In a recent issue of The Monthly a reader asked me about the Fertility Awareness Method (FAM), who should use it and who should not. It was a great question and aside from inspiring me to think more in-depth about FAM, it spawned the idea for this post. I stumbled upon the Fertility Awareness Method (FAM) when I was 25 years old. My husband and I were newly married and I wanted to switch to a more natural method of birth control. After doing a few Google searches, I found, ordered and immediately read cover-to-cover what I consider to be the FAM bible, Toni Weschler’s best-selling book Taking Charge of Your Fertility.
After only a few months of using FAM I discovered my undiagnosed Metabolic Reproductive Syndrome (formerly known as PCOS). Thanks to charting I had become an educated patient and my own advocate when it came to treatment options. I believe every woman and girl who is interested in taking charge of their reproductive health should chart their cycles, regardless of whether or not you are sexually active or trying to achieve pregnancy. So, let’s dig a little deeper into what FAM is and how it works.
What is the Fertility Awareness Method (FAM)?
The Fertility Awareness Method, or FAM, is a method by which a woman or girl learns to read her fertility signs in order to determine her most fertile days. FAM is a natural, effective, hormone-free and relatively low-cost method of birth control. It is also used by women who are trying to achieve pregnancy because it allows you to pinpoint when you are ovulating.
FAM is not to be confused with the widely discredited Rhythm Method. The Rhythm Method is based on the assumption that all women have a 28 day cycle and ovulate on day 14 (a healthy menstrual cycle can last anywhere from 21-35 days). FAM is tailored to your unique cycle.
What are fertility signs?
Amazingly, our bodies have subtle ways to help us discern our health and wellness if we are willing and able to listen. During a healthy cycle, there are four distinct characteristics that signal fertility changes:
- Basal body temperature (BBT): Our BBT is our base body temperature when we are at rest. It changes slightly from day to day and then spikes when progesterone levels rise. This rise in temperature signifies that you have ovulated. Your temperature will then remain elevated until menstruation. At this time, estrogen beings to take over and your BBT will return to pre-ovulatory levels. Unless, however, you become pregnant. In which case your temperature will remain high throughout your pregnancy.
- Cervical position: At different stages of the menstrual cycle the cervix will change position and texture as our body approaches and moves away from ovulation. During and after menstruation, the cervix will sit low in the vagina and feel hard, like the tip of your nose. As you approach ovulation, the cervix will begin to rise higher in the vagina, open slightly and soften, like your lips. For the few days surrounding ovulation your cervix will remain elevated and open. Once ovulation has occurred, your cervix will return to a low, closed and hard state. However, if pregnancy is achieved, your cervix can remain soft, but will be tightly closed.
- Cervical fluid: Just as how the cervix changes states throughout the cycle, so too does your cervical fluid. Before and after menstruation your cervical fluid will feel dry. As your body approaches ovulation you will begin to notice white, crumbly or lotion-like fluid. The closer you are to ovulation, the more clear, stretchy and abundant your fluid will become. This is your most fertile fluid and has the best ph balance for sperm to survive. It also allows them quick passage to the cervix. Once ovulation has occurred, your fluids will step back down to become more crumbly or lotion-like before it dries up completely.
- Saliva ferning: Amazingly, our saliva is also an indicator of ovulation. Just like how cervical fluid changes consistency, saliva changes the way it crystalizes around ovulation. On non-fertile days, your saliva will have the appearance of scattered dots when viewed under a microscope. Transitional saliva occurs as your body approaches ovulation and will look a little more detailed. Fertile saliva is fully crystalized and will mimic the look of fern leaves. This means ovulation is likely. To monitor saliva you will need to purchase a kit.
Why does FAM work?
Individually, the signs listed above are just fun-facts about your body. But tracked together on a chart they are powerful indicators of your fertility. In any given cycle, the five days leading up to ovulation, the day of ovulation and the day or two after ovulation are when pregnancy from unprotected sex is most likely to occur. This is known as the fertile phase. Fortunately, thanks to fertility signs, it doesn’t have to be a guessing game when this phase will occur.
It is important to note that when a woman releases an egg during ovulation it has roughly 24 hours to become fertilized before it disintegrates. However, sperm can live inside the female reproductive tract for up to a week. This is why it is important to abstain from unprotected intercourse during your fertile phase. A backup method like male/female condoms, a diaphragm or cervical sponge/cap can assure your protection (refer to individual method for effectiveness).
If you plan to use FAM as your primary form of birth control it is imperative you are well-versed on the method. Accuracy, consistency and compliance are key to FAM’s effectiveness. Average use of this method can lead to a 25% chance of pregnancy over the course of a year, but if used perfectly, there is less than a 2% chance of becoming pregnant over the same duration of time.
*You can read the original Q&A about FAM here where I dive more into why FAM may not be for you. If you are interested in subscribing to The Monthly, our free, everything-period newsletter, sign up here!
Amy Sutherland is a period-positive advocate and graduate student at the University of Minnesota where she is currently researching and writing her thesis on how menstrual stereotypes and stigmas affect health outcomes in women and girls. Read her full bio here.