The Basis of the Justisse Method

Cervical Mucus Cycle Wheel

Cervical Mucus Chart

The basis of the Justisse Method is the observation of cervical mucus in the menstrual cycle. Basal body temperature, cervical changes, and other cycle events and signs of fertility are used to support the information provided by cervical mucus observations. All events and signs are important in understanding reproductive health and fertility.

The 1st day of the cycle is the 1st day of menstruation. Menstrual flow lasts about three to seven days. A healthy menstrual flow begins as heavy or moderate and subsides to light or very light.

After menstruation, you will usually notice a few days where the sensation at the vulva is and no cervical mucus is observed (except in shorter cycles).

After those dry days, you may notice some discharge at the vulva. You may notice it on your undergarments or as a sensation of extra smoothness or lubrication when you wipe yourself after going to the bathroom. You may first notice a sticky white mucus discharge. After a few days, the discharge becomes clear and/or stretchy, accompanied by a sensation of lubrication or slipperiness at the vulva. The last day of mucus that is clear, stretchy, or lubricative is called the Peak Day.

Following the Peak Day, there is a dramatic change. The mucus changes to a sticky white discharge or disappears altogether. The sensation at the vulva returns to dry. From the 4th day after peak until the beginning of the next menstrual flow, you will notice you are dry.

Fertile days include the menstrual flow and all mucus days, from the first day mucus appears through to the Peak Day and for 3 days following.

Infertile days include the dry days after menstruation and from the fourth day after Peak Day until the beginning of the next menstruation.

In the diagram of the “cervical mucus cycle wheel” you will notice that the days between the Peak Day and the onset of menstruation are numbered from 1 to 14. No numbers appear from the start of menstruation and up to and including the Peak Day. This is because the phase before Peak Day may vary in length. The phase after Peak Day is stable in length. Fourteen (14) days is the average length of this post-Peak-phase. Peak Day correlates very closely with the time of ovulation.

Occasionally women experience a cycle that is shorter cycle than they would normally expect. When this happens, ovulation may occur earlier in the cycle. The clue to an early ovulation is that there are no dry days following menstruation. Instead, mucus will be present during the light and very light days of menstrual flow. Taking this possibility into consideration, and being aware that you cannot predict when a cycle will be short, the menstrual flow is considered fertile. However, the light and very light days of the menstrual flow can be observed for mucus as any other day. If there is no mucus on the light and very light days then these days are infertile.

All days of menstruation are considered fertile until a woman can confidently identify her light days of bleeding as dry. As well, she must be confident that her bleeding is a true menstrual bleed and not another type of bleeding. When she is confident of these two things then she may consider days 1-5 (the first 5 days) of her menstrual cycle as infertile. Such confidence generally comes after having charted for at least one year.

The Count of 3 after Peak Day is necessary because ovulation can possibly occur on those days. On average, ovulation occurs on Peak Day. However, statistics have shown that ovulation can occur on the first, second or third day after peak, or the day before Peak. Even though you are dry on the days after peak your vaginal environment is still alkaline enough to support sperm life. Thus if ovulation were to occur on one of those dry days within the Count of 3 intercourse might result in a pregnancy. That is why those days are considered fertile, and it is important for a woman who is avoiding pregnancy or wanting to become pregnant to consider this.

Pregnancy Complications

Pregnancy complications are difficult events, or happenings, that can take place in different phases of a pregnancy. Some actually happen after you give birth. Many times, they are unpredictable. Knowing all possible risk factors that may apply to your own health during your pregnancy is a surefire way to help prevent possible complications.

Placenta previa is a rare, but serious condition that can occur. This is when the cervix is blocked by the placenta. It can be harmful to both mother and child. There are a variety of problems that you can encounter while pregnant. Some are related to genetics; such as Trisomy, and others in which can be treated if detected early enough. Iron deficiency anemia in pregnancy is a pregnancy complication that should be tested starting from your first prenatal visit, and continue on throughout. Anxiety during pregnancy is a common complication that can start as early as conception.

Early Pregnancy Symptoms

Symptom

When It Occurs

What Causes It to Occur During Pregnancy

Other Possible Causes

A missed period

Around the time that your period is due.

Rising levels of progesterone fully suppress your menstrual period.

Jet lag, extreme weight loss or gain, a change in climate, a chronic disease such as diabetes or tuberculosis, severe illness, surgery, shock, bereavement, or other sources of stress.

A lighter-than-average period

Around the time that your period is due.

Your progesterone levels are rising, but they are still not high enough to fully suppress your menstrual period.

May also be experienced by birth control pill users.

A small amount of spotting

Approximately 1 week after conception.

This type of spotting may occur when the fertilized egg implants in the uterine wall about a week after conception has occurred.

May be experienced by users of birth control pills and women with fibroids or infections. Some women routinely experience midcycle spotting.

Abdominal cramping (periodlike cramping in the lower abdomen and pelvis and/or bloating and gassiness)

Around the time that your period is due.

Abdominal cramping may be triggered by the hormonal changes of early pregnancy. Some women describe this cramping as a feeling like their period is about to start.

PMS, constipation, irritable bowel syndrome.

Breast tenderness and enlargement

Breast tenderness can set in as early as a few days after conception; It doesn't typically last beyond the first trimester.

Breast tenderness and enlargement are caused by the hormonal changes of early pregnancy. You may also notice some changes to the appearance of your breasts: the areola may begin to darken and the tiny glands on the areola may begin to enlarge.

Premenstrual syndrome (PMS), excessive caffeine intake, or fibrocystic breast disease.

Morning sickness (a catchall term that is used to describe everything from mild nausea to severe vomiting that can lead to dehydration)

2 to 8 weeks after conception.

Scientists believe that morning sickness is somehow linked to high levels of progesterone and human chorionic gonadotropin (hCG), but they aren't sure of the particular mechanisms involved.

Flu, food poisoning, or other illnesses.

Food aversions and cravings (e.g., a metallic taste in the mouth and/or a craving for certain types of foods)

2 to 8 weeks after conception.

Food aversions and cravings are triggered by the hormonal changes of early pregnancy.

Poor diet, stress, or PMS.

Heightened sense of smell

2 to 8 weeks after conception.

The heightened sense of smell that many pregnant women experience is the result of the hormonal changes of early pregnancy.

Illness.

Increased need to urinate

As early as 2 to 3 weeks after conception.

The increased need to urinate is triggered by increased blood flow intake.

A urinary tract infection, uterine fibroids, or excessive caffeine to the pelvic region and by the production of human chorionic gonadotropin (hCG) during early pregnancy.

Constipation

As early as 2 to 3 weeks after conception

Progesterone relaxes the intestinal muscles, resulting in varying degrees of constipation.

Inadequate intake of high-fiber foods or inadequate consumption of fluids.

Bleeding in the First Half of Pregnancy

Bleeding in the First Half of Pregnancy:

Bleeding in pregnancy can be extremely alarming upon first finding out that we are expecting. Here are some possible reasons for spotting during early pregnancy.
  • Implantation Bleeding. A normal symptom of early pregnancy. Occurs 5-12 days after conception. Implantation is experienced differently for each woman.
  • Infection in the pelvic cavity or urinary tract.
  • Bleeding after Intercourse. The cervix is very sensitive. Normal intercourse does not cause a miscarriage. Be sure you know what can contribute to miscarriage ahead of time. Discontinue intercourse until you consult your physician if you experience any amount of vaginal bleeding after intercourse to prevent further irritation.

Bleeding in the Second Half of Pregnancy:
Any bleeding in pregnancy can be scary. In the second half of pregnancy, minor bleeding can be caused by an inflamed cervix or growths on the cervix. Bleeding in the late part may also pose a threat to the health of the fetus or the mother. Be sure to be in touch with your physician if you experience any bleeding in the second or third trimester of pregnancy. All bleeding in pregnancy should be reported to your doctor.

Placental or Placenta Abruption:
When the placenta detaches from the uterine wall before or during labor, placental abruption occurs. This happens to 1% of pregnant woman and usually occurs during the last 12 weeks of pregnancy.

What are the signs of Placental Abruption?
- Bleeding
- Pain in stomach

Who is at risk for Placental Abruption?
- Women over the age of 35
- Women who have already had children
- Women who have had an abruption in the past
- Women who have sickle cell anemia
- Women who have high blood pressure
- Women who have had trauma or injuries to their stomach area
- Woman who use drugs/cocaine

Placenta Previa:
When the placenta lies low in the uterus, placenta previa is occuring. This is a serious condition that requires immediate care. Positioning of the placenta will often partially or completely cover the cervix. Placenta previa occurs in 1 in 200 pregnancies. There usually is no pain associated with placenta previa.

Who is at risk for Placenta Previa?
- Women who have already had children
- Women who have had a previous cesarean birth
- Women who have had previous surgery on uterus
- Women who are pregnant with multiples

Preterm Labor:
Vaginal bleeding in pregnancy can be a sign of labor. A few weeks before labor starts, the mucus plug may dislodge and pass. This is usually made up of mucus and blood. When this happens, this can mean that preterm labor may begin in the very near future. Preterm labor occurs before the 37th week of pregnancy.

What are the signs of Preterm Labor?
- Vaginal discharge. This can be watery, mucus, or bloody.
- Lower abdominal/ pelvic pressure
- Low, dull backache
- Cramping in stomach either with or without diarrhea
- Consistent Uterine tightening or contractions

Norlevo

Norlevo (0.75 mg levonorgestrel) is a new emergency contraceptive tablet available from Laboratoire HRA
Pharma. This product is the same as Plan B and patients are to take one tablet as soon as possible (i.e. within
72 hours following intercourse), followed by another tablet 12 hours later. Common side effects include nausea
and vomiting. If vomiting occurs within 1-2 hours after the first tablet is taken, the first tablet must be repeated.
Norlevo is considered a non-prescription requiring product that will be kept behind the pharmacist’s counter.
This product will only impact those plans that cover Plan B and similar non-prescription products. Price and
availability of Norlevo are currently unknown.