This is a post from the “For Women Only” category. It is about the female reproductive system. You have been warned.
Just over a year ago, I started using the fertility awareness method of birth control, or FAM. My main reason for ditching the birth control pill, which I was previously on, was that I was uncomfortable with the abortient property of the pill. Basically, the pill prevents pregnancy in three ways: by preventing ovulation, by thickening cervical mucus, and by making the lining of the uterus inhospitable to implantation. This third property is called an abortifacient because technically speaking, it causes an abortion (any eggs that manage to get fertilized are not able to implant). Of course, the chances of this are slim because if the pill does it job right, an egg will not be released in the first place. And even if one is released, the sperm should not be able to reach it because of the thickened cervical mucus. The abortifacient is the pill’s last-ditch effort to prevent pregnancy. Still, it made me uncomfortable to use it knowing that there was even the slightest possibility that I was causing an abortion. All hormonal methods of birth control work in generally the same way, so when I found out about this I quickly discovered that hormonal methods were no longer an option for me.
Now, don’t get me wrong. I pass no judgment on women who choose to use hormonal birth control methods. In fact, I strive not to pass judgment on women who choose to get abortions either because I understand the fear that may drive some women to terminate their unwanted pregnancies. My place is not to judge, but to love and encourage others. Personally, I hate abortion because I love babies and I believe that life is precious, but it is still not my job to judge others. But anyway, my point of saying this is that my decision to search for another method of birth control was the right decision for me.
Unfortunately, it did not take me long to discover that there are really no non-hormonal methods of birth control that are highly effective. At least, that was how things appeared until I finally stumbled upon FAM. I was shocked to discover that FAM is not only extremely effective, (as effective, if not more effective than condoms) but it requires no medications or uncomfortable devices. Best of all, through learning and using FAM I have gained a new understanding of how my body works. I am so much more comfortable with my body and I feel empowered because for the first time, I am in control of my own reproductive health. So what is FAM exactly?
The Fertility Awareness Method involves learning to be aware of when you are fertile, and abstaining from sexual intercourse during those times. For most women, the period of abstinence would be somewhere around 1/3 of the length of her cycle, perhaps 10 days or so. Now of course, this requirement of periods of abstinence is probably the biggest drawback to FAM, and for some people may be too big of a drawback to make the method worthwhile. On the other hand, many women report that periods of abstinence actually improve their sex lives because it forces them to be more *ahem* creative during their fertile phases, and it builds excitement for when intercourse is once again safe. For me, FAM is well worth the sacrifice.
One benefit of FAM is that barrier methods of birth control, such as condoms, are unnecessary. Then again, some FAM users decide to eliminate the periods of abstinence and just use condoms during the woman’s fertile periods, which is an option. Of course, it is important to recognize that having intercourse during a woman’s fertile period puts the couple at the mercy of the barrier method’s failure rate. For pregnancy-avoiders, it is much safer to abstain during these times. And for couples who want to be extra safe and avoid pregnancy, a barrier method can be used even during the “safe” phases of the woman’s cycle, thus boosting the effectiveness of the method even further. Lastly, for couples in which one person has or may have an STD, it is important to use condoms every time to protect against spreading the infection to the other partner. Obviously, using FAM without a condom will not protect against STDs. This is one reason why FAM is really only appropriate for monogamous relationships.
Now that I’ve explained some of the benefits and basic concepts behind FAM, I’ll explain the method in greater detail. For a FAM user, the most important tools to have are a chart and a thermometer (and a female reproductive system, of course!) This method involves keeping track of fertility signs and using them to understand when you are ovulating. There are two main fertility signs; waking temperature, and cervical fluid. A third optional sign to observe is cervical position. Without describing the biological processes of the menstrual cycle in too much detail (because this could get way too long), I will briefly explain the changes that can be observed in these three fertility signs throughout the cycle.
Waking temperature, or basal body temperature, can be taken with a basal body thermometer every morning and recorded on a chart. At the beginning of the cycle, starting on the first day of menstruation, a woman’s basal body temperature is typically within a low range— somewhere between 97 and 98 degrees, perhaps. A day or two after ovulation, the temperature shifts into a higher range, somewhere between 98 and 99 typically, and remains within that range for the duration of the cycle. When you chart your basal body temperature, you can observe the thermal shift to determine when you have ovulated, and that will allow you to know when you are safe again for intercourse.
Cervical fluid is sometimes called cervical mucus, but I think that “fluid” sounds nicer. Simply put, it is the moist substance that comes out a woman’s vagina throughout the month, and it changes dramatically over the course of the cycle. After the period of bleeding at the beginning of the cycle, cervical fluid is typically absent, or “dry” for a short time (5 days or so). Next, it becomes “sticky” which is sometimes also described as crumbly, flaky, gummy, or rubbery. Then, usually within a few days, it becomes “creamy,” also described as lotiony, watery, or smooth. Finally, it becomes fertile “slippery” cervical fluid, which is either clear or streaked and appears similar to raw eggwhites. Then, it dries up rather quickly and remains dry until the next menstruation. By observing your cervical fluid each day and classifying it as dry, sticky, creamy, or slippery you can know when your body is becoming more fertile and intercourse is no longer safe. For most women, it is safest to abstain from intercourse as soon as sticky cervical fluid appears and until 3 days after the last slippery fluid is observed.
The last fertility sign is cervical position, and is optional to observe. It can corroborate your observations of the other signs by giving you more evidence of when your fertile and infertile phases occur. In the beginning of a cycle, the cervix is typically sitting lower in your vagina (closer to the opening), and it gradually rises higher as you approach your fertile phase. It is also firm and closed in the beginning of the cycle, and becomes much softer and more open as you become more fertile. After ovulation, the cervix typically drops back down quickly and becomes firm and closed once again. A woman can easily observe her cervical position by inserting a finger into her vagina; the cervix is at the end of the canal. Once you start checking your cervix, you will soon learn to gauge its changes throughout the cycle.
Those are the three fertility signs that you can observe to help you know when you are fertile, and thus should abstain from sexual intercourse. Using your observations, you can follow the four FAM rules to avoid pregnancy.
The four FAM rules:
1. The first 5 days rule – You are safe the first 5 days of your cycle if you had a clear temperature shift during your last cycle.
2. The dry day rule – Before you ovulate, you are safe on dry days.
3. The temperature shift rule – You are safe 3 days after your temperature is above the coverline. Draw the coverline 0.1 degrees above the highest of the last six temperatures when your temperature rises at least 0.2 degrees above that temperature.
4. The peak day rule – You are safe 4 days after your peak day, or your last day of wet/slippery cervical fluid.
So there you have it. Those are the basics of the Fertility Awareness Method of birth control. If you have any questions, please leave a comment or use the contact button at the top of the page to send me a message. I am not an expert, but I will do my best to answer your questions. And if you are considering using FAM, please do some more research on your own and make sure that you fully understand how to use it safely. Most of my information came from a book called Taking Charge of Your Fertility by Toni Weschler, MPH. I highly recommend it for anybody interested in using FAM.
Sometime in the near future, I am planning on writing a post about my personal experience with FAM after switching from the birth control pill. It literally took me over a year from when I stopped the pill to start having normal cycles again, and I would like to share that experience to hopefully help others who may be in the same boat. But until then, hopefully this post was enlightening and helpful. Thanks for reading!