The book is targetted towards infertile women living in the US, and is written in the currently fashionable "chick-lit" style. It's amusingly written; and is a breath of fresh air , if you are the sort of person who finds a sense of humour helps you cope better with infertility.

The book has lots of Top-10 lists, and I have modified their list of Top Ten Monthly Mistakes Women Make

# Ten Monthly Mistakes Women Make
1. Women go on the Pill to regulate their cycles without first
  determining why they are irregular.
2. They disregard heavy periods.
3. They worry too much about the colour and texture of their periods.
4. They worry about their physiological vaginal discharge
5. They have productive baby-making sex at the wrong times of their  monthly cycles.
6. They think that every women has a twenty-eight-day cycle and every
    women ovulates on day fourteen.
7. They are not sure how to track their menstrual cycle.
8. They try to maximise their fertility by " storing up " sperm by scheduling sex only on their fertile days in an effort to get pregnant.
9. They try to time sex by charting their temperature ( BBT charts)
10.They don't use OPKs

It's true that most women have very little understanding of how their reproductive system works - and for many of them, their menstrual cycle is a complete mystery !

Here are my comments on their list.

1. Women go on the Pill to regulate their cycles without first
  determining why they are irregular.

Irregular cycles mean that you do not ovulate. This is called anovulation; and women who don't ovulate will have irregular cycles; and will also be infertile. The infertility is a result of the anovulation. While taking the Pill will regulate the irregular cycle so that it starts coming like clockwork, it will not treat the underlying anovulation problem. This means that when you stop the Pill when you want to have a baby, your periods will go back to becoming irregular again - and you will need ovulation induction treatment to correct your infertility.

 
2. They disregard heavy periods.
 

While heavy periods are not always a sinister sign, if your periods have started becoming progressively heavier, then you need to seek medical attention. This could be because of a uterine polyp, for example; and this polyp could also cause infertility.

3. They worry too much about the colour and texture of their periods.

You only need 4 things to make a baby - eggs, sperms, uterus and tubes. Now since women cannot see their eggs, and all they can assess is their menstrual flow, many infertile women obsess over even minor normal variations in their menstrual flow. If it's too dark, they feel that there are toxins in their body which are not being washed out; or that the "bad blood" is getting accumulated in their bodies, causing them to become infertile. This is why a D&C ( dilatation and curettage) used to be such a popular procedure in the past; women felt that the doctor was cleaning out the dirt in their uterus !

4. They worry about their physiological vaginal discharge

For many women, their private parts are a "no-man's" land
( pun intended) . They don't have a clue as to how their insides work; and these worries are magnified a hundred-fold in the mind of an infertile woman, who thinks that her infertility is a result of her body is defective. A mid-cycle vaginal discharge is normal, and is a result of the production of cervical mucus prior to ovulation. However, many women think this discharge represents an infection; and demand treatment for this !

5. They have baby-making sex at the wrong times of their monthly cycles.

Many women are uncertain as to how to calculate their "fertile" period. They know it has a relationship to their ovulation cycle, but often don't know what this is, as a result of which they don't time baby making sex properly. You can calculate your fertile days by using our free fertility calculator at www.drmalpani.com/freefertilitycalculator.htm !

6. They think that every women has a twenty-eight-day cycle and every women ovulates on day fourteen.

This is true only in textbooks - and many women's bodies have not read the text book. Completely normal women have cycles which range from 21 days - 45 days - and this is very normal, as long as the cycles are regular.  Ovulation occurs 14 days before the next period is due - which means it can occur normally from a range of Day 7 ( for women with a 21-day cycle) to Day 31 ( for women with a 45-day cycle).

7. They are not sure how to track their menstrual cycle.

For example, women are often unsure of the significance of spotting. They think that the spotting signals the start of their period, and count the spotting as Day 1. Actually, the spotting is pre-menstrual spotting, and should be ignored. Only the start of a proper flow is considered to be Day 1. If they miscalculate, they end up mis-charting their entire cycle, and get frustrated and confused. To make a bad situation worse, they are reluctant to ask their doctor about this, because they feel that this is basic knowledge,which every women should know, and they don't want to ask "stupid " questions.

8. They try to maximise their fertility by " storing up " sperm by scheduling sex only on their fertile days in an effort to get pregnant.

This can actually be counterproductive. For one thing, husbands get very frustrated, when their wives "allow" them to have sex only on the fertile days. They feel they are being treated as "studs" whose only job is to "perform" and impregnate their wife. Not only does this take all the fun out of sex; it can actually cause infertility, if the timing is done incorrectly.

9. They try to time sex by charting their temperature ( BBT charts)

The BBT chart is a hangover from the hoary days of gynecology, when doctors did not have a clue as to how the reproductive system worked; and keeping BBT charts gave women something "useful" to do. It also allowed doctors to pore over them - but the analysis was as flawed as the analysis of traditional soothsayer, who would analyse tea leaves or the entrails of a sacrificed animal, to try to fortell the future. While BBT charts are useful for pinpointing when ovulation occurs
( on a retrospective analysis), they are useless for helping women to time sex during their fertile time. This is because the temperature rise occurs only after ovulation - by which time the woman is already infertile !

10.They don't use OPKs

Because OPKs are not available in India, most women in India have no idea as to how they can use OPKs to track their ovulation and their fertility. This is a shame, because OPKs can be very useful tools to help couples plan baby making sex. Unfortunately, even most gynecologists do not advise their patients to use these, because they are not easily available at the chemist; and because they prefer doing ultrasound scans to monitor ovulation ( even though the scans are much more intrusive, and waste a lot more of the woman's time and
energy). The good news is that Indian women can now buy OPKs from our clinic; and from our online store at www.drmalpani.com/store.htm.