Natural birth control – The Fertility Awareness Method

FAM, or the Fertility Awareness Method, is a form of fertility tracking that is guided by the signs provided by the menstrual cycle. Tracking ovulatory signs is the mainstay of this method (BBT, cervical fluid, cervical position, ovulatory spotting etc.). By tracking ovulation, we are able to determine when a woman is most fertile, and when she is not fertile. FAM can be used as a form of contraception by bringing into focus the best time to abstain from unprotected intercourse or to use a barrier method. FAM requires a woman to track and chart her cycle, and to follow basic rules outlined by her individual fertility. FAM is not only a great way to provide contraception, but can be used to improve pregnancy outcomes, as well as determine abnormalities in the cycle (PCOS, anovulation, irregular bleeding etc.). Before diving into FAM head first, read my previous blog post ‘Fertility and understanding ovulation’ https://www.healthflow.ca/fertility-understanding-ovulation/ for a summary on the common fertility signs.

Fertility Awareness Method: the basics

1. FAM will not protect you against STIs (sexually transmitted infections).
2. In order to use FAM as a contraceptive, you must know the day you ovulate. This is determined through charting. The 4 FAM rules identify the beginning & end of the fertile phase, which is the time that unprotected sex can cause pregnancy.
3. The fertile phase lasts about a week or so (approximately 5 days prior to ovulation, and 3 days after your peak day).
4. Sperm can survive for up to 5 days. This means sperm can be present in the vaginal canal before ovulation occurs, and can ultimately result in a pregnancy.
5. FAM is most effective as a contraceptive if you abstain during your fertile phase. If you decide not to abstain, a barrier method of contraception should be used (condom, diaphragm, femcap).
6. As with all contraceptive methods, there is a potential for failure. This is especially true with improper use.

The following FAM rules have been summarized from Toni Weschler’s book: ‘Taking charge of your fertility’. This is an incredible resource on fertility and the female body that has been simplified and broken down in easy to understand examples. I highly recommend it for all women.

FAM rules:

1. First 5 days rule: the first 5 days of your menstrual cycle are considered a safe window to have unprotected sex. However, this is only if you had a thermal shift 12-16 days prior.

Modification:

-If any of your last 12 cycles have been 25 days or less: assume only the first 3 days are safe.

-If you did not have a thermal shift around days 12-16: it’s unlikely you ovulated this month and it’s likely anovulatory bleeding, or a different underlying cause.

-If you are pre-menopausal: do not rely on this method, because hormonal changes can result in very early ovulation.

1. Dry day rule: before ovulation, you are considered safe to have unprotected sex the evening of every dry day (after 6pm). Check cervical fluid throughout the day. However, the next day is considered potentially fertile if there is residual semen that could be masking your cervical fluid.

-The day after intercourse is considered possibly fertile if semen or spermicide is present. Both can mask cervical fluid.

1. Peak day rule: you are safe to have unprotected intercourse the evening (after 6pm) of the 3rd consecutive day after your peak day (the last day of egg-white or lubricative vaginal sensation).
2. Thermal shift rule: you are safe to have unprotected sex the evening (after 6pm) of the third consecutive high temperature past your peak day, as long as the 3rd temperature is at least 3/10ths above the cover line. If a temperature falls on or below the cover line during the 3 days: start the count over again once the temperature has risen again.

If you are interested in using FAM as a form of birth control, make sure you are completely informed on ovulatory signs, and have learned to properly track your own cycle. This blog post is meant to educate, but is not extensive enough to cover all the important details of FAM. Invest in TCOF or talk to your doctor!

Dr. Michelle Hislop ND

Reference: Weschler, T. (2015). Taking charge of your fertility. Seattle: Collins.