Understanding and Using Fertility Awareness Methods

For women and couples who aren't looking to have kids, more birth control products are available than ever before. However, for a variety of reasons, ranging from religious to medical concerns and beyond, not everyone wants to use birth control options such as the pill, implants, IUDs or even condoms.

For those who would like to use a more natural approach to family planning, fertility awareness methods (FAMs) may be an option. FAMs use nonpharmaceutical approaches to help predict when someone is most fertile, and on those days couples know to avoid unprotected sex.

These methods can take some dedication and understanding to use, and it's important to know their limitations. Fortunately, if you decide to become pregnant later, the same methods can help you determine the best days to conceive.

How do FAMs work?

FAMs rely on the knowledge that:

• Ovulation releases one egg, which can be fertilized for the next 24 to 48 hours.
• Sperm can live in the uterus and fertilize an egg for up to six days.

This means that pregnancy can occur about eight days around ovulation. FAMs predict the date of ovulation using various indicators, and therefore indicate the time frame that you're most likely to conceive. This window lets couples know when to use another form of birth control or to avoid vaginal sex altogether.

Types of FAMs

Several types of FAMs can help you predict ovulation, all of which are most effective when used together. Because all methods involve tracking indicators of ovulation over time, none of them can be used instantaneously to prevent pregnancy.

The temperature method

During ovulation, body temperature increases slightly, often by just a fraction of a degree. By tracking basal temperature—your resting body temperature—every day, you can detect patterns in body temperature changes to help predict your ovulation days.

This requires some organizational skills, though, as you need to take your temperature the first thing in the morning and track it on a chart. Things like stress, smoking and drinking alcohol can change your temperature, so it's important to list these activities as well.

You should record your temperature for at least three months before relying on this method of birth control. Once you have established a pattern, you can use it to help predict ovulation and avoid unbarriered sex on those days.

The cervical mucus method

Throughout the menstrual cycle, changes in cervical mucus (vaginal discharge) can let you know when you're near ovulation. Using the cervical mucus method involves examining the appearance and feel of cervical mucus and charting it every day. By familiarizing yourself with your typical cervical mucus changes, you can have a better idea of when ovulation occurs for you.

This method can be tricky to learn by yourself, so starting with the help of a medical professional is your best bet. You should log your cervical mucus for at least one month before relying on this method of birth control. It's also important to be aware of other factors that may change your cervical mucus, including things like breastfeeding, douching or having a sexually transmitted infection (STI).

The calendar method

Finally, the calendar method involves tracking the length of your menstrual cycle and doing some simple math so you can figure out when you're ovulating. For this method, you should track your periods for at least six cycles. Then, using a simple formula, you can determine the most likely window of fertility, even with easy-to-use calculators.

A variation of this method, called the Standard Days method, may be useful for people with extremely regular periods, but it's not for anyone whose cycles are irregular or shorter than 27 days.

Are FAMs right for me?

FAMs are a great option for many reasons: They're cheap or free, come with zero side effects and help you get in touch with your body and fertility. On the other hand, FAMs have one of the lowest efficacy rates among birth control methods—around 76 to 88 percent effective. They also don't protect against STIs.

If you want to make FAMs more effective, you should use multiple methods, consult with a knowledgeable medical professional and be diligent in tracking your indicators. If you have an irregular menstrual cycle or an STI, FAMs may not be the right birth control option for you.

Because so many factors can influence the effectiveness of FAMs, it's important to keep in mind how comfortable you are with a potential pregnancy. For some individuals, this risk is worth it so they and their partner can avoid other forms of birth control. Your best bet is to do your research, consult with your doctor and have a plan in case this birth control method fails. Ultimately, only you can determine if FAMs are the best birth control method for you.