Fertility Awareness Method (FAM) is an evidence based approach for women to connect in with their own cycle and understand the signs her body is telling her during her menstrual cycle. It is also known as The Billings Method, Natural Family Planning or the Ovulation Method. Having an understanding of male and female fertility is important for us all, whether it is to connect deeper with the rhythm of our bodies, plan a pregnancy or to prevent getting pregnant.
Having this connection to our cycle and understanding it is an empowering means of taking control of your reproductive health and allows women to make decisions on their own reproductive health and sexual activity. Educating yourself on FAM can help to optimise chances of pregnancy and when using a combination of fertility indicators, offer a highly effective means to avoid pregnancy and upto 98% effective (Freundl 1999) and (frank-Hermann 2007). The NHS (UK) states that with perfect use the contraceptive pill is 99% effective and with typical use is 91% effective.
Not all menstrual cycles are 28 days, knowing and understanding your cycle is a great way to start on your journey to knowing your body and witnessing the rhythm it holds.
When charting your cycle and using FAM, I recommend using a pen and paper, you can create your own chart which has body temperature, days of the cycle and cervical fluid and other notes or you can use a simple template that I have created here cycle tracking – fertility In my own opinion and experience using an app can sometimes lead to the app providing averages and giving information that may or may not be relevant to you and potentially setting seeds of doubt.
When using FAM you will be taking note on a daily basis of your cervical fluid and your basal body temperature. Other’s may recommend checking your cervix as another indicator as our cervix also changes throughout our cycles. This can take some time to get use to and for more infomation on this I would recommend checking out FertilityUK as they have some downloadable charts and information that cover this.
Before I continue, Did I mention how amazing our bodies truly are. Let’s take a moment to appreciate our body. With the right education and support, we don’t need ovulation prediction kits or birth control pills or indeed pregnancy tests. There are many industries thriving on us women not being connected to our bodies.
Just to note; FAM does not protect against Sexually Transmitted Infections or Disease. If you are interested in using FAM then you need to take responsibility and ensure an open conversation is had with your partner and appropriate screening is carried out. Your GP can give you more information on this.
For the purpose of this post, the focus is on identifying the fertile time in a cycle for pregnancy to happen, so lets dive in…..
Day 1 of your cycle is the first day of a fresh red bleed (not spotting). The last day of your cycle is the day before you start to bleed. This can vary in length for us all, very few of us have an exact 28 day cycle and that is normal. Even if your cycle is irregular, charting and connecting in with your body can give you some great insight.
The first fertile indicator is; Basal Body Temperature (BBT) is resting body temperature. This is taken first thing in the morning or after 3 hours of consecutive sleep. Once you wake and before you do anything, check your temperature, that is before you check your phone, drink water, speak etc. check your temperature and note it down. Tracking your temperature for a few cycles will give a good indication if ovulation has occurred and the length of the luteal phase of the cycle (phase after ovulation).
During our cycle, our temperature changes slightly and can be an indication to when ovulation has happened. You will need to track it for a few months to understand your cycle. It can be easy to get caught up on daily readings, but you ultimately want to identify a pattern of low and high temperatures, rather than focusing on individual ones.
The start of our cycle is known as the follicular phase, our body temperature is slightly lower in this phase of the cycle in comparison to post ovulation and our bleed time. Just before ovulation our body temperature will dip. At ovulation our BBT dips and rises by 0.3 degrees Celsius due to the hormone progesterone, it will remain elevated for at least 3 days, after ovulation we enter into the luteal phase which is typically 10-16 days long post ovulation – Our luteal phase needs to be at least 10 days for implantation to occur. You can identify when the luteal phase has ended if your BBT drops, indicating that the next cycle is about to begin, if it remains high beyond the expected time of your bleed it can be an indicator to pregnancy.
Monitoring your temperature can help identify issues such as, lack of ovulation, progesterone deficiency or luteal phase defect. If you have any concerns over your findings do seek guidance from your GP or someone trained in Fertility awareness.
The second fertile indicator is; Cervical Fluid. Cervical fluid is something not really spoken about and sometimes misunderstood. For the most part of our cycle cervical fluid is usually thick, sticky, cloudy or not visible (dry) this is known as the non fertile times. Interestingly, during the non fertile times the vagina is acidic and actually destroys the sperm. The hormone Oestrogen rises in the later part of the follicular phase changes the cervical fluid to a wetter, slippery, stretchy fluid, consistency is similar to egg whites. It is an encouraging sign that reflects the growing follicles and higher levels of oestrogen. This change in cervical fluid makes it the ideal environment for sperm to survive, and help them pass through the cervix, the uterus and into the fallopian tubes.
There are three ways that you can monitor cervical fluid, one is from just observing what is on the underwear, second is to wipe with a clean white tissue before passing urine and observe and the third is to insert a finger into the vagina and observe. Observe throughout the day and record at the end of the day.
Other signs of ovulation maybe increase in libido, mid-cycle abdominal cramp/pain, breast tenderness or spotting. You can also note these on your chart to create a fuller picture of what is going on.
I hope you have found this information useful and insightful. It is also important to further educate yourself on female and male fertility, which I will write about shortly.
Fertility Awareness Method is something I encourage all my fertility clients to do, If you are interested in having regular reflexology to support you on your fertility journey, do get in touch, I would be delighted to work with you and your partner.
If you would like to read more indept on this topic, I would recommend the book ” Taking charge of your Fertility” by Toni Weschler and her website also has downloadable charts.
Yours in Health
Frank-Herrmann, P., Heil, J., Gnoth, C., Toledo, E., Baur, S., Pyper, C., Jenetzky, E., Strowitzki, T., and Freundl, G., The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple’s sexual behaviour during the fertile time: A prospective longitudinal study; Human Reproduction, 22(5):1310–1319, May 2007.
Freundl, G.,. European multi-centre study of natural family
planning (1989-1995). Advances in contraception. 1999; 15: 69-83