Please note that whilst I have spent hours doing my own research, and using this method myself, I'm not a medical practitioner. This blog is purely an introduction to the Fertility Awareness Method of contraception. Conducting your own further research and/or having a discussion with your trusted medical professional is strongly suggested.
I spent the better part of 13 years on some form of hormonal birth control. My GP suggested I start taking the pill at 16, and it was at that point where I lost my body autonomy (although I didn't know it at the time). Take a pill, they said. It'll prevent pregnancy. Insert this rod in your arm, they said. It'll prevent pregnancy. Pop this IUD in your cervix, they said. It'll prevent pregnancy. Yes, there will be nasty side effects for all of these methods of contraception and you won't know a thing about your true menstrual cycle, but hey, this is what you have to do if you want to avoid an unplanned pregnancy!
For 13 years I was lead to believe that hormonal birth control was the only option to prevent pregnancy. I still believed it was really the only option, when I decided I wanted to come off hormonal birth control, just to "get in touch" with my natural menstrual cycle. So I had my IUD removed after a few short months of having it, and I started to track my menstrual cycle. As I physically witnessed my cycles unfolding, I became more interested in learning what was actually happening throughout my cycle. I'm sure I'd learnt it at various stages throughout school, however I learn best in a hands-on, real-life, self-directed way - so I feel I've only recently truly started to understand it.
I started chatting with a friend who had been tracking her cycles for a while - she explained to me how tracking her menstrual cycle was helping her increase her chances of conceiving. It was then I realised that the opposite must also be true - menstrual cycle tracking can surely help up to prevent conception! Then I learnt that there were a LOT of women out there who knew this already. I eventually came across the term "Fertility Awareness Method" of contraception, which I'd now like to dive into.
Preventing pregnancy without the need for hormonal birth control is a way to regain body autonomy back from the patriarchal system.
This is an introductory guide to using the Fertility Awareness Method of contraception to prevent unwanted pregnancies. I'll start by explaining what it is; we'll unpack what's actually happening in your body throughout your menstrual cycle; and then I'll write about how to put this method into practice.
This method of contraception provides women the opportunity to re-engage with their natural menstrual cycles. With the FAM, you can become more aware and in-tune with your own body, as a way to reclaim responsibility and body autonomy. Not to mention the fact that this method allows natural hormones an opportunity to rebalance in your body! The ultimate aim is to achieve greater well-being, whilst still preventing unwanted pregnancies.
Fertility Awareness Method of contraception
What is the Fertility Awareness Method?
The Fertility Awareness Method (FAM, for short), is a method of contraception that doesn't involve hormonal birth control. It's quite simple, once you know what to do. It is based around understanding your own unique menstrual cycle, and tracking a couple of key signs in your body that indicate when you are in your fertile window. When you know when your fertile window is, you're able to avoid unprotected sex, to prevent unwanted pregnancies.
To use the FAM, you first need to understand what happens during your menstrual cycle. A menstrual cycle begins on the first day of your period, and ends the day before your next period. Everyone's menstrual cycles are different in length, and may even vary cycle to cycle, but typically they'll be about 28-35 days long.
You can think about your menstrual cycle having two phases, each phase similar in length (see Image 2):
- The Follicular Phase: Day 1 of your period, to ovulation
- The Luteal Phase: ovulation to the day before your next period (a date you will be able to define when you start your next period).
Image 2: phases of the menstrual cycle
https://fertilityscience.org/how-to-increase-your-luteal-phase-naturally/
The follicular phase is a time where your body sheds the thick, bloody lining of your uterus that built up from your previous cycle (this shedding is known as your period). Hormones then begin to stimulate the production of follicles on the surface of an ovary. Most of the time, only one of these follicles on the ovary will mature into an egg. As the follicles grow, estrogen is released. This stimulates the uterine lining to start to thicken in preparation for potential implantation of a fertilised egg. Towards the end of the follicular phase, a hormone known as "Luteinizing hormone" (LH) will be triggered by the high levels of estrogen, which stimulates the release of the matured egg from the follicle. Hello, ovulation! This is roughly around Day 14 of your cycle (but will vary person to person, and often cycle to cycle).
In the luteal phase, the matured egg will travel down the fallopian tube, where it will be on the look-out for sperm, in order to become fertilised. If it meets sperm, fertilisation may occur, and the fertilised egg may implant into the wall of the uterus, signalling the start of a pregnancy. If the egg doesn't meet any sperm on its travel down the fallopian tube (over about 24 hours), it'll disintegrate. Progesterone initially rises after ovulation which causes the uterine lining to stop thickening, so potential implantation can occur, but then the hormone drops off if no pregnancy occurs. These fluctuations in progesterone can contribute to common premenstrual symptoms. Then about 10-12 days after ovulation, the uterine lining starts to shed and your period begins, and so your next cycle begins.
Now, according to biology, you can only fall pregnant about seven days before ovulation, and about a day after ovulation. People refer to this as the fertile window. Basically, sperm can live in the uterus and/or fallopian tubes for up to seven days in ideal environments. But then once the matured egg is released from the ovary at ovulation, it will only live for about 24 hours before disintegrating (if it doesn't meet sperm). This forms the basis of the FAM. The important thing to learn from here, is how to know when you've ovulated.
How do I know exactly when I've ovulated?
This is the fun part! Two simple signs you track in your body daily throughout your cycle, to know when you're ovulating. A third can be a simple ovulation test, to confirm.
Basal body temperature (BBT): for this method to be effective, you must take your BBT every morning, before you get out of bed. You need to have a thermometer that reports up to two decimal points for accuracy. In your follicular phase, your BBT will be slightly lower - so remember the follicular phase is the time between your period starting, and ovulation. The hormones that trigger ovulation will cause a rise in your BBT. Once you see this spike in your BBT at ovulation, it will remain slightly higher for the rest of your cycle (the luteal phase). Your BBT will then drop down again when you get your period, and your next cycle starts. See Image 3 below, to understand how BBT charts in a regular menstrual cycle:
Image 3: changes in BBT over the course of a standard menstrual cycle
https://www.tempdrop.com/blogs/resources/detecting-pregnancy-or-ovulation-on-your-basal-body-temperature-chart
Cervical fluid: it's important to monitor your cervical fluid (ie. mucus, or discharge) throughout your cycle, as this changes through your cycle and is another important indicator of fertility. This means frequently checking when you wipe in the toilet - not just checking your undies at the end of the day! In a regular menstrual cycle, in the days leading up to ovulation, you should notice more slippery cervical fluid, and possibly more fluid than other times in your cycle. Even closer to ovulation, you should notice cervical fluid that looks/feels like raw egg white. This is an important sign that you're about to ovulate.
Ovulation tests (see Image 4): these tests can help you confirm whether ovulation is about to occur. It measures LH in your urine, which is the hormone that surges just before ovulation, and drops off quickly after ovulation. I would recommend using these tests just to help you pinpoint if/when your ovulation has occurred in your cycle! You can purchase bulk ovulation tests for a pretty reasonable price through many online shops. Just like a pregnancy test, you dip the stick in the mid-stream urine sample you've collected, and wait a few minutes. One control line, or a dark control line and a much lighter test line, means no ovulation yet (or you've missed it for this cycle). If the test line is close in colour or the same colour as the control line, you would consider that a positive ovulation test, whereby you are likely to ovulate in the next 24-48 hours. Some menstrual cycle apps such as Premom have a function where you can take a photo of a test and it will determine the 'ratio' between the control and test line (ie. a ratio of 0.59 would mean that the test line is 59% of the colour compared to the control line), to give you a 'low' or 'high' reading. This can help you better decipher whether it's a positive ovulation test or not.
Image 4: deciphering positive and negative ovulation tests
https://www.invitra.com/en/ovulation-test/
Other signs and symptoms, unique to your body: over time, as you become familiar with your cycles, you will become in tune to other signs in your body that help you determine where you are in your cycle. For me, I know when ovulation has occurred, as the next day my breasts and nipples become SUPER sensitive, tender and swollen. They stay like this until Day 1 of my period - and then just as if someone has popped a balloon, they deflate! I really encourage you to use a cycle tracking app - I use FEMM - to document your BBT, cervical fluid, and other signs and symptoms throughout your cycle.
What does the FAM look like in practice?
I measure my BBT almost every day before I get out of bed (as any movement will raise your temperature). I say almost, because after almost a year of tracking my cycles very closely, even though they're slightly irregular, I'm now familiar with where I'm at in my cycle at any given time. I certainly still become more religious with monitoring things around my fertile window! About 7 days before I expect to ovulate, my partner and I will start to use alternative contraceptive methods, such as condoms. Once I've ovulated (confirmed by observing egg-white cervical fluid paired with a rise in my BBT over the same couple of days, along with tender nips/breasts which is a unique symptom of mine), we will continue to use condoms for about two days after, just to be super cautious.
Basically, I am confident to have unprotected sex outside of my fertile window (see Image 5) and know that I won't fall pregnant. Regardless of this confidence, almost daily tracking of BBT and cervical fluid ensures that I'm closely monitoring my body for signs of ovulation. This hasn't happened to me, but if in the event I discovered I ovulated within 7 days of having unprotected sex, I would be seeking immediate medical advice from my GP if I didn't want to fall pregnant. But because my cycles are fairly regular, and I'm pretty conservative with my seven days pre-ovulation condom rule (ie. its possible but fairly unlikely that sperm would live for the full seven days in the uterus/fallopian tubes), I'm confident this wouldn't be a situation I'd need to consider.
Image: chart showing approximate fertile window in a 28-day cycle. Fertile window opens a few days before ovulation to a couple of days after ovulation. Please note everyone's cycles are unique, and your cycle can change from month-to-month. It's therefore strongly advised to utilise all of the components of FAM, rather than basing your decisions on any assumptions about your cycle, as assumptions may result in unplanned pregnancy.
I would definitely encourage spending some time discerning all of this information, doing your own research, and applying it in a way to yourself that honours your own unique situation. I would be getting clear on your intention for wanting to use the FAM, and I would factor in your own level of comfortability with risk (in this context, the risk is falling pregnant), and consider ways to adjust using the FAM that fits best for you. Technically, I don't use the FAM on it's own, because we also use condoms, which is of course another form of contraception.
I hope this blog post helps you understand the FAM, and I hope it shows you that there are alternatives to hormonal birth control despite what you've been told since you were a teenager. I also hope it inspires you to get in touch with your natural menstrual cycle! If you have any questions, or any stories you would like to share with me - please get in touch via email at soulfulkinetics@gmail.com, or send me a DM on my Instagram @shae.soulfulkinetics. Wishing you well on getting your body autonomy back, sis! xx