What is the Fertility Awareness Method?

Increasingly, women are exploring alternative methods to hormonal birth control, including using fertility awareness methods (FAMs). But there’s a lot of misinformation out there about what FAMs are and their efficacy, so we figured we’d break down exactly what some of the options are and how they work. From there, you can decide what’s best for you - because you know your body best.

Although the fertility awareness method is often thought of as a singular concept, there are actually quite a few ways to practice this method, from monitoring BBT (basal body temperature) to cervical fluid. Some are more effective than others, though, and some require more effort than others.

And while FAM is often confused with the rhythm method, they are not the same. The rhythm method is highly ineffective, and is based only on a woman’s cycle length. As you’ll learn, FAM is more involved!

What is the fertility awareness method (FAM) as a concept?

Also known as natural family planning, FAM is a non-hormonal birth control option. In learning more about your own cycles and body signals, you are able to pinpoint the approximate day that you’re ovulating each month. To successful use FAM, you must be familiar with the menstrual cycle and how it works. 

As women, we’re only fertile for ~seven days of our cycle, largely because of these three cycle facts:

  • When you ovulate, you only produce one egg in each menstrual cycle
  • That egg can only live for 24 hours (or less!)
  • But those pesky sperm can stay alive for up to six days in the uterus. Why aren’t men on birth control again ;)? 

If your goal is to prevent pregnancy, you’ll want to avoid sex (or use a barrier method) in the five to six days leading up to ovulation day, on ovulation day itself, and possibly the day after. Since this method does require more attention than using an IUD or taking a pill, it’s not for everyone, but it can be an amazing way to get to know your cycle. We don’t know about you, but we think we could all use a little more knowledge of our own bodies! 

As an aside - though we won’t dive into them in this article (maybe in a future one!), there are a lot of documented risks of hormonal birth control. Often, these risks and side effects are what lead women to turn to FAMs instead. But let’s get one thing straight - we’re not in the business of judging anyone’s choices here, and we’re so glad that women have the option of the birth control they choose to go with. We’ve got you, no matter what!

What are the different FAM options?

Though FAM is often categorized as one overall method, there are a few different options under its umbrella, most incorporating a mix of BBT, cervical mucus, and cervix position (some utilize urine metabolites, too!). 

  • Cervical Mucus Method - it’s critical to use this method correctly, since with typical (read: not proper!) use, the failure rate is 23%. With this method, you analyze their cervical mucus multiple times a day to determine their fertile window. It is definitely a bit restrictive, as it requires using a barrier method for about half the month or more (14-17 days of your cycle).
  • Symptothermal Method - this method combines cervical mucus observations with BBT. It’s more tedious than other methods, but it’s also a great way to learn your cycle. 
  • TwoDay Method - consider this an easier way to do the cervical mucus method. With this option, you check for cervical secretions at least two times a day. Any mucus is an indication of fertility and requires abstinence or a barrier method.
  • The Standard Days Method - this option is reserved for regular cycles (never shorter than 26 days or longer than 32 days), and while it’s simpler than other FAMs, it requires you to avoid vaginal sex from day 8 through 19 of each cycle. It’s essentially a calendar method. This is not a good option for anyone with PCOS or irregular cycles. 
  • Fertility Monitors (aka fertility tech!) - digital options, like Daysy or Natural Cycles, can be a great addition to the above methods. Not only do they make tracking your cycle easier, but they take away some of the guesswork. A few of our team members have used Daysy, and we find it super easy to use. It’s color-coded: green for infertile days, yellow for days you should be cautious, red for fertile days, and purple for menstruation. Daysy measures your BBT and then uses a detailed algorithm to sort through temperature spikes (which go hand-in-hand with ovulation). 

And a general note about cycle tracking apps (those that don’t involve any fertility monitor tech) - unfortunately they are largely ineffective. One study reviewed their efficacy and found that 4 out of 40 apps properly used the symptothermal method. The more effective apps included Lady Cycle, LilyPro, nfNFPnet, and Sympto. 

Though we know that some of these options might seem complicated, they get a lot easier as the months go by and you learn more about your body. Once you get the hang of them, they can be great options for birth control. 

How effective is FAM?

As with most birth control methods, this depends largely on how well you follow the directions! Just like missing a few birth control pills can greatly reduce the efficacy of that method, incorrectly following FAM will reduce its effectiveness, too. 

When it comes to FAMs, the efficacy can be 98% or more. It largely depends on how well you’re following your chosen protocol and which option you choose to begin with. 

As far as tech options go, Daysy has been shown in research to be 99.3% effective! We love this option to make FAM a bit more accessible for the apprehensive among us. 

If you’re considering FAM or getting off hormonal birth control, we hope this article was helpful! We’d recommend reading a few books to get you started:

  • Taking Charge of Your Fertility
  • Beyond the Pill
  • The Period Repair Manual 

And as always, we recommend consulting with your practitioner! In this case, since many conventional doctors are sometimes behind on the FAM research or just not big fans, we’d recommend meeting with a provider that’s knowledgeable about FAMs. 

And above all, do your research and choose the option that you feel most comfortable with! Maybe that’s hormonal birth control, or maybe that’s one of the FAMs we mentioned above. Whatever you choose, we’re here to support you along the way.