The Fertility Awareness Method
Being able to understand and manage your menstrual cycle has a significant impact on your quality of life, not to mention giving you the tools you need to choose if and when you become pregnant. Contraceptive methods give women independence and autonomy over their lives.
Today, there are many different types of contraceptives. The most reliable are hormonal contraceptives. Unfortunately, they have some side-effects, which can be debilitating for some women. To avoid such problems, many women use a natural method of preventing pregnancy.
What is fertility awareness?
Hormonal birth control became widespread in the 60s. Since then, it has granted millions of women greater control over their bodies and therefore, their choices. Regulating when and how many children you want has been critical in giving women autonomy. These steps towards progress have not come without a cost, and even though hormonal birth control has come a long way since the 60s, it still comes with side effects ranging from skin irritation to migraines.
Nowadays, various non-hormonal contraceptives are available to women who can't tolerate the pill or simply don't want to stress their bodies with artificial hormonal fluctuations. The practice of using body temperature, heart rate, and cervical mucus to determine fertile and infertile days is referred to as the fertility awareness method (FAM), sometimes also known as the "rhythm method."
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FAM is nothing more than understanding your cycle and using that knowledge to your advantage. Women are fertile—can become pregnant—no more than seven days each month. By tracking your cycle, you can determine which those days are. If you do that, you can live worry-free for the rest of the time.
How does the fertility awareness method work?
One of the main concerns women have when switching to FAM is its effectiveness. If done properly, FAM is up 93–95% effective, but it does require knowledge, preparation, and follow-through. Typically, it is approximately 76–86% effective, with all the inconsistencies that can happen. One of the major drawbacks to this method is that it requires dedication and consistency to keep track of the significant parameters, and there is no safety net if you get it wrong. Using FAM in combination with other contraceptives, such as the condom, can give you additional protection against unwanted pregnancy.
Here are the steps you need to take for FAM to work:
Basal body temperature (BBT)
A day or two before ovulation, your BBT drops to 36.1–36.4°C. When the ovaries release an egg, your BBT rises by one degree and stays elevated for the next few days. You are most fertile 2–3 days before your temperature rises.
Changes in basal body temperature are slight and can be difficult to detect. To be accurate, you should take your temperature every morning. It is best if you get into the habit of doing this a couple of months prior to relying on FAM as your primary contraception method. This will give you time to establish the habit and become familiar with what 'normal temperature' is for you. Factors other than your menstrual cycle also change your body temperature. You will become more aware of the variables over time.
Your resting heart rate is another indicator. As you start ovulating, your heart rate increases by up to 2 bpm and keeps rising by 3.5 bpm up until the mid-luteal phase (the time period after ovulation and before menstruation begins). You can measure your heart rate by using your fingers (not your thumb) to feel your pulse at the neck or the wrist and counting the number of pulses per minute. There are also devices, such as the pulse-oximeter, that will measure your pulse for you.
Cervical mucus (vaginal discharge)
A woman's vaginal discharge changes in texture and consistency throughout her cycle, determined by her oestrogen levels. 1) At menstruation (starting on day 1), there is little vaginal discharge, and you wouldn't notice it anyway. 2) In the days just after your period, oestrogen levels are beginning to rise, but cervical mucus is still mostly absent. 3) Around day 9 or 10, levels are high enough for the cervix to begin producing more fluid—it may be tacky or sticky at first but soon becomes wet and creamy, like hand lotion. In your underpants, it may look whiteish or yellowish as it dries.
4) A few days before ovulation, when the ovaries release an egg, oestrogen levels have peaked, and the cervix can produce up to twenty times more fluid than at low production, although this differs greatly between individuals. The mucus is now slippery, similar to raw egg whites. This consistency makes it easier for sperm to reach the egg. This 'ovulation discharge' is 95% water.
5) A day or two after ovulation, the consistency will change again. Progesterone inhibits the production of cervical fluid, and it becomes sticky and tacky again or simply absent.
The position of your cervix can also indicate ovulation. Your cervix's position changes throughout your cycle, and with time, you can learn to recognise what position it is in. You can feel your cervix by inserting one or two fingers into your vagina. It feels soft, like the tip of a nose.
If the cervix is low, you should be able to touch it with your finger. If it is high, you might not be able to reach it. The cervix is high right before and during ovulation and low the rest of the month.
Tracking your menstrual cycle
If your cycle is regular, it can be used as a reliable method of tracking ovulation and fertility. It is best to use this in combination with other methods for the most precise results. Apps such as WomanLog make tracking easier, as they estimate ovulation days and menstruation days algorithmically. Accuracy increases, the longer you track your cycle.
Ovulation indicator testing kits
These are at-home testing kits you can buy in most pharmacies. You just pee on the strip and wait for results. They are mostly used by women who want to identify their fertile days to aid conception but can also serve the opposite goal. The downside is that they can be expensive if used repeatedly. For the purpose of contraception, you will need to test throughout a full cycle.
Benefits of the fertility awareness method
If done properly, FAM can be a safe way to monitor your cycle without any side effects. Here are some benefits:
- FAM helps you understand your body better—not only do these methods indicate when your most fertile days are, but they can also help you understand your menstrual cycle. You will begin to notice reoccurring signs that indicate the different phases of your cycle.
- No synthetic hormones—although hormonal contraception is safe for most women, it can cause hormonal imbalances in your body. FAM doesn't interfere with your natural hormonal cycles.
- No side effects—most people who opt-out of hormonal birth control do so because of the side effects. FAM poses no such risk.
- Money—FAM doesn't cost anything other than your time and preparation.
- You can stop it at any time—it is an observation rather than interference, and, therefore, can be used in combination with other methods that don't interfere with your natural cycle, and you can switch methods anytime.
- FAM can help you get pregnant—if you decide that you do want to get pregnant, all of the techniques mentioned above can help you with that goal as well.
Disadvantages of the fertility awareness method
- It takes time. FAM is based on your body's rhythms, and you will probably need to track at least a few cycles to notice a pattern. The method can easily fail if you don't fully understand it.
- If done wrong, it's easy to get pregnant—the method doesn't provide any artificial protection, therefore even one slip up can lead to pregnancy.
- You need to keep track of your cycle at all times. FAM requires consistency to be reliable.
- It requires coordination—it is best if both partners are informed and know what to expect at each phase of the cycle.
- FAM is not recommended for people with irregular cycles as it can be difficult to determine the days of ovulation. Women who have PCOS, endometriosis, or other reproductive health issues are more likely to need additional protection. (Learn more about living with endometriosis and PCOS.)
- It doesn't protect from STDs—even if you have been tracking your cycle for a while, always use a condom (or other barrier contraceptives) with new partners. (Learn more about how to protect yourself during sex)
- If done correctly, FAM can be very effective. However, it is best to consult your doctor before relying solely on this method. If there is no reason for you not to do so, FAM can help you take control of your cycle with no side effects.
The WomanLog app was created to help you understand your body better and track your menstrual cycle. Whether you want to prevent pregnancy or increase your chances of conceiving, WomanLog can help.
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