If you were to ask someone you came across what they understand and know about fertility, you may receive a range of responses…
“Oh, when sperm meets an egg!”
“If someone can become pregnant?”
“I guess the part in your menstrual cycle when you’re fertile?”
And some folks may not be able to tell you much about fertility, which is not their fault. Having been a sexual health educator over the last twelve years, I’m well aware of the gaps of knowledge that many of us have overall with sexual health, and there are a few reasons why these gaps specifically exist about fertility. Let’s explore these barriers to understanding fertility.
Sex education is overwhelmingly “abstinence-only” focused
When we explore the landscape of sex education in the United States, a pretty grim picture is painted. There is no national mandate requiring comprehensive sex education, and as such, many states continue to provide limited, abstinence-only perspectives that are rooted in fear-based approaches.
Two scientific review papers find abstinence-only-until-marriage programs and policies in the United States to be ineffective because they do not delay sexual initiation or reduce sexual risk behaviors. According to the researchers, these programs also violate adolescent human rights, withhold medically accurate information, stigmatize or exclude many youths of diverse identities, reinforce harmful gender stereotypes, and undermine public health programs. And since abstinence is often focused upon, fertility is often not addressed within the broader sex education landscape, because such information is thought to “make youth more curious” about their bodies.
Or worse yet, “why should youth learn about fertility if they shouldn’t be sexually active?”
Unfortunately, both such myths take away the feeling of empowerment that comes with learning accurate and holistic reproductive health information, regardless of whether we are sexually active or not.
Fertility is reduced down to the biological process of egg + sperm
Many of us, during high school, can probably remember our science textbooks covering the human reproductive systems. Lessons were most likely taught from an overly simplistic perspective of biology: Egg + Sperm = Fertilization! And while this part of fertility is true, it does not represent the many complex processes that have to occur for an egg (or ovum) to meet with sperm.
For example, many of us don’t know the many hormones that play a role in fertility, such as estrogen, luteinizing hormone (LH), and even thyroid-stimulating hormone. We may further not be aware of the intricacies of menstrual cycles, and how to track ovulation (i.e. when an egg is released into the uterus), or when peak fertility occurs (usually starting with the rise of estrogen before ovulation occurs).
And given the under-diagnosis of conditions such as endometriosis, PCOS (Polycystic ovary syndrome), and other conditions – many of which impact fertility – we further may not be aware of the whole picture of our reproductive health. All of this is to say that there is a lot to learn about fertility above and beyond “egg + sperm.”
We’re taught that getting pregnant is as easy as “penis meets vagina”
Given the constant bombardment of abstinence-only education, many of us incorrectly believe that getting pregnant is as easy as having sexual intercourse. And while this may be true for some folks who have sexual intercourse and are trying to conceive, it is simply not the case for many of us.
Research indicates that 1 in 8 couples struggle with infertility, which can also impact mental and spiritual health. And infertility is complex in and of itself, occurring at many different ages, and often due to complex issues that may exist within either reproductive system. Without a complete picture of what entails conception and pregnancy, our understanding of fertility is incomplete, resulting in now knowing if something with your fertility may be worth looking into, or how and when to reach out for professional support
Our reproductive health systems are intervention focused
The healthcare system in the United States has many issues, and one such issue is the overwhelming focus on intervention, and not nearly enough on prevention. Many of us seek reproductive and sexual health services when something is wrong.
We don’t often, unfortunately, learn about prevention-based, empowering steps that we can take during the course of our lives to enhance our reproductive and sexual health. For example, completing blood tests on a regular basis, both for fertility hormones and overall health; visiting an OB/GYN on an annual basis for pap smears and pelvic exams, which are critical to screen for certain health conditions; and being taught how to use our menstrual cycle and fertility awareness methods (FAM) to track fertility and what this can tell us about our bodies.
Without empowered, prevention-based health skills, many of us are left in the dark about our reproductive health until we notice that something is wrong, which can have many dire results.
With these considerations in mind as to why we lack important knowledge about fertility, what can we do about it? The good news is, a lot!
Educate yourself about fertility
Thankfully, there are many accurate and comprehensive resources about fertility – the trick is whether we are investing time and energy into educating ourselves. Before you start Google searching “fertility,” which may lead you down a rabbit hole, it may help to reflect on your existing knowledge and the gaps that exist. The links shared above are good places to start gaining comprehensive information, as is the Planned Parenthood website. Social media is also home to many excellent sexual health educators and reproductive health professionals!
Learn about your body, including tracking your menstrual cycle to gain insights into your fertility
Gaining knowledge about fertility is important, and the next step is to implement it towards your reproductive health! Skills that are critical to have are tracking your menstrual cycle and being aware of your overall menstrual health; understanding when your peak fertility is; learning about ovulation predictor kits (OPKs) or fertility awareness methods (FAM), if you’re trying to conceive (commonly called “TTC”) or avoid pregnancy; as well as birth control methods and potential impacts on your fertility hormones. The more you learn and understand, the better of a picture you’ll gain about your reproductive health.
Complete your annual pap smear and pelvic exam
While pap smears and pelvic exams are not the most comfortable experiences in the world, they are only uncomfortable for a short period of time and can provide us with insights into our reproductive health. Most folks with a uterus should start getting Pap smears at age 21. However, if you are younger than 21 and sexually active or if you are experiencing any reproductive health concerns, you should speak to an experienced gynecologist.
It’s a common misconception, but Pap smears aren’t just for those who are sexually active. The purpose of a Pap smear is to collect cells from the cervix and screen for abnormal cells, for cervical cancer. Such information can also provide critical information about our fertility.
Consider fertility hormone testing, regardless of your relationship status and your desire for children
There are natural fluctuations in hormone levels throughout our lives and our menstrual cycles. But when levels become too low or too high, that can lead to issues that make getting pregnant more difficult. Those with w uterus most commonly experience imbalances in their thyroid, testosterone, and estrogen hormone levels. 1 in 8 will have issues related to thyroid imbalance — like hyperthyroidism or hypothyroidism — at some point in their lives. 1 in 10 have polycystic ovary syndrome (PCOS), which is often linked to higher testosterone levels.
A blood test is the simplest way to detect hormonal imbalances. Although hormone tests aren’t regularly performed by doctors before symptoms arise, companies such as Modern Fertility are making it easy to perform this test from the comfort of your home. And your test results would be a great conversation starter with your OB/GYN or fertility specialist about your reproductive options and how to address potential issues.
Fertility is one part of our reproductive and sexual health, and it’s an important aspect to be fully informed about. Many of us are exploring our desire for children, now or in the future; are perhaps struggling with infertility, or may not be aware of the power of having fertility information within our hands. We each have our own reasons to seek our fertility information, so take a few moments to reflect on your “why,” let that ground your journey, and start to slowly but surely empower yourself! And remember that you’re never alone in your journey.
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