NaPro? Not For Me

There are few times in life that I have been thankful that I am not an especially helpful person, and this is one of them. You see, if I were the helpful sort then I would have countless people to apologize to for ignorant advice regarding NaPro. You know the sort of flippant “oh! Don’t worry about that gynecological issue! We have a Catholic answer to all of your problems and it is called NaPro and and and!!!?”

Oh wait, you don’t know NaPro? With greatest apologies I must ask you to excuse me. This is one of those annoying posts that is only readable by a very limited audience.

Furthermore, even though I won’t try to explain NaPro here, I must say that this post is about why NaPro is not the right choice for me. It could still be perfect for you, and that is wonderful. I strongly believe that we need more options for every area of women’s health, and NaPro could be a great option for some people. One of the things I have learned from exploring CrMS is that I am an unusually challenging health case. But that just means that NaPro can provide a good resource for those who are a bit more “usual.”

Despite the fact that NaPro isn’t a good fit for me, I hope that those who believe it to be worth their time will continue working well with it in every aspect, whether as a physician, teacher, or patient. This post isn’t about you, it is about me. It is about me, my body, my religion, and what I’ve learned since the first time I saw those women in white running along the beach.

As recently as this past May I thought that NaPro could be the answer to all of my gynecological health issues. My hope in NaPro was one of the many reasons I did not make a mad dash to a pharmacy for the pill as soon as I got health insurance. After all, I wasn’t just suffering from a childish belief that somewhere out there was a magical non-pill natural cure for me: I knew there was a real system of medicine which could address all of my concerns. All I had to do was save up something like $1,000,000.00 and I could be on my way to Omaha for salvation. ::Cue chorus of angels::

Of course I wasn’t quite that naive, but NaPro makes some pretty big claims, and it is easy to overlook otherwise glaring issues when you so want something to be all that it could be.

But then a bit more exposure to NaPro info and CrMS made me realize that it just isn’t for me.

To understand why NaPro is not (for me) worth seeking out, one would have to understand what would be worth such great effort.

  • A cohesive healthcare system that is truly distinct from the options available to me at my local hospitals.

“NaPro” is…? I still can’t find the answer to this. Perhaps I just don’t understand what a “women’s health science” is, but “NaPro” seems like it is its own patchwork of random things, much like the treatment I can get from local doctors completely covered by my health insurance. I do not need a special name to make me feel better about surgery, the typical hormones, and experimental uses of various drugs.

Which brings me to the second thing that would make NaPro valuable:

  • Ultimate expertise in the conditions with which I need help (like maybe endometriosis?)

Simply put, treating endometriosis for endometriosis’ sake is not a focus of NaPro. If one were going to the effort to find an incredible expert in endometriosis, then it would make much more sense to seek out the type of experts who make the treatment of endometriosis their entire work.

I could find no evidence that NaPro doctors have more success than other specialists for surgical treatment of endometriosis in terms of pregnancy, much less pain reduction.

Which brings me to my next issue:

  • Gynecological health, and not merely reproductive health.

Don’t get me wrong, reproductive or “procreative” health (the ability to conceive, carry, and give birth to a healthy child) is incredibly important. But completely aside from the fact that this is actually a comparatively small part of women’s health time-wise, it is not my primary concern. My largest issue is getting my body to function with the most basic tasks, not obsessing over fertility treatments.

Because of NaPro’s hyper-focus on the procreative, it does not appear to have much to offer me other than fertility drugs for the sake of seeking pregnancy. This was the part where I finally began to understand why all of the other “NFP only” doctors prescribe the pill for women with chronic pelvic pain. It just does not make sense to always go around prescribing pregnancy and fertility drugs which are in themselves at least as harmful as the pill.

And speaking of fertility “treatments” and things I can’t dance lightly enough around:

  • A Catholic healthcare practice where I could relax my moral alertness and not question anything offered.

NaPro encourages, and apparently sometimes requires, things which I believe are immoral. Don’t get me wrong, I am not suggesting that they are violating the clearest of the Church’s teachings. In fact, I don’t know of anything they do that directly contradicts the explicit directives of the US Bishops. So it is all good, right?

But my conscience isn’t ruled merely by how up-to-date the bishops are on all nuances of the lived reality of fertility treatments. To borrow from the hackneyed example: abusing indulgences was wrong even before the pope wrote my bishop a letter telling him to clean things up.

I realize that there must be broad disagreement about what is moral in these areas, particularly when the Church has not had time to catch up with current practices. But the point remains that NaPro holds no advantage for me over any of my local Catholic hospitals. It is not (and most likely cannot be) some bastion of perfect Catholicism. This is not a reason to reject it out of hand, but it does mean that it is not especially worth seeking out for moral reasons when there are many other Catholic resources.

Yet one promising thing about NaPro is that it is so closely connected to CrMS. And who wouldn’t respect Catholic healthcare that places a large emphasis on fertility understanding that enables people to follow the Church’s teachings?

This is precisely why I value:

  • Healthcare based on a profound understanding of not only the theoretical fertility cycle, but also my unique body.

Unfortunately CrMS does not work for me. I can see how it could work for most women, and would be well worth its existence simply to serve women with a certain personality type, if nothing else. But it is insufficient for my body for the purpose of avoiding pregnancy, and somewhat silly for other purposes.

This was very hard for me to accept at first because I have never thought of my fertility cycle as especially challenging. I have many troubling issues, but a few of these actually lend themselves to making fertility awareness easier. Because of this, the greatest challenge of learning CrMS was the effort it took to see why my FCP could not see what was so obvious to me. The simple answer is that the CrMS obfuscates my fertility signs by zeroing in on precisely the wrong aspects of my symptoms.

Again, I realize that this system is quite adequate for most women. But the fact that it is so ridiculously inadequate for me  does not give me reason to put faith in the health system which has grown up with CrMS. I have even more issues with CrMS in general, but the most essential is the question of why I would want to follow a system which declares itself superior to other forms of NFP, and then, without adequate instruction for their correct application, turns around and requires me to utilize tools perfected by other methods?

Lastly, something which isn’t a criticism of NaPro at all, but more of a reflection of where I am at this point.

  • I want healthcare which treats me as efficiently as possible without being unnecessarily invasive or experimental.

It is good that NaPro tends toward the experimental side of things. After all, if no one ever tried anything new… BUT at the same time, I am tired of being a lab rat. Also, I had just a little dose of the NaPro approach this summer and the invasiveness is the last thing that I need at this point. I was quite willing to have surgery because I needed it, but the fact is that the NaPro style seems heavily geared toward invasiveness in every area. This goes along with the experimental aspect and makes sense for figuring out new treatments, but my body has been through enough without subjecting it to pointless over-treatment.

And this, my dear readers who have skimmed to the end, is why–even if I suddenly turn into a helpful person–I will not indiscriminately recommend NaPro as the Catholic cure-all for women’s health issues.

If those of you who are dedicating your lives to NaPro wish to comment to clear up any way in which I may be misleading a hypothetical interested but ignorant reader, please do so. I won’t take offense, and will indeed be flattered that you imagine my writing to be so fascinating that any but the most ardent devotee of NaPro would bother to read this post!

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17 thoughts on “NaPro? Not For Me

  1. Rebecca

    First – yay! you’re back :) .

    Second – thank-you for this awesome look at another opinion :) . One of the biggest struggles we are facing is ‘how much to do’ towards having a child. We are blessed that our insurance covers everything that has been prescribed so far and in our case, even the local ‘Catholic’ hospitals can’t necessarily be trusted to provide the best advice. If I were in an area where there were specialists upon specialists and reliable Catholic doctors, I would be much more likely to stick with more ‘traditional’ methods. My main reason for not seeing a ‘regular’ Ob/Gyn for the additional steps is because those in my town are geared towards IVF and IUI and I would worry that if they were performing surgery that they weren’t being careful enough to preserve my fertility.

    I don’t mean this as an argument at all. It really is a thank-you for opening the discussion as to other paths and the reasons behind them. :) .

    And again, Yay! you’re back :) .

  2. Rebecca

    Oh, and I forgot to say that I share your frustration with the CrMs method not using all of the information available to them. I was blessed that the Nurse Practitioner I saw was willing to take my Sympto-Thermal charts and use them for information. I KNEW they had value and it was nice to have that validated. :) .

  3. Michelle

    I’m not a CrMS girl. I’ve done STM and Marquette, mostly. I have a hard time with any in-fighting about what method is “the best” or “superior.” I have run into the “superiority complex” mostly when people are discussing CrMS or STM. It’s silly, though, because we are all different and what works for one of us, may not work for another.

    Temps helped me out when I was in my late 20′s and early 30′s, but then they stopped being reliable the older I got and the more children I had and the more issues with progesterone I had. So, I moved to Marquette with a monitor. And I’m all good with that, for now.

    I don’t blame you for not wanting invasive treatments.

    Thanks for this post!

    1. Rae Post author

      It is really great that you could switch methods to find the ones that worked best for you at various times. And considering all of the in-fighting I find it impressive that you can switch methods without bashing others as inferior!

  4. Meg

    Now that I’ve had two kids, I’m appalled by the way my uterus (during pregnancy) and my vagina are no longer mine. As if somehow they belong to my children and any choice I make regarding myself, in anyway but more specifically my reproductive organs, isn’t right.

    Example: We didn’t have health insurance for about a month of my second pregnancy near my 15-18 week mark due to transitioning into a new job. I called my practice (that I left because they continued to violate my rights as a human being) and told them I couldn’t do an ultrasound. The woman went on and on about how I was hurting my baby that I basically had no right to do this and when I told her we couldn’t afford the ultrasound and could there be a payment plan, she told me “Oh, well we don’t do that. But you should still get an ultrasound, for the sake of your baby.”- As if some ultrasound was going to save my pregnancy (that wasn’t in danger by the way) and if I chose not to have one then I was basically killing my baby. So she convinced me to come in and get the heart rate checked for $60 bucks. I get in there and they couldn’t find the heart beat. The doctor told me, “Oh, not to worry. I don’t know why you’d come in this early for an external heart rate exam. Usually you can’t even hear it outside on the stomach this early.” – I still had to pay the $60 bucks (that we really couldn’t afford) all because some woman made me feel like crap about my own unborn child and my own body. This practice also bullied me into taking meds to “save” my pregnancy (when I went to the practice I’m at now, they told me those meds were unnecessary), assigned me a nurse who looked at my then 9 month old daughter and said “WOW!..Another one..SO SOON!?”, and messed up my paper work and told me it was my fault. I was so frustrated, demoralized, and outraged at the way I was treated.

    Now that I’m finished with my comment I don’t even know if it relates at all to your post..But anyways, reproductive rights and women’s health care issues are basically trampled on and making educated decisions about our bodies when they don’t go along with powers a be is unheard of and you’re basically a crazy woman who doesn’t care about herself, her children, or spouse!

    1. Rae Post author

      This is horrible and yet another sign of how crazy our culture is. As if somehow it were possible to take care of your unborn children without first taking care of you, the one in whom they were living! I hate poor medical care and am sorry that you have had to suffer through so much of it. You’d think that if an ultrasound were so crucial for your baby’s health the practice would be required by law to give it to you without regard for whether you could pay…

    1. Rae Post author

      Small world, eh? It isn’t close enough, but I’ve been going there anyway. Interestingly enough they do prescribe the pill for medical reasons (which I certainly agree with) and have a NaPro trained doctor on staff, though they don’t officially follow it all (for which I am thankful, all things considered). Anyway, thank you!

  5. Megan

    I really appreciate this post. As a CrMS practitioner, I would love to know more about your personal experience with the method and Napro. I don’t think that the CrMS/Napro path is right for everyone, but I am still learning which medical conditions, cycle issues, personal goals, etc. are most compatible and which are not.

  6. therese

    Rae,
    I’m sorry you did not find the help you were looking for with NaPro. Your post also saddens me because of its many half truths, and the implication that “NaPro encourages, and apparently sometimes requires, things which I believe are immoral”. Absolutely follow the dictates of your conscience re those “things”, but in fairness of discussion, at least name them.
    Your comment:
    Simply put, treating endometriosis for endometriosis’ sake is not a focus of NaPro. If one were going to the effort to find an incredible expert in endometriosis, then it would make much more sense to seek out the type of experts who make the treatment of endometriosis their entire work.

    Ironically you link to Dr. Redwine, whose work Dr. Hilgers extols, and sites as fundamental to his own in the area of endometriosis. The treatment link, is also exactly what NaPro says-endo requires, surgical excision. The surgical advantage that NaPro techniques provide is they are ADHESION FREE, see the research published in Near Adhesion-Free Pelvic Surgery: Three Distinct Phases Over 23 Years
    http://www.liebertonline.com/doi/abs/10.1089/gyn.2009.0031. NaPro surgeries for endo also have a recurrance rate of less than 7%, very difficult to find outside of NaPro. And I must clarify, NaPro indeed does “treat endo for endo’s sake”, or at least the sake of the women suffering its very real effects, infertility or not.
    This comment:
    I could find no evidence that NaPro doctors have more success than other specialists for surgical treatment of endometriosis in terms of pregnancy, much less pain reduction.
    Here is your evidence http://www.naprotechnology.com/infertility.htm See In Figure 51-5, a life table comparison of the effectiveness of NaProTECHNOLOGY (in blue) with a similar non-NaProTECHNOLOGY approach taken at Johns Hopkins University is shown. The success rates are clearly better using the NaProTECHNOLOGY approach.

    [Figure 51-5, p. 682 from the NaPro textbook. Cumulative pregnancy rate of patients with endometriosis treated with NaProTECHNOLOGY compared to conservative surgery only. Patients with normospermic husbands only (From: Pope Paul VI Institute research, 2004 and Rock JA, Guzick DS, Sengos C, et al: The Conservative Surgical Treatment of Endometriosis: Evaluation of Pregnancy Success with Respect to the Extent of Disease as Categorized Using Contemporary Classification Systems. Fertil Steril 35:131-137, 1981).]
    For further evidence, independent research on NaPro is ongoing with the International Institute of Restorative Reproductive Medicine, http://www.iirrm.org/.
    There are many more points I could take time clarifying, but time does not allow. Please take more time to research things before posting.

    1. Rae Post author

      I wish that reading about my experience did not sadden you, though I suppose that given my own sadness at realizing how NaPro has been unfortunately (and often inadvertently) puffed up to more than it can possibly be, it is only reasonable that others would also find recognition of this truth sad as well.

      This post is not intended to declare the absolute truth about NaPro, but rather why NaPro is not helpful for me. This is my personal blog with no pretense at being authoritative. I have thought quite a bit about posting my moral concerns with some NaPro methods, but do not yet see how that would be useful, and certainly not in a post already as long as this one! I believe that those who cannot imagine any wrong with NaPro would not be convinced, no matter my argument, and those who are open to twinges of their conscience need no more than the knowledge that others too believe that something is not quite right. They can then return to study and prayer and make the best decisions that they are able.

      My link to Dr. Redwine was quite deliberate as I was pointing to one of the sources used by NaPro, a source that is valuable because it has focused so much more on endometriosis rather than infertility. In the service of truth I feel the need to point out that you dropped the word “near” from the “near adhesion-free” claim. Thankfully many medical professionals have been advancing as well and that it is now quite possible to find many others performing “near adhesion-free” surgeries. I had the privilege of having an adhesion-free surgery in 2007 which I know because it was revealed to be so at a follow-up surgery this year before which the surgeon explained to me the various techniques which are now standard to minimize adhesions.

      It is, however, unfortunate that some are being lead to believe that perfectly guaranteed adhesion-free surgery is an option. This is why it is important to not forget words such as “near.”

      I hope that you can see my point that the very reason that Hilgers relies on Redwine is that the latter has actually dedicated his time to endometriosis in a way that the former has not. That isn’t a bad thing, it just means that if you are going to bother to seek out an expert in endometriosis you might want to go the one who is the source because he has focused on it more.

      I am happy to hear that in your experience NaPro treats endo for its own sake, not merely for infertility. It would be wonderful if those stories could make their way onto the websites, books for laypersons etc.

      One thing that I did not have room to get into in this post is the way in which endo-stats in particular are… skewed to promote NaPro. I don’t think it is particularly worth the time since all medical professionals are likely to do the same. This is why one must not merely look at a NaPro website to find information for success for alternate treatments.

      The graph you refer to is incredibly misleading to the quick glance. It appears to give the implication that a woman with endo-related infertility must merely wait 6 years in order to have a 92% chance of pregnancy. But that isn’t the case, is it? Also, I read that graph as comparing women treated with everything NaPro has to offer as opposed to those treated *only* with conservative surgery. Thankfully non-NaPro doctors have a lot more than surgery alone to offer. So a fair comparison would either be between NaPro surgery alone, or between all that both NaPro and non-NaPro medical care could provide.

      Ultimately, you have to understand that people promoting NaPro are only going to show you comparisons when they look better. It takes additional effort to seek out other sources where you can find studies that equal or exceed NaPro results.

      I appreciate your concern for the truth and hope that you will consider my view that there is very limited use to “clarifying” when you lack time to delve more fully into the details. Also, I sincerely hope that you will share your concern for the truth with the many personal bloggers who spread unrealistically positive views of NaPro. That too hurts many women such as myself by offering false hope which contributes to poor decisions.

  7. alison

    Despite getting pregnant after “Napro” and knowing full well the tremendous good that it provides, I can’t consider myself on the selflessly and fully promote it bandwagon. I think of it as an option, but not THE option. Customer service and ease of treatment aside (it is never ideal to have a doctor that you can never physically talk to yourself or discuss your future course of treatment with), I did not gather that “health” was always the main goal of Napro, although that’s what it suggests. Great treatments and lots of different angles, but it was more focused on overcoming infertility rather than fixing health. And unfortunately its often hard in the emotional state of undergoing infertility to tell the difference. I do believe Dr. Hilgers is a researcher and a great surgeon, but his treatment paths are very different because he’s not primarily a doctor first.

  8. Miki

    I just came across the post on a google search.

    My experience with napro is very different to yours, and perhaps it’s because I look at what else is available to me (and would have a different napro doc to you)

    Going from IVF clinic that diagnosed me with unexplained fertility, then tell me I need IVF and don’t truly listen to my concerns, to then go to my absolutely wonderful napro doc who is a wonderful listener and diagnosed me with 5different causes for intertility within 3 months (and seems to have fixed them all!) is completely invaluable to me!!!

    While its not right for you, it is the best thing I’ve ever done!

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