Picking the right Fertility Awareness method for you

This may come as a surprise, but I don’t think there is one ‘perfect’ or ‘correct’ Fertility Awareness method for everyone, and I absolutely believe that different methods may suit different life stages better. Something that works for you in your early 20’s may be totally unsuitable in your 40’s.

‘Right’ is also subjective and really comes down to your intentions. Are you charting for health, trying to avoid pregnancy (and if you fell pregnancy would it be potentially life threatening, or a very welcome surprise) or trying to conceive?

My area of interest is teaching folks to chart for contraception, so that will be the focus of this blog post.

There are three main ‘types’ of Fertility Awareness methods:

• Sympto-thermal (what I am certified in)

• Sympto-hormonal

• Cervical mucus only (what I am currently doing teacher training in)

I’ve created the flow chart below to help you understand what kinds of questions you need to ask your self and different things to consider when picking a method. It’s a very basic flow chart and it doesn’t take in every question that needs to be asked, but it’s a start. Following on from the flow chart I will provide some more information on the three different kinds of Fertility Awareness.

Sympto-thermal methods

Sympto-thermal methods are split into two categories: single and double check.

• Single check - Natural Fertility Education Australia, Justisse or Taking Charge of Your Fertility (TCOYF, book, self-teach method)

• Double check - NFPTA, Fertility UK, SymptoPro, Couple to Couple League, Sensiplan (can be taught with an educator but the book is also a very popular self-teach method and the only self-teach method I recommend)

Sympto-thermal methods use cervical mucus and basal body temperature (to learn more about those click here) to determine the fertile window. The double check methods also use a calendar rule to open the fertile window, which can add another (often very welcome) layer of security if you’re avoiding pregnancy.

Because you must take your temperature at ideally the same time everyday after a minimum of 3 hours sleep it can be difficult for a small group folks to get useable temperature data (shift workers, new mums, those struggling with insomnia), so if this is you then a TempDrop might be a valuable investment.

In saying that - taking your temperature upon waking everyday very quickly becomes second nature and most of my clients settle into a really good rhythm very quickly.

Pros:

1. There are a lot of different institutions and instructors that teach sympto-thermal methods

2. Self-teaching options are available for those that would like to do so

3. All you need is a thermometer (one from the chemist for $12AUD is sufficient), a chart (paper is fine) and some toilet paper to get started

4. Accessible option regardless of sleeping patterns (TempDrop)

5. Cross check with cervical mucus and temperature to confirm ovulation has occurred is comfort to a lot of folks

6. Some methods permit barrier use

Cons:

1. I’ve noticed a lot of people quote the efficacy rate of one method in a particular situation (Sensiplan when learnt with an educator/instructor can be as high as 99.6% effective when the rules are followed 100% of the time) and apply it to other methods that either don’t necessarily have that efficacy. For example, there are no studies available that conclude that self-teaching has a high efficacy rate. There is also no information on the efficacy of Taking Charge of Your Fertility (a very popular self-taught method) but a lot of folks quote the 99.6% efficacy rate. If avoiding pregnancy in anyway I would strongly recommend learning with an educator to get the highest efficacy possible.

2. Because sympto-thermal is definitely the more popular option there are people that may teach one of the methods after reading the Sensiplan manual or the TCOYF book, without being correctly certified. This is concerning, it’s best practice to always ask for certification details!

Sympto-hormonal methods

Sympto-hormonal methods include:

• FEMM

• Marquette

Sympto-hormonal methods use urinary hormone metabolite observations in conjunction with cervical mucus observations (sometimes optional, sometimes not).

FEMM uses cervical mucus observations in conjunction with LH testing/OPK testing strips.

Marquette users are required to purchase a Clearblue Fertility Monitor with optional cervical mucus observations.

Pros:

1. It’s not necessary to take temperature everyday

2. Must be learnt with an educator, so you will receive support and guidance until you’re proficient in the method

Cons:

1. Must be learnt with an instructor - this may be difficult for some people to afford

2. The test strips can be a costly recurring expense

3. The Clearblue Fertility monitor can be a costly initial expense

4. Can create excess waste that ends up in landfill. To be fully transparent, the waste is very small - however I am aware that excess waste is a concern to many people so I thought it was worthwhile to add here.

5. An LH surge doesn’t confirm that ovulation has occurred, just that it is approaching and may occur in 24-36 hours

6. Some folks have a very narrow time that they may have a positive test result which can be missed.

Cervical Mucus only methods

Cervical mucus only methods include:

• Billings Ovulation Method - focuses primarily on walking sensation

• Creighton - focuses primarily on visual appearance of cervical mucus.

Pros:

1. Must be learnt with an educator, so you will receive support and guidance until you’re proficient in the method

2. No devices needed, so very accessible option for a lot of people

3. No need to take your basal body temperature every morning

4. Once Basic Infertile Pattern (BIP, more on this later) is established the user may have a lot of safe days for unprotected sex

5. Works from menarche (first period/puberty) all the way through to menopause

6. Suits those with PCOS, Endo, and those in postpartum or peri-menopause.

Cons:

1. Barrier methods are not allowed/encouraged because it can disturb cervical mucus observations. Some genuine abstinence is required ever other night, even after you have established your Basic Infertile Pattern

2. Sex is only permitted in the evening of a genuinely dry or BIP day

3. Must be learnt with an instructor - this may be difficult for some people to afford (if this is you I’d encourage you to look into Billings wherever you’re located in the world, Billings won’t turn you away even if funds are an issue)

4. No cross check with temperatures, this can be a deterrent for a lot of people.

If you want to have a discussion about you and your circumstances to learn if the method I teach is right for you and if it’s not what methods might be suitable then I’d encourage you to book a 30 min discovery call with me - link here to book!