Family Planning of Clallam County
FACT SHEET FOR FERTILITY AWARENESS METHODS (FAM)
(Periodic Abstinence, Natural Family Planning, Rhythm)
Before you decide to use FAM, be sure you understand both the benefits and the possible problems of using FAM. If you have any questions as you read, we will be happy to talk about them with you.
A woman is fertile (able to get pregnant) only for a rather short time during each menstrual cycle. For most of the cycle, she should be infertile (not able to get pregnant). A woman or couple may learn how to tell fertile days from infertile days by checking the woman’s bodily signs daily and keeping a chart of the changes.
WHAT ARE FERTILITY AWARENESS METHODS (FAM)?
Fertility awareness methods consist of those techniques used by women to estimate the time of month they are most fertile (about 7 days in length). Some women choose to avoid sexual intercourse during the time of month when they are most likely to become pregnant. This is called periodic abstinence. Other women choose to use one or more contraceptive methods during their fertile time. Fertility awareness methods are named after the method a woman uses to recognize her fertile days. These include: Natural Family Planning, Sympto-Thermal Method, Ovulation Method, Mucus/Temperature, and/or Rhythm, and Standard Days Method.
WHO CAN USE FAM?
Any woman who is having menstrual cycles. You do not have to have regular cycles to use these methods, but women with regular cycles have more success in preventing pregnancy.
A woman’s natural menstrual/fertility cycle is changed when taking birth control pills. FAM cannot be learned or used while a woman is on the pill.
FAM is not hard to use but you must understand clearly how it works and how to use it right. A woman or couple should be well taught by an experienced teacher. If you do not know of such a person, you can read very carefully and completely one or more books about these methods.
HOW DOES FAM WORK?
It is based on the fact that a woman is fertile only around the time of ovulation (the release of a ripe egg from an ovary). It relies on the following beliefs:
• an egg is usually released each cycle
• the egg is released about 14 days before menstruation
• the egg lives 12-24 hours
• after sperm get into a woman’s reproductive system, they might
be able to fertilize (join) an egg for up to 5 days.
This means that a woman is fertile for as long as five days before ovulation due to sperm life. And after ovulation she is considered fertile for two to three days. This amounts to 7-8 days of fertility in her cycle each month. The remaining days are not believed to be fertile days, and intercourse during that part of the cycle should not result in pregnancy.
The aim of FAM is to recognize when ovulation is approaching (fertile phase begins), and when it has passed (fertile phase ends).
Standard Days Method
The Standard Days Method (SDM) is a somewhat new method of natural family planning and can be used to help you and your partner recognize when you are most fertile. To use this method, you must have a monthly menstrual cycle between 26 and 32 days long (your menstrual cycle begins the first day of your period and ends the day before your next period starts). Many women who practice SDM use CycleBeads to help them know where they are in their menstrual cycle. CycleBeads are a string of different color-coded beads with a rubber ring that you move each day. The color of the beads tells you whether or not you are likely to get pregnant that day. If used as recommended, it is 95% effective. For more information on CycleBeads, you can also check their website at www.CYCLEBEADS.com.
Combination Methods of FAM
The methods of FAM mainly depend on keeping a daily chart of body changes (see sample). The two most important things to check are cervical mucus and basal body temperature (BBT). Each of the methods of checking body signs daily keeps a woman aware of what is going on in her current cycle. This helps her know if ovulation happens early or late. Methods can be used alone, but FAM is more reliable when the signs of one method are used to confirm the signs of another.
Cervical Mucus
A woman can learn to tell when ovulation is about to happen and when it has passed by checking her mucus discharge daily. She can check externally by touching the inner lips of the vagina and/or internally by putting her finger into her vagina.
A woman may notice that for several days after menstruation she has no noticeable discharge and that her vagina feels relatively dry. She will start to notice some mucus as ovulation approaches. It will probably be thick, white or yellow, tacky or pasty. The first sign of mucus is the start of the fertile phase. Right around the time of ovulation mucus increases to a peak, and there will be one or more days of clear, slippery, very wet type mucus similar to the consistency of raw egg white that can be stretched between two fingers. She must avoid intercourse for at least four days after the last day of slippery mucus.
After ovulation the mucus begins to dry up, getting thick and pasty again. Sometimes it disappears entirely until shortly before ovulation the next month.
Basal Body Temperature (BBT)
BBT is the temperature of the body at rest. The temperature must be taken every morning immediately after waking and before getting out of bed, smoking, or taking food or liquid. A basal body thermometer ($4-$7) is recommended because it measures small temperature changes more accurately than a fever thermometer.
Before ovulation daily BBT is lower than after ovulation. Within 12 hours following ovulation, BBT usually rises several tenths of a degree, and remains up until the next menstrual period begins. Keeping a BBT record helps indicate when an egg has been released. After a woman sees her temperature rise and remain higher for 3 or more days, she knows it’s likely that ovulation occurred shortly before her temperature rose, and she should no
longer be fertile. When using this method alone, she must abstain from sex from the end of menstruation until she’s sure ovulation is past by at least 3 days.
Temperatures can be affected by many different things, such as fever, drugs, lack of sleep, travel, etc. It is important to note these things on a daily chart. Otherwise one may mistake a fever for a sign that ovulation has passed, for example.
Other Symptoms
Some women may notice other physical signs of ovulation along with temperature and mucus changes. Such changes occurring at that point in the cycle will help a woman to determine the time of ovulation. Some symptoms or findings are: changes in position of the cervix; softening of the cervix; slight pain in the lower abdomen in the region of the ovaries, often on one or the other side; slight and temporary bleeding (spotting); breast tenderness; or abdominal heaviness.
Calendar Method
One method of FAM is guessing when ovulation will happen based on a record of how it has happened in the past, called the calendar method. This method is not reliable alone, and its main use is to provide a probable date when fertile days may start.
WHAT CAN BE DONE ON FERTILE DAYS TO PREVENT PREGNANCY?
• Some couples don’t have sex at all on fertile days.
• Some couples choose to make love without having intercourse, by using their hands or mouths to bring each other to orgasm during fertile days. These ways of achieving orgasm without intercourse have been used for thousands of years to prevent pregnancy and may make sex more varied and exciting. Women may find such practices helpful in reaching orgasm because they can provide more direct stimulation to the clitoris.
• Some couples supplement FAM by use of various barrier methods such as the condom, foam, or diaphragm and jelly during fertile days. Spermicidal cream, jelly or foam can hinder checking the mucus pattern, so women who use these will need special instruction.
HOW EFFECTIVE IS FAM?
Pregnancy rates vary depending on whether one method or a combination of methods of FAM are used, or whether barrier methods are added during the fertile time. FAM is most effective with no intercourse during the fertile phase. About 24 out of 100 women who are average users and rely on FAM with periodic abstinence may become pregnant each year.
Careful and consistent use can give better results. Also, the addition of barrier methods during the fertile period will probably give better results. To make the method work best for you, you should talk with a counselor about it, take a FAM class, or carefully read one or more books.
WHAT ARE THE ADVANTAGES OF FAM?
• The method has no health risks or side effects for the woman.
• It can be used to prevent or to plan a pregnancy.
• It can be quite effective if used correctly and consistently,
especially if you have regular periods.
• It is acceptable for couples with religious concerns about birth
control.
• The method is free, except for a thermometer (and possibly a
class fee and purchased charts).
• It can lead to greater awareness and understanding of the body.
• Couples may develop greater communication, cooperation and
responsibility.
• Barrier methods that have very few side effects may be used with
FAM during the fertile period to increase the effectiveness of
pregnancy prevention.
WHAT ARE THE DISADVANTAGES OF FAM?
• Even with correct use, the failure rate is often higher than with
other methods. If the method is not used correctly and
consistently, pregnancy is risked.
• Learning the method takes time and effort.
• Using the method requires considerable commitment,
calculations and self-control.
• Both the woman and her partner must use self-control, unless a
barrier method is added during the fertile time.
• If the woman or her partner has other sexual partners there is the risk of transmitting (passing on) a sexually transmitted infection.
Page 3 of 3 FPCC 8.04 5/09