NFP for Pre-Menopause

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NFP for Pre-Menopause
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Opening Prayer for Families
Blessed to be Woman

• We bless your name, O Lord,for sending your own
  Incarnate Son,to become part of a family,so
  that, as He lived its life,He would experience
  its worries and its joys.We ask you, Lord,to
  protect and watch over these families,so that in
  the strength of your gracetheir members may
  enjoy prosperity,possess the priceless gift of
  your peace,and, as the Church alive in the
  home,bear witness in this world to your
  glory.We ask this through Christ our Lord. Amen

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You are considered to be in Pre-menopause if
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• You are 45 years
• Or younger if you have a family history of early
  menopause before 45.
• You have experienced the first unexpected short
  or long cycle (lt23 days or gt 40 days)

Definition The 5-8 years prior to menopause when
one or more of the following occur
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Pre-Menopause
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• Menstrual cycle irregularities
• Unusual bleeding
• Decreasing fertility
• Altered menstrual and cervical mucus patterns
• Fewer thermal shifts
• Shorter Luteal (high temp)phases
• FSH is high, estrogen is low.

Menopause Definition 12-14 months with no
menses. Average age is between 50-52.
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Pre-menopause Challenges
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• Previous reliance on Temperature or Rhythm Method
• Unusual bleeding vaginal atrophy
• Decreased cervical mucus is common
• Hot Flashes
• Use of Hormone Replacement Therapy
• Fear of pregnancy, birth defects

A time of decreasing fertility 45-50 yrs
1.3/1,000 are fertile/ 50 yrs 1/25,000 are
fertile. Risk of Down Syndrome is higher, but
only 3.6 risk at age 45.
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Examples of Pre-Menopause ChartsShort Long
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Each Cycle Has 3 Phases
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Relatively Infertile Time
Completely Infertile Time
Possibly Fertile Time
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Observing and Charting Cervical MucusTissue
Examination
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Cervical Mucus

• - Wipe
• Look
• Test

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Observing and Charting Cervical MucusTissue
Examination- 3 Easy Steps
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• Wipe Look Test for Cervical
  Mucus
• Each time you go to the bathroom, day night,
  use white, unscented tissue, folded flat, several
  layers thick.
• 1. Wipe front to back at the vaginal entrance.
• 2. Look at tissue.
• 3. Test for stretch, color, clarity.

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Tissue Symbols
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• Tissue-Dry Ø
• Sticky Mucus M
• Traits P, O, ¼, ½, ¾.
• Egg-White Mucus EW-M
• Traits 1, OT, T, G.

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Vaginal Sensations
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Separate from tissue examination- a
mental awareness of internal and external
vaginal sensations felt throughout the day.

• d nothing, dry, or slightly itchy
• something, as if
  secreting moisture
• L lubrication, slipperiness or
  runny-wet feeling

m M
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Peak Day Identification
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• Peak Day (PK) is the Last Day of the Most Fertile
  Sign. (by Tissue Sensation)

mM
mM
d
L
d
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Good Hygiene Health Habits for Women Charting
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• Avoid perfumed toilet paper and feminine hygiene
  sprays, as well as powders that contain talc
  (cancer).
• Avoid use of deodorant tampons, soaps, lotions,
  powders, or bubble baths that are perfumed or
  irritating in any way.
• Wear only cotton lined underwear and panty hose,
  as nylon and other synthetics do not absorb
  moisture.
• The vagina is a self-cleansing organ daily
  baths and showers are all that are needed for
  good hygiene.

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Charting the Cervix Let your cervix SHOW you
when youre fertile!
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F firm S soft
L low H high
C closed O open
Ø dry M or EW-M wet
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Charting the Cervical Mucus at the Cervix
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Sympto-Thermal Rule Mucus Temps
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Lets Say Peak Day Is Here
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Watch for 3 Temperatures in a Row
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All higher than immediately preceding 6
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2
6
5
4
3
1
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To separate the initial highs from the final
lows
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6
5
4
3
2
1
Number Backwards
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Draw a Pre-Rise Baseline through the highest of
the final 6 lows.
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PRB
2
6
5
4
3
1
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Full Thermal Shift Level is 0.4F above the PRB
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FTSL
.4F
PRB
FTSL 0.36 F or 0.2 C
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CIT starts the evening of the 3rd post-peak high
in a row, if it is on or above the FTSL.
PK
FTSL
.4 F
PRB
6
5
3
4
2
1
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If the 3rd post-peak high is not on or above the
FTSL, wait until the evening of the 4th post-peak
high to assume the CIT.
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Understanding Bleeding
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Relatively Infertile Time
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Menses Fertile, Dry Days Infertile Early Dry
Days Rules
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• At age 40 and beyond, women who are avoiding
  pregnancy should no longer use the 6 or 5 Day
  Rule.
• The new rule for this last phase of your
  reproductive lifetime takes into account changing
  cycle lengths and by starting at age 40, it
  anticipates the first unexpected short cycle.

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First Unexpected Short Cycle
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MFDDI and Early Dry Days Rule
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• To avoid pregnancy while using the RIT
• (Pre-Ovulatory Relatively Infertile
  Time)
• 1. Abstain during menses until tissue and
  sensation can be considered dry, even if still
  spotting.
• 2. Crosscheck tissue, sensation, and cervix, and
  assume fertility with any change from
• Ø to M or EW-M
• d to m/M or L
• F,L,C,Ø to S, H, O, W (M or EW-M)

• Whichever change comes first!!
• If avoiding Pregnancy, intercourse is available
  only in the evenings of every other dry day,
  unless experienced with cervix checks and cervix
  is FLCD just prior to intercourse.

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Complete Activity MFDDI STR
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• Using Menses Fertile, Dry Days Infertile Rule,
  mark the first change of fertility by tissue,
  sensation, or cervix with a wavy, vertical line.
• Apply the Sympto-Thermal Rule

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In the absence of a temp rise
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• Be vigilant in observing all other signs

mM
mM
d
L
d
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DO NOT USE Patch Rule- the variation of the Basic
Mucus Rule which omits the count on 1-2 day
patches of M and m/M and is NEVER recommended
during Pre-Menopause.
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Pre-Menopause
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Pre-Menopause
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Pre-Menopause
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Complete Activity 10 Basic Mucus Rule
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• Go over with instructor and bring home to husband
  if he isnt present to go over again with him.
• Be sure to chart everyday, at end of day.
• Be patient and take good care of yourselves. This
  stage of your life doesnt last forever!
• We are always happy to provide chart review!

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Keep a sense of humor!
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• I dont have hot flashes, I have short, private
  vacations in the tropics!
• The menopause fairy ate my brain!
• I dont want to go through Menopause, I want to
  go around it!
• Im trying very hard to understand this
  generation. They have adjusted the timetable for
  childbearing so that menopause and teaching a
  sixteen year old how to drive a car will occur in
  the same week. Erma Bombeck

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Blessed to be Woman

• There is a time for everything, and a season for
  every activity under the heavens (from
  Ecclesiastes, Ch. 3)
• May our Lord enlighten our minds and touch our
  hearts.
• May we learn more about, and keep faithful to,
  all of the Church's teachings.
• May our Lord give both of us strength, courage,
  peace, and the deepest faith.
• In Jesus Name, we pray. Amen