What is Fertility Awareness?

I’m going to be talking a lot about Fertility Awareness Method, also called the Symptothermal Method, and some of you of you may have no idea what that is.  I had no idea what it was until a lovely roommate of mine handed me a tome called Taking Charge of Your Fertility by Toni Weschler and told me that reading it might help me make sense of my irregular menstrual cycle.   I read it, amazed that I had never heard of this before.

Fertility Awareness is about being aware of your fertility, specifically when you are fertile (meaning able to conceive a baby) and when you are not.

The Fertility Awareness Method is a specific set of rules applied to measuring and keeping track of your primary fertility signs. When practiced correctly you can gauge your fertility day by day, and be able to know with a high degree of accuracy if you are fertile or not. “Amazing!”  you say, or perhaps, “Who cares?”  Well, if you find yourself in one of the situations below, you might care a whole lot.

1) You want to postpone or avoid conceiving a baby and don’t want to use hormonal, invasive, barrier, or permanent methods of birth control.

2) You DO want to have a baby and would like to plan intercourse for the optimum time to conceive.

3) You have long or irregular cycles and want to figure out what the Deuce is going on with your body.

4) You would like to gain a greater level of body awareness.

5) You are Catholic and want to use the only method of family planning approved by The Pope himself.

You can do all of this and more by tracking your primary fertility signs over time, and using several rules to interpret your fertility. It takes about 3 minutes per day and becomes as second nature as brushing your teeth.

Your primary fertility signs are your basal body temperature, or BBT for short, and your cervical fluid, sometimes called cervical mucus, but I don’t like the word “mucus”, so I prefer the more euphonious term, (coined by Toni Weschler) “cervical fluid”.  Your BBT is the temperature of your body at your most rested state, the minute you wake up in the morning, before you get out of bed or move around at all, after at least three hours of sleep.

In the first half of your cycle, the pre-ovulatory phase, your BBT will be low, usually around 97.3 to 97.8 F for most women.  After ovulation (when you release an egg) your body will start producing the hormone progesterone.  Progesterone will cause your BBT to rise, and your temperature each morning will be slightly higher (usually at least 0.3 degrees) than in the pre-ovulatory phase, and will stay high until you get your period. If you were to get pregnant at ovulation, your BBT would remain high throughout your pregnancy.

The other primary fertility sign is cervical fluid. Cervical fluid is produced by your cervix, and changes throughout your menstrual cycle.  It’s what you’ll sometimes notice on your underpants at the end of the day. Cervical fluid is normal and healthy and tells the epic tale of your estrogen level over the course of your cycle.  Some women don’t know what cervical fluid is and sometimes normal healthy cervical fluid is mistaken for a recurring infection, as it’s cyclic and changes over time.

Generally speaking, if you’re not itching or burning, and your cervical fluid doesn’t smell like bread or fish, and isn’t green, it’s probably normal healthy cervical fluid.  You should go to your clinician, however, if you experience any of the symptoms above, and also for your yearly Pap and check up.  This is not medical advice, I’m not a doctor, I’m just saying that cervical fluid is normal and not to freak out about it.

Normal cervical fluid varies widely from woman to woman. It can be cloudy, white, yellowish, clear, even slightly pink.  The consistency changes over the course of your cycle, and usually goes a little something like this:  None, for the first few days after your period ends. Then as your estrogen level begins to rise it goes from sticky or gummy, to creamy. As you approach ovulation, your cervical fluid may become clear, slippery and stretchy, like a raw egg-white. Then after ovulation, estrogen levels drop and progesterone takes over.  Your cervical fluid will go back to being dry, or perhaps sticky for the remainder of your cycle, until you get your period, about 12 to 16 days after ovulation.  Then you get your period, and the whole process starts again.

That is a textbook menstrual cycle. Each woman is different. My own cycles vary between 27 and 83 days.  But through tracking my cycle I can confirm that I’m not pregnant, and that I do indeed ovulate.

The two primary fertility signs tell you about the hormone levels in your body.  Cervical fluid tells you when your estrogen level is rising, indicating impending ovulation.  Basal body temperature tells you when progesterone has kicked in, signaling that ovulation has occurred.   So, if you’re watching those two signs, you’ll get a pretty accurate picture of when you ovulate and therefore when you’re fertile.

Two things to note about fertility:  Although the woman’s egg only lives for 12 to 24 hours,  a man’s sperm can survive for up to 5 days in fertile cervical fluid (the wet, clear, stretchy kind).  When we talk about fertility awareness we are talking about the combined fertility of the couple.  A woman on her own is only fertile for 12 to 24 hours per cycle. But with the addition of the sperm brigade, hangin’ around in the fertile cervical fluid for days, the number of potentially fertile days jumps up to about 6. (5 for the sperm, one more for the egg) So, to plan for or avoid pregnancy, this must be taken into consideration. Using the Fertility Awareness Method on a classic 28-day cycle, there might be around 7-9 days that are considered fertile, and 18-21 days that are considered infertile. Obviously this varies from woman to woman and from cycle to cycle.

Here’s how fertility awareness works in practice:

1) You take your temperature every morning upon waking, before you get out of bed. Record this temperature on your Kindara chart.

2) Check your cervical fluid every time you visit the restroom.  Using folded toilet paper, or the tip of your finger, wipe your inner labia front to back and notice the sensation.  Then look at any cervical fluid that’s there on the toilet paper or your finger. Notice the color and consistency. Touch it and see if it’s sticky, creamy, or perhaps stretchy.  Fertile cervical fluid is very distinct. It’s usually clear and very stretchy. It will stretch an inch or more between your fingers.  Record your CF observations on your chart as well. Note: cervical fluid is different from female arousal fluid.

3) Use the rules of Fertility Awareness to achieve or avoid pregnancy.   To be safe, I recommend you read a book on Fertility Awareness, take a class, chart for 3 months and consult with a Fertility Awareness instructor to make sure you understand everything before you use Fertility Awareness as contraception.  Do not use this method without a clear understanding of it and a commitment to diligently record your observations.  That said, the rules for using Fertility Awareness to avoid pregnancy are as follows:

First 5 days rule – You are generally considered infertile for the first 5  days of your period, unless you have ever had a cycle that was less than 25 days long.

Dry day rule – You are generally considered infertile the evening of any day you observed that you had no cervical fluid.

Peak plus 4  – You are generally considered infertile the evening of the 4th day after your most fertile CF once your cervical fluid has become infertile again, and you have observed a clear temperature rise.

Temp plus 3  – You are generally  considered infertile the evening of the 3rd day after your temperature shift.

All of these rules must be followed simultaneously.  It might sound complicated but once you start charting your cycle it will start to make sense and become easy very quickly.  Remember that these are just the general rules and that every woman is different.  When in doubt, assume you’re fertile.

If you have a clear understanding of the method and diligently observe and chart your fertility signs, abstaining from sex during your fertile time, Fertility Awareness has been shown to be up to 99.4% effective.  If you use a barrier method during sex, such as a condom, in your fertile time, the method is as effective as the condom you are using (usually around 97-98% if you use them perfectly).

That is a brief overview of Fertility Awareness. Charting my cycle has changed my life. I feel more in touch with my femininity.  I have a greater understanding of my body and I feel more connected to my husband as we discover the power and mystery of the female reproductive cycle together.  It’s the coolest thing I’ve discovered in the last 5 years and if you’re interested in learning more I invite you to do so!

Books:

The Garden of Fertility by Katie Singer

Taking Charge of Your Fertility by Toni Weschler