The Missing Vital Sign: Why Menstrual Cycle Literacy Belongs in Healthcare
In 2006, the American College of Obstetricians and Gynecologists (ACOG) formally recognized the menstrual cycle as a vital sign for adolescent females. A landmark step toward recognizing the importance of ovulatory health. Yet nearly two decades later, widespread clinical adoption has been slow. Fortunately, another movement was already gaining momentum: menstrual cycle literacy.
Across the globe, more people are learning to understand their menstrual cycles thanks to fertility awareness educators, pioneering researchers like Dr. Jerilynn Prior, and authors such as Toni Weschler and Katie Singer. As more individuals began bringing observations about cervical mucus and basal body temperature to their healthcare appointments, many discovered that these valuable insights were unfamiliar or underutilized by their healthcare providers.
To help close this knowledge gap, physician allies founded FACTS (Fertility Appreciation Collaborative to Teach the Science) in 2010 to educate medical professionals on the science behind fertility awareness-based methods (FABMs). Despite these efforts, only about 4% of physicians currently receive formal training in FABMs. Without an understanding of menstrual cycle charting, clinicians may miss valuable clinical information offered by one of the body's most important vital signs.
Where does the gap come from?
One of the biggest challenges is the long-standing belief that ovulation only matters when someone is trying to conceive. Historically, healthcare has focused primarily on the frequency of menstruation, leaving the remaining 75–85% of the menstrual cycle largely unexplored. When irregularities arise, treatment often centre on symptom management based on reproductive goals rather than identifying the underlying cause.
Adding to this challenge, menstrual cycle health cannot be fully understood during a single 15-minute appointment. Like any meaningful vital sign, it requires observation over time. That calls for either expanded clinician training or stronger collaboration with professionals who specialize in menstrual cycle education.
Bridging the Gap Through Collaboration
Justisse Fertility Awareness Educators (FAEs) offer a practical way to bring meaningful cycle data into healthcare. Trained to teach standardized, evidence-based observation of fertility biomarkers, FAEs help clients collect accurate, consistent information that can reveal patterns easily overlooked in a routine clinical visit.
By tracking bleeding patterns, basal body temperature, and cervical mucus, clients can provide clear, reliable information that supports clinicians in evaluating:
Endocrine & Metabolic Function: Thyroid health, follicular and luteal phase sufficiency, relative estrogen and progesterone balance, and liver function.
Gynaecological Health: Early indicators of PMOS, endometriosis, adenomyosis, PMS/PMDD, cervical health, and vulvovaginal conditions.
Reproductive & Obstetric Care: More accurate pregnancy dating, miscarriage risk assessment, optimal timing for insemination, and emergency contraception protocols.
Clinical Management: Monitoring the impact of lifestyle changes, evaluating treatment effectiveness, and identifying the best timing for laboratory testing, examinations, or procedures.
Integrating the menstrual cycle as a vital sign doesn't require reinventing healthcare. Nor does it mean adding more work for already busy clinicians. Highly trained fertility awareness educators are already supporting clients around the world, often virtually, and the collaborative framework already exists. What is still needed is greater awareness and a stronger commitment to interprofessional care, expanding partnerships that have already proven successful in restorative reproductive medicine into family practice and broader healthcare settings.
Working alongside a Justisse FAE
Can ease the clinician's workload while strengthening patient care. Instead of spending valuable appointment time teaching charting techniques or piecing together incomplete symptom histories, healthcare providers receive organized, standardized biomarker data collected consistently over time. At the same time, clients become active participants in their own care, learning to recognize patterns, ask informed questions, and engage more confidently with restorative treatment plans.
When people understand the language of their menstrual cycles, they become more informed partners in their healthcare. When clinicians recognize and value that information, everyone benefits. Collaboration between healthcare providers and Fertility Awareness Educators isn't simply an enhancement to care. It's an opportunity to create more informed conversations, more accurate clinical decisions, and better outcomes for the people at the centre of it all.
