Unlocking Fertility: A Comprehensive Guide to Understanding Fertility Awareness Methods
Congratulations! You’ve decided you want to learn how to chart your cycle. Maybe for general hormonal support, or maybe for non-hormonal birthing, or because you want to get pregnant. You start doing some google researching and you wound your way down a cycle charting rabbit hole!
You may have already realized that there’s different organizations and different methods that someone can use to chart their cycle. Even within the sympto-thermal method (STM), the method that I teach, there are subtle variations in the way people teach this method, the language that is used to describe cervical fluid, and even a variations to the guidelines for contraception. In this post, I’m going to help suss out some of the nuances in the Fertility Awareness World.
Fertility Awareness (FA) and Fertility Awareness Method (FAM) are not the same
FA is a general term, an umbrella term, that encompasses the way someone tracks their fertility. People can do this through tracking their monthly periods, or changes in their desire and arousal, or even with the phases of the moon.
FAM is a specific method with guidelines that a charter uses on the daily to track their signs of fertility. There are many different types of FAMs.
Fertility Awareness Methods vs. Natural Family Planning
Fertility Awareness Methods (FAM) are similar to Natural Family Planning (NLP), however there are some differences to be aware of. To be clear, both methods involve observing fertility signs to determine when a person is in a fertile time of their cycles.
FAM:
Approach: FAM involves observing and tracking fertility signs such as basal body temperature, cervical fluid, and an optional sign of cervical position to determine fertility.
Flexibility: FAM allows for more flexibility and individualization in terms of how the method is used. For example, many FAM educators will teach options such as using barrier methods like condoms during fertile days if pregnancy is not desired.
Education: FAM can be learned through various resources and is not necessarily tied to any particular religious belief.
NFP:
Religious Association: NFP is often associated with certain religious beliefs (especially within the Catholic Church) and typically does not allow for the use of any artificial contraception (ie condoms) during fertile days.
Education: NFP is taught within religious institutions and thus there are certain requirements, such as marriage and being in a heterosexual relationship before a couple can learn NFP. Many NFP methods also include teachings related to the moral and ethical aspects of human sexuality and reproduction.
Method Choices: NFP usually emphasizes abstinence during fertile periods for those trying to avoid pregnancy, rather than using barrier methods, and they do not support or provide education related to accessing any form of emergency contraception, including the morning after pill or abortion.
Okay, so now we understand the difference between Fertility Awareness (FA), Fertility Awareness Methods (FAM), and Natural Family Planning (NFP).
Here’s the next layer…
Which type of Fertility Awareness Based Method (FABM) do you want to use?
There are 3 main categories
Observation Based Methods: require daily observations and interpretations of signs of fertility to identify fertile and infertile periods in a cycle. These methods are often considered more accurate than calculation-based methods because they directly observe changes in the body in the present moment that indicate ovulation.
Temperature only
Cervical fluid only (The Creighton & Billings Methods, both fall under the NFP umbrella)
Sympto-thermal methods single-check: Taking Charge of your Fertility, Jusstice Method, The Well (this is the method that I teach!)
Calculation Based Methods: use mathematical formulas and algorithms to estimate the fertile windows and typically involve tracking the length of previous menstrual cycles to predict future fertility windows. These methods tend to be less effective at preventing pregnancy because of the difficultly in using past cycles to predict the future. That’s because algorithms can’t take into account what is currently happening in your life. Say, for example, you got a cold during your follicular phase, which delayed your ovulation. There’s no way for a formula to take this into account, so you may not be able to calculate your fertile window accurately.
Lactation Amenorrhea Method (for people postpartum)
Standard Days, 2 day methods, and Cycle Beads
The (dreaded) rhythm method- I say the “dreaded” rhythm method, not because it is inherently bad, but most practitioners, when they ask you what you are using for birth control and you say “Fertility Awareness”, they think you are talking about this method, which is one of the least effective methods within the FAM world.
Calculation & Observation Based Methods: includes a calculation based on past history as well as daily observations
Symptom-thermal method plus a calculation: ie Sensiplan - uses a calculation to open your fertile window
Lactation Amenorrhea Method plus ecological breast feeding: can be very effective at delaying fertility postpartum
Cervical fluid & possibly temping paired with a device that uses hormones found in your urine to predict fertility: ie Marquette, Mira
Do fertility awareness methods actually work?- YES!!!!!
These methods can work on both ends of the spectrum; that is they’re effective at helping people get pregnant more quickly and helping people avoid getting pregnant.
I’ll speak more to the effectiveness on The Sympto-thermal Method (STM), which is the method that I teach and is recognized as one of the most effective fertility awareness methods for contraception when practiced correctly. STM relies on observing and charting multiple fertility signs, including basal body temperature (BBT), cervical fluid changes, and other secondary fertility indicators such as cervical position.
When used consistently and accurately, STM has been shown to have a typical failure rate of about 2-3% per year, which is comparable to many other hormonal contraceptives and barrier methods. However, this effectiveness highly depends on the charters access to accurate education of how to use the method, on the charter being able to correctly identifying their fertile window, having support from their partner(s), and their behaviors during the fertile window.