Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.
Amy Beckley:
Welcome everybody. We have another episode of the Proov Podcast and I am super excited to be joined by Melissa [Buchan]. You're going to have to help me with the last name cause I always get it wrong. But she is the founder of Chart Your Cycle. She is also involved with Chart Neo, which is an amazing app that helps you chart your cycle. It's a fertility coaching company that really helps people understand their fertility by learning how to chart it. So, Melissa, please start with your last name and then tell us how you got here and what exactly do you help women do?
Melissa Buchan:
Amy, it's so wonderful to be here. And I love that you're asking this question while we are recording, because everybody always asks me that. And I always say, how do you think you say my last name? Because nobody ever gets it right. The only time it's ever been said correctly, was when I was visiting Ireland because it's an Irish name. So it's buckin’ like a buckin’ Bronco. So just think Melissa lives in Texas with all the cowboys and her last name is “Buchan” like a bucking Bronco.
And yes, I'm the founder of Chart Your Cycle. It's an online fertility coaching program where I teach women how to really tap into their menstrual cycle, which is documented in the medical literature as the fifth vital sign. If you know how to listen to your body and read the signs, it really is a great way to biohack, optimize health and wellbeing, or get to the underlying cause of infertility. I always say charting is more than a method. It's a lifestyle and it really offers some key insights into who we are as women.
Amy:
I say this all the time, the menstrual cycle is that fifth vital sign. If it is not functioning properly, there is something wrong.
Melissa:
We see that again and again, especially in this era of COVID where I'm starting to see more and more “COVID” cycles. I had my own personal COVID cycle and it was just crazy, but it helped me to navigate back to normal. It helped me to know what to focus on to help restore my health. It's fascinating. I'm sure we both could just talk about menstrual cycles all day.
Amy:
So first of all, this term, charting your fertility. What exactly does that mean?
Melissa:
That's a great question. And let's begin by saying charting your cycle is very different from tracking your period. Tracking your period is very easy to do. It is the basic minimum that every woman should be doing. And nowadays you go to your doctor, heck you go to the dentist office. What's the first thing they ask you? “When was the first day of your last menstrual period?”
We need to know this information, but charting your cycle takes it a step further in depth. So you're not just knowing when you start, how long that cycle was, but you're able to navigate and map the different phases of the cycle. We begin with the menstrual phase. Then we transition into the follicular phase, the ovulatory phase and the luteal phase. And each one of those phases is dictated by hormonal shifts, which is orchestrated by a symphony of events in our body.
So not only are we doing it for ovulating and ovulating well, but we know what to expect. As far as our overall mental state, our mood, our energy levels, I would say women are not little men. We do not operate on the same. We're kind of always ready to go. We're [not] fertile every single day, but we ebb and flow in and out of these phases of fertility and infertility, these phases of creativity and the need for more rest, our dietary changes. Our needs will change depending on where we are in our cycle. So when you learn to chart your cycle, you're really learning to tune into some specific biomarkers.
First and foremost, cervical mucus tends to be the most accurate for understanding the estrogenic activity of the ovaries. But we can also look at temperature. I love the biomarker of the Proov strip. This is kind of my go-to favorite thing now for helping women to open up that follicular phase to know, okay, now I'm closing my fertile window. I have passed the ovulatory event and I am now in that luteal phase, infertile, digestion tends to slow down. We tend to be a bit more relaxed. We need more sleep. If you begin to exercise and your exercise needs are going to change. It's a great way to confirm that transition.
Amy:
There's a common misconception that, you know, “Oh, if I have a 30 day cycle, I'm going to ovulate and ovulation is either yes / no,” like you're going to or you're not. And it's not — it's more about healthy ovulation, healthy cycles. So by charting things, not just tracking what days you have your period, but what kind of flow? Is it painful? Is it heavy? Is it light? Does it have clots in it, right?
Melissa:
Yeah, absolutely. You made a very key point that I think is often overlooked, but we're really starting to understand more really just within the last five years I would say is if you have a regular cycle, say you have what you call a normal menstrual bleed every 30 days, you're thinking everything's okay. And yes, we can assume if you're bleeding every 30 days, you're most likely having an ovulatory event. There's some sort of hormonal shift and an ovulatory event happening.
I'm thankful that women are wanting to know this information so that they can dig deeper to set themselves up for success if they are trying to achieve a pregnancy or to even just feel well. I guarantee you, if you're not ovulating well there are probably some other symptoms or complaints in your overall health that are proving to be quite annoying as well.
Amy:
I want to go backwards on something you said that I caught on to; there's certain hormone thresholds that you have to hit. So I struggle with this a lot because women that are LH testing...and they want to know when they're ovulating [because] they're either timing intercourse to conceive or they're trying to not conceive within that fertile window or they're just tracking their cycle. They want to know what level of LH they need and that's a tricky question. And I always usually say, well, the level that triggers ovulation, right?
Melissa:
Yeah. That is a tricky one. I think I was leaning toward the progesterone threshold when I said that statement, LH is a tricky thing. It can be a very helpful biomarker for a lot of women, but more often than not, I feel like it can prove tricky if there's an hormonal imbalance, especially with PCOS cycles with ovulatory dysfunction cycles. LH is a really hard thing to navigate. It's at what level does it initiate ovulation for you? Not every LH surge is directly correlated with ovulation. So you have to follow up in a few days to make sure that that LH surge actually triggered ovulation. You can have multiple LH surges without an actual ovulation event.
Amy:
I think most people think about it with LH, but absolutely with Proov tracking. It knows those PdG levels, those progesterone metabolites. There's a certain threshold that your body needs to be what we call successful. You've heard doctors say this is a weak ovulation or a strong ovulation or sufficient or insufficient. So there's a certain threshold that we like to see that says this was successful and this was healthy. And it's not just, you hit that one day, but if you hit that and then you kind of sustain those levels over time. Cause that's really what makes it a very healthy ovulatory event.
Melissa:
Absolutely. You can get that Proov positive just right after ovulation within a few days, but then you need to follow up with how that progesterone curve works. And we often see late luteal defects where you're doing fine and well, and then for whatever reason, progesterone just plummets.
Amy:
That is literally me. I will get one positive Proov test on my first day of testing, which is seven days after my LH surge, beautiful surges, by the way. Perfect. First Proov, great blood work on cycle day seven after ovulation. But then it drops and I'm getting negatives on day nine or 10 after ovulation.
I have a problem with ovulation and I'm 40 years old and I've never actually done a deep dive into why I have a weak ovulation, now I've done things to try to fix it. Seed cycling is amazing. Supporting different supplements, different diet lifestyles, but I've never really deep dived into what is going on inside my body to realize I'm not ovulating well. So step one is, are you ovulating? Do you have a great cycle, a great chart? And if the answer is no, what do you do next?
Melissa:
That's right. A well-treated cycle is step one of creating a diagnostic tool so that you can begin that deep dive and that looks different for everybody. You have to say, okay, what is my end goal here? And this is the beautiful thing about women's health and the way that it's going is that it's such a customized approach of, what is your end goal? Is it obtaining a pregnancy? Is it balancing those cycles? Is it feeling your best? Is it aging well? What is it that you are after?
What are your kind of primary goals and then what are your primary complaints that you want to resolve and then finding that kind of specialty niche approach for you, whether it be working with a doctor who specializes in restorative reproductive medicine or health coach who takes a functional approach and kind of looks at metabolic health and digging into gut health, and could there be an imbalance there that's causing a cascade of events and throwing off hormonal regulation? It all is so fascinating.
Amy:
There's so many data points, right? And there's so many innovations. I've seen gut health mapping and I've seen urine hormone mapping and all kinds of crazy allergen intolerance testing and all this stuff. So it's really complicated to, as a woman, to sift through and say, “You know what? These are $400 or $500 things, is this what I should be doing?” And it's not a cheap thing that you could just go over to target and grab it off the shelf for 20 bucks. It's like it's an all in kind of thing. Right?
Melissa:
It absolutely is. And the important thing is if you're doing this all in it's that you are working with somebody who's going to take the time to explain the results and then create a customized plan of healing. I can't tell you how many times in the past I've tried one or these other other tests, gotten the results back, but I have no action plan, so yes, I've got the knowledge of what's going on, but I don't necessarily know what the next step is for healing.
So then it kind of feels like chasing my tail of trying this, eliminating this thing or that thing, or the other, rather than a systematic protocol. This is something I'm fascinating and it's actually what I'm studying this year with my end goal. By the end of the year to be offering specific protocols for women to guide them in their healing process, because it doesn't look the same for everybody. It might be a gut and balance for one person. It may be severe food sensitivities for another, that yes is causing the gut and balance. But you have to get to the level of what's the trigger here.
Amy:
And that all starts with a well charted cycle.
Melissa:
It does. I tell women from the beginning, let's start charting your cycle, grab some Proov tests. Let's first evaluate what your ovulatory event looks like. Are you ovulating? And are you ovulating well to get that positive test? Again, women coming to me who they're bleeding every 28 to 35 days, So it's simple, it's an affordable first step that you can take.
Part of the work that I do with women is to help them to become their own best self advocate so that they can partner with a doctor who takes an approach that is in line with what their hopes and dreams are. And this first starts with them showing up with that cycle and saying, this is what it looks like. And I already know I have a poor ovulation. I'm not getting these positive tests. Let's dig even deeper.
When you go to a doctor and you have no idea what's going on and I'm not talking bad about doctors at all, they're amazing. But I think they really appreciate it when a woman does the work upfront, they kind of tend to take them a bit more serious. She knows what she's talking about. Okay. Let's, let's take some time to dig into this and, and get to the root cause because look, I mean, doctors are overworked. They've got 15 minutes with you. You can only cover so much ground in 15 minutes. Oftentimes I've been doing this work for 15 years.
The typical approaches a woman will first go to a doctor. They meet with them and they say, okay, come back in three months after you've worked with Melissa and created this diagnostic map of a well charted cycle, then we can really start investigating. So the work I'm doing now is kind of trying to intercept before women have to go through that frustration of paying the time, carving out time in their schedule, paying the money to see the doctor only to say, Oh gosh, okay. Now three months later we can start digging in.
Amy:
I 100% agree. I call these guided conversations. You have what, 10, maybe 15 minutes with them. There's only so much you can cover. So if you really dive deep with, I know, it's not these things. I checked those off the list and these are the things I have questions about. I remember going into my OB appointments and I would have to write a list of the questions. Otherwise I would forget because they're just going a mile a minute and they're like, they took the Doppler thing out or checking the heart they're in and they're measuring your belly and they're belting out numbers. And I'm like, I don't even know what this means. I guess it's okay if they're not concerned, but then you forget to answer the questions, right?
Melissa:
What you are saying is exactly point number one, when I am consulting with a woman, I say, okay, in your appointment, I help them prepare their chart. And I say, take a notebook. And in that notebook, there should be at least five questions that you want to ask and just write as they're talking, write it all down because they talk fast. A lot of these protocols are very specific. And sometimes when it's written out on the script, it doesn't make a hundred percent sense if you can't recall everything that was covered in that appointment.
So show up with a notebook, write the questions down ahead of time. For the 15 minutes that you're spending in that consultation, you should be spending 35 minutes to an hour mentally preparing and going through doing your research, being prepared so that yes, exactly. As you said, it can be a guided conversation.
Amy:
And then one more note about that is if, if you took the time to prepare this notebook of genius insights on your body, and you sit down at that doctor and you open up the book and their eyes roll or you could see them shut off. That's a cue that you're not at the right doctor and that's okay. It's okay to not be right.
Melissa:
Sometimes it takes a little bit of searching around just like any other profession. Sometimes we have to do little interviewing to find the right fit. And that leads to a point. I am always telling women, I help my clients find the right fit doctor for them. And that's frustrating to have to go on that journey alone. So that's something that I work really hard to network with physicians to understand what their approach is, what their expectations are. And there are a lot of really incredible physicians all across the country and the world. I have a referral source in Africa that I have a couple of clients in Africa and this physician is phenomenal, but he wants his women to show up with their charts so that he can start targeting those diagnostic evaluations.
Amy:
That is amazing. I just made some connections in my mind that I don't think I've ever thought about. So sometimes women and it could just be me, maybe I'm just the outlier, but I'm like, Oh, if I work with a fertility coach, I'm not going to be able to work with a doctor or they're going to have different things and it's not like they're going to fit together. And what you basically said was I help you have better conversations with your doctor. I work together and I help you find that fit, which honestly is like mind blowing right now. I don't know why. I've always been like, Oh, well, you know, traditional doctors, aren't working, go get a fertility coach or a health coach. And it's not one or another.
Melissa:
It's both, I call it building the web of support. I always ask people, who's on your team. Who do you want to be on your team? It's a doctor who is the right fit for you. I am a big advocate of health coaches. Sometimes it's also maybe a physical therapist for pelvic floor therapy. Maybe it's a nutritionist depending on what your needs are or what your primary complaint is.
So yes, that web of support, it's just not a one size fits all approach. And everybody's team looks a little different. The important thing is that you do build that web support and you do get the key players on your team who have you in their best interest. Which I hate to say that you, in your best interest, it sounds like these people are not out for your best interests. That's not true, but we have to be realistic about it. There are industries out there that their primary goal is all about things other than maybe prioritizing patient care. It's just the nature of the beast, but that doesn't mean they all are. And there are some amazing practices out there where it's all about customer service, patient service.
Amy:
I went to an IVF clinic, a fertility doctor that specializes in IVF. And if I walked through the door expecting anything other than IVF, I shouldn't have walked through the door just like you don't go to a chiropractor and expect to get spinal surgery. You go to a surgeon, right. And so some people say, you know what? I don't want surgery. I want to do chiropractic care. That's great. It's two ways to solve the same problem. But if you walk into the wrong institute and ask the wrong type of doctor, that's not aligned with what your goals are, you're not going to get the right answer. So it's not that one's doing it wrong or the other it's matching your expectations and how you want to manage your own health.
Melissa:
That's a great analogy. I really like that. It's about setting your expectations. And so first it all comes back to your why, why are you doing this? And how do you want to approach it and then finding the right people to get on your team?
So, yes, if it's not IVF, but you're struggling with infertility, then don't walk into an IVF clinic. If you're not wanting to go a more holistic route. Well then, you know, that's not the route that you go. So it really is then coming back to taking some moments. And this is really about the coaching philosophy that I've spent the last couple of years studying, health coaching. It's kind of like, Oh, a term that everybody throws around and there's a philosophy.
So for somebody who's truly been trained in integrative health coaching, it's a philosophy about partnering with your clients and guiding them through a conversation to help them understand their intrinsic motivation, because ultimately you're never to get the result that you want if you first can't understand, what's guiding you to that goal. And so first and foremost, understanding your why, why is it important? And always coming back to that, because in a journey, especially with infertility and health issues, it's a hard journey and you're going to hit roadblocks. You're going to stumble along the way. Sometimes it's this journey of a couple steps forward and then step or two back. But if you can come back to that, why and recommit to that, then it makes those difficult days easier to navigate.
Amy:
So I want to shift the conversation just a little bit. How exactly should a woman chart their cycle and the idea of Chart Neo. So there's like a thousand different cycle charting apps on Google or the Apple store. And it's like, how does chart Neo compare to the other ones?
I just want to say that I've used it before, and it's more like using your chart as a diagnostic tool, as opposed to just entering data. That's the way that I see it, you get entered data all day long, but if you're not entering the right data at the right time and prompted by certain things and to ask certain questions. So the way that they ask for the charting is a way to help you discover your cycle health and how to make the people reading the chart help you understand what that means to do better. So talk a little bit about the cool features of Chart Neo and how it's, I would say, better than others.
Melissa:
I love that awesome plug and people ask me all the time, like why in the world are you spending your time on the development of an app when there are millions of cycle tracking apps out there, and it's because I've been doing this long enough, and none of them met the standard that I was after, which is creating a diagnostic roadmap, taking a medical management model.
So Chart Neo is different in that it's not just a period tracking app. It's actually used to chart according to this medical management model. And it's taking the proven elements of all of the, what are known as fertility awareness based methods out there. So methods that have been created based on kind of research and studies to show that yes, they're tracking certain biomarkers based on hormonal activity to pinpoint where you are in your cycle and evaluate the overall health parameter of any particular phase of that cycle.
So in Chart Neo, it's not a predictive app, a lot of the apps out there are predictive. So they say, Hey, you're going to ovulate in a couple of days or your periods starting in three days. That has never worked for me personally. I’m regularly irregular as the majority of women are, only 13% of women consistently have a 20 day cycle where they ovulate on cycle day 14. So unless you have a pretty standard textbook cycle, a lot of these predictive features don't work for you.
So where we don't predict, we do have some interpretive elements where you know, for example, we take the quality of the mucus based on external observations and estrogenic qualities to say, okay, is this most commonly termed depending on, on how you're trained in charting peak type or non-peak type mucus. And then we're actually, we're constantly working on updates as anybody in Apple knows that's a constant battle to always keep up with updates of building in our algorithms to have the cervical mucus observations, talk with the temp shift and the Proov [PdG] strips to help you identify a fertile window and infertile window.
But more importantly, what the data, the way that it is recorded is that if you work with the new fertility advisor, they can calculate your fertility score to see the overall ovulation of that event, which is a pretty cool thing to do. So really something like Chart Neo, it's something that you have to know how to use it. You have to know what you're recording and how to interpret the data, because it's just too complicated to say, yes, you ovulated on this day. We can’t quite tell you that without really knowing your body. I mean, it's an alignment of the symptoms you're experiencing: the cervical mucus, the temperature shift, the Proov test, yes, there are some elements that we could probably build an algorithm for. We are working on that.
But it really is a tool that allows you to track your biomarkers and interpret it for whatever your intention is, whether you're charting for family planning or for women's health assessment or for infertility evaluation. The other thing I love about our app, we are a small team but we take most seriously the security of the data.
Ladies, this is intimate data that you're plugging into an app. I mean, a lot of women we’re tracking cervical collectivity, you're tracking intercourse. If you're making it a full diagnostic tool for an infertility evaluation there's a place for notes. And so you want to make sure that that data is not being fished out or sold to third parties. And so we follow the HIPAA compliance. We are HIPAA compatible. Big goal of this year is to file for HIPAA compliance. That's a lot of stuff that people don't care about, but it's super, super important. And it should be for consumers of apps, super important to know how your data's being.
Amy:
Yeah, that is really important because I know there was a popular app that had a data breach and it's huge, it's simple, it's really, really important. I mean, everyone stores their entire life on their phone at this point. Your bank accounts are there and you just click a button and you could transfer all the money out. That's scary stuff.
Melissa:
In the app development world, again, I don't want to move the conversation too far away cause it's just all the nitty gritty but it's to be a secure app, it takes a lot of work and a lot of checks and balances. And I'm just happy to say that we've got those in Chart Neo so if you're using this, you can know that it is secure and what I love and how we utilize it in my program, Chart Your Cycle, is the secure messaging center. So this allows me to really provide one-on-one chart evaluation services to my clients.
So if they have a question about their chart or they're preparing to meet with their doctor they send a message in the secure messaging center allowing me as their practitioner to pull that information up, have their intake form, do a thorough evaluation and get back to them in a very timely manner. I've been at this for a while and I was losing so much time on all of the administration, because it is data gathering, gathering the chart, just so I could evaluate it. So for those listening, who may even be fertility awareness teachers or coaches, check out the Chart Neo, you can actually apply to be a provider and we have an amazing backend.
Amy:
So we're also working on the Proov app, but it's in a beta version. We don't do predictive functions either because I don't know, I can't tell, I don't have a crystal ball and I'm not going to tell you when you're going to ovulate, I have no idea until you actually feed in the data that tells me, “Hey, you're fertile. Now you might be ovulating.” I don't know. There's no crystal balls, like next Tuesday is the day.
Melissa:
So much could happen between now and next Tuesday within all of those biochemical pathways. And you have no idea what's going to take place.
Amy:
What we get all the time is, “Well, my app said that I was ovulating yesterday, but my LH was low. Why is my LH test wrong?”
Melissa:
And that's why, again, the approach I teach, I teach women how to chart and read their chart. So it's one thing to put the data in. It's another thing to be able to interpret that and make sense of your cycle when it's charted well and documented well has a story to tell.
And I keep coming back to this, but it was just, for me, the most relevant is my COVID cycle. I just really think there should be a study on COVID menstrual cycles because I have personal experience and I'm seeing it again and again in the clients that I work with. Now, the clients I work with, they tend to be susceptible to cycle imbalances based on either internal or external stressors. Not everybody is, but more and more, we're seeing that if you have a sensitive composition where internal or external factors really have an impact on your stress level or on your overall health it's going to impact your menstrual cycle.
Amy:
I've heard that a lot. We've had a couple of questions on the board about, Oh my gosh, did you have a really long cycle when you had COVID? Yes.
Melissa:
That's the first thing that typically women have happened is; where'd my period go. I'm not pregnant. Am I always sick with COVID all month?
Amy:
Those would be loss of taste. Loss of smells. Exactly. Awesome.
Well, this has been a really amazing conversation. Is there anything you want to talk about that we haven't covered?
Melissa:
Well I'm sure we could talk all day Amy, but no, I think I covered it all today. I'd love to, if people are interested, could I just give them a little resource?
Amy:
Absolutely, please.
Melissa:
So if you're interested, you know, we talked a little bit about Chart Neo and about different kinds of cycle patterns. So if you're interested in what that looks like, I've got this great guide called the Five Most Common Cycle Patterns. So if you go to MelissaBuchan.com/cycleguide, you can download that cycle guide and figure out which one most relates to your cycle.
Amy:
So we'll post this on YouTube. If you're on Stitcher and you're listening to the podcast, go to YouTube Proov channel, we'll post the links, go to the Proov site, find the blog, that's the transcript of this. And so we definitely share that because I think it's really important. Education is key. If you walk into somewhere that you're wanting someone to help you with your health and they don't like the education that you're putting in front of them, please go find another resource. There's plenty of people out there that want to help you. I've always been a fan of Melissa, I think we've known each other for at least two years, at least.
Melissa:
I don’t know how our paths crossed but I'm a huge fan of Amy and I absolutely love the Proov test as a woman who struggles with cycle irregularity. The Proov is the thing I come back to again and again, to confirm that I've ovulated. I absolutely love it. And just to follow up what you said, like part of my mission in life is that every woman shows up to her annual well woman exam with a well charted cycle in hand, it should just be a common practice.
Amy:
Yeah. Yeah. Well, I mean it's a fifth vital sign, right. Thank you so much. I appreciate you coming on and I'm sure we will talk again soon.
Melissa:
Fantastic.
