There are at least three good reasons for honing awareness of your natural fertility: It can help you get pregnant more easily; it can help you avoid pregnancy naturally; and it can provide a treasure trove of information about your health. The fertility awareness method (FAM) has been around for a long time. It teaches women how to observe their bodies closely to develop an intimate knowledge of their menstrual cycles.

You learn what’s happening during a menstrual cycle generally, meaning what hormones you produce and when. What these hormones do and why. How to recognize the signs of these fluctuations and understand their meaning. You also develop a deeper appreciation of your individuality because menstrual cycles vary from woman to woman, from month to month, and from year to year. Having this knowledge of your inner workings is not only empowering and deeply satisfying, it also gives you intelligent tools to honor your fertility, whether this means you’re trying to conceive or trying to avoid conception.

Conventional contraceptives

Many women cannot or do not want to take prescription hormonal contraceptives like the birth control pill or medicated intrauterine devices (IUD) because of their potential for side-effects. Using the FAM diligently can be as effective as oral contraceptives or IUD’s, without the detrimental effects on your health. Many couples combine the FAM with a barrier method, such as condoms or a diaphragm, when they are unsure of their fertile and infertile days.

What is fertility awareness?

In broad strokes, the fertility awareness method works like this: You learn what usually happens during a menstrual cycle. You observe what’s happening during your own cycles. You interpret your observations.

Your menstrual cycle

A menstrual cycle starts on the first day of your period. In most women, the menses begins in the early-morning hours. On average, a period lasts about five days, the first two or three with heavier flow, then tapers off. Young women often have heavier periods, perimenopausal women tend to have lighter periods. (Certain health conditions can also impact how long you bleed and how heavy your flow might be.) During the period your uterus lets go of the inner lining, called endometrium, so that you can start from a clean slate. Four different hormones play an important role in regulating your menstrual cycle. Two are produced by the pituitary gland directly below your brain. They are follicle-stimulating hormone (FSH) and lutinizing hormone (LH). The other two are produced by your ovaries: estrogen (mostly estradiol) and progesterone (made by the corpus luteum, the follicle that formerly held the ripening ovum). Estrogen promotes the growth of a healthy endometrium that’s ready by mid-cycle to receive and nurture a fertilized egg. Progesterone, which is only produced once ovulation occurred, is important to maintain the endometrium so that pregnancy can be established. FSH and LH, as their names imply, direct and trigger these developments. It’s worth looking at a picture of the peaks and valleys in these hormone levels during a cycle to better visualize their fluctuations and actions.

How to do it

To observe and understand your (unmedicated) menstrual cycle, you need to start paying attention to how your body feels not only while you menstruate but on the days in between as well. There are three strategies to tracking what’s happening during your cycle: charting your basal body temperature (BBT), observing your cervical mucus (CM) and any other ancillary signs like the position of your cervix. (Some women may add an ovulation predictor kit (OPK) to this.) The BBT, measured consistently each morning immediately after at least 4-5 hours of uninterrupted sleep, can confirm that you ovulated and are producing enough progesterone. You should notice a rise by about 1 degree Fahrenheit that lasts for 12-14 days. (If your temperatures stays up 16 or more days, you are almost certainly pregnant!) BBT cannot predict when you will ovulate. The number of days after ovulation is pretty constant in most women, whereas the number of days from the onset of your period to ovulation can vary from woman to woman and fluctuate from month to month. Do not rely on your BBT alone to determine your fertile days if you are using the FAM to prevent pregnancy!

Observing cervical mucus is the part of the FAM that can actually tell you when you are more likely to be fertile. It is a little more intricate and requires some practice (and precautions) to become really useful. Peak fertility occurs when you observe profuse, clear, stretchy mucus of an egg white-like consistency. But the days before this stage can also lead to pregnancy because sperm may survive in a woman’s body for several days. The ovum, on the other hand, generally disintegrates within approximately 24 hours after ovulation, if not fertilized. Once your cervical mucus has dried up and your BBT remains elevated, you are unlikely to be able to conceive until the onset of your period (and usually a few extra days).

Collecting your data

Keeping track of your observations and correlating them to other events in your life, like stress, travel or illness, requires diligent charting. You can find downloadable grids in PDF form. You can also use one of the many smartphone apps now available. Some are free, some require a subscription, and some are paired with a thermometer that makes life a bit easier. Some even provide suggestions about how to interpret your data.

I recommend charting your BBT, CM and everything else for at least three cycles before you begin to rely on your own interpretation of these observations. During this time, continue to use a barrier method if you do not want to accidentally get pregnant.

Getting help

If, on the other hand, you are using the FAM to learn more about your reproductive health, you also need to be patient because just one cycle often doesn’t produce information that’s clear and consistent enough for interpretation. Initially, it can feel like parsing tea leaves, so don’t hesitate to speak with a reproductive health specialist who can help you analyze your data. Some doctors of Chinese medicine or naturopathy specialize in natural fertility and use this information to create a fertility support treatment protocol for women (and their partners), if conception is difficult.

I often recommend Lisa Hendrickson-Jack’s website and book to those of my patients who want to learn more about their menstrual cycles and become knowledgeable and aware of their fertility.

© 2021 Christiane Siebert