Fertility Awareness Methods
There are a variety of fertility awareness methods (FAMs) of family planning, but all require that the woman have fairly regular periods and, if not, they will be less reliable. All have the benefit of requiring no medicines or devices—and thus are free from the side effects of medicines or devices. However, they offer no disease protection and have a fairly high failure rate (24%).
Strictly speaking, FAMs are free or nearly so, except for the thermometer needed for temperature-based methods. However, there are various devices that can help with fertility tracking (search “fertility tracking device”), and these can be beneficial. Costs of these devices range from $20 for an ovulation detection test strip to $500 for an electronic temperature-based fertility monitor. There are also phone apps available for tracking fertility, ranging from free to a few hundred dollars or even a monthly subscription fee (search “fertility tracking app”).
In general, women are most fertile during the following times:
- 5 days before ovulation
- the day of ovulation
- 12 to 24 hours after ovulation
All fertility awareness methods require that the couple avoid unprotected sex during these fertile times, and the Catholic church teaches abstinence during these times.
However, FAMs can also be used when a couple is ready to have a baby, as it greatly improves a couple’s odds of conceiving if sex occurs during the fertile days.
If you are interested in FAM-based family planning, it is generally recommended that you undergo some training in your chosen method. Furthermore, it may be best to start charting your cycle a few months before you get married, so that you have a good baseline with which to start.
There are several FAMs available, but the methods are grouped into one of three types: 1) symptom-based methods, 2) calendar-based methods, and 3) breastfeeding-based methods. There are many combination methods as well, using two or more of these various methods.
The three primary signs of a woman’s fertility are basal body temperature, thickness of the cervical mucus, and the cervical position. Hormones can also be detected, but detection requires the purchase of test kits. Some are marketed for getting pregnant, rather than avoiding it.
Temperature goes up very slightly after ovulation. For temperature-based methods, you must take your temperature orally each morning before you get out of bed using a special basal temperature thermometer, which can detect very small changes.
If you record your temperature every day, you will see that prior to ovulation your temperature is somewhat regular. As you approach ovulation, you may notice a slight decline, followed by a sharp increase after ovulation.
Because the increase happens after you have ovulated, this method is best used by those who have time to track and study their charts for a few months in advance, to ensure the best chances of success.
Illness, travel, and alcohol or drug use can affect temperature and make it difficult to establish an accurate reading. Lack of sleep can also affect temperature reading, so it is important to get at least three consecutive hours of sleep before taking your basal body temperature.
The mucus-based method tracks mucus quality, which is more wet and slippery during ovulation. To practice this method, collect the mucus from the vaginal opening with your fingers by wiping them from front to back. Record it daily on your fertility calendar by making note of the color, consistency and the feel. Ovulation usually occurs within one to two days of when the mucus is clearest, slippery, and most stretchy, if not on the peak day itself.
With training one can also feel the position of the cervix. Feeling for the position of the cervix is done once a day in the evening. This method is never used alone, but only in conjunction with another fertility indicator such as temperature or mucus.
During the fertile phase the cervix moves upward, away from the vaginal opening. Around the time of the “peak” mucus symptom, at the time of maximum fertility, the cervix reaches its highest point making it difficult to reach with the finger. This is called the maximum cervix position. During the fertile phase the cervix becomes progressively softer and feels wet due to the presence of mucus. The cervical opening will gradually open to admit a fingertip and will be at its maximum diameter at ovulation.
Any change in position and consistency of the cervix from its original infertile state indicates the beginning of the fertile phase and usually corresponds with the beginning of the mucus symptoms.
Calendar-based methods determine fertility based on a record of the length of previous menstrual cycles. They include the rhythm method and the standard days method.
Before relying on the rhythm method, a woman records the number of days in each menstrual cycle for at least 6 months. The first day of monthly bleeding is always counted as day 1.
The first day of the fertile time is estimated by subtracting 18 from the length of the shortest recorded cycle. The last day of fertility is estimated by subtracting 11 days from the length of the longest recorded cycle. Unprotected sex is then avoided during this fertile period.
The concept behind the standard days method is that women with regular menstrual cycles lasting 26–32 days can prevent pregnancy by avoiding unprotected intercourse on days 8 through 19. This 12-day fertile window takes into account the variability in the timing of ovulation and the viability of sperm in the woman’s reproductive tract. A string of color-coded beads in the shape of a necklace (CycleBeads) helps users of the Standard Days Method to identify the fertile and infertile days of their cycle, as well as to monitor their cycle length.
The lactational amenorrhea method (LAM) is a method of avoiding pregnancy based on the natural infertility that occurs after giving birth when a woman is amenorrheic—not having periods—and fully breastfeeding the new baby. The rules of the method help a woman identify and possibly lengthen her infertile period.
A woman can use LAM if:
- her period has not returned since delivery (light spotting during the first 56 days does not count), AND
- she is breastfeeding her baby on demand, both day and night, and not feeding other foods or liquids regularly, AND
- her baby is less than six months old.
As you can see, fertility awareness–based methods are somewhat complicated and require some training and consistency. Further, there are many variations on FAMs that are not covered here. Our treatment of this topic is by necessity incomplete, and we only touched on the basics. Really, an entire book could be written on this topic, and many have been.
For a quiz on which FAM method might be best for you, visit:
For more information on fertility awareness-based methods, the links below may be helpful: