by Emily Kennedy, MSc, RHN, Billings Ovulation Instructor (in Practicum) and health coach
In the BOMA-USA pamphlet entitled “Unraveling the mystery of PCOS”, Dr. Mary Martin speaks to natural ways of treating this increasingly common condition. As Billings user may already be more natural-minded than the average woman, this is a great question to know how to address with ready-to-go tips.
Besides drugs such as metformin, bromocriptine or dexamethasone, Dr. Martin has some good advice for managing PCOS naturally. This advice can be organized into two categories:
First, improving insulin sensitivity. Here are some proven therapeutic lifestyle changes:
Exercise – works by activating the Glut 4 alternate pathway for glucose entry into the cell. Three 10-minute session per day (ie a brisk walk after every meal) only 5 days per week will give you the CDC recommended 150 minutes per week. Doesn’t that sound doable?
Calorie shifting (or caloric cycling) – works by improving fasting insulin concentrations as well as subcutaneous and visceral fat. There are many variations of the calorie shifting approach, all involve eating a regular amount of food for a set number of days, then significantly reducing caloric intake for another set time frame. Some variations also include specific intervals between meals. (Using a food tracker like the MyFitnessPal app helps a lot with this technique.)
Limit sugars and starches – works by reducing the carbohydrate/glucose load in your bloodstream, thereby reducing the insulin spike. Sugars include refined sugars from processed “treat” items as well as natural sugars found in fruit, dairy, grains and starchy vegetables like potatoes and corn. Ask your client to start by picking one sugary/starchy item they can do without.
Emphasize fat, fiber and protein – works by slowing the digestion of food, resulting in a slower rise in insulin. Choose unprocessed plant-based fats like nuts, seeds, avocado, and coconut more often than animal-based fats like cheese, butter or bacon. Many of the whole foods listed as plant-based fats are also sources of fiber and protein. Bonus!
In some cases, PCOS has an autoimmune component in addition to endocrine and reproductive effects. A physician can determine the presence or absence of antibodies that indicate autoimmunity.
What’s going on with your client’s digestion? Protein components (ie gluten, casein) from foods containing wheat and dairy are some only partially digested, creating macromolecules the immune system does not recognize and therefore attacks. This is the food-digestion-autoimmunity connection.
An Elimination Challenge is the best way to determine if improving autoimmune PCOS is as simple as cutting out gluten, dairy or another possible food offender. Per Precision Nutrition’s infographic guide, here’s a synopsis of an Elimination Challenge:
(N.B. When eliminating gluten, be mindful of the tips to improve insulin sensitivity and stay away from highly refined carbohydrates like gluten free cookies, pretzels, crackers, etc.)
According to the U.S. Department of Health and Human Services, PCOS affects 1 in 10 women of childbearing age worldwide. Lifestyle changes are hard work but have the potential to cut medication costs and restore reproductive and endocrine function naturally. If your client is motivated, consider referring them to an experienced health coach who can help them stay on track with their wellness goals.
As Billings Ovulation Method® teachers we cannot be seen to advise in areas where we do not have the expertise or training. However, this article may be a good resource for you to give to women you are helping who have PCOS, so they can decide if they would like to follow up and get help with their diet and lifestyle changes.
1. “Unraveling the mystery of PCOS (Polycystic Ovarian Syndrome): Q&A with Mary Martin, MD, FACOG. BOMA-USA pamplet available at www.boma-usa.org
2.Davoodi, Sayed Hossein et al. “Calorie shifting diet versus calorie restriction diet: a comparative clinical trial study” International journal of preventive medicine vol. 5,4 (2014): 447-56.
3. Mobeen, Hifsa et al. “Polycystic Ovary Syndrome May Be an Autoimmune Disorder” Scientifica vol. 2016 (2016): 4071735.
As part of our continued series that features our board members, Sue Ek interviewed John Worden, MD, who is finishing his last term on the board.
Photo L-R: John V, Cecilia, Dr. John , Dr. Rebecca, Rachel and Patrick
Q. Years ago, I remember meeting you at the first Teacher Training we hosted with trainers from WOOMB in Australia. One of your comments remains vivid even to this day. You had just returned from medical training for another NFP method in Omaha and, you told me you got more science in our weekend training than you did in two sessions there. Tell us about the differences.
John - I think I was impressed with the Billings Method™ because we were able to learn a huge amount in just a few days whereas with the training in Omaha it took two one-week sessions.
Q. As a family practice physician, how has the use of Billings impacted your practice of medicine?
John - Knowing the Billings Method™ allows me to be able to be much more comfortable diagnosing and treating women with various menstrual or other issues. It also gives me something to offer them that will help them understand themselves.
Q. Do you utilize www.nfpcharting.com to view patients’ charts?
John - I have used NFP charting.com to look at charts. It is very useful and easy to navigate and use.
Q. Am I remembering correctly that you and your wife, Becky Worden, MD own a family medicine practice? Tell us about that and, your children.
John - We practice medicine in Gardner, MA at Mercy Family Practice which is owned by my myself and my wife who is also a family practice physician. We have two nurse practitioners and several nurses and staff. They are all excellent people. We take care of the full range of family practice from conception to natural death. We also take care of obstetrical patients as well as pediatrics and adults. We heard we are some of the few remaining doctors in our hospital who still admit our own patients to the hospital.
Rebecca and I have four children, two boys and two girls. The oldest boy is a senior in high school. The youngest is a girl who is in fourth grade. They all have their activities and are interested in different things. We are very happy to have such lovely children.
We belong to Saint Martin’s Parish here. We have a vibrant group of Catholic friends with whom we share much time together.
Q. Speaking directly to physicians, what would you tell them to encourage them to learn the Billings Method™?
John - I would think that every physician should be aware of The Billings Method™. I would think it would be even better if every physician knew The Billings Method™. It should be a required part of every medical school education. I teach all my medical students who come through my office about the Method.
BOMA – Eileen, thanks for agreeing to be our featured BOMA Family Member for this month. Why don’t you start by telling us a little about yourself? Where do you live and how long have you been married?
Eileen – My husband, Christopher, and I have been married for 31 years. I am originally from Chicago and he is from the Boston area. We currently live in Tewksbury, MA which is about halfway between Boston and the New Hampshire border.
BOMA – What a lovely family photos. Please tell us a little about each of your children and grandchildren.
Eileen – We have been blessed with six daughters and four grandchildren (so far!):
~ Bridgette (29) is married to Steve Southard. She has a Bachelor’s in Hospitality and Hotel Management with a focus on Food & Beverage and she currently works at Starbucks – great little escape when she needs to take a vacation from a household of four young children, especially three energetic little boys!
~ Samantha (27) has a Master’s in Guidance Counseling from Providence College. She is the Office Manager of our company, but is currently in Seville, Spain for 8 months teaching high school English.
~ Caitlin (24) is married to William McKinnon. They live in Melbourne, FL where Caitlin is finishing her Master’s in Chemical Engineering at Florida Institute of Technology.
~ Vanessa (21) is finishing her last semester of college at St. John’s University in Queens, NY where she is also on the cheerleading team.
~ Anastasia (17) will be graduating from high school this spring and is busy touring the country looking at colleges. That is when she isn’t playing the lead role in her school’s musicals and plays.
~ Lorna (11) is in 6th grade. She is also a competitive gymnast (Level 6) and plays the piano, violin, and is a cantor for Sunday Mass at our parish.
~ Our grandchildren are Skylar (6), Brogan (4-1/2), Oliver (3), and Peter (1).
BOMA – How long have you been involved with NFP and the Billings Ovulation Method® specifically?
Eileen - We first learned the Creighton Model (CrM) while we were preparing for marriage. We used that method for the first 6 years of our marriage. Then, I was trained as a CrM teacher and I taught the CrM for 8 years. In 2001, I switched to Billings Ovulation Method®, both as a user and a teacher. I have been teaching Billings ever since, which has been so rewarding in many ways.
BOMA – You mentioned that Samantha is your Office Manager. What do you do for work?
Eileen – Christopher and I started our own business in 2007 called FireLink, LLC, which focuses on fire forensics. I have a BS in Chemical Engineering with a MS in Fire Protection Engineering. Christopher has a BS in Management Engineering (half business and half Electrical Engineering), an MS in Fire Protection Engineering, and he is also a licensed attorney. Our company primarily investigates fires and explosions after they have occurred to look at origin and cause, spread issues, if and why suppression and alarm systems failed, etc. We also do Computer Fire Modeling and Christopher is an Adjunct Professor at the WPI Graduate Fire Protection Engineering Program in Worcester MA.
BOMA – Wow! Between your business, large family, teaching NFP, and being the BOMA Board President, do you have spare time for anything else?
Eileen – There is a saying about when you want something done, ask a busy person! About 12 years ago, my pastor asked me to help him start a Perpetual Eucharistic Adoration Chapel at our parish. We opened that chapel in Nov of 2006. It is still running 24/7 to this day and I still organize the staffing of the hourly adorers.
Christopher and I also founded an organization called Catholic Quest in 2004 which brings out nationally known speakers to the local area for special live events to further adult catechesis. We usually host between 3-5 events/year, including people like Patrick Madrid, Peter Kreeft, Eric Genuis, and Jesse Romero. We have also rented out local theaters to show theatrical release Catholic movies from Ignatius Press.
Finally, in 2008, Sean Cardinal O’Malley asked us to be on the creation team of a new marriage preparation program. After several years of writing a curriculum and piloting several programs, with corresponding tweaks, our team now has two books published with the Pauline Books and Media: a leader guide and a participant workbook. The program is called Transformed in Love. We still run about 1-2 programs for engaged couples each year.
BOMA – What do you like to do in your free time, if there is any left!?
Eileen – In the quiet times of my day, I enjoy playing the piano. It is a good way to unwind and focus on something completely different from work and all the other ministries that I am involved in running.
Wearable Fertility Monitors By Betty McGehe, RN, MA, MSN
I have clients who have been using Billings for years. Recently, they have been doing research and discussing with other women the different gadgets out there, specifically the Ava Fertility Bracelet or Tempdrop. Has anybody else been getting similar questions?
As Billings teachers, we either already have – or soon will have – questions asked of us about one or more app purporting to be a quick, easy way to pinpoint fertility. Technology and the internet are producing glitzy aids for the woman wanting to achieve or avoid pregnancy. Entrepreneurs have recognized this gold mine. As a result, the field has exploded and it can seem impossible to get a handle on all the methods and gadgets on the market.
So how can we prepare ourselves to respond in the most helpful way to our clients, friends, and family members? Let’s begin with some specific thoughts about the question above. In a subsequent newsletter, we can develop a general approach to evaluating any device or method.
If a current client is asking about a specific website, app, or device, it might be easy to feel defensive. It has helped me to remind myself that her question does not necessarily mean she is unhappy using Billings. However, it is important to discover why she is interested in the particular device. Think about the following:
1) Initially, it is more helpful to ask questions than to begin giving her facts and advice. Just start by asking something like, “What caught your eye about ….?”, or, “What are your friends saying about ….?” Her response might help you identify something in her understanding or use of The Billings Method™ that calls for more education.
2) Unless you are already familiar with the app in question, it would be best to acknowledge her question, tell her you will look into it, and give her a day and means by which you will get back to her. Not only does this tell her you are interested in being sure she always gets accurate information from you, but it also gives you time to formulate your response 😊. Spend some time investigating the particular app. As you mentally compare the app to what you know about fertility and The Billings Method™, you will begin to identify the app’s deficiencies. This is also a great opportunity to review the research behind Billings. Don’t forget to consult other teachers using the BOMA-USA Teachers Network on Facebook.
Now, a few observations about the devices mentioned in the question:
1) Both are marketed to be easy to use and require no evaluation on the part of the user. Many women are lulled into a false sense of security, thinking that a device can give her 100% accuracy and relieve her of the need to observe her sensation throughout each day. No device is 100% accurate and capable of accounting for all the normal and abnormal variability in human physiology. This is an opportunity to reassure her that she knows her body.
2) Both devices are geared toward achieving pregnancy. How do we know this? First, both websites market to couples wanting to become pregnant. In addition, both devices rely heavily on a change in basal temperature. Since a sustained elevation in basal temperature is an indicator that ovulation has occurred, couples wanting to achieve pregnancy engage in intercourse at that time. Remember, though, that the mucus change after Peak, mediated through the activity of the Pockets of Shaw, gives us an indicator of the same hormonal activity as does the temperature change.
Emphasis on achieving pregnancy is an important point for another reason. Many couples falsely assume that they can take a method or device intended for achieving pregnancy and just adapt it to avoid pregnancy by refraining from intercourse during days the device indicates are fertile. Why doesn’t this always work? Devices intended to achieve pregnancy are calibrated to recognize the time of the greatest chance of conception and are not necessarily designed to be sensitive to the onset of the fertile window - what we would identify as the Point of Change. Couples needing to avoid pregnancy need to be able to recognize the ENTIRE time of potential fertility, from the point of change through the Peak or time closest to ovulation and three days following the Peak Day.
Manufacturers of any device worth considering should make available quality medical research noting the device’s sensitivity and specificity when identifying the entire fertile window and the time of ovulation. The device or method should be tested in clinical trials with actual users seeking to avoid or achieve pregnancy. Look for research that compares the method or device to hormonal levels. This is the type of research that has been done to verify the efficacy of the BOM.
3) That brings me to a third point. An app, method, or another device should always make available the research behind their claims. Neither the AVA bracelet or the Tempdrop provides satisfactory research on actual use of the device.
The Tempdrop site links to research testing the same category of thermometer, but not this particular device. Furthermore, there is no verification that this device accurately pinpoints ovulation.
The AVA bracelet site refers to research measuring pulse rate variability during the phases of the menstrual cycle; published and available at Nature.com. There are notable limitations to this study, but three aspects of the article are especially interesting:
1) The research does not evaluate the actual use of pulse rate information to achieve or avoid pregnancy.
2) The authors acknowledge the validity of the mucus sign and its superiority to basal body temperature when they write, “The self-detection of peak mucus day, defined as
clear, slippery and lubricative mucus, is a better predictor of ovulation…”. Although we would take issue with that definition of “peak mucus” (and would certainly not use that language), AVA researchers recognize the premier position of the mucus sign.
3) The authors conclude, “Given our findings, pulse rate is a strong candidate for inclusion in modern multi-parameter fertility awareness based methods (FABM).” In other words, they advocate that pulse rate information provided by the AVA bracelet be used in addition to verified signs such as cervical mucus changes. This article does not support the use of the AVA bracelet as a stand-alone cycle monitor.
The AVA bracelet declares it is “listed” by the FDA. A listed medical device is one that has been registered with the FDA and for which a registration fee has been paid. It does not mean the FDA has approved the device for its intended use. Being listed is NOT an FDA seal of approval. The AVA bracelet also indicates a Declaration of Conformity and a Testing Certificate. The Declaration and Certificate are requirements of the European Union. Looking at these certificates on the AVA website, neither document gives the user an indication of what standards are being maintained nor verifies the device’s medical accuracy.
Talking about testing and research may seem confusing at first. The main point is, if something is being marketed to help couples achieve or avoid pregnancy, lack of medical research giving the effectiveness in achieving or avoiding pregnancy is an automatic red flag. These devices are expensive. Although neither device is likely to harm, consumers should question if they are getting what they think they are getting.
It is a misconception that high tech automatically means high quality. With accurate use of the Billings Ovulation Method®, couples can be assured that they have high quality with high simplicity.
If you would like to share your thoughts, please do so in the comment section below.
Betty McGehe, RN, MA, MSN Billings Ovulation Method® teacher, trainer supervisor
BOMA Family Spotlight
Interview with long-time BOMA Teacher, Pat Kuhlman, RN, of Florida BOMA – Pat, thanks for agreeing to be our featured BOMA Family Member for this month. Why don’t you start by telling us a little about yourself? How long have you been married?
Pat – Peter and I have been married for 38 years. Peter is an invasive cardiologist and he will occasionally refer patients to me to naturally alleviate pre-menopausal symptoms. BOMA – What a lovely family photo. Please tell us a little about each of your children? Pat – We have been blessed with seven children: ~ Peter Joseph (35) is the father of three children (Peter Daniel, Mary, Julie) and works as a pharmacy technician. ~ Joseph (33) is a priest in our diocese and is currently stationed at the Cathedral of St. Augustine. ~ Patrick (29) is married and doing his fellowship in hematology/oncology at Wake Forest. He and his wife, Kelsey, have three children (Blaise, Benedict, Stella). ~ John Paul (27) works as a teacher and basketball coach at St. Elizabeth Ann Seton School in Palm Coast. Justin is a third-year medical student at Florida State University. ~ Josie (22) graduated from the University of Florida this past year and is now training to play professional tennis tournaments as well as managing her blog (Beautiful Depths Blog). ~ Maria (19) is a sophomore at Belmont Abbey College where she plays basketball.
BOMA – When did you start using the Billings Ovulation Method®?
Pat - We have practiced Billings since we were 25 years old. After being diagnosed with endometriosis and hearing from two OB/Gyn doctors that we would be better off adopting, Peter and I proved them wrong by the grace of God. We had a ruptured tubal pregnancy and conceived seven healthy children on one fallopian tube after that. We had five sons first, and then were blessed at 40 and 44 with two beautiful daughters. We thank God for the Billings Ovulation Method® and the profound impact that it has had on our lives.
BOMA – Yes, I’d say from “diagnosed” infertility to seven children is a profound impact. Thanks so much, Pat, for that family history. How long have you taught the Billings Ovulation Method®?
Pat – We have been teaching Billings for 18 years. It has been a calling from God to minister to sub-fertile and engaged couples. We also educate seminarians, priests, and young, single women. Peter and I have spoken at St. Vincent de Paul Regional Seminary in Boynton Beach. I have been active at the University of North Florida, teaching the Catholic Ospreys the Billings Ovulation Method®. I hope to be involved at Belmont Abbey College in the near future through the help of the FOCUS missionaries. To educate the youth about Humane Vitae and God’s purpose for human sexuality is of utmost importance to the future of the family in modern society.
As a registered nurse, I teach Billings, with a special desire to help people with anorexia, endometriosis, and PCOS as well. Peter and I, with our passion to serve through the medical field, teach the Billings Ovulation Method®. As medical people, we thank God for Dr. and Mrs. Billings for sacrificing their private practices for the sake of The Billings Ovulation Method®. BOMA – What inspired you to become a Billings Ovulation Method® teacher? Pat – Nancy Fischer, RN, had called to encourage me to become a certified teacher. I told her maybe in about two years because I was so busy with 7 children and we had just moved into a larger house. Two weeks later, she and her husband died suddenly while walking across a street in Jacksonville, Florida! They were killed by a drunk driver who ran a red light.
Sitting in church at their funeral, I starting crying in a corner realizing that I had to take the certification course and begin teaching! God had blessed Peter and me with seven beautiful children and I knew it was His time to give back and educate others in the truth and beauty of the Billings Method! So, Peter went with me to San Francisco to take our girls to the zoo and streetcars while I went to hear the Australians at a Teacher Training Conference. So, it was a calling; a vocation and a ministry to young girls, engaged couples, married couples, seminarians and priests!
It has been 18 years and I feel called to spread this truth about Humanae Vitae by Pope Paul VI until the day I die!
God said He would never abandon us...he raises people up like Mother Teresa, Drs. John and Lyn Billings, Pope John Paul II, and Pope Paul VI to wake us up to live chaste lives in the service of the Lord. Romans 12:1-14
BOMA – We know that you contribute to BOMA in so many ways. Why do you think it is important to support BOMA-USA through financial donations in addition to your time?
Pat – Where your heart is, will be your treasure! Peter and I give ongoing to Billings to spread the truth!
BOMA – What do you like to do in your free time? And, do you have any final thoughts to share?
Pat – In our free time, Peter and I love to spend time with our beautiful children and six grandchildren. We travel to basketball games, tennis matches, and love attending Masses celebrated by our son, Fr. Joseph, at his parish. Athletics have taught our family much about the relationship between sport and virtue. Peter is a runner and I play tennis to stay in shape as we age.
As a family, we are very grateful for the Billings Ovulation Method®. Who knows...without the knowledge of the Billings Ovulation Method®, we may not have been blessed with seven amazing children.
Article continued from newsletter............
The conference was opened up to the public on Friday and Saturday. Hundreds of smiling faces poured into the Ontario Convention Center. Although many were strangers, a feeling of camaraderie filled the air. Attendees enjoyed presentations from many world-renowned speakers including Archbishop Salvatore Cordileone, George Weigel, Janet Smith, Christopher West, Patrick Coffin, Pia de Solenni, Patricia Sandoval, and Ray Guarendi. In a break-out session, the Executive Director of BOMA-USA, Sue Ek, represented the Billings Ovulation Method on a panel of the modern methods of NFP. In her 10-minute presentation, she was able to include information on the Pockets of Shaw and the work of Dr. Erik Odeblad.
Ek, who also staffed the BOMA-USA table in the exhibit hall, said, “Our exhibit table was well received with several teachers coming to either introduce themselves or give a friendly hello.”
After a phenomenal weekend full of encouragement, theology, and science, the conference ended with a gala to celebrate Humanae Vitae Heroes, among whom Drs. John and Evelyn Billings were honored.
BOMA-USA board member Carlin Gould said of the weekend, “HV50 was a wonderful conference with GREAT speakers and a chance to meet new friends and reconnect with old ones committed to learning and spreading the good news about HV. My husband, Deacon Dave, really liked the opportunity to meet with other clergy for the special Clergy Day, learning how to get the message out from the pulpit! We learned a lot and can't wait to share with others.”
If you were unable to attend, CANFP will be offering videos of the conference talks, without cost, on their website www.CelebrateHV50.com.
“What will the next 50 years bring? May we all be inspired to carry the message of Humanae Vitae far and wide, with love and compassion, and to start a true sexual revolution.” -- Lynn Keenan, President CANFP.
UNCSW - Billings and the United Nations
Every year, WOOMB Australia sends a small team of representatives to the United Nations Commission on the Status of Women (CSW) at the United Nations Headquarters in New York City, to share how The Billings Ovulation Method® (BOM) helps advance the rights of women around the world. Alison Dreher, the lead instructor for the Sisterhood of Catholic Women and Adolescents, Education Coordinator for the St. Augustine Foundation, and a BOMA-USA teacher and member, has been on this small team for the last four years. Alison’s work with the UN includes influencing the delegates of the UN member states, assisting with and attending the side events that surround the commission, and raising awareness about the BOM and its benefits for women from all over the world. The team attends events, networks with other groups, holds parallel events, and every other year they partner with the Holy See to hold a side event as a contributing nation.
This past March, the CSW’s theme was “Empowering Rural Women through the Use of Technology.” Alison orchestrated the parallel event to present the benefits of the BOM to anyone who wished to attend. In the planning stages, she had a stroke of genius to use technology to “bring rural women” with her to New York by using a video conference program on the projector as part of the presentation. She hoped that other groups, who are opposed to her message, would not hear about her idea and steal it. Her hope was realized, and WOOMB’s presentation of rural voices via technology was a unique and beautiful implementation of the CSW’s 2018 theme.
The presentation, entitled “Empowering Rural Women and Girls with The Billings Ovulation Method® ,” began with Louise Allard, an experienced teacher trainer with extensive international experience, and her colleague Emily Iradukunda, a WOOMB fertility awareness consultant and teacher trainer. They shared the outcomes of their work with the BOM in a rural context.
The second portion of the presentation featured Alison. She began by sharing her own story of empowerment through the BOM and then opened the floor to the voices of 12 rural women who, as a result of using natural fertility regulation, have felt empowered in their relationships and overall health. One by one, each woman spoke from the comfort of their own homes, transmitted all the way to New York to speak to this event open to a worldwide collaborative body. In between each testimony, Alison read several stories from rural women around the world including stories from women from the Kikuyu tribe in Kenya and Lagos, Nigeria.
The parallel event was a success and all the participants were thrilled to be able to add their voices to this cause. The Billings Ovulation Method® continues to engage the culture with the truth, beauty and empowerment that comes through the knowledge that every woman ought to have.