Blindsided by Depo | FAMM Practitioner Series | Carla Lagunas (Episode 639)

Full Transcript: Episode 639

Lisa Hendrickson-Jack: This is the Fertility Friday Podcast, episode number 639. Today I am sharing a brand new episode in my FAM practitioner series. I’m sharing my interview with Carla, one of our FAM practitioners, and we are really diving into her experience of body literacy.

I feel like her story is so relatable. Many of our practitioners have shared similar experiences — what it was like before you had this knowledge about your body, navigating birth control, navigating hormonal contraception without a lot of information. In this conversation, we dive into Carla’s experience with hormonal birth control and how that led her to want to be in this field and make it her career.

There are a couple of other themes that come up in today’s episode. Carla is currently living in Chile, and we talk about the challenges associated with language. As an English-speaking North American woman, I’ve realized over the past few years how much we take for granted what is available to us as English speakers. Within the past year or two, within our FAM program, we’ve developed somewhat of a translation team. We’ve had practitioners from all over the world working with clients in different languages who are now actively working to translate our materials so they can teach their clients, whether it’s in French, Spanish, or even Hebrew.

Before we jump in, I want to tell you a little bit about Carla. Carla Lagunas is a Chilean educator, physical education teacher, and women’s health advocate. Her journey toward holistic wellness began in 2018, when she discovered the Fertility Awareness Method and began charting her own cycles using basal body temperature. The same year, she opened her own women’s fitness and wellness studio specializing in postpartum recovery and pelvic floor rehabilitation.

In 2023, using her menstrual cycle information as a fifth vital sign, Carla took a deeply intentional step toward one of her greatest dreams: becoming a mother in Costa Rica, the country that had long captured her heart. Today, Carla is completing the FAM program while walking alongside clients on their reproductive health journeys and preparing to open her Symptothermal Method education practice in Costa Rica.

Without further ado, let’s jump into my interview with Carla.

Lisa: I’m really excited to be here today with Carla. Welcome to the show.

Carla Lagunas: So happy to be here today, Lisa. This is such a treat. I always love these calls. I feel like I’m a broken record with these calls, but it’s so fun because we have been in class together for many months and I feel like we’ve gotten to know each other quite well. So it’s nice to have an opportunity to have a one-on-one conversation and dive a little bit more into your story.

Lisa: I would love to start with my favorite question, which is: let us know what it was like when you had your first period. Also, if you’ve used birth control before, what your menstrual reproductive history was like, and essentially what led you to be teaching fertility awareness as a big part of your professional career.

Carla: Absolutely. I was 11 years old when I had my first period. I was in grade six. My parents are educators. They were lovely to me. They prepared me. I had this beautiful menstrual kit with a change of underwear and some pads. When it happened, it was like, “Oh, it happened, I have to share this with mom.” But it just took me going to my classroom to get my backpack, and then the day continued as normal. It felt very normal to me. Then I shared with my relatives and life continued.

Regarding the use of hormonal contraceptives, the first time I used them I was 17 years old and I was suffering from acne. Like many other women around the world, I was put on hormonal contraceptives because I had acne. It wasn’t that bad, now that I think about it with the knowledge I hold today. I was on those contraceptives for about three to four years. When I stopped their use, the acne came back, unfortunately.

Later, I was in a relationship, and I think my parents were a bit scared of everything that was happening. So I went with my mom to the center and they recommended a subdermal implant that is inserted in your arm — this one was called Jadelle. I had it for, wait for it, five years. Now that I think about it, it’s crazy. I didn’t have any bleeding, and it felt wonderful.

When I completed those five years, I started bleeding, and this bleeding didn’t go away, so I had to go to a doctor. This doctor said that I needed to remove it. Then when I needed contraception again to prevent a pregnancy, they recommended an injection that I would put in my abdomen, and it would last for three months. That’s when I had a bunch of symptoms — pain in my breast, which was unbearable. That’s when I went back to the doctor who prescribed this hormonal contraceptive, and she told me I needed to stop using it.

What happened, Lisa, is I was in amenorrhea for eight months after that. When it hit me, I thought, “There must be something better.” I was very lucky — I asked for an appointment at this clinic and the gynecologist that day was a lady from Canada. She prescribed a high dose of vitamin D to bring back my menstrual cycle, which happened. She gave me a page with BBT tracking and told me, “When you finally have your period, you are going to start tracking your basal body temperature with a normal thermometer that you have at home, and you bring it to me and we are going to go through this together because you are going to be able to identify ovulation.” That, for me, opened a new world.

Unfortunately, when it happened, it was nine months after seeing this lady, and she was no longer working at the clinic — she had returned to Canada, so I was never able to have a conversation with her. But that’s how my introduction to fertility awareness began.

Lisa: Wow. Oh my goodness, there’s so much there. Can we first just start by talking about how amazing your parents are? That gave me chills. I have done this podcast for a long time and interviewed a lot of people, and you’re the first one who’s told me that.

Carla: I feel so blessed, and I had a conversation with my mother previous to this episode and she also had a good experience. I think she wanted to also bless me with that.

Lisa: I have a daughter — she’s turning four soon. The menstrual kit that you had in your backpack, and you were excited and ready — not everyone has that experience, so that is amazing. And what’s so interesting is that even though your experience was so amazing, there was still so much that was to come, so much that you didn’t know. There’s a whole lot of irony there — using the pill for acne, then the implant, then the shot. I read a lot of research, and there’s a big push in the contraceptive health space for what they call long-acting reversible contraceptive methods. From their perspective, they’re always looking at what methods will be the most effective, and if you can take user error out of the equation, those methods seem to be the best. They like the implant, they like the IUD — methods where there’s not a lot of opportunity for the user to “mess it up.”

Let me make sure I understood what you were saying. It sounds like you were recommended the implant at a stage of your life where you needed protection from pregnancy, and when you received it, you went five years with no bleeding, then all of a sudden you started bleeding with it still in, and the bleeding would not stop. How long did you bleed for?

Carla: Two weeks.

Lisa: Oh my goodness — I’m not laughing because it’s funny.

Carla: No bleeding at all, and then all of a sudden. I thought, “Oh, this is new, maybe it’s going to go away.” I was young, I wasn’t giving it much attention. Then it was light, but it was very uncomfortable and I didn’t like it. That’s when I set an appointment with the same doctor who recommended it.

Lisa: That must have been a big surprise. That’s not what you had on your calendar for that day. It’s hard to imagine — I’ve never gone five years without bleeding, so the shock level must have been, “Whoa, what’s this?”

Carla: “What’s this? Take it away, I don’t want it anymore.” And probably after five years it was no longer really working, so it was a good moment to remove it. I was also getting headaches — I do remember that.

Lisa: And then, of course, joy after joy. No one who’s a longtime listener is surprised that Depo is my least favorite. I am not a fan of Depo. I can talk somewhat neutrally about the pill, but Depo — I am incapable of being neutral, because it’s just the worst. I don’t even understand how people give it to women. So you got one injection?

Carla: I got three doses.

Lisa: Oh, so you did it over nine months, then?

Carla: Nine months, yes. And you know what is the most terrible thing? No one asked me, “Are you planning for a pregnancy? Are you thinking of being pregnant?” Because that’s very important information.

Lisa: Because Depo consistently has the longest time to pregnancy of any method. Whenever you look at any study — I recently recorded an episode where I was going off on a study, but it was a very strange study design. They were looking at women coming off contraceptives, but they only used women who were already pregnant, with a retrospective design. That naturally excludes anybody who came off contraceptives and wasn’t pregnant. I was already irritated. But even with that imperfect study design, when they looked at the results, it was always the women on Depo who took the longest to conceive. So even in the study I’m railing on, this is always very consistent. If somebody wanted to conceive and needed temporary birth control, this should not be the option. There should be a different option.

So then you came off, you had pain in your breast that was horrible, and then you stopped taking the Depo, but it took eight months. That is actually not unusual for Depo — for it to take eight to nine months for you to start bleeding again. What are the chances that you had this amazing OBGYN who talked to you about tracking and sparked that interest in you at that time. I do feel like you had these challenging experiences in the middle, but it’s always fascinating to me to see how people find their way to this knowledge.

Carla: Yeah, it was the light at the end of the tunnel. It was no fun to go through that experience, feeling that something was wrong with me. I also remember headaches. It’s not fair to go through all that horrific experience, but it led me to fertility awareness, and that’s how everything began.

Lisa: It’s wonderful. For me to place everything together — about how old were you after this Depo debacle?

Carla: From age 17 till I was 20, I was on the birth control pill. Then from 21 to 26, I was with the subdermal hormonal implant — those were five years. Then it was removed. Then I used the injectable contraceptive for nine months. So 27, and then, yeah, that’s it.

Lisa: That’s quite the journey — on the pill as a teen, and then a lot of your 20s spent on either the implant or the Depo. So now that you had gone through all of that, and had been introduced to fertility awareness methods, at what point did you make the shift into actually teaching it? I guess I probably could have asked you about using it first, but the reason I ask is because you came to us already with educator training, so this was already a significant part of your story. What happened after you were introduced to BBT charting, but this doctor went back home and you didn’t have her to go to?

Carla: That was a complete new world for me. It opened up all of these possibilities and I started researching. I learned about Symptopro and SensiPlan and the Justisse method, and I went through two years of training. During that time I worked with clients, then I taught the method for different uses. My favorite one was as a fifth vital sign, because all the rich information you can get through menstrual cycle tracking is crazy.

Lisa: Oh, it totally is. During that time, did you start charting for personal reasons before you actually started the program, or was it at the same time?

Carla: I was trying to prevent pregnancy, but at the same time I was a bit concerned about certain symptoms I was experiencing. I wanted to be sure I was ovulating. I was very interested in knowing the length of my luteal phase, and I discovered I had a very short luteal phase — so probably there was an imbalance between estrogen and progesterone. I remember having symptoms, Lisa — I was sweating at night, I was having anxiety. With that information, I was able to use different methods, techniques, and supplements to improve my luteal phase.

Lisa: One thing that has come up in our most recent couple of years of FAM — we have a lot of women from all over the world. In our last couple of years we had women from South Africa, Israel, Spanish-speaking countries, and the UK. One of the challenges — I think it was last year that I did a virtual presentation to a group of doctors in a Spanish-speaking country, and they were all asking me to translate my book into Spanish, which I would really love to do. It’s a bit challenging because I don’t speak Spanish, and there’s a lot that goes into making a book, so I have to wait for the right team of people to help me with that.

What I’m getting at is there is a very real limit to information available in Spanish-speaking countries. Share a little about how you were able to find this information, because I know this is a challenge for many Spanish-speaking women in countries where they don’t necessarily have materials in the language they speak.

Carla: The point you’re touching on is a very complex one. Even the research that has been done in Chile, in my case, is in English. I feel very privileged to have access. But as you’re sharing, it would be incredible if you could translate your books — both books.

Lisa: It’s not even just mine, but it’s definitely one of those things. Book translation is a very challenging thing. I’m a little nervous to take it on myself outside of a publishing company because I’m not able to do a lot of the proofreading and checking. But the bigger issue is access to information. I’m thrilled with all of the different women from different countries who have gone through our program to access areas I would never be able to reach to provide these services to women who otherwise — not to say they could never get the information — but it’s just not as accessible. I know it’s a really big challenge, but in your case, it’s accessible to you because you also speak English. That’s just not the case for everybody.

Carla: A hundred percent correct. There is wonderful information at the moment in Argentina and some schools in Spain as well, but my preferred way of being informed about FAM has always been in English.

Lisa: It’s hard enough to find good studies and information at all — I shouldn’t say it’s not a field that’s extensively studied, because there’s quite a bit of research available, but even within what’s available, it’s limited. There are so many studies I would love to see done that haven’t been, so much additional information that could be researched and studied that isn’t. When I interviewed Dr. Marguerite Duane, she talked about this concept — I think she called it the “gray literature.” There’s a lot of studies in this field that are not being published, or haven’t been approved, or whatever the case is. So if you had to limit yourself to publications in Spanish, that would mean you’d have access to so little.

I guess part of the reason that came to me is because you didn’t only find the information, but trained and are teaching it. Share a little about how discovering fertility awareness and charting has impacted you personally, and also why you decided to shift, because this is now your career.

Carla: Before sharing, I want to tell you that I would love to be on your team if you ever need support, because I have already translated all the documents I’m using with my clients. I’m working with beautiful clients in Chile and Costa Rica at the moment, so it would be my pleasure.

Regarding the impact this method has had on my life — first of all, have you ever seen the poster for the movie Bird Box, with Sandra Bullock? She’s in a boat and she’s blindfolded, she cannot see anything, and it looks very scary. That for me is the graphic representation of how the world is for a woman without knowing about FAM. Because you don’t understand anything — you are basically in the hands of doctors. But when you start tracking your cycles, a window opens and you have access to your symptoms, to what is happening. You begin understanding for the first time — you have clarity. You can identify your follicular phase, if you are ovulating, your luteal phase. That, for me, was the beginning of the most beautiful journey of my life.

I was able to use it as a contraceptive for many years. It gave me valuable information about my own health, and I used it for conception — I conceived my beautiful son. I can also link that with giving birth naturally. I wanted to have a home birth, and I thought it was going to be possible where I am. Then, thinking about it, I decided to go to a hospital, but I gave birth in a swimming pool — it was almost like giving birth at home. During all that process I was in deep connection with my body, and I think that was given to me by FAM.

Lisa: I so relate to what you’re saying, Carla, because I feel the same way. For anybody who didn’t catch the Bird Box image, you must have seen it as a meme — Sandra Bullock has a navy blue thing over her eyes and she’s walking around not understanding anything. Someone could think, “Well, that’s kind of severe to say that a woman without charting knowledge is blindfolded, walking around not knowing anything.” That might be a little extra to say. But I don’t think it is, because if we don’t know how our body’s working, we don’t know about our reproductive system, we don’t know about our birth control options, we don’t even know to ask about some of the birthing options. It opens up conversations you wouldn’t even think to have, because until you learn how little your average doctor knows about your reproductive system, you don’t even know what questions to ask — you don’t even know that you should be asking questions. You’re just believing what they say. So you are walking around with a blindfold. That is a very stark illustration.

There’s so much there. I’m very thankful that you had a positive entrance into menstruation — I think that played a big role for you. And I’m so thankful that you discovered fertility awareness and that now you’re supporting women. You did mention our translation team — over the last couple of years, we’ve always had women from different countries, and we provide a ton of resources, handouts, and checklists — client-facing handouts that are ready to go, and checklists that support our practitioners in working with different kinds of clients. We’ve bent over backwards to provide as much as we possibly can, but do we have a whole library in every language on earth? No, we don’t. There are limits to what we can do.

So we’ve had a number of our practitioners join our translation team, essentially volunteering to translate our handouts into a variety of languages. We now have some handouts in French, Spanish, and Hebrew, which is incredible. It’s also demonstrating to me how important it is to think about getting my book translated — not just for my book, but for any authors out there to think about getting translations happening, because it’s not only women in Western countries who need this information.

I think we’re in an interesting time now, because there are a lot of different opportunities with AI to make things a little easier — like even for our practitioners to translate, when I don’t speak Hebrew, and I speak very little Spanish, and French — good luck. Even though Canada is a bilingual country, they don’t mandate us to speak it — I feel like they probably should, like in Germany, where every person speaks at least two languages. But at least with some of these new tools available to us, we’re able to run translations through AI to check for spelling errors — otherwise we wouldn’t even have a way to check. I’m very thankful it all came together when it did, because now we’re able to put together high-quality resources in other languages with the help of our practitioners. Carla, thank you for being part of our translation team.

Carla: You are so welcome.

Lisa: So you’ve shared a little about your experience in FAM, but I want to ask — because you came to us already certified, already teaching — tell me about what your experience has been, and even why you came to us already with training. What were you looking for?

Carla: I was looking to become a master, to be able to help clients with very difficult and complex cases. FAM gives it in a beautiful way, because my cohort today is wonderful. My favorite thing about this program is being in a group of professionals — we are all sharing rich information about different study cases, and that is absolutely wonderful. That’s my favorite thing about FAM until today.

Lisa: Thank you. It’s so fun to see how the groups connect. Our cohorts are not huge — we don’t have a gazillion people. I think it’s a really good size to allow people to connect with each other. We’ve seen this phenomenon of our FAM groups meeting outside of class hours, connecting, supporting each other through assignments or case questions. There are instances of our previous FAM alumni and graduates who meet in real life after graduating — one of our practitioners got married, and some of their cohort traveled to another country to attend the wedding. We’ve seen lifetime friendships form.

Carla, I’m thrilled that you’ve been in the program for as long as you have, and that we’ve had the opportunity to connect. It was such a treat today to hear your story. I feel like I have so much greater understanding of why this is so important to you, and the impact it’s made in your life. I would love for you to share what you have happening on the horizon — for anyone listening who wants to learn more about you and what you do, where you are in the world in Chile — tell us all the things.

Carla: Lisa, you are a leader, a master of building community. Here I am from Chile — I was playing your podcast, Fertility Friday, for so long. Every time I see Lisa on our calls and she asks the magical question, “Did you have any questions for me?” — I have twenty questions. And Lisa always gets passionate about every single question. She is incredible at building a beautiful energy in every call.

Regarding your question — at the moment I am building my website. I’m also super excited because I’m going to open my own practice here in Guanacaste, Costa Rica. If anyone wants to find me, they can do it on social media, but I have an email, which is [email protected]. If they want to talk with me, they can send me an email and I’ll be super excited to talk with them.

Lisa: Amazing. We will put the links — the social media links, your email — and once you have your website up and running, we’ll add that to the show notes as well. For anyone listening on the go or listening in the future, check out our show notes page for Carla’s episode for those details. Carla, thank you so much for being here — this was so much fun, and I love your energy. You always have questions, but your questions are always so thoughtful.

Carla: To be honest with you, it is the best part.

Lisa: If you think about it, because you’re on the inside — if you think about the portal, our resource index, all the different studies and categories we have, all the different resources, our checklists — a lot of those things over the years have come from specific questions, feedback, and different inquiries that have happened. You can probably tell, because there’s so much stuff, and sometimes you’re probably like, “I wonder why she has this specific study about this specific thing — it seems very specific.” But this is how our program has grown. It has really been a joy. I look forward to all of your questions.

Carla: Me too, Lisa. I would always have questions for you.

Lisa: Amazing. Thank you so much for being here, Carla, and I look forward to seeing you again soon.

Carla: It was amazing talking with you, Lisa. Have a wonderful day.

Lisa: If you enjoyed today’s episode, I hope you will share it with a friend or colleague. You can always head over to fertilityfriday.com to find today’s episode — it is episode number 639. And if you’re listening in your favorite podcast player, you can also use the share link to share today’s episode.

I hope you enjoyed my conversation with Carla. It was such a treat to have her on the show. I love doing these episodes — it always gives me another opportunity to connect with our practitioners, and I feel like I always learn something new, something different about their story.

Carla’s story has so many themes I’ve often heard about. Many of our practitioners have had their own personal journeys with hormonal contraception, and when the journeys are not smooth — when we run into issues, whether that’s waiting for your period to return and not knowing when that’s going to happen, or other reproductive health issues — I feel like often these challenges are what bring us into this work. One of the most common themes I’ve seen among our practitioners is that they’re jumping into this work because they’ve had these challenging experiences, often negative experiences, and they want life to be easier and better for the women of the future — whether it’s for our daughters or for all the women out there struggling with very similar things.

I do hope you enjoyed our conversation today. It was so much fun to delve into these topics, and always a pleasure to share this with you — hopefully inspiring you to think about how you can incorporate some of these learnings into your own journey, or how they could help your clients in the future.

I hope you have a wonderful week, weekend, whenever you’re tuning into the show. And of course, as always, until next time — be well, and happy charting.