Restorative or Just Routine? How to Know the Difference
If you've been listening to our podcast Cycle Wisdom or reading the news recently, you've probably heard of the term “restorative reproductive medicine,” but what does restorative actually mean? Is it just a buzzword? Or does it point to a fundamentally different way of approaching your health and fertility? How do you know if the way you're being treated is truly restorative?
Today we're going to break down what makes a medical approach restorative, and how it might be the missing piece in your journey, whether you are navigating menstrual health concerns or fertility.
Ebony’s Story
When I met Ebony, she was a 34-year-old high school teacher. She had painful periods, irregular cycles, and years of trying to conceive with no success. When she was 18 years old, she was put on hormonal birth control for her menstrual cramps, and she stayed on it for over a decade, because she said, “It was the only thing that let me be functional when my periods happened.”
When Ebony stopped the birth control pill to try to conceive, her symptoms returned with a vengeance. And she had new problems. She still had the terrible cramps, but now she was also having a period about every three weeks. Plus, her mood was low, and she was still not able to get pregnant, even though she had been told that when she stopped the pill, she would likely be able to conceive right away. She was confused and frustrated and really, really fed up with the system.
Her OB doctor told her that her labs were normal, and she was eventually started on Clomid, an ovulation stimulation medication, without any additional monitoring. She ovulated but she didn't get pregnant, and each round left her feeling more bloated, more anxious, and less hopeful. After six medicated cycles, her OB doctor told her there was nothing else they could do and referred her to IVF.
Ebony and her husband did not want to go through IVF for multiple reasons. That’s when they found our Radiant Clinic. We utilized our restorative reproductive medicine approach and started with the basics of cycle charting, lab evaluation, and getting a diagnosis to address Ebony's menstrual cycle symptoms.
Among other things, we identified a luteal phase defect, which means that her progesterone levels were lower than they should be after she ovulated. Her thyroid levels were also subclinical. We treated all of the different factors with ongoing monitoring, personalized lifestyle changes and supplements, and targeted prescription strength medications at the appropriate times in her cycle. Our focus was on healing her menstrual cycles and correcting the underlying inflammation and ovulation defects.
Within four months, Ebony was cycling regularly, ovulating consistently, and her menstrual symptoms were significantly improved. She told us, “I didn't know that medicine could actually work with my body.”
She was able to get pregnant, and she said, “More importantly than getting pregnant, I'm grateful. I finally feel healthy.”
Ebony left our care empowered, knowing that the next step of her journey, no matter what that would be, was one she understood and could navigate with grace and understanding while working alongside the medical professionals who were able to restore her health.
What is Restorative Reproductive Medicine?
So what makes a medical approach truly restorative? This term is now being used quite frequently, and many doctors are saying that they're doing restorative approaches, but either they don't really understand what that term means, or they think that they understand but aren't really seeking the full healing that comes along with true restorative reproductive medicine. So how can you identify if your doctor is utilizing a truly restorative approach, versus one that is just masking your symptoms?
Treating the Root Cause
The first thing that identifies restorative care is that it seeks to identify and treat the underlying cause, not just provide relief of symptoms. Oftentimes in conventional medical care, we hear phrases like, “Well, let's just try birth control and see if that helps,” or “You can always do IVF later if this doesn't work out,” or worst of all, “It's probably just stress. Maybe you should try reducing your stress levels.” Now, these phrases don't necessarily come from a place of ill intent – they're often the result of a medical system that's been taught to treat symptoms as endpoints.
The difference with restorative reproductive medicine is that we ask why at every step of the way. Why is your cycle irregular? Why are your hormone levels not what they should be? Why are you having a hard time trying to conceive? We dig deeper using timed hormone testing, ultrasound tracking, evaluation of charting patterns, and full body lab evaluations.
In Ebony's case, painful periods weren't just a normal part of being a woman. Infertility isn't always unexplained, and most importantly, we want to make sure that we are not treating symptoms in isolation. We follow it like a trail back to the source and correct that underlying cause in order to produce long-term impacts of healing and relief.
Restorative Medicine Works with the Body, Not Against It
Restorative reproductive medicine works to support the body's own design, rather than trying to override it. Instead of shutting down ovulation or trying to create a regular cycle or force things to happen with your hormones, like birth control does, we aim to support ovulation by helping to improve follicle development, enhance hormone function, and correct underlying imbalances that are metabolic or anatomic in nature.
So, for example, if you're not ovulating consistently, we don't just jump to egg retrieval or hyperstimulation. We support your body in ways that improve ovulation. If your progesterone levels are low after ovulation, we supplement with bioidentical progesterone and discuss other natural ways to help improve your body's progesterone response. If you have painful periods and we find endometriosis, we don't suppress your cycle. We look at understanding how inflammation and immune dysfunction and hormone imbalance may be contributing, and we address those layers while we await getting definitive treatment, typically with surgical excision.
This medical model honors the natural rhythms of a woman's body and works together to optimize things, not to silence them, suppress them, or cover them up.
Personalized, Ongoing Monitoring
In many traditional models, you may be given a medication and asked to return in two, four, or even six months if it isn't getting the intended consequence. In restorative reproductive medicine, on the other hand, we track your body's real-time responses using our fertility awareness charting. We're able to monitor cervical mucus, cycle length, and ovulation timing, and we can see those patterns change over time.
Additionally, we typically check your mid-luteal phase hormone labs. About a week after you've ovulated, we assess progesterone, estradiol, and other relevant markers to make sure that our treatments are having the intended consequence. If you are trying to conceive, we also are using ultrasound to measure the follicle size, to confirm ovulation, and to ensure there's an appropriate response to medications. Again, this helps us to have faster adjustments in care, shifting the dosages, changing what we need to in order to make sure that your treatment is optimized. We decrease our risk for over-treating and help to improve outcomes because we're treating what's actually happening in real time.
Most importantly, this allows for an increased understanding of your own cycle so you become empowered to understand what's going on, how to track those changes over time, and be able to identify if something is not going as planned.
Looking at the Whole Person
Your reproductive health and your reproductive organs don't exist in a vacuum. We've seen many cases where a woman's infertility or her cycle irregularity is being addressed just based on what's happening with her ovaries. But we know it's about so much more.
For example, thyroid dysfunction is a very common finding. There may be labs that seem to be “normal” on paper, but they may be too high for optimal ovulation and miscarriage prevention. Metabolic dysfunction is another big thing that we address. Insulin resistance often comes up, even without having full-blown PCOS, but those subtle shifts in blood sugar and insulin issues can disrupt both hormone production and ovulation. So it's important to make sure that we're addressing that from a big picture because that also helps to improve long-term health.
Adrenal stressors, or cortisol dysfunction, can also have significant impacts when there is chronic stress. Cortisol dysfunction can cause irregular cycles and body-wide inflammation. This is really important to address, again, not just for menstrual cycle or fertility concerns, but from an overall health perspective.
And finally, poor digestion, nutrient deficiencies, and gut health issues can play a huge role when it comes to hormone production, as well as clearance of excess hormones.
With restorative reproductive medicine, we integrate all of these factors into the picture. We never just hand you a prescription. I work to create a foundation of health that supports fertility as well as your energy, mood, and overall wellbeing, and prioritizes long-term health.
Educating and Empowering
One of the most powerful aspects of restorative reproductive medicine is that our patients leave understanding more about their bodies, their menstrual cycles, and their fertility than they ever did before.
Through charting instruction, you learn what cervical mucus means. We teach women to identify ovulation and a fertile window based on their own chart, and you can start to recognize the signs that your body is giving you when it needs support before something terrible happens, like your periods turn off altogether or you have periods every two weeks.
I strongly believe that informed and empowered patients are able to make better medical decisions. They're able to partner with healthcare professionals who care and who want to help improve their overall quality of life, and that's why we work closely with our trained instructors who guide you in learning charting. We work with our health coaches and our dieticians to provide that whole body picture. This is not just data for a medical professional to interpret, it's knowledge that puts you in the driver's seat of your health journey.
Unfortunately, many women have had their menstrual concerns dismissed or minimized. Being educated and empowered on what is normal, what is not normal, and how to clearly articulate those concerns helps you to regain a sense of control. That is life-changing!
Why Restorative Reproductive Medicine Isn’t the Norm
One of the most common questions I get asked is, why have I never heard of this before? Why hasn't my own doctor told me about this? Unfortunately, most medical schools don't teach fertility awareness, the science behind the modern methods, or even a restorative approach to reproductive health. Restorative reproductive medical care is not a part of standard curriculum in medical schools or in residency programs. The nuances of menstrual cycle diagnostics are often summed up with “if it is irregular, put them on the pill.”
So doctors must pursue additional certification. Most physicians that practice restorative reproductive medicine pursue postgraduate or specialized training through programs like NeoFertility, FEMM, or NaProTECHNOLOGY, or get involved with organizations like the International Institute for Restorative Reproductive Medicine or Facts About Fertility to learn these methods. More education takes more time, which unfortunately does create an access issue for many patients.
Another challenge for medical professionals is that restorative reproductive care takes time – it takes time to review charts, to tailor medications, and to educate patients. It’s just not possible to provide this level of care in a quick 10-15 minute appointment in most cases. For many physicians who are practicing with a fairly strict time schedule, it is nearly impossible to provide this level of care within their current model. That's why in our practice, the minimum length of time we would see you is 30 minutes, and most of our visits are 60 minute appointments.
Furthermore, many doctors are under the insurance-based model, and this requires them to follow standardized pathways which may not allow for individualized, root cause exploration. For example, if you want to order a lab test, it may not be covered by a patient's insurance. And some patients are not able to pay for it out of pocket. Over time, this creates an ongoing system where we can't get the right evaluation, we can't get the right treatment, and there's not the correct amount of time to be able to provide the needed level of care.
Now the good news is there are so many physicians like myself who are able to offer telehealth services all across the country, and in some cases, across the world. At Radiant Clinic, we practice restorative reproductive medicine because I believe healing is possible and because I have seen it change lives. Whether you're struggling with infertility, irregular cycles, or hormone symptoms that no one has explained, we are here to listen, to investigate, and to walk together with you along this journey. Imagine if your doctor didn't dismiss your symptoms, but actually worked with your body to restore natural cycles to improve health and promote your fertility.
If you're ready to work with our elite team of healthcare professionals, schedule a free discovery call and learn more about our package-based pricing for comprehensive care. We are currently able to see people for in-person appointments in our Cedar Rapids, Iowa clinic, or we can arrange for a telehealth visit if you live in many different states across the US.