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IFS Book Review – The Fifth Vital Sign: Master Your Cycles & Optimize Your Fertility


Book: The Fifth Vital Sign: Master Your Cycles & Optimize Your Fertility (368 pages)

Author: Lisa Hendrikson-Jack

Publisher: Fertility Friday Publishing Inc, 2019

Reviewed by: Sheila Mukami

Women’s health has increasingly become a topic of interest for many health practitioners, a trend evidenced by the number of books written and podcasts aired in recent times on the topic. One such person is Lisa Hendrickson-Jack, a certified Fertility Awareness Educator and Reproductive Health Practitioner who also runs the popular podcast, Fertility Friday, which currently boasts over 300 episodes and counting. Her first book, The Fifth Vital Sign, published by Fertility Friday Publications in 2019, is a well-researched book packed with evidence-based facts making it an invaluable resource for women, married couples, and health practitioners alike.

Vital sign of health

The main premise of the book is that a woman’s fertility cycle is a vital sign of health and that regular ovulation is crucial in maintaining good health during her reproductive years. Regular ovulation cannot be experienced where the endocrine and reproductive systems are not functioning properly; irregular ovulation (and consequently irregular menstruation) is a clear signal of an underlying health problem. Some underlying health problems that may lead to irregular cycles include; polycystic ovarian syndrome, thyroid disorders and hypothalamic amenorrhea, conditions that may also lead to other health complications such as cardiovascular disease and type 2 diabetes.

Ovulation is the main event in a woman’s cycle since a true menstruation is only experienced after ovulation. Observing the biomarkers related with ovulation therefore is central to proper fertility education. This is unfortunately not the case since contemporary education on reproductive health has as its focus, the prevention of pregnancy, leading to the early uptake of hormonal contraceptives by young women, a common feature of modern society. Hormonal contraceptives, unfortunately, are designed to function primarily by stopping the most important event of a woman’s cycle, ovulation. Without ovulation, a woman is left without an important vital sign and hence to a certain extent, powerless. Notwithstanding, the use of contraceptives has been associated with a myriad of problems. Research shows that it affects the woman’s physical body (clitoris and vulva) as well as the emotional well-being by increasing the chances of experiencing depression and anxiety. Further, the woman’s sex life is affected by lowering libido and increasing the chances of painful sex. Hormonal contraceptives also disrupt how the body metabolizes and stores nutrients such as B vitamins and others. Finally, and most interestingly, they affect one’s choice of an intimate partner.

Recognize your cycle

In view of this, Lisa Hendrickson-Jack provides important solutions to the problems outlined above. According to her, the recognition that one’s natural cycles as an essential part of optimal health is the first step. The second step is figuring out how to manage fertility without synthetic hormones; this means embracing Fertility Awareness. Fertility Awareness as described in the book is a set of practices that allow one to determine which days of the cycle are fertile or infertile through charting three important indicators. This presents zero side effects to a woman’s health and has been seen to have an effectiveness rate of 99.4% among couples who for legitimate reasons choose not to conceive. Of importance to note is that Fertility Awareness is not synonymous with the Rhythm Method; fertility awareness involves daily observation of biomarkers, while the rhythm method tries to predict fertile and infertile days based on past observation.

The book firmly shows that it is imperative for every woman to be informed on how to effectively chart her cycle if she wants to maintain proper body functioning. Body literacy allows one to understand the signs of fertility as they happen and track changes to one’s health and fertility over time. This explains why coming off hormonal contraception is equally important for those who want to conceive and those who do not. Tracking of these changes assists the woman in identifying the anomalies which with the help of a trained physician can lead to a proper diagnosis of an underlying health condition.

Finally, to experience healthy cycles, one needs proper nutrition and prudent lifestyle choices. A good understanding of how certain food choices affect one’s fertility as outlined in the book, is an important aspect of fertility education that has long been overlooked. Lifestyle choices that lead to exposure to xenoestrogens is also another area of fertility education that many women remain oblivious to. Apart from hormonal contraception, personal care products, cookware used, food consumed among others, could be the reason why many women are not experiencing healthy cycles, as these may contain xenoestrogens which when introduced to the bloodstream interfere with the endocrine system. Additionally, common symptoms associated with menstrual health problems such as premenstrual syndrome (PMS) and painful periods can dramatically improve with dietary and lifestyle changes as suggested above; unfortunately many women believe that these conditions cannot be eliminated and are simply to be endured, a position that one pleasantly comes to the realization, by reading this book,  that it is false.

Fruit of Love

Fertility is an important concern for married couples most especially during the reproductive years of a woman. Many desire to have children and legitimately so, as this is the visible fruit of their love. Unfortunately, women have not been empowered with the necessary tools to help them achieve pregnancy as well as space their children. Terms such as cervical mucus and basal body temperature are foreign to many women of reproductive age, yet these are the key to understanding the inner workings of their fertility and reproductive health. Exposure to hormonal contraception as a method of preventing pregnancy is detrimental to the physical and emotional wellbeing of women which in turn affects the wellbeing of the family. However, contraception in our current world is synonymous with women’s health. Adoption of fertility awareness method is therefore indispensable for married couples as it is scientifically sound and poses no risk to the health of the family. But for this to happen, there is urgent need for proper fertility education for couples and single people alike and ideally from the very moment a young girl experiences her first period.


This book review is an initiative of the Institute for Family Studies and Ethics.