The 5th Vital Sign has a mission to use education as preventative care, encouraging individuals to make informed choices about their health. They strive to spread unbiased, free, reproductive health information so that we all feel more secure, safe, and alive in our bodies.
In 2006, The American Congress of Obstetricians and Gynecologists (ACOG) recommended using the menstrual cycle as a vital sign--The Fifth Vital Sign, as we’ve dubbed it. Besides helping monitor normal development, the fifth vital sign can help diagnose medical conditions such as endometriosis, polycystic ovarian syndrome, thyroid issues, and infections, as well as indicate miscarriage and the beginnings of pregnancy and menopause. Our bodies have much to say, and it’s time to start listening.
We initiated the project, The Fifth Vital Sign, in order to inspire one another to have conversations with our bodies. We listen to our bodies, and then respond to our needs in a dynamic, patient dialogue and in a language that once learned is of use throughout every phase and stage of our reproductive health journey. So if we’re not conversing with words, how are we listening and responding? Fertility awareness is one method of communication. It’s one of our favorite, most effective modes of conversation with our menstrual cycle and endocrine system. Fertility awareness allows us to gather information about our fifth vital sign, in the same way that placing your fore and middle finger on your radial pulse gives you information about your heart rate.
In symptothermic Fertility Awareness Language, our conversations center around three fertility signs: basal body temperature, cervical fluid, and cervical positioning, in order to gain the best understanding of our menstrual cycle. Here’s what one snippet of the conversation might sound like:
[It’s a slow, rainy Sunday morning, and I’ve just had a huge cuppa tea. Needing to pee, I enter the bathroom, sit on the toilet, and pull down my underwear.]
CERVICAL FLUID: Good morning! I decided to dress up today. That milky outfit I had on the past few days began to feel passé, so I changed into a dress that looks more like raw egg whites. That’s in vogue, right?
ME: Hello, Cervical Fluid! You did change! And when I put you in between my thumb and forefinger, you stretch you an inch or more. Let me check in with Cervix, too. [I insert a clean finger three to six inches into my vagina.]
CERVIX: Hi! This morning, I’m feeling softer and more open to possibilities.
ME: Egg-white cervical fluid, a cervix that’s softer and slightly more open than usual . . . it sounds like I’m going to ovulate soon. BASAL BODY TEMPERATURE will confirm if and when I ovulate, but you both are indicating this is a fertile time.
This is a dialogue between me, myself, and I first and foremost. Yes, fertility awareness can be used as a method of contraception. In the example above, my body was indicating to me that I was entering my most fertile window, a time to attempt or avoid conception. However, before we consider our bodies in relation to other bodies, we invite you to dialogue with, understand, and celebrate yourself and your own, individual body. Ovulation is a “bellwether of women’s well being,” physically, emotionally, nutritionally, and socially, according to Dr. Jerilynn C. Prior. Furthermore, normal ovulation, along with regular menstrual cycles, prevents osteoporosis, breast cancer, and heart disease. We also know the hormonal dance of our cycles can influence our emotions. According to Miranda Gray in the The Optimized Woman peri-ovulation is an optimum time for “empathy, relating to others, communication and teamwork. It’s a good time to work with others, talk about relationships, support projects, make connections and be generous.” Fertility awareness is about way more than fertility. It’s about your general health and well being, too, and you are allowed to prioritize these things.
For many of us listening to and understanding our own individual cycles can be the first step in interacting with any of the less comfortable experiences of menstruation such as cramping, PMS, etc. In listening to our cycles and taking time each day to check in, we are able to make connections between the way in which we live in our bodies and how that affects our experiences in them. Dr. Laura Brighton talks about how the period is a report card each cycle and tells us how our body processed what we ate, how we moved, how we slept etc. This is the part of the conversation where we are able to respond. For example:
[It’s a busy Monday morning, and I’m reaching for my second cup of coffee. I’m in the luteal phase of my cycle, and upon sitting down at my desk, I realize I’m a little more uncomfortable than usual awaiting my period.]
UTERUS: I’m trying my best to get ready to shed my lining, and the caffeine in this coffee is creating a hormonal imbalance. In order to my job, I need to be in balance.
ME: [Checks Kindara app.] Hmm I have been stressed this month, drinking more coffee than usual, and I can tell my chart looks different than last cycle. I’ll plan next cycle to drink less coffee during my luteal phase to see if that helps me feel more comfortable.
We are thankful technology is making this conversation more understandable, accessible, and accurate. Fertility awareness apps, like Kindara, allow us to keep track of and organize lots of data about our menstrual cycles in one place, on our phones (which we usually have with us, am I right)? It fosters community, too, as you can share your charts with friends, other app users, and experts to better understand what you’re looking at. Wink, Kindara’s oral fertility thermometer, is making data entry even easier, by automatically syncing your daily temperatures with your phone’s Kindara app via bluetooth. Technology does not have to be a part of your fertility awareness journey, but it’s a growing, convenient option.
To kickoff The Fifth Vital Sign this year, we drove 15,000 miles across the United States, offering over 60 free reproductive health classes in 43 states. During each class, we discussed fertility awareness and technology, emphasizing two issues that can help you make an informed choice about apps. Make sure you are using a fertility awareness app, like Kindara, and not a period tracker app. Sometimes, apps for period tracking will predict ovulation by simply counting 14 days after the first day of your last menstrual period. We are not machines and don’t always ovulate on the same day! It’s important to have an app that allows you to look at all three indicators of fertility, rather than working on the assumption that you ovulate on day 14.
You can find out more information about informed choice, fertility awareness, and the ongoing conversations we’re having with our cervical fluid, basal body temperature, cervix, and uterus at www.5thvitalsign.com.
Kelsey Knight is a labor and delivery nurse, lactation consultant, and educator in New York City. She recently returned from a three month, 15,000 mile reproductive health education tour across the US to teach about body literacy and informed choice with her best friend, who is a doula. Their project is called The Fifth Vital Sign.
Emily Varnam is co-founder of The Fifth Vital Sign. She is a birth and postpartum doula, midwive’s assistant, birth control doula, placenta encapsulation specialist, and holds a degree in counseling and mentoring. It's her goal to be able to take people’s hands during puberty and walk with them through every stage of reproductive health.
You can contact the 5th Vital Sign at firstname.lastname@example.org and follow them on social here: