Fertility Awareness-Based Methods: Birth Control without the Drugs


It’s no secret that prescription birth control methods are not without their side effects. Deep vein thrombosis (DVT), pulmonary embolism, stroke and heart attacks are all serious conditions that can potentially result from blood clots caused by the hormones in certain birth control drugs. Side effects can be found in birth control pills, implanted devices, shots, and vaginal rings (among other methods), and it’s not hard to see why some women may opt out of these contraceptives.

So, what’s a woman to do if she’s not currently (or ever) interested in having children—but she doesn’t want to pump her body full of hormones to put things on hold? For some, the answer could be fertility awareness-based methods (FAMs).

What are Fertility Awareness-Based Methods?

Essentially, these methods of family planning are based on tracking ovulation in order to prevent (or encourage) pregnancy. FAMs require unrelenting dedication and consistency, as a woman (and her partner) must be acutely aware of and able to track her body’s cyclical changes. Education is an absolute must before committing to FAMs; there are multiple best-selling books (one of the most popular here), online resources, and institutions that can provide step-by-step instructions.

The Calendar Method

The rhythm (or calendar or standard days) method requires that a woman have a regular cycle between 26-32 days long, otherwise this practice may not be effective.

Using this method, a woman keeps track of the days of her menstrual cycle, starting with the first day of monthly bleeding as day 1. Days 8-19 are considered fertile days, and at this point the couple either avoids vaginal sex or must use some sort of barrier form of protection if they are looking to prevent a pregnancy.

Days 1-7 and from day 20 to her next bleeding starts are days when the couple can have unprotected sex. As evidenced, this method is not based on anything other than a woman’s cycle; there is no temperature taking or discharge monitoring. The rhythm method is based solely on tracking days, and is not known for being remarkably effective on its own.

The Temperature Method

Women will commonly track their temperature when they are trying to get pregnant, but this method can also be used to avoid pregnancy as well.

When using this method, a woman will wake up and immediately take her temperature; prior to getting out of bed, talking, eating, drinking, etc. A woman’s body temperature is lower during the first part of her cycle, and then generally rises slightly after ovulation. Her body temperature will then stay elevated for the rest of her cycle, and will then drop again before her next period.

To avoid getting pregnant, a woman and her partner won’t have unprotected vaginal sex until three days after ovulation each cycle. Days that are safe for unprotected vaginal intercourse begin after the temperature rise has lasted 3 days, and end when the temperature drops again before her next period.

The Cervical Mucus Method

The same hormonal changes that directly affect a woman’s cycle also cause her cervix to produce mucus. There are significant mucosal changes (visually and in texture) at specific points throughout her cycle, especially just before (and then during) ovulation.

In order to adopt this particular method (also known as the Billings method or the ovulation method), a woman must chart her mucous every day, including period days and dry days. Period days and 2-3 days before the first sign of slippery mucus are not safe days to have unprotected vaginal sex. Safe days begin after the slippery mucus is no longer present and the mucous is instead cloudy and tacky. The dry days following are also considered safe.

Education on this method is important, as a woman needs to be acutely aware of changes in her cervical mucus. Once she becomes familiar with her body’s cycle, a woman will know when she ovulates, and which days are “safe” vs. “unsafe” days.

The Sympto-Thermal Method

This is without contest the most effective choice, as it is a combination of multiple methods in order to achieve the maximum amount of fertility awareness. If a woman is going to opt for using FAMs, the sympto-thermal method is the undisputed champion.

The sympto-thermal method requires that a woman be diligent and committed to monitoring her cycle. She will take her temperature every morning before getting out of bed as well as observe her cervical mucus daily. She will also note the length of her cycles and track all of this information on a calendar so she can be keep all of her information organized. During unsafe days, a woman and her partner must make sure to abstain from vaginal intercourse or use an additional form of protection. Even just a few weeks of negligence can result in an unanticipated pregnancy.

Conversely, the symptom-thermal method can be used to assist couples who are trying to conceive by finding a woman’s most fertile days. Again, the more committed a woman is to monitoring her cycle, the more accurate her results will be.

If you are interested in opting out of hormonal birth control, FAMs are an option that could be worth looking into. There are no side effects associated with any of the methods, save for the fact that their effectiveness at preventing pregnancy ranges from 76-99% (a bit lower than hormonal birth control, but without any of the health-related side effects). Make sure to do your homework if you are considering fertility awareness-based methods, and make sure that you can commit to practicing the method/methods correctly 100% of the time.