Today, Dr. Marguerite Duane, M.D., is perhaps best known as the intrepid co-founder and executive director of FACTS About Fertility, a self-described “group of physicians, healthcare professionals and educators working together to provide information about natural or fertility awareness based methods of family planning with the medical community.” FACTS is the professional organization for physicians, fertility awareness instructors and practitioners, similar to how the American College of Obstetricians and Gynecologists (ACOG) is the professional organization for OB/GYNS. But as an undergraduate pre-med student at Cornell University in the 90’s, Dr. Duane was like most young women: suffering from painful periods, and unsure what to do about it.
Painful periods and the campus health center’s solution: Hormonal birth control
“Ever since high school, I’d had debilitating, painful periods, but I’d usually get a heating pad, some ibuprofen and get through it,” she told me in an interview over the phone. “But during my second year of college, I got my period right before a biochemistry midterm, and it was bad. I was doubled over, nauseous, I couldn’t think straight—and I ended up doing terrible on the exam. I’d tried the ibuprofen and the heating pads, and just thought, ‘if I want to become a doctor, I need to do well in college’, so I finally decided to seek help at the student health center.”
Of course, she was immediately offered birth control.
“I wasn’t sexually active, so I wasn’t really interested in birth control, but the doctor at the student center reassured me it was the best option for me,” said Dr. Duane. So, she decided she’d try it, “even though I questioned why I needed to take something every day for pain during periods that only lasted 2 or 3 days each month.”
6 months later, a baseball-sized bald spot appeared
Fast forward about 6 months, and Dr. Marguerite Duane remembers being in her dorm room with a friend, and reaching up to tie her long, thick hair back into a ponytail. “And my friend just says, ‘Whoa! You have a big bald spot right there!’ And she was a bit of a joker, so I didn’t take her seriously at first, but she insisted there was a bald spot. She got up to show me in the mirror, and she was right—there I was with a baseball-sized bald spot that I hadn’t noticed before.”
Upset and more than a little freaked out, Dr. Duane began to think back to anything she’d done differently for the past few months that might have caused her hair loss—and she landed on her recent birth control prescription. She rummaged through her things to find the drug insert, and, sure enough, “hair loss” was listed as a side effect.
But she was told hair loss from birth control was ‘common’
“So I called the student center, and spoke to a nurse about it. When I said I was experiencing hair loss from my birth control, she just said ‘Oh, that’s common.’ But I pushed back—if this was so common, why didn’t anyone tell me it could happen?—and I asked to be scheduled for another appointment with the doctor. I mean, I was a 21-year-old woman with a bald spot! This wasn’t normal, and I wasn’t okay with it.”
But when Dr. Duane’s appointment came around, and she went to be seen by the doctor, she couldn’t believe her suggestion: “She said, ‘yes, this is common’, but did admit that the size of the bald spot was a little unusual. So she said we could try a different type of birth control pill, and a cream to use on the bald spot to see if that would help. But when I asked her what would happen if that didn’t work, she said, ‘well, we’d send you to a dermatologist for steroid injections.’”
“I couldn’t believe it,” said Dr. Duane, “We were talking about me seeing a specialist, now? It just didn’t make sense to me. And I just felt this frustration like, ‘you really don’t have anything else to offer me?’”
Gritting through her period pain, and prescribing birth control to her own patients
So that day, Dr. Duane decided to stop taking birth control. Her bad periods returned (along with her hair), but she only endured pain for 2-3 days per month. She figured she would just get through it with heating pads and ibuprofen, same as she always had.
Fast forward through the rest of college, and medical school—where Dr. Duane was taught that birth control was the solution to practically every woman’s health issue, from painful periods, to heavy bleeding, to acne—to her family medicine residency.
The night Dr. Duane heard of fertility awareness for the first time
“I’ll never forget this night,” says Dr. Duane. “It was my first year of family residency, on an overnight OB call, and I was getting postpartum patients ready for discharge–which involved making sure they had prescriptions for birth control. It had been drilled into me that every woman who leaves the hospital with a baby needs to leave with a prescription for birth control, because heaven-forbid they get pregnant again too soon. I was on call that night with a senior resident, Dr. Pearl Huang, who had recently been trained in the Creighton Method, and she was walking me through how I wanted to counsel patients about the side effects of various forms of birth control, including their potential effects on their mental health, milk supply, all that. Then the resident says, ‘Did you know there are some methods of family planning that have no medical side effects?’
She was skeptical that any family planning method could be side effect-free
“I just looked at her, like ‘What? Every method can have adverse reactions. Even condoms can cause a local reaction.’ And the resident then explained to me that women could chart their fertility using biomarkers like cervical mucus, basal body temperature—all these things I had never heard of before—and that they could use that information to avoid pregnancy, without any side effects. And she explained how this information could be used to help treat the underlying causes of things like painful periods, heavy bleeding, and other menstrual cycle-related issues.
“I was just shocked. I mean, I was 29 years-old when I started my residency, I had graduated medical school and I just wondered, how have I never heard about this? Why didn’t I learn about this in medical school… Why didn’t I get offered this in college at the student health center, when I was having painful periods? Or at 13 when I started having periods?”
Shock, anger, and a decision to learn more about fertility awareness
Like most women who learn about fertility awareness in their 20s and 30s, Dr. Duane recalls having a profound sense of shock, “shock, followed by anger,” she says. “Anger that I didn’t need to be on birth control back then… anger that I had spent all this money on medical school, and was never taught this.
“And so I asked the senior resident, do you think I can learn to chart, even though I’m not married, or would want to get pregnant anytime soon? And she was just like ‘Oh yeah! It’s really helpful before you need it for family planning.’” The resident connected Dr. Duane with a teacher, Sharon, who taught her the Family of the Americas Method (which was built on the Billings method)—and she never looked back. “Upon hearing about FAM,” she says, “I just wanted to learn everything about it I could.”
Dr. Marguerite Duane used FAM to manage her own period pain, and her patients’…
In learning how to chart her own cycles, Dr. Duane also finally learned how to manage her painful periods. “I learned that period pain comes from an increase in prostaglandins,” she says, “and that I could take ibuprofen or Aleve in the day or two leading up to my period to kind of head off the pain before it could start, based upon my charting. And then my period no longer disrupted my life.”
Later on, when Dr. Duane got married, she and her husband used various natural methods for family planning, including the Sympto-Thermal Method (“I’m not a morning person, and could never remember to take my temperature.”), before settling on the lactational amenorrhea method (LAM) and then the Billings and later Marquette methods to space their children. Today, she and her husband have four children, ages 10 to 18–and their first child started college this past fall.
… and teaches other doctors to do the same
Learning about fertility awareness impacted Dr. Duane so profoundly, on both a personal and professional level, that it’s one of the key reasons why FACTS exists today. And, more recently, Dr. Duane has a new role to add: Director of the brand-new Center for Fertility Awareness Education and Research and Associate Professor at Duquesne University College of Osteopathic Medicine.
Dr. Marguerite Duane feels very strongly that all young women need this information, that knowledge of their bodies and their fertility is their birthright. Her work at FACTS helps ensure that more physicians can learn about fertility awareness and restorative reproductive medicine, and come to believe these things—for themselves and their patients—too.
To learn more about FACTS, visit: https://www.factsaboutfertility.org/
Are you a healthcare professional interested in learning more about fertility awareness and restorative reproductive medicine? Consider joining FACTS for their annual conference on March 21 and 22 at Duquesne University. Find out more about the conference and register, here: https://www.factsaboutfertility.org/2025-conference/
