What is the Fertility Awareness Method?
The Fertility Awareness Method (FAM) is a natural approach to family planning that involves tracking your menstrual cycle and fertility signals. It can help women either avoid pregnancy (Trying to Avoid or TTA) or achieve pregnancy (Trying to Conceive or TTC). The principle is simple: each menstrual cycle, a woman ovulates just one egg, which lives for a maximum of 24 hours, while sperm can survive up to five or six days in the uterus. This translates to a fertility window of about 7-8 days per cycle.
Beyond its use as a natural form of birth control, FAM encourages a deeper understanding of your body. In fact, many consider the menstrual cycle a “fifth vital sign” due to the insights it provides into overall health.
What FAM is Not
While some mistakenly lump FAM together with the rhythm or calendar method, they are distinct. Unlike the rhythm method, FAM is evidence-based and relies on real-time fertility signs—not just period tracking. FAM requires consistent tracking of primary fertility indicators, including:
Cervical Fluid Changes
Waking Body Temperature (BBT)
Cervical Position
Urinary Hormones (Optional: depending on the method)
By recording these indicators daily (through apps or charts) and interpreting them according to FAM guidelines, you can accurately identify your fertility window and make decisions based on your pregnancy goals, whether that’s conception, contraception, or understanding your cycle better.
Different Methods of FAM
1. Standard Days Method
How It Works: Use abstinence or barrier methods (like condoms) from days 8-19 of your cycle.
Best For: Women with regular cycles; not suitable for those with PCOS, postpartum, or perimenopausal women.
Pregnancy Rate (TTA): <5 per 100 women per year with correct use; 12 per 100 with typical use.
2. Two-Day Method
How It Works: Avoid unprotected intercourse on any day when cervical mucus is present.
Pregnancy Rate (TTA): 3.5 per 100 women per year with correct use; <14 per 100 with typical use.
3. Cervical Mucus or Ovulation Method
How It Works: Check cervical mucus multiple times daily and abstain or use barriers on fertile days (14-17 days/month).
Pregnancy Rate (TTA): 3 per 100 women per year with correct use; 23 per 100 with typical use.
4. Symptothermal Method (STM)
How It Works: Combines cervical fluid tracking with basal body temperature (BBT) changes. STM is often recommended by professionals due to its high accuracy and effectiveness in both TTA and TTC.
Pregnancy Rate (TTA): 1.8 per 100 women per year with correct use; 13 per 100 with typical use.
Effectiveness for TTC: Couples using STM are more likely to conceive within 6 months than those without this method (81% vs. 85% within 12 months).
Choosing the Right FAM Method
Selecting the best FAM method depends on your goals and lifestyle. Here’s a scale to help gauge your family planning intentions:
TTC (Trying to Conceive): Ranges from serious efforts (would pursue treatments if needed) to casually excited.
TTW (Trying to Whatever): Open to pregnancy; unprotected intercourse is welcome.
TTA (Trying to Avoid): Ranges from “loosely avoiding” with low concern to “strictly avoiding” due to personal or financial reasons.
For those in the lower TTA range (0-1), it’s crucial to understand that no method, including FAM, is 100% effective. For those at 2-4 on the scale, STM provides the most reliability in avoiding pregnancy. For others, the best approach depends on personal preferences, dedication to tracking, and lifestyle.
Why Consider FAM?
The drawbacks of hormonal birth control are well-documented. Beyond common side effects like weight gain and mood swings, hormonal birth control has been associated with severe risks, including blood clots, infertility, and even certain cancers. Despite its frequent prescription for menstrual issues, birth control often masks symptoms rather than addressing the underlying issues.
Switching to FAM offers freedom and empowerment. As one FAM user describes:
“Even if you haven’t experienced side effects from birth control, switching to FAM can enhance your understanding of your body’s natural cycles and make you a more engaged participant in your fertility and health.”
With FAM, many women feel liberated from the mystery and frustration surrounding reproductive health.
References:
Fertility Monitors: Tempdrop, Wink, Daysy, or a BBT thermometer from Walmart, Target, or Amazon.
Top Charting Apps: Kindara, OvuView, Read Your Body, Fertility Friend, OvaGraph, Flo, Glow.
Books:
Taking Charge of Your Fertility
The 5th Vital Sign
Further Reading:
