Jana Pechová is a physiotherapist and certified lecturer of the German Symptothermal Method of Natural Family Planning (STM PPR). Jana teaches women to navigate their cycles and restores their harmony, informs about contraceptive methods and teaches methods of natural prevention and planning of conception. You can contact Jana on her website www.silaplodnosti.cz or via Instagram: @silaplodnosti
Jana, how did you get involved in the topic of women's health and fertility?
In the last year of my physiotherapy studies, we had teaching blocks with various experts. Some also focused on pelvic floor therapy, and with physiotherapist PhDr. Miroslav Dobeš we had a block on the method of Mrs. Ludmila Mojžíšová. He was the first expert (and a man!) who broke the taboo before me that menstruation and lovemaking should not be painful, that it is not normal for a woman to spot during her cycles and not have red menstrual blood. Until then, I took everything mentioned as NORMAL, because that is how my gynecologist presented it to me during preventive visits. Since then, I have become more interested in women's health and women's cycles, that same year I discovered the Symptothermal Method (STM), I gradually learned it and began to absorb information from many sources and professional courses.
Why should women track their cycle? How can it help them?
The menstrual cycle is one of the body's vital signs, an indicator of a woman's health. Stress, illness, malnutrition, or any other discomfort in the body can manifest itself in it. In short, the menstrual cycle is controlled by hormones and has two basic phases - follicular (pre-ovulatory) and luteal (post-ovulatory). The course and length of these phases, plus the fact that ovulation (the release of a female sex cell) occurred in the cycle, can indicate a health problem and a woman can start to solve it earlier, often more effectively .
What methods are there for tracking your cycle?
There are a number of methods. Some women use mobile applications that try to predict the day of ovulation, fertile and infertile periods and the final length of the cycle, i.e. the arrival of a new menstruation. They are based on the so-called calendar method. They use knowledge of the lengths of previous cycles and information about the cycles of other women. However, each of us is different and no two 30-day cycles will have the same course. Temperature methods are a little more sophisticated, where a woman only measures her basal body temperature after waking up, and there are also mucus methods based on monitoring changes in cervical mucus. Thanks to a lot of research, these methods have developed into the "sympto-thermal" method (monitoring specific symptoms + measuring basal temperature), which I personally consider the best choice. Each method also has specific variations, e.g. in different countries.
What should we record and in what form?
The entire cycle is the period between the first day of one menstruation and the first day of the next. We record information about menstrual bleeding - which day it started, duration, intensity, color, accompanying pain. After the end of menstruation (later in the case of longer cycles), a woman practicing STM begins to measure her basal temperature after waking up and observes cervical mucus daily (usually enough on toilet paper and panties). This continues until ovulation is confirmed, and then it does not need to be monitored anymore. The time required is about 4 minutes, with everything in between, a few days in the cycle. From the information obtained, ovulation is determined in a given cycle, the length of the pre-ovulatory and post-ovulatory phases is calculated, and the woman usually knows very precisely when the next menstruation will arrive.
A popular form of cycle recording are the aforementioned mobile applications, which I understand. Just don't trust them too much if they try to predict your fertile period and ovulation on their own. They don't have enough data to be reliable for every woman . However, they are convenient for recording. I recommend keeping STM records on paper or in an electronic spreadsheet on a PC. The only mobile application for STM that I support is the paid application Read Your Body , which was created by lecturers of various methods for monitoring cycles, not only STM. It is the only one that does not transfer women's intimate data to third parties and is constantly developing according to the needs of users. There will also be a Czech and Slovak version of the application.
For example, what do our basal body temperature and our cervical mucus tell us?
Cervical mucus is produced in the crypts of the cervix depending on the hormonal activity of estrogen and progesterone. Accordingly, its appearance, consistency and quantity change during the cycle. Before ovulation, the mucus becomes thinner, stretchy to watery, the woman perceives the sensation of moisture or wetness in her panties. The changing consistency indicates the beginning of the fertile period, the approaching ovulation and the end of the fertile period.
Basal body temperature rises by at least 0.2°C after ovulation, which is due to the thermogenic effect of the released progesterone . By measuring basal body temperature, we can confirm that ovulation has indeed occurred in the cycle.
Can the results be distorted during monitoring?
Yes, it can. Still, I wouldn't like women to be afraid of the influence of circumstances. We don't live in laboratory conditions. STM is a tool that should serve me so that I can benefit from it. There is no reason to be a slave to this method. Today, there are many STM consultants operating in the Czech Republic and there are opportunities to take courses where a woman can learn how to proceed if she has an irregular regimen - for example, she works shifts or has small children, or has a chronic illness and takes medication regularly.
How can a woman determine when ovulation occurs?
The most accurate method is an ultrasound examination at a gynecologist, but it must be timed well. The label “You are not ovulating” may not actually be true. A woman can help herself in this regard. A very reliable and undemanding method is the aforementioned STM, which was developed by gynecologists and other experts, and its reliability has been proven by studies. I see the pitfall in the fact that a woman must be motivated to want to learn to understand the processes of her body. The guide On the Waves of Fertility , which is available for download on my website, can be helpful.
Some women prefer modern gadgets, such as ovulation tests or ovulation microscopes, where they can see the result quickly. Both of these provide information about the levels of the hormone LH (in urine or saliva), which triggers ovulation in women. The problem is that the hormone LH is always present, its levels just change. And we don't know if a positive test detected the LH peak that will lead to ovulation. For some women, ovulation fits nicely with a positive result, but for many women, negative results come out even though they ovulate regularly. This can be frustrating. If a woman wants to use these tools, I recommend at least measuring basal body temperature to really confirm that ovulation has occurred . But it is not necessary to buy such tests.
How do we know which days are fertile and which are infertile?
Fertile days are only around ovulation, but without knowing the course of a particular woman's cycle, this information is very generalized. A woman can get pregnant just a few hours after ovulation. The mystery of our shared fertility as a couple, however, lies in the fact that male sperm can burrow into our cervical mucus and survive there for up to a week.
What are the most common myths about the menstrual cycle and fertility?
So there really are... The most common myth is that a woman can get pregnant during the menstrual cycle, because ovulation can occur multiple times in a cycle and we never know when it will happen. This is not true. Physiologically, there is only one ovulation and it is preceded by a clearly defined interplay of hormonal processes. Furthermore, a woman can get pregnant during menstruation. The truth is that a woman can get pregnant from making love during menstruation if she ovulates very early in the cycle. But she will get pregnant during ovulation. By monitoring her cycles, a woman will learn whether this can happen to her. Another important truth is that not all bleeding is menstruation. This can also be found out thanks to STM. A woman can bleed (even heavily) at other times during the cycle, for example during ovulation. Such a woman would swear that she got pregnant during menstruation, but in fact she got pregnant during ovulation, during which she was bleeding.
On your website silaplodnosti.cz, you offer consultations and STM courses. What can women contact you with?
I am most often contacted by women who want advice on cycle tracking and evaluation of records. I also organize (online) STM courses several times a year. Consultations are also used by women who are solving various problems with menstrual cycles (irregularities, discontinuation of hormonal contraception, PCOS, anovulatory cycles, etc.) or other gynecological problems, or women who would like to get pregnant and have not been successful so far.
How are your consultations conducted? What can women expect from them?
In the case of cycle consultations, the woman sends me her record and I either comment on it or we have a short phone call. I prefer "spoken" consultations, when I can ask questions and immediately make sure that the woman understands. Consultations for problems with conception and health problems are preceded by filling out a questionnaire, where I have a number of questions not only for the woman, but also for her partner. If possible, we then meet live or online (Skype, Zoom, Messenger...) and we address the situation in depth. I often recommend visiting doctors - specialists, recommend what examinations to undergo, what are the possible procedures for solving the situation, what natural ways the woman can try herself, what to avoid, and I answer questions. I probably recommend gynecological physiotherapy to every woman, and sometimes I even show the woman directly how to start pelvic floor exercises. The basics can also be taught online.
Do you have any favorite books or podcasts on women's health that you would recommend?
The books are mine, my husband could tell you 😊 I own so many that we can't fit in our libraries anymore, but they are mostly foreign titles. From Czech works, I would highly recommend the book Ženství jako dar by Veronika Lančaričová to women and the title Proč spíme by Matthew Walker to absolutely everyone. As for podcasts, I am not loyal to any, I only listen to what interests me. When we are doing this interview together, I like to listen to: Eva Kejíková from the Eva ženám project and Janina Černá from the Cukrfree podcast.
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