When Christine Cremer was a D1 track and cross country athlete at Santa Clara University she suffered several stress fractures during her athletic career.
But it wasn’t until years later when she started classes to be a fertility education and medical management instructor that she realized she had a hormone imbalance.
Never during her treatment for her fractures was she asked about her menstrual cycle, which would have helped doctors determine the hormone imbalance. And when she studied public health at Santa Clara University, she said she also noticed a lack of discussion about women’s menstrual cycles.
She wishes doctors would have known more about this area of women’s health and could have seen that her health and fertility are deeply connected.
Rebekah Knobeloch feels the same way. She said she experienced anxiety and depression on the birth control pill and her doctor never explained how the pill might affect her and if there were other birth control options for her.
Both women said they want women to understand their bodies and know their options when it comes to fertility health.
Cremer is a University of Nebraska-Lincoln FOCUS missionary who is taking fertility education and medical management classes to teach women how to track their menstrual cycles and understand their fertility health.
Knobeloch owns Feminine Genius Ministries, a Lincoln company that teaches women and couples the Marquette model of natural family planning.
Natural family planning – also known as fertility-based awareness methods – is a way for women to track their natural biomarkers and discover if and when they are ovulating so they can make more informed family planning and reproductive health decisions. It requires no hormones or contraceptive barriers but has a woman track her menstrual cycle using biological signs already happening, like cervical mucus and body temperature.
Knobeloch learned about natural family planning as a practicing Catholic. The Catholic Church teaches against any form of contraception but allows the use of natural family planning, which uses the natural timing in a women’s menstrual cycle to make family planning decisions. As she discovered natural family planning, she said she felt as though she had previously been uninformed about her menstrual cycle and reproductive options.
“There’s this whole side of women’s health that gets neglected,” she said. “It seems like a whole area that needs exploration.”
In a 28-day cycle, women are only able to get pregnant 5-6 days, according to the American College of Obstetricians and Gynecologists. By tracking the women’s biomarkers and estimating the time of ovulation, couples can determine those fertile days and make more informed planning family decisions, depending if they are trying to avoid or achieve pregnancy. Of 100 women using fertility awareness to prevent pregnancy, fewer than one to five women will become pregnant in the first year of perfect use (following all protocols), according to the obstetricians’ group.
In 2015, the obstetricians’ group recommended the menstrual cycle be considered the fifth vital sign of health, along with blood pressure, body temperature, heart rate and respiratory rate, noting that identifying irregularities in a woman’s cycle may help with early diagnosis of health problems.
Knobeloch was a pediatric nurse for six years. When she and her husband started having children, she started to re-evaluate her career and sought to understand the effects of the birth control pill. She said she had developed anxiety and depression as a young woman and thinks now that it was directly linked to the birth control pill.
Knobeloch became trained in the Marquette model of natural family planning, which was created by Marquette University. Instructors must be trained medical professionals with at least a bachelor’s of science, and they help women track their basal body temperature, cervical mucus and hormone levels to determine if ovulation occurred and if so, when.
Feminine Genius Ministries, which has seven instructors, works with women and couples but also provides speakers. Instructors have spoken at schools, churches and sororities. Knobleoch said they often give a biology lesson on the menstrual cycle and talk about the birth control pill. She said she has found while many women are offered the pill, few are told how it can affect their cycle.
“The nurse side of me says everyone should have informed consent,” Knobeloch said.
When she studied public health, Cremer said she was never taught about the complexities of a woman’s reproductive cycle. She saw how important fertility awareness can be for not only couples but for all women so they know the health and state of their bodies.
“There’s an extension of my heart when it comes to women’s health and empowerment,” Cremer said. “It just tells a lot about our physical and emotional health.”
In addition to discovering her hormone imbalances by tracking her cycle, she said she also has become more attuned to her body and her moods and has a better understanding of when outside stressors affect her.
“The more I learn about my body, the more I’m amazed I am of the person God created me to be,” Cremer said. “It’s a miracle for my body to do what it does every day.”