Knowledge gives assurance. With the Billings Ovulation Method of natural family planning, free from manipulation by chemicals and devices, the woman learns to interpret her natural signs of fertility through all her changing cirucmstances from puberty to menopause.

The method of natural family planning engenders co-operation and respect between the woman and man. It develops love and concern for each other and for the child, thus enriching their relationship.

The Billings Ovulation Method is easy to learn and is highly successful when used by a couple to achieve or avoid pregnancy.

What is menopause?
Woman is unique in that her reproductive capacity ends in middle life. The loss of fertility happens over a number of years, a time known as the climacteric (change of life). Menopause is more strictly applied to the natural end of menstruation, but many use the term to describe the years around that event, when hormone levels are changing in certain ways. Menopause is a natural phenomenon.

What happens during menopause?
After menopause, very little progesterone is secreted and the level of oestrogen drops dramatically. So ovulation ceases and the cervix reduces its mucus production. During the fertile period of a woman's life, the mucus causes wetness and slipperiness at the vulva. This mucus is essential for the life and vitality of the sperm and is an indicator of a woman's fertility.

What are the signs of approaching menopause?
The change of life may occupy 5 to 10 years, or it may happen more quickly. A woman may experience a number of symptoms, including breast tenderness, dryness of vagina, urinary irritability, irregular bleeding, hot flushes, weight gain, anaemia, tiredness and irritability. Many women are not inconvenienced by these symptoms.

Irregular cycles and bleeding
Menstrual periods may stop without obvious warning and not begin again. Or periods may cease for months at a time, only to be followed by several apparently normal, or short, cycles. Irregular ovulations cause irregular bleeding. There may be a shortening of the post-ovulatory phase from the normal 11 to 16 days indicating infertility.

Not all bleeding is true menstruation. Oestrogen levels may stimulate the lining of the uterus causing it to bleed, without ovulation preceding it. Sometimes bleeding will accompany ovulation, therefore intercourse during bleeding occasionally results in pregnancy. The amount of bleeding may vary considerably from very light with prolonged spotting to very heavy with clotting. Heavy bleeding with clotting may be associated with fatique, lack of energy, light-headedness or depression. Iron supplements may relieve some of these symptoms. It is wise to consult your doctor for a medical diagnosis of any unusual bleeding.

Cervical mucus
As a woman ages, the cervix fails to respond to raised oestrogen levels and does not produce that mucus which ensures fertility by transporting the sperm. The Billings Ovulation Method helps a woman to understand these natural events so that she can recognize her declining fertility. By observing the mucus pattern, a woman can establish reliably: a) the signs of infertility b) the signs of possible fertility.

Breast signs
Often after ovulation and just before menstruation, many women notice they have tender, lumpy breasts. Approaching menopause, this tenderness may be absent, indicating ovulation may not have occurred in this cycle. Some may experience prolonged breast discomfort never felt before and there may be an increase in breast size.

Hot flushes
Oestrogen levels fluctuate markedly. When they are low, hot flushes may be experienced, to disappear with the natural rise of oestrogens, and recurring when oestrogens next fall. Hot flushes are not detrimental to the health, but may be annoying, embarrassing and sometimes may distrub sleep. A day of hot flushes accompanied by dryness at the vulva (no mucus) indicates an infertile day.

Dry vagina and painful intercourse.
Due to thinning and dryness of the vaginal lining, some women occasionally find intercourse painful. This symptom comes and goes with fluctuating hormone levels. More time may be needed in love making to produce the natural lubricants that occur prior to loving intercourse.

Urinary disorders
Occasionally there may be an increased urge to pass urine, or recurring urinary tract infections. A short course of oestrogen cream applied into the vagina may assist in relieving these symptoms.

Weight gain
Declining fertility may lead to some weight gain. Emotional factors such as depression and lethargy may contribute to the tendency to overeat.

Hormone Replacement Therapy
Being a natural event, the menopause should not be interfered with by replacement hormones. A woman's natural hormones fluctuate for several years before stabilising at a normal low level. Sometimes, short courses of Hormone Replacement Therapy (HRT) may benefit a woman with particularly distressing symptoms. There must be a diagnosis of abnormal symptoms before any treatment is undertaken.

HRT, like any drug treatment, should be a carefully considered decision because of its side-effects. The proposed evidence that HRT protects against heart conditions and osteoporosis has not had sufficient time to be adequately researched. There is good evidence for oestrogens causing breast cancer and cancer of the uterus. Adverse heart and cerebral conditions can result from hormonal medication such as contraceptives.

HRT - oestrogen plus progesterone- results in clinical bleeding for the duration of treatment. If treated for the rest of her life, a woman may continue cycles of bleeding and not enjoy the benefit of natural menopause when bleeding ceases in middle life. Management of hormonal dosage may minimize or eliminate bleeding.

Alternatives to Hormone Replacement Therapy
Good cardiac and bone health can be maintained following menopause using natural alternatives to HRT.
Good diet. A diet rich in calcium, supplemented with calcium tablets 1000mgs per day and vitamin C (a daily glass of orange juice) will help maintain strong bones.
Exercise. Healthy bones need weight bearing and postural exercise such as walking, gardening, golf or tennis.
Rest. Adequate rest each day and attention to physical and mental health contribute to general wellbeing.
Sympathetic counselling. Some problems may have nothing to do with menopause but, by causing stress and anxiety, may contribute to a worsening of menopausal symptoms.
Communication. Relationships benefit greatly when the husband also has an understanding of menopause.

The Billings Ovulation Method is based on observations of the mucus secretion which accompany fertility. It is a natural method of understanding fertility which gives women knowledge of their own bodies. By observing the presence or absence of mucus, a woman can identify fertile and infertile times. During the change of life, it is common for dry days to increase in number, and for whole cycles or months to pass during which no mucus is apparent. Any return of possible fertility will be readily recognised at the vulva by the sensation of mucus.

The Billings Ovulation Method teachers can help you interpret your observations and explain guidelines to ensure avoidance of pregnancy if desired. (E.L. Billings MD)