The Fertility Awareness Method
While a man is fertile every day of the month, a woman is fertile for only six days of her cycle - the five days leading up to and including ovulation (because sperm can survive for five days), and for one day following ovulation (because the egg only survives for one day). This is important to know if you are trying to get pregnant OR are trying to avoid getting pregnant. The fertility awareness method is an incredibly powerful, empowering and successful approach to birth control and fertility - in fact, when used correctly, it can be as effective as the birth control pill.
The fertility awareness method (or FAM) is different than the “rhythm” method of birth control that relies solely on the days of the calendar. Instead, it considers three physiological signs: waking body temperature, cervical fluid or fertile mucus, and cervical changes. Before discussing these in more detail, let’s take a closer look at the intricacies of your menstrual cycle:
The Fertility Awareness Method : A method of predicting fertile and infertile times within your cycle, based on the monitoring of your ovulation.
Understanding your Cycle
Every healthy cycle is the sum of three phases:
The follicular phase: Day 1 of your period to ovulation. This phase can last anywhere from 7 to 21 days
The pituitary gland releases follicle stimulating hormone (FSH) during this phase to both push you closer to ovulation (by stimulating the growth of the ovarian follicles), as well as to stimulate the release of estrogen from your ovaries. During this phase, estrogen (estradiol, in particular) is slowly building, and your body is preparing to release an egg. Estradiol’s main job is to grow and thicken the uterine lining in preparation for a baby. The more estradiol you have, the thicker your uterine lining - and the heavier your period will be (if you do not conceive). It also stimulates a vaginal discharge called fertile mucous
Ovulation: Lasts 1 day
Luteinizing hormone (LH) is released by the pituitary which triggers the ovarian follicle to swell and rupture, releasing the egg. LH, FSH, and Estradiol are all at their peak at ovulation
Luteal phase: 10 to 16 days following ovulation and leading up to your next period
After ovulation, the emptied ovarian follicle restructures itself into a temporary endocrine gland called the corpus luteum which is responsible for secreting progesterone. Progesterone’s biggest job is to hold and nourish a pregnancy. It also counter-balances estrogen - where estrogen thickens the uterine lining, progesterone thins it (in preparation for shedding, if there is no conception). It also has many other benefits including reducing inflammation, promoting sleep, and calming the nervous system. At the end of the luteal phase, the corpus luteum shrinks and progesterone drops - this stimulates your uterus to shed its lining
One of the worst things about hormonal birth control is that it robs you of all of the beneficial effects of progesterone. This is why the FAM can be such a powerful tool - as it keeps your hormones in balance while being used for either trying to conceive or as birth control
*One thing to note is that every woman's cycle will vary based on the length of days between the first day of your period and the next. A healthy menstrual cycle, on average, can be anywhere from 21 to 35 days, with 28 days being the average.
How you can predict ovulation
Waking body temperature (also called Basal Body Temperature - or BBT) is the cardinal sign for FAM
Another handy effect of progesterone is that it slightly raises body temperature. Prior to ovulation, your average BBT is typically between 97.0F and 97.7F (36.1C and 36.6C). After ovulation, BBT will increase by about 0.5F (0.3C) and will stay that way until you get your period. A few consecutive days of that small, but significant increase in temperature is enough to know for certain that you ovulated and cannot become pregnant for the rest of that cycle
How to measure: Temperature is taken daily, first thing in the morning before any movement. This should be taken approximately the same time each day. The reason for this is because temperature tends to rise throughout the day. The best way to take the temperature is orally, under the tongue, with with a digital or glass thermometer. If you choose, a fertility thermometer may be more accurate than a standard fever thermometer
While waking body temperature is very helpful in determining when ovulation has taken place, it isn’t as helpful in predicting your “safe days” leading up to ovulation. That’s where cervical fluid or fertile mucus comes in
Cervical fluid or fertile mucus
Cervical fluid or fertile mucus is the sign of ovulation that occurs before ovulation. It is a unique type of vaginal discharge that looks and feels just like raw egg whites. It is clear, stretchy and slippery. You will see it on the toilet paper after you wipe or feel it at your vaginal opening, and when taken between your thumb and index finger, it can stretch more than an inch
This sign is optional, but helpful if there are changes going on in your life, especially if you have been sick or are travelling - they can throw off temperature. In addition, stress can throw off your cervical mucus reading
Throughout your cycle, your cervix shape will change. During the most fertile phase in your cycle, the cervix will drop further into the vaginal canal, with a wider opening to allow sperm into the uterus (it will feel like it’s pointing straight up towards your stomach). During the non-fertile phase, the cervix will be up higher (about one finger length), and have a more narrow or closed opening into the uterus (by the time you reach menstruation, it will feel like it’s pointing towards your rectum)
How to measure: Check daily after your last day of menstruation. Wash your hands with soap. Get into a comfortable position, - the most convenient position is typically a squatting position - and insert your index finger into your vagina. Using your index finger you will want to check:
Softness (firm, medium or soft)- If you push on the tip of your nose with your finger this would be considered medium softness.
Height (low, midway or high)- how far can you insert your finger?
Opening (closed, partly open, open)
Wetness (same as the cervical fluid)
How to track your cycle
Manual- you can look up various charts on Google or use a regular calendar. Be sure to note down temperature, cervical mucus and position daily
Use an app- this will be more user-friendly some apps ideal for FAM
Daisy Fertility Monitor - predicts your “safe days” using a computer algorithm using data from 5 million cycles of thousands of women to analysis your temperature to predict fertility. It is more costly but involves the least amount of work
*note -YOU will always know your body best, so tune into the signs and signals over any app/tracker. These tend to be quite accurate, but are not always exact.
Understanding tracked results
Ovulation will be depicted by a spike in temperature, peak cervical fluid, and a high, soft cervix. This will be your most fertile point. Depending if you are using FAM for birth control or pregnancy planning you will have sex according to fertile or infertile phases.
4 FAM rules for infertile phase:
First 5 Days Rule: you are safe for the first 5 days of the menstrual cycle if you had an obvious temperature shift about 12 to 16 days before (you ovulated in your last cycle)
Dry Day Rule: You are safe the evening of every dry day
Temperature Shift Rule: you are safe the evening of the 3rd consecutive day your temperature is above coverline (your coverline is determined by observing the highest temperature between the last day of your period and the highest of the previous 6 days. When your temperature rises at least 2-tenths of a degree, go back and count the last 6 temperatures before the rise. The coverline will be 1 tenth of a degree higher than the cluster of 6 temperatures)
Peak Day Rule: you are safe the evening of the 4th consecutive day after your peak day (your peak day is the last day of cervical wetness)
When trying to get pregnant you should have sex every day that you have wet cervical fluid or vaginal sensation through to the day you have a temperature rise. The more likely you time sex to your peak day, the more likely you are to conceive in that cycle.
FAM is a great way for women to be in tune with their bodies. It brings awareness to signs that your body is giving you depending on hormonal changes. By tracking when you ovulate and on which day of your cycle, you are able to determine predominant hormones acting within your body. For example, let’s say you have a 35-day cycle. By normal standards, a 28-day cycle is a good length and a 35-day cycle would be too long. However, we need to focus on more than just the full length of the cycle. In one cycle, if you ovulate on day 30, this would tell you that you have a lengthy estrogenic luteal phase, followed by a shortened follicular phase. This means that progesterone is not maintaining the uterine lining and is shedding prematurely. In contrast, if you have a 35-day cycle with ovulation occurring on day 18, this shows a standard length in the follicular phase (12-16 days) with a standard length in the luteal phase which progesterone is maintaining the uterine lining for a proper amount of time.
FAM can also help determine the best day to perform breast self-exams. Throughout your cycle, there may be cyclical lumps. Using FAM, you can determine that day 7 of your cycle is a hormonally optimal day for self-examination as the breasts are less likely to have lumps and are less susceptible to breast tenderness in relation to progesterone release.
There are many options to fertility and birth control available to women today outside of the traditional birth control pill offered by most medical professionals. FAM is an incredibly empowering option for women - not only for family planning but for discovering the natural flow of their bodies and developing a deeper connection from within.