Difference between revisions of "Increase Fertility Naturally"

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After trying unsuccessfully to conceive, many couples find that it is harder to become pregnant than they believed it would be. Unfortunately, there can be many contributing factors to infertility, sometimes making it difficult to determine what is causing a fertility problem. Some couples who face infertility will have to undergo extensive fertility treatments to help them conceive, while others may just need to make some simple lifestyle changes that can help boost their fertility. There are a variety of simple, effective ways to help improve a couple’s chances of conceiving. These natural techniques can be beneficial for all couples trying to conceive.
 
After trying unsuccessfully to conceive, many couples find that it is harder to become pregnant than they believed it would be. Unfortunately, there can be many contributing factors to infertility, sometimes making it difficult to determine what is causing a fertility problem. Some couples who face infertility will have to undergo extensive fertility treatments to help them conceive, while others may just need to make some simple lifestyle changes that can help boost their fertility. There are a variety of simple, effective ways to help improve a couple’s chances of conceiving. These natural techniques can be beneficial for all couples trying to conceive.
[[Category:Trying to Conceive]]
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[[Category: Trying to Conceive]]
 
== Steps ==
 
== Steps ==
 
=== Making Lifestyle Changes ===
 
=== Making Lifestyle Changes ===
# Watch your weight. A healthy BMI has been linked to increased fertility in both men and women.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref><ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref> This is because your weight affects your body’s hormone production. Being overweight leads to decreased sperm production in men<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref> and decreased frequency and consistency of ovulation in women.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref>  
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# Watch your weight. A healthy BMI has been linked to increased fertility in both men and women.<ref name="rf1">http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref><ref name="rf2">http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref> This is because your weight affects your body’s hormone production. Being overweight leads to decreased sperm production in men<ref name="rf2" /> and decreased frequency and consistency of ovulation in women.<ref name="rf1" />  
#* A normal BMI is between 18.5 and 24.9.<ref>http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm</ref> You can find a BMI calculator online through the NIH or Mayo Clinic.
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#* A normal BMI is between 18.5 and 24.9.<ref name="rf3">http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm</ref> You can find a BMI calculator online through the NIH or Mayo Clinic.
# Balance your diet. A big part of watching your weight means eating right. While no research suggests that one specific diet increases fertility, a balanced diet promotes overall health, including reproductive health.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref> You should avoid sugar and other simple carbohydrates, as well as fatty or fried foods. Focus on a diet rich in fruits, vegetables, legumes, whole grains, lean meat protein (such as fish and skinless chicken), and healthy fats (such as omega-3 and omega-9 fats).  
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# Balance your diet. A big part of watching your weight means eating right. While no research suggests that one specific diet increases fertility, a balanced diet promotes overall health, including reproductive health.<ref name="rf1" /> You should avoid sugar and other simple carbohydrates, as well as fatty or fried foods. Focus on a diet rich in fruits, vegetables, legumes, whole grains, lean meat protein (such as fish and skinless chicken), and healthy fats (such as omega-3 and omega-9 fats).  
#* Note that once you become pregnant, you should slightly alter your diet, especially avoiding fish such as tuna that can have harmful amounts of mercury.<ref>http://www.consumerreports.org/cro/magazine/2014/10/can-eating-the-wrong-fish-put-you-at-higher-risk-for-mercury-exposure/index.htm</ref>
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#* Note that once you become pregnant, you should slightly alter your diet, especially avoiding fish such as tuna that can have harmful amounts of mercury.<ref name="rf4">http://www.consumerreports.org/cro/magazine/2014/10/can-eating-the-wrong-fish-put-you-at-higher-risk-for-mercury-exposure/index.htm</ref>
#* Unchecked celiac disease has been linked to reduced fertility in women.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref> If you have celiac disease, make an extra effort to avoid gluten while you’re trying to conceive. Consult your doctor for an ideal gluten-free diet during pregnancy.
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#* Unchecked celiac disease has been linked to reduced fertility in women.<ref name="rf1" /> If you have celiac disease, make an extra effort to avoid gluten while you’re trying to conceive. Consult your doctor for an ideal gluten-free diet during pregnancy.
# Stay active. Another important step in maintaining a healthy weight is to get plenty of exercise. In men especially, moderate exercise can help produce enzymes that help to protect sperm.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref>  
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# Stay active. Another important step in maintaining a healthy weight is to get plenty of exercise. In men especially, moderate exercise can help produce enzymes that help to protect sperm.<ref name="rf2" />  
 
#* You should aim to get at least thirty minutes of moderate cardio (anything that gets your heart rate up, such as jogging, cycling, swimming, etc.) five days a week.
 
#* You should aim to get at least thirty minutes of moderate cardio (anything that gets your heart rate up, such as jogging, cycling, swimming, etc.) five days a week.
#* Note that women should stick to a moderate exercise routine as vigorous exercise reduces progesterone levels, which is an important hormone for ovulation.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref> You should limit vigorous exercise to fewer than five hours each week.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref>
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#* Note that women should stick to a moderate exercise routine as vigorous exercise reduces progesterone levels, which is an important hormone for ovulation.<ref name="rf1" /> You should limit vigorous exercise to fewer than five hours each week.<ref name="rf1" />
# Avoid exposure to sexually transmitted infections (STIs). STIs, especially chlamydia and gonorrhea, can cause infertility in both men and women.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref><ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref> Both of these STIs can occasionally present asymptomatically (without warning signs), so it’s always a good idea for you and your partner to schedule an STI screening before you stop using condoms when you plan to conceive.  
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# Avoid exposure to sexually transmitted infections (STIs). STIs, especially chlamydia and gonorrhea, can cause infertility in both men and women.<ref name="rf1" /><ref name="rf2" /> Both of these STIs can occasionally present asymptomatically (without warning signs), so it’s always a good idea for you and your partner to schedule an STI screening before you stop using condoms when you plan to conceive.  
 
#* Both infections are bacterial, and you can treat them with a course of antibiotics from your doctor.
 
#* Both infections are bacterial, and you can treat them with a course of antibiotics from your doctor.
# Quit smoking. Use of tobacco products is another leading cause of infertility amongst both men and women.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref><ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref> Women who smoke risk aging their ovaries and depleting their eggs prematurely.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref> In men, smoking is associated with reduced sperm counts, decreased sperm mobility, and even misshapen sperm.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref>  
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# Quit smoking. Use of tobacco products is another leading cause of infertility amongst both men and women.<ref name="rf2" /><ref name="rf1" /> Women who smoke risk aging their ovaries and depleting their eggs prematurely.<ref name="rf1" /> In men, smoking is associated with reduced sperm counts, decreased sperm mobility, and even misshapen sperm.<ref name="rf2" />  
 
#* Quitting all at once is rarely the most effective way to stop smoking for good. Consult your doctor concerning the best smoking cessation aids that are also safe for a couple trying to conceive.
 
#* Quitting all at once is rarely the most effective way to stop smoking for good. Consult your doctor concerning the best smoking cessation aids that are also safe for a couple trying to conceive.
 
#* You can also find more information at [[Quit Smoking|How to Quit Smoking]].
 
#* You can also find more information at [[Quit Smoking|How to Quit Smoking]].
# Reduce your alcohol consumption. Experts have linked alcohol consumption to a number of fertility complications in both women and men. Heavy drinking can cause ovulation disorders in women, making it more difficult to pinpoint when you are most fertile.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref> In men, heavy drinking is associated with lower levels of testosterone, which can lead to decreased sperm counts and even impotence.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref> You should always drink in moderation and consider cutting out alcohol entirely while trying to conceive.  
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# Reduce your alcohol consumption. Experts have linked alcohol consumption to a number of fertility complications in both women and men. Heavy drinking can cause ovulation disorders in women, making it more difficult to pinpoint when you are most fertile.<ref name="rf1" /> In men, heavy drinking is associated with lower levels of testosterone, which can lead to decreased sperm counts and even impotence.<ref name="rf2" /> You should always drink in moderation and consider cutting out alcohol entirely while trying to conceive.  
# Check your lubricant. Consider skipping additional lubricant during sex if at all possible. Many lubricants contain chemicals that will kill sperm or make it more difficult for sperm to reach the woman’s egg. If you do need to use a lubricant, try using simple baby oil or a fertility-friendly brand (such as Pre-Seed).<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref>  
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# Check your lubricant. Consider skipping additional lubricant during sex if at all possible. Many lubricants contain chemicals that will kill sperm or make it more difficult for sperm to reach the woman’s egg. If you do need to use a lubricant, try using simple baby oil or a fertility-friendly brand (such as Pre-Seed).<ref name="rf2" />  
# Cut out caffeine. Consuming too much caffeine has been linked to fertility issues, especially in women.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref> Experts in family planning suggest that women trying to become pregnant should limit their intake of caffeine to less than 200 or 300 milligrams each day.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref>  
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# Cut out caffeine. Consuming too much caffeine has been linked to fertility issues, especially in women.<ref name="rf1" /> Experts in family planning suggest that women trying to become pregnant should limit their intake of caffeine to less than 200 or 300 milligrams each day.<ref name="rf1" />  
#* This means limiting yourself to roughly one eight-ounce cup of coffee or two one-ounce shots of espresso (or less).<ref>http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20049372</ref>
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#* This means limiting yourself to roughly one eight-ounce cup of coffee or two one-ounce shots of espresso (or less).<ref name="rf5">http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20049372</ref>
# Work days if possible. Working swing or graveyard shift often affects one’s sleep schedule, which can also affect reproductive hormones.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref> If you work nights, see if you can switch to day shift at least temporarily. If that’s not an option, do your best to keep a consistent sleep schedule.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref>  
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# Work days if possible. Working swing or graveyard shift often affects one’s sleep schedule, which can also affect reproductive hormones.<ref name="rf1" /> If you work nights, see if you can switch to day shift at least temporarily. If that’s not an option, do your best to keep a consistent sleep schedule.<ref name="rf1" />  
# Discuss your medications with your doctor. Some medications (such as calcium channel blockers and tricyclic antidepressants) can lead to reduced fertility.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref> Talk to your doctor about any effects your medications might have. He or she might be able to switch your medication or reduce your dosage while you try to conceive.  
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# Discuss your medications with your doctor. Some medications (such as calcium channel blockers and tricyclic antidepressants) can lead to reduced fertility.<ref name="rf2" /> Talk to your doctor about any effects your medications might have. He or she might be able to switch your medication or reduce your dosage while you try to conceive.  
 
#* Never alter your prescription regimen without first consulting your doctor.
 
#* Never alter your prescription regimen without first consulting your doctor.
# Avoid exposure to chemicals and toxins. Both women and men should limit exposure to chemicals and other toxins, which can lead to menstrual disorders in women and reduced, damaged sperm counts in men. <ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref><ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref> You should wear protective clothing and equipment whenever possible if you work with chemicals. Some of those to avoid include:<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/female-fertility/art-20045887?pg=2</ref>
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# Avoid exposure to chemicals and toxins. Both women and men should limit exposure to chemicals and other toxins, which can lead to menstrual disorders in women and reduced, damaged sperm counts in men. <ref name="rf1" /><ref name="rf2" /> You should wear protective clothing and equipment whenever possible if you work with chemicals. Some of those to avoid include:<ref name="rf1" />
 
#* Nitrous oxide if you work as a dentist or dental assistant
 
#* Nitrous oxide if you work as a dentist or dental assistant
 
#* Organic solvents like those found in dry cleaning chemicals
 
#* Organic solvents like those found in dry cleaning chemicals
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#* Industrial and manufacturing chemicals
 
#* Industrial and manufacturing chemicals
 
#* Salon hair treatment chemicals
 
#* Salon hair treatment chemicals
# Reduce stress. Increased stress levels may also affect reproductive hormones and fertility in both men and women.<ref>http://www.scopemed.org/?jft=89&ft=89-1455553222</ref><ref>http://www.webmd.com/infertility-and-reproduction/features/infertility-stress</ref> If you experience high levels of stress in your work life or at home, then ensure you take time to relax with meditation, your favorite hobbies, or any other preferred stress-reducing activity.   
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# Reduce stress. Increased stress levels may also affect reproductive hormones and fertility in both men and women.<ref name="rf6">http://www.scopemed.org/?jft=89&ft=89-1455553222</ref><ref name="rf7">http://www.webmd.com/infertility-and-reproduction/features/infertility-stress</ref> If you experience high levels of stress in your work life or at home, then ensure you take time to relax with meditation, your favorite hobbies, or any other preferred stress-reducing activity.   
 
#* You can find more info on the best ways for you to reduce stress at [[Reduce Stress|How to Reduce Stress]].
 
#* You can find more info on the best ways for you to reduce stress at [[Reduce Stress|How to Reduce Stress]].
# Avoid high temperatures. Temperatures in excess of normal body temperature around a man’s scrotum can affect sperm production.<ref>http://mayoclinichealthsystem.org/hometown-health/speaking-of-health/tips-to-improve-fertility</ref> Wear loose, breathable underwear (such as cotton) and avoid hot environments like saunas and hot tubs.<ref>http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2</ref>  
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# Avoid high temperatures. Temperatures in excess of normal body temperature around a man’s scrotum can affect sperm production.<ref name="rf8">http://mayoclinichealthsystem.org/hometown-health/speaking-of-health/tips-to-improve-fertility</ref> Wear loose, breathable underwear (such as cotton) and avoid hot environments like saunas and hot tubs.<ref name="rf2" />  
 
=== Using an Optimal Timing Method ===
 
=== Using an Optimal Timing Method ===
# Track your cervical secretions on a calendar. Women can track their body temperatures and changes to their cervical mucus to determine when they are most fertile—collectively called the symptothermal method.<ref>http://www.mayoclinic.org/tests-procedures/cervical-mucus-method/basics/why-its-done/prc-20013005</ref> After the final day of your most recent period, begin recording information about your cervical mucus on a daily calendar.<ref>http://www.mayoclinic.org/tests-procedures/cervical-mucus-method/basics/what-you-can-expect/prc-20013005</ref>  
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# Track your cervical secretions on a calendar. Women can track their body temperatures and changes to their cervical mucus to determine when they are most fertile—collectively called the symptothermal method.<ref name="rf9">http://www.mayoclinic.org/tests-procedures/cervical-mucus-method/basics/why-its-done/prc-20013005</ref> After the final day of your most recent period, begin recording information about your cervical mucus on a daily calendar.<ref name="rf10">http://www.mayoclinic.org/tests-procedures/cervical-mucus-method/basics/what-you-can-expect/prc-20013005</ref>  
# Check the mucus when you urinate. One of the easiest ways to check is to wipe using toilet tissue before urinating first thing in the morning.<ref>http://www.mayoclinic.org/tests-procedures/cervical-mucus-method/basics/what-you-can-expect/prc-20013005</ref> You want to observe the mucus for several things, including:<ref>http://www.mayoclinic.org/tests-procedures/cervical-mucus-method/basics/what-you-can-expect/prc-20013005</ref>  
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# Check the mucus when you urinate. One of the easiest ways to check is to wipe using toilet tissue before urinating first thing in the morning.<ref name="rf10" /> You want to observe the mucus for several things, including:<ref name="rf10" />  
 
#* Color - Is it yellow, white, clear, or cloudy?
 
#* Color - Is it yellow, white, clear, or cloudy?
 
#* Consistency - Is it thick, sticky, or stretchy?
 
#* Consistency - Is it thick, sticky, or stretchy?
 
#* Feel - Is it dry, wet, or slippery?
 
#* Feel - Is it dry, wet, or slippery?
#* To avoid confusing standard sexual lubrication for cervical mucus, you should avoid sex during the cycle when you first record the information.<ref>http://www.mayoclinic.org/tests-procedures/cervical-mucus-method/basics/what-you-can-expect/prc-20013005</ref>
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#* To avoid confusing standard sexual lubrication for cervical mucus, you should avoid sex during the cycle when you first record the information.<ref name="rf10" />
# Note changes to the mucus during your cycle. You will notice several distinct changes to your cervical mucus throughout the month. These changes usually include:<ref>http://www.mayoclinic.org/tests-procedures/cervical-mucus-method/basics/how-you-prepare/prc-20013005</ref>  
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# Note changes to the mucus during your cycle. You will notice several distinct changes to your cervical mucus throughout the month. These changes usually include:<ref name="rf11">http://www.mayoclinic.org/tests-procedures/cervical-mucus-method/basics/how-you-prepare/prc-20013005</ref>  
 
#* No apparent secretions in the first three or four days after your most recent period ends
 
#* No apparent secretions in the first three or four days after your most recent period ends
 
#* A small amount of cloudy, sticky secretions for three to five days
 
#* A small amount of cloudy, sticky secretions for three to five days
 
#* An abundance of clear, wet, and slippery secretions for three to four days, which corresponds to the time just before as well as during ovulation
 
#* An abundance of clear, wet, and slippery secretions for three to four days, which corresponds to the time just before as well as during ovulation
 
#* A sharp drop in cervical mucus for the next eleven to fourteen days until your next period starts
 
#* A sharp drop in cervical mucus for the next eleven to fourteen days until your next period starts
# Track your basal body temperature on the same calendar as your cervical mucus. Your basal body temperature refers to your temperature when you’re completely at rest.<ref>http://www.mayoclinic.org/tests-procedures/basal-body-temperature/basics/definition/prc-20019978</ref> Many women record a slight rise in body temperature—around 0.5°F (0.3°C)—during ovulation, which you can use to help in determining your most fertile days.<ref>http://www.mayoclinic.org/tests-procedures/basal-body-temperature/basics/what-you-can-expect/prc-20019978</ref>  
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# Track your basal body temperature on the same calendar as your cervical mucus. Your basal body temperature refers to your temperature when you’re completely at rest.<ref name="rf12">http://www.mayoclinic.org/tests-procedures/basal-body-temperature/basics/definition/prc-20019978</ref> Many women record a slight rise in body temperature—around 0.5°F (0.3°C)—during ovulation, which you can use to help in determining your most fertile days.<ref name="rf13">http://www.mayoclinic.org/tests-procedures/basal-body-temperature/basics/what-you-can-expect/prc-20019978</ref>  
 
#* Since the change in temperature is so slight, you’ll need a highly accurate digital thermometer that measures tenths of a degree.
 
#* Since the change in temperature is so slight, you’ll need a highly accurate digital thermometer that measures tenths of a degree.
#* You can use the thermometer orally, vaginally, or rectally, but ensure that you always use a consistent method to record accurate results.<ref>http://www.mayoclinic.org/tests-procedures/basal-body-temperature/basics/what-you-can-expect/prc-20019978</ref>
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#* You can use the thermometer orally, vaginally, or rectally, but ensure that you always use a consistent method to record accurate results.<ref name="rf13" />
# Record your temperature before you get out of bed every morning. To get a consistent basal temperature under the same conditions each day, keep your thermometer at your bedside and record your temperature before you get up in the morning.<ref>http://www.mayoclinic.org/tests-procedures/basal-body-temperature/basics/what-you-can-expect/prc-20019978</ref> You should also make sure that you get at least three uninterrupted hours of sleep during the night to avoid any changes due to sleep disturbances.<ref>http://www.mayoclinic.org/tests-procedures/basal-body-temperature/basics/what-you-can-expect/prc-20019978</ref>  
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# Record your temperature before you get out of bed every morning. To get a consistent basal temperature under the same conditions each day, keep your thermometer at your bedside and record your temperature before you get up in the morning.<ref name="rf13" /> You should also make sure that you get at least three uninterrupted hours of sleep during the night to avoid any changes due to sleep disturbances.<ref name="rf13" />  
# Try to conceive on the days when you’re most fertile. Your most fertile day is approximately two days before your basal temperature rises.<ref>http://www.mayoclinic.org/tests-procedures/basal-body-temperature/basics/what-you-can-expect/prc-20019978</ref> By tracking both your cervical mucus and your basal temperature, you can pinpoint your most fertile day when your cervical mucus has become abundant and clear but your basal body temperature has not yet risen.  
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# Try to conceive on the days when you’re most fertile. Your most fertile day is approximately two days before your basal temperature rises.<ref name="rf13" /> By tracking both your cervical mucus and your basal temperature, you can pinpoint your most fertile day when your cervical mucus has become abundant and clear but your basal body temperature has not yet risen.  
#* Though two days before your temperature rises is before you begin ovulating, it’s still ideal because your partner’s sperm can survive for up to five days in your reproductive tract.<ref>http://www.mayoclinic.org/tests-procedures/basal-body-temperature/basics/what-you-can-expect/prc-20019978</ref>
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#* Though two days before your temperature rises is before you begin ovulating, it’s still ideal because your partner’s sperm can survive for up to five days in your reproductive tract.<ref name="rf13" />
 
#* You may have to track this period over several months to conceive. Stay patient and plan sex with your partner during this period each month.
 
#* You may have to track this period over several months to conceive. Stay patient and plan sex with your partner during this period each month.