The Basics of the Fertility Awareness Method

Your menstrual cycle is not something that should be shrouded in mystery ~Toni Weschler

In my last post, I touched on some of the reasons why women might want to start tracking their own fertility. Today I'll cover some of the basics of FAM, but if you really want this to be your primary method of preventing conception then I highly recommend reading “Taking Charge of Your Fertility” by Toni Weschler. This book also has some great information in regards to potential fertility issues and common menstrual problems.  

If you're ready to start charting your cycle, you can use an app on your phone, like Kindara or Read Your Body, or you can print off blank paper charts here. Using this method, there are three primary fertility signs to track throughout the month: 

1. Cervical Fluid: Cervical fluid changes throughout the month based on where you are in your cycle. In a normal, healthy cycle, after menstruation it tends to be dry then slowly starts to shift to sticky or creamy as you approach ovulation. Around ovulation, or at peak fertility, cervical fluid tends to be stretchy or raw egg white in consistency. After ovulation, it shifts back to a dry or sticky consistency. 

All of these changes are in response to estrogen. As estrogen increases and you approach ovulation, the cervix responds by creating fluid that is more receptive for sperm to live in. Essentially the stretchy or egg white cervical fluid is associated with your highest fertility. That's why it's important to take note! If you are trying to conceive, this is the best time for intercourse. If you are trying to prevent, this is a time to use a barrier method or avoid intercourse. 

To track this, try checking around the same time each day, like in the morning. You can check by wiping front to back with toilet paper and taking note of what's there. Or more accurately you can insert two clean fingers inside the vagina until you can feel the cervix. Place one finger on either side of the cervix, gently press either side as you slide your fingers down towards the opening of the cervix, collecting any fluid that is present. Note how it feels: dry, sticky, creamy or slippery. You can also note the amount, which also increases as you approach peak fertility.  

1. Waking Basal Body Temperature (BBT): After ovulation, your basal body temperature increases due to progesterone being released. This results in a bi-phasic temperature chart with lower temperatures in the first half of the cycle and higher temperatures in the second half. This can vary from woman to woman; however, an average increase is by 0.5 to 1.0 degree Fahrenheit. For example, you may hover around 97.0-97.3 before ovulation and then to 97.7-98.0 after. It's important to look at the big picture and not get caught up in the numbers day to day. 

To record this, you need to take your oral temperature first thing in the morning before getting out of bed or talking or drinking something or staring at your phone. To be most accurate, you can buy a specific thermometer for basal body temperature charting. 

Also, be sure to take it around the same time every day and record it in your app or on your chart. If you sleep in or have to get up super early, note it in your chart in case the temperature for that day is a little off. On the other hand, if you don't get at least 3 hours of consecutive sleep before taking your temperature, the reading may not be accurate for that day. 

BBT can be influenced by many different factors, like stress, alcohol, fever, illness, travel and sleep disturbances to name a few. So, if you are noticing one temperature that seems to be an outlier, look to these factors first before assuming hormonal havoc.

1. Cervical Position (stated as optional according to Toni Weschler): During the most fertile time of your cycle the cervix is soft, high, open and wet (SHOW). The increase in estrogen leading up to ovulation is responsible for this change. At other times of the cycle, the cervix tends to be low, closed and more firm, like the tip of your nose. 

To track this, be sure to check around the same time each day and in the same position. Essentially you can do this as you check cervical fluid. It's easiest to check either squatting or with one leg up supported on the bathtub or toilet. Some women notice that it feels as if the cervix moves back and forward, rather than up or down. Noting either is fine, as long as you are becoming more aware of changes that take place throughout the month. 

When you start tracking these simple fertility signs, be sure to start on day one of your cycle, which is your first day of bleeding, or start at any time as long as you know which cycle day you are on. You don't have to check cervical fluid or position during menstruation, but continue to take basal body temperature. 

If taking your temperature every day seems like too much effort, consider the TempDrop, which is a wearable sensor that tracks your basal body temperature for you. 

If you want to use this as birth control, there are some rules around when it is safe to have unprotected intercourse. Plus, you would want to chart for at least 3 consecutive cycles before relying on this method alone.  

Generally, the most important time to avoid intercourse or use another method of birth control is when you are noticing fertile cervical fluid, which is stretchy or egg white in quality. The egg itself only lives up to 24 hours; however, sperm can live up to 5 days in fertile cervical fluid.

After you see a temperature shift, indicating that ovulation has occurred, then wait 3 days with consistently higher temperatures before unprotected sex. At that time, you may also notice that cervical fluid becomes drier due to the presence of progesterone. 

If you are trying to conceive, you'll want to start noticing around which cycle day you ovulate. It's not always day 14 as you may be familiar with. Remember that once your temperature increases, ovulation has already occurred. It's better to rely on the presence of fertile cervical fluid for timing intercourse. It's important to be having sex before the temperature increase if you want to conceive. 

This information can be really supportive for those who are trying to conceive and those trying to prevent. It's also really helpful to have this information recorded if you are having some hormonal health challenges, such as: irregular cycles, heavy bleeding, spotting, mood swings, night sweating, infertility, cramping or ovulation pain. 

This does not have to be hard or inconvenient. It can be as simple as brushing your teeth. Learn a little bit at a time and go from there. Use this as a way to get familiar with your body and your fertility cycle. It is my hope that someday this information will be standard education for teenage girls, so they can begin to partner with their cycles from a young age.