There are many reasons women may consider Fertility Awareness Method. With more than 58 million women of reproductive age in the United States, it is important to have options when it comes to contraceptive methods.
Fertility Awareness Methods, also known as Natural Family Planning, are self-awareness methods that incorporate tracking of symptoms, signs, and rhythmic patterns for predictability of your fertility window. These methods can help you achieve ownership over your desire to procreate or not without the use of hormonal birth control options.
What Are the Different Kinds of Fertility Awareness Methods (FAMs)?
There are four commonly used methods of fertility awareness that have an effective rate of 76-88% when done correctly. Using multiple FAMs together can help increase the effectiveness.
- Standard Day
- Cervical Mucus
- Basal Body Temperature
- Symptothermal Method
Each method requires precise tracking and record keeping of 6-12 cycles to see pattern formations and establish a timeline for your unique ovulation period. Understanding your ovulation days is essential for determining your potential days for conception, which can be accomplished through proper implementation of Fertility Awareness Methods. Depending on your body, commitment to details, and regularity in your cycle, one or more of these methods may suit you best.
Standard Day Method (SDM)
The Standard Day Method, also known as the Rhythm Method, is focused on avoiding unprotected sex or practicing abstinence on days 8 through 19 of your cycle. This form of fertility awareness is ideal for women with regular cycles that fall between 26-32 days. The 12-day gap accounts for ovulation while also giving wiggle room for days before and after.
If you have irregular periods, are breastfeeding, are an adolescent, or are perimenopausal then this method is not recommended.
An efficacy trial of SDM found this method to be 95% effective when done correctly. If using this method, you’ll need to keep track of the first day of your period and the length of your cycle, and then track what days of the month, days 8 through 19, would be each month.
You can do this by using a calendar and marking the appropriate days or using CycleBeads. CycleBeads are a visual representation used to track the days of your period over consecutive cycles, so you can visualize which days you are fertile. The beads are color-coded- red for period start day, brown for non-fertile days, and white for days you are likely to become pregnant if you have unprotected sex. You can purchase actual CycleBeads, a paper version that you check mark, or you can use their approved app.
Cervical Mucus Method
Tracking your ovulation days can be done through the cervical mucus method, also known as the Billings Method. Cervical mucus is the vehicle that helps sperm travel to an egg, leading to fertilization. Checking your cervical mucus daily to observe color and consistency and tracking the observations will reveal days when your mucus progresses from dry to slippery and cloudy to clear. Here’s a guide to what these signs indicate:
- Dry- lack of fertility, usually present three to four days after your period
- Sticky, Cloudy, Scanty discharge- next stage, typically three to five days.
- Clear, slippery, “egg-white” consistency- before and during ovulation. Following three to four days
- Void days- mimics the dry phase. 11 to 14 days before your period.
On the days when cervical mucus represents before and during ovulation, you’ll want to avoid unprotected sex. Like the other methods discussed, you’ll want to track this for multiple cycles before using this as the primary means of contraception. If you have unpredictable mucus discharge, you suffer from vaginal dryness or excess discharge; this method may not be an accurate way for you to determine your fertile window. Consulting a practitioner that can address the root cause of this issue would be a great step toward FAM practicing.
Basal Body Temperature (BBT) Method
Tracking daily body temperature can identify a pattern associated with fertility. During ovulation, your body temperature will slightly rise, less than ½ a degree, as an ovary releases an egg. These slightly higher temperature readings typically stay elevated for the next three days. Considering how conception works, your fertile window is about two days before temperature elevation to three days after, making it a six-day fertile window. Many women will place an accurate reading thermometer at the bedside and take the readings as soon as they wake up on the same body location. Keeping a record of this daily over a few months can reveal a pattern that can then be used to avoid unprotected sex during the times that indicate ovulation.
The benefit of BBT is that it is low cost and relatively easy to follow, as long as you have regular cycles. BBT has its limitations, as it is not considered effective in predicting ovulation in lactating women lacking a period. These women should consider other FAM, such as the Symptothermal Method.
This method is thought to be the most effective fertility awareness method! It combines cervical mucus checking with BBT and the calendar method to determine a precise ovulation window.
Although Calendar Method is not discussed above, the Standard Day Method is a type of Calendar Method. The Symptothermal Method takes other preovulatory signs and symptoms into consideration as well, such as breast tenderness and premenstrual back and pelvis pain.
Things to Consider When Using Fertility Awareness Methods
A study from 2007 found the Symptothermal Method as effective as modern contraceptive methods, such as oral contraceptives, when done correctly.
Multiple sources report the Basal Body Temperature method to be less accurate than other FAM methods. Acute illnesses that cause an elevated temperature can give a false representation, and so can medical conditions such as hypothyroidism, diabetes, sleep disturbances, and excessive stress.
The BBT method is also not precise in showing a full ovulation window, as it will reveal when ovulation has already occurred but is not a predictor that it is about to occur. Like BBT, the cervical mucus method is most effective when used as criteria for the Symptothermal Method.
Functional Labs to Track Hormones
Addressing any hormone imbalances would be necessary prior to implementing Fertility Awareness Methods. If you have signs of estrogen imbalance or suffer from PMS, you’ll want to have a thorough evaluation to achieve the most success with FAM. Here are a few labs commonly ordered by functional medicine practitioners to track cycles and hormone imbalances.
DUTCH Cycle Mapping is an excellent option for women with irregular menses, PCOS, and fluctuating hormonal symptoms, but would like to implement the Fertility Awareness Method. This test identifies progesterone and estrogen patterns throughout your menstrual cycle while also analyzing cortisol secretion. Results from this can help your provider create a plan to regulate your cycle to get you to your desired goal of FAM practicing.
Genova Rhythms Plus Test is a salivary test that looks at six hormone metabolites from 16 samples over 28 days. These samples are then used to analyze and create a graphical representation of estradiol, progesterone, and testosterone to help your practitioner assess if your hormones are in balance with the phases of the menstrual cycle.
There are many reasons women may consider Fertility Awareness Method over hormonal birth control. It is important for women to have accurate, evidence-based educational material available to them so they can make the best decision for their bodies.
Implementing one or more of these methods, with precise attention to detail and the guidance of a doctor, can help women achieve ownership over their fertility.
Becoming more in tune with your body, your cyclical patterns, and how your fertility window operates can bring peace of mind and a natural way to prevent pregnancy.
Al-Taee, H., & Edan, B. J. (2018). Estimation of Day-Specific Probabilities of Conception during Natural Cycle in Women from Babylon. International journal of fertility & sterility, 11(4), 314–317. https://doi.org/10.22074/ijfs.2018.5100
Are´valo, M., Jennings, V., & Sinai, I. (2021, December 12). Efficacy of a new method of family planning: The Standard Days Method. Retrieved from Institute for Reproductive Health website: https://www.irh.org/resource-library/efficacy-of-a-new-method-of-family-planning-the-standard-days-method/
Basal Body Temperature Method. (n.d.). Retrieved from Cleveland Clinic website: https://my.clevelandclinic.org/health/treatments/21065-basal-body-temperature
Cervical mucus method for natural family planning - Mayo Clinic. (n.d.). Retrieved from www.mayoclinic.org website: https://www.mayoclinic.org/tests-procedures/cervical-mucus-method/about/pac-20393452#:~:text=The%20cervical%20mucus%20method%2C%20also%20called%20the%20Billings
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European Society for Human Reproduction and Embryology. (2007, February 21). Natural Family Planning Method As Effective As Contraceptive Pill, New Research Finds. ScienceDaily. Retrieved August 26, 2022 from www.sciencedaily.com/releases/2007/02/070221065200.htm
Fertility Awareness-Based Methods of Family Planning. (n.d.). Retrieved from www.acog.org website: https://www.acog.org/womens-health/faqs/fertility-awareness-based-methods-of-family-planning
Frank-Herrmann, P., Heil, J., Gnoth, C., Toledo, E., Baur, S., Pyper, C., Jenetzky, E., Strowitzki, T., & Freundl, G. (2007). The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple's sexual behaviour during the fertile time: a prospective longitudinal study. Human reproduction (Oxford, England), 22(5), 1310–1319. https://doi.org/10.1093/humrep/dem003
Planned Parenthood. (2019). Retrieved from Plannedparenthood.org website: https://www.plannedparenthood.org/learn/birth-control/fertility-awareness
Standard Days Method. (n.d.). Retrieved from Institute for Reproductive Health website: https://www.irh.org/standard-days-method/
Weishaupt, J. (2021, November 25). What Is the Cervical Mucus Method? Retrieved from WebMD website: https://www.webmd.com/infertility-and-reproduction/what-is-cervical-mucus-method
- Calendar Method (Standard Days Method) ...
- Basal Body Temperature Method. ...
- Cervical Mucus Method. ...
- The Symptothermal Method. ...
- Cervical Position Method. ...
- Ovulation Predicator Kits. ...
- Saliva Ferning Tests.
Symptoms-based methods: FAB methods based on observation of fertility signs (e.g., cervical secretions or basal body temperature) such as the cervical mucus method, the symptothermal method, and the TwoDay method.What are the best fertility tracking methods? ›
The two most commonly used are the BBT method and the cervical mucus method. The Marquette method combines BBT and cervical mucus tracking with use of an electronic hormonal fertility monitor. The monitor detects hormones in urine to confirm fertile days. It can be purchased online or at a pharmacy.What are the fertility awareness methods tracker? ›
There are a few ways to monitor your fertility for birth control — they're called Fertility Awareness Methods (FAMs for short). Every day you take your temperature, monitor your cervical mucus, and/or chart your menstrual cycle to track your fertility signs.