Books about reproductive health, Fertility Awareness, and Natural Family Planning

More about Katie Singer

Garden of Fertility Book CoverHonoring Our CyclesIn her books, The Garden of Fertility (2004) and Honoring Our Cycles (2006), Katie Singerintroduces Fertility Awareness (also called Natural Family Planning).With these methods, a woman who charts her temperature and cervical mucus can know when she is fertile and infertile. A woman who charts her fertility signs can also know whether she is ovulating or miscarrying. You can learn remedies for problems like Polycystic Ovarian Syndrome (PCOS) and fertility.

R E P R O D U C T I V E   A N A T O M Y
S e x u a l l y   T r a n s m i t t e d   I n f e c t i o n s

When a woman is fertile, she's more susceptible to Sexually Transmitted Infections (STIs), because slippery mucus and an open cervix can both encourage semen to enter the uterus. Including the possibility of STIs in your awareness is part of using Fertility Awareness responsibly.

Most forms of contraception, including Fertility Awareness, offer no protection from STIs. Before you have genital contact with anyone, each of you should get tested for sexually transmitted infections. County clinics often provide tests for free. The incubation of HIV can take six months for it to show up in a test. Once you and your partner have abstained from genital-genital contact or have been monogamous for six months, then a test for HIV will be accurate. Test results for HIV typically take two weeks, though a new test, costing about $150, can give results in about 20 minutes. Other STIs can accurately be tested immediately. If you have multiple partners, you should be tested every six months.

If you have sex with someone who has not been tested for sexually transmitted infections, only male or female latex or polyurethane condoms can provide protection. Please be aware that men and women can be allergic to latex. Skin reactions may be immediate, or slow in developing. Try polyurethane condoms. Lambskin condoms can prevent pregnancy, not STIs.


To get a sense of the size of an STI, consider that the true size of a woman's mature egg is about the dot of a pen. If you magnify that egg so that it's the size of a nickel, and put a dot inside that nickel, then you can begin to see the size of one sperm in relation to the size of one egg. The larger sperm shown here has been magnified about 1250 times!

In this drawing, one cell each of the sexually transmitted infections syphilis, gonnorhea, chlamydia, herpes, HPV and HIV has been magnified as many times as the larger sperm shown here. This is why lambskin condoms (which are slightly porous) can effectively prevent pregnancy, but not STIs.

Drawing of relative sizes of egg, sperm, syphilis, gonnorhea, chlamydia, Herpes Simplex, Human Papilloma Virus (HPV), Human Immuno Deficiency Virus (HIV)


An ulcer or sore that appears on your vulva, vagina or cervix two to four weeks after exposure may be a symptom of syphilis. Usually, the ulcer doesn't hurt or itch. Syphilis is treated with antibiotics.

Usually, women who have gonorrhea do not have symptoms. Those who do will have a yellow discharge, burning and soreness at the vulva, burning while urinating, pain or bleeding during sex, a sore throat, or bleeding between periods about ten days after exposure. Gonorrhea is treated with antibiotics.

Chlamydia is the most common sexually transmitted infection in the U.S. Most women who have it do not show symptoms. Ten percent of women will experience pain in their pelvis, pain during sex, burning while urinating, yellow discharge, bleeding after sex, bleeding between periods, or fever. Chlamydia is treated with antibiotics.

About 20% of American adults have been infected with genital herpes. Many women who carry the virus have no symptoms. Those who do have symptoms may experience blisters or ulcers on their vulva or vagina. These lesions can be very painful or itchy; they can last for a few days or a few weeks. While there is no cure for herpes, meditation, homeopathy, acupuncture and antiviral medications have been found to lessen the frequency of lesions recurring.

Human Papilloma Virus (HPV)
HPV causes genital warts and is thought to be the primary cause of cervical cancer. HPV is the most commonly transmitted virus in the U.S. Many women who have HPV will not have symptoms. Women who do experience symptoms may notice bumps on their vulva, at the vaginal opening, or on the anus. These bumps may be flat or look like tiny cauliflowers; they might itch or burn. HPV can cause abnormal pap smears. While there is no cure for HPV, warts can be removed to decrease the chances of your transmitting the virus to a partner.

Human Immunodeficiency Virus (HIV)
Most people who are in the early stages of HIV infection show no symptoms. Those who do notice symptoms in the infection's early phase will experience a skin rash, swollen lymph nodes, fever, severe fatigue. There is no cure for HIV, and it can be fatal, though medications can often slow down the infection.


Studies show that professional sex workers rarely experience condom breakage, because they know how to use them. To increase the effectiveness of condoms:


Before making love, have several condoms available.

* Make sure their expiration date has not expired.
* If you have sex when you're in your fertile phase or if you're unsure if your fertile, you can use vaginal spermicide--either spermicidal jelly with a diaphragm or a cervical cap, Delfen foam, or vaginal suppositories (Encare) in addition to the condom. The amount of spermicide used on condoms which claim to be lubricated with spermicide is miniscule: it does not provide sufficient protection in preventing pregnancy if the condom breaks or slips off. So even if a man's condom is labeled "lubricated with spermicide nonoxyl 9," for contraceptive protection, the woman should still use vaginal spermicide.
* If the woman is not well lubricated, intercourse can be painful for her, and friction created by intercourse in dryer vaginal walls can also weaken the condom. Enjoy plenty of foreplay so that the woman is well lubricated before intercourse.
* If foreplay doesn't make the woman sufficiently lubricated, apply a water-based lubricant on the outside of the condom after it's on the penis. Hand lotion and baby oil can encourage breakage, because they're oil-based. For added pleasure and to prevent friction, you can continue to add water-based lubricant as needed throughout lovemaking.
* While applying the condom, keep the tip pinched to prevent an air bubble. Roll it down to the base of the penis.
* If you have sex for more than 30 minutes, or if your partner ejaculates and you continue having genital contact, remove the old condom and apply a new one.
* Remove the condom after ejaculation. Hold the condom's rim against the base of the penis while withdrawing from the vagina. When removing the condom from the penis, keep the penis turned away from the vagina.
* Wash hands and the penis before cuddling.
* If a man has difficulty maintaining an erection while using a condom, he can learn to use one by masturbating with one on.
* If the condom breaks while you are making love, the woman has 72 hours to take the Emergency Contraceptive Pill (ECP). Call 1.888.NOT-2-LATE (888.668.2528) to learn about health care providers in your area who prescribe this pill. You can also check The sooner the ECP is used after unprotected or inadequately protected intercourse (i.e. pills are missed, condoms break), the more effective it is. The ECP is not designed to be used as a regular method of contraception.
* A broken condom sometimes signals miscommunication within a relationship. As you address the possibility of an unintended pregnancy, or the possibility of contracting an STI, you may also need to communicate your needs more clearly--to yourself and to your partner.


American Social Health Association (ASHA), PO Box 13827, Research Triangle Park, NC 27709; 919.361.8400;http: This organization operates hot lines and publishes numerous materials. Several of their publications, including Questions and Answers about Chlamydia, PID, Herpes (etc.) are available for free. Their National Herpes Hotline operates Monday through Friday, 9am to 7pm, EST, at no charge. 919.361.8488.

Bell, Ruth, et al, Changing Bodies, Changing Lives: A Book for Teens on Sex and Relationships, revised edition, Vintage, 1998. Our Bodies, Ourselves for teenagers.

The Boston Women's Health Book Collective, Our Bodies, Ourselves for the New Century, Simon and Schuster, 1998. This book is a bible for women wanting clear information and personal experiences for a wide range of topics. In the section on STIs, descriptions of women's and men's symptoms numerous infections are given, along with straightforward information about how tests and diagnoses are made, and what treatments (including alternatives) are available. A Spanish edition, Nuestros Cuerpos, Nuestros Vidas was issued in 2000 by Seven Stories Press.

Federation of Feminist Women's Health Centers, A New View of a Woman's Body, Feminist Health Press, 1995. Includes clear information and drawings about common infections. Order from Feminist Health Press, 8240 Santa Monica Blvd., Los Angeles, CA 90046. Your local office is listed in the white and yellow pages of your phone book.

Project Inform, 205 13th Street, Suite 2001, San Francisco, CA 94103-2461; hotline 800-822-7422; admin 415-558-8669. A nationwide referral organization for HIV/AIDS treatment.