We start with the fact that the majority of doctors count with 28 days cycle length and ovulation on the 14th day (or in case of long cycles 14 days luteal phase length), they don't know (?) what cervical fluid is and they are not willing to dig deep to find the source of a problem. Now let's see why this attitude might be dangerous and how Fertility Awareness can help us get the proper treatment:
1. "White flow": Probably the most common misapprehension (I, myself have experienced it several times and heard the same from others also) is when you go to the gynecologist in your fertile window and s/he tells you that "Unfortunately you have some white flow" and immediately writes a prescription for fungicide. This can happen either because s/he is not aware of the existence and function of the cervical fluid and thinks it is a sign of vaginal infection; or because s/he assumes that you have no idea whether it is cervical fluid or vaginal discharge caused by infection, so why even ask, it is easier to prescribe the medicine just to be sure.
What can you do? You can try saying "Yes, I am fertile right now" after the diagnosis, if s/he understands, then good. If s/he ignores what you said and prescribes the fungicide anyway, you can thank her/him politely but not buy the medicine because you know perfectly well that you do not need it.
2. Blood test on the 21st cycle day: This is also based on the theory of 28-14 cycles. Every hormone has an optimal day within the cycle for getting its level checked. Most of them can be examined in the first few days of the cycle which is not an issue because it is very easy to tell when a cycle starts. The problem is when they call you in on the 21st day to check your progesterone. The progesterone level is the highest on the 7th day post ovulation, if conception did not occur then it starts decreasing after that. We already know that ovulation rarely happens exactly on the 14th day, therefore a blood test on the 21st day (14+7) will show an accurate reading just as rarely and a false result can lead to unnecessary hormone treatments.
What can you do? In a cycle chart the basal body temperature shows when your ovulation happened (just before the shift) so you will be able to tell which day is the 7th after. This way you will be able to get your progesterone level tested on the correct day and you will always get an accurate reading.
3. Determining the time of conception: This is probably the most dangerous mistake someone can make because it does not affect only you but also the embryo growing inside. When your pregnancy test turns positive and you go to the doctor for the first time, s/he asks the first day of your last period. S/he then adds 14 days to it (the assumed time of ovulation and therefore conception) and based on this s/he checks if your baby is growing at an appropriate pace. But what if your ovulation was late for some reason and it happened, say, on the 21st day? Then the doctor says that the embryo is not growing properly and s/he prescribes some medication or suggests abortion, believing that there is something wrong with the baby and it would probably die soon anyway. When in reality there is nothing wrong at all, only conception happened a week later.
What can you do? If you are charting your cycles properly then, before you start trying for a baby, it is advisable to find out whether your doctor believes you regarding the day of ovulation. If s/he does then it is an easy case, you can just tell her/him during the first examination exactly when the baby was conceived and s/he will calculate accordingly. If s/he doesn't believe you then the simplest thing you can do is to count back 14 days from the ovulation day and say that that is when your last period started. (One of my friends did this, resulting in a worry-free pregnancy.) S/he will not be able to verify your statement anyway but this way at least, because s/he counts with ovulation on the 14th day, the age of the foetus will be calculated accurately.
4. "You cannot conceive? Take hormones!": Unfortunately this comes from a personal experience, when, after several months of trying, I was still not pregnant and we visited the doctor to find out what to do. The doctor only asked how many months we have been trying and whether I have any unusual symptoms or complaints and then she immediately prescribed hormone treatment. She told me to take it as advised and keep trying, it will solve the problem, the baby will come. Luckily at that time I had already been charting my cycles and could clearly see that there was nothing wrong with my hormones at all, I had proper ovulation each month, so why take medication to fix something that is not broken?
What can you do? Again I would say you might try to convince your doctor that you know exactly what is going on in your body and when. If s/he doesn't believe you, then you might want to find another doctor. Naturally I did not take any of the prescribed hormones because they were not necessary. (And to prove this, right after that our first baby conceived without any external 'help'.)
5. Progesterone for bleeding during pregnancy: Again personal experience that when our first baby conceived and I had spotting at the end of the 5th week, we called the doctor that something is wrong. Without asking anything she told us to go to the clinic so she can give me progesterone injection, it will solve the problem. I was shocked that she did not even want to try to figure out the cause of the bleeding, no examination at all, only immediate artificial hormone treatment once again. As we found out later, the spotting was caused by the pregnancy being ectopic (the egg implanted in the Fallopian tube instead of the uterus), so injecting progesterone probably would have made the situation even worse. You could read in the previous blog post how dangerous ectopic pregnancies can be and how important early diagnosis is.
What can you do? In a case like this it is better to visit another doctor who does not treat blindly but examines first. We, instead of her clinic, went to a nearby hospital where they did not mind the time they spent to figure out the cause of the symptom and do the proper treatment, therefore the situation did not end in tragedy.
With all this I do not intend to judge or criticize doctors, I respect them, they have enormous professional knowledge, I, myself have already trusted them with my life once. But they are not omniscient, not unerring, they generalize and average because they do not have the time and capacity to pay special, personal attention to each individual which can cause the above seen mistakes and mistreatment. Let's help them (and ourselves!) by dedicating 2 minutes of our time each day to chart our cycles so we can avoid being falsely diagnosed and treated unnecessarily because, after all, we are the 'suffering' party, not the doctors!
Feel free to share your experiences or ask your questions in the comment section below, and once again, let's take care of ourselves! 😉
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