle. You will open and close your fertile window several times as your body tries to ovulate and doesn’t quite get there with each attempt, however only the last fertile window - the one with a true ovulatory temperature rise - will be the true fertile window where ovulation occurs and pregnancy could be achieved. There is a special rule called the BIP rule (or basic infertile pattern rule) for folks with PCOS and irregular cycles to help them account for the longer stretches of infertility that occur in their cycles as opposed to those with regular cycles.
It is highly recommended that if you have PCOS or irregular cycles you work with a trained fertility awareness educator (FAMs Educator) when learning how to use FAMs methods as birth control or for pregnancy achievement to help you make sense of your more unconventional cycle shifts.
In my 13 years of FAMs experience, I have taught many with PCOS & irregular cycles how to use fertility awareness methods. Here’s what a few of them had to say…
“After 2+ years of absent & irregular periods and a PCOS diagnosis, I had no idea where to begin. But, after just 3 months of working with Brandy I was able to confirm that I was in fact ovulating and achieved a more regular cycle. And, I got pregnant on my first try when I was ready! Working with Brandy changed my life!” - Christina
“Since working with Brandy my irregular cycles have now been back within the 31-35 day range every month! My PCOS symptoms have completely cleared up. I have lighter and shorter periods. I feel like I'm the most in tune with my body I've ever been in my life. I can say with 100% certainty that working with Brandy is so worth it!” - Micaela
3 Steps for Getting Started with Fertility Awareness Methods (FAM Method) If You Have PCOS or Irregular Cycles
Step 1.Chat with your doctor about transitioning off of hormonal birth control if you haven’t already
Step 2.Work with a naturopath and other holistic health care providers to create a food, supplement, and lifestyle protocol for managing and healing PCOS without hormonal birth control (more on that here - in other blog post)
Step 3.Work with a trained Fertility Awareness Educator (FAM Educator) to learn how to track your cycle with PCOS and learn how to apply the rules of the FAMs Method for birth control, pregnancy achievement, & cycle wellness
Curious about the science behind the FAMs Method and how it’s scientifically proven to be up to 99.6% effective as birth control (that’s the same as the pill!)? I wrote an article about that here.
Ready to break free from hormonal birth control and use fertility awareness methods (FAMs methods) as a person with PCOS & irregular cycles? I can help!
Join me for one of my monthly Cycle Wisdom FAMs Classes.
These classes are perfect for folks who are beginners and/or totally new to fertility awareness methods and cycle tracking. In each class I teach the full FAMs method - how to track cervical fluid, how to track basal body temperature, and how to use the rules of the method for birth control & pregnancy achievement. It’s the perfect opportunity to experience the method before diving all the way in. You can learn more about the Cycle Wisdom FAMs Classes here.
For folks who are like f*ck it, I’m ready to dive all the way in, my Monthly FAMs Support Membership was made for you.
In the Monthly FAMs Support Membership you get access to:
> Self-paced teaching modules to learn the full FAMs method(including how to use it as birth control, for pregnancy achievement, and for greater cycle awareness)
> 24/7 on-demand voice & text messaging with me to answer all your cycle-related questions
> Unlimited cycle chart reviews to get my expert FAM Educator support with analyzing your personal cycle tracking charts to help you open & close your fertile window, identify ovulation, and spot potential underlying cycle imbalances
> Access to my extensive practice chart library so that you can practice using the rules of the method BEFORE you need to use them in your own cycle
> Unlimited access to my menstrual wellness masterclass training vault with self-paced classes specific to transitioning off of hormonal birth control, perimenopause, postpartum cycles, natural menstrual cycle support, and more
> Exclusive access to 1:1 Deep-Dive Sessions with me for more intensive, in-depth, personalized support with your cycle needs (available only to members!)
You can learn all about the Monthly FAMs Support Membership here.
Disclaimer: Brandy Oswald, Sauvage Wellness LLC, and her employees are not doctors, nurses, physicians, psychotherapists, or in anyway licensed medical practitioners and information presented here is to serve as an educational resource and not to be interpreted as: (1) medical advice or parameters for diagnosing medical conditions; (2) a 100% effective birth control or pregnancy achievement options or (3) nutrition or health guidelines. By reading this you acknowledge that you understand that as a specialized form of consulting, fertility awareness education is not the same as professional or licensed therapy or medical advice and intervention; and recognize that it is your responsibility to seek such services from a licensed professional. Brandy Oswald is not a medical provider and cannot give medical advice. All information provided by Sauvage Wellness LLC and Brandy Oswald is of a general nature and is intended only for educational purposes to help with your personal health improvement goals and should not be relied on as medical advice. Always consult a physician with any health concerns and prior to changing your diet, lifestyle, supplements, birth control, fitness, or prescription medicine routine. Should you choose to take action based on the information provided by Brandy Oswald it is of your own volition and you recognize that neither Brandy nor Sauvage Wellness LLC is not held liable for any intended or unintended outcomes. All readers hereby WAIVE AND RELEASE Brandy Oswald and Sauvage Wellness LLC from any claim, demand, cause of action of any kind resulting from or related to reading educational articles, and/or participation in classes, workshops, and all service offerings provided by Brandy and Sauvage Wellness. As a reader you hereby acknowledge that you are fully responsible for any and all risks, injuries, or damages, known or unknown, which might occur as a result of your participation.
