Disclaimer: I am not a medical professional. What I share here are insights from scientific reading and research and I'll always share my sources. Consult your doctor for personalized medical advice.
What if I told you that...
You don't need to put any synthetic hormones or physical devices into your body to have 99%* protected safe sex with a partner?
Those pricey ovulation test kits are completely unnecessary to find your most fertile days to conceive?
Your body is the only tool you'll ever need again to effectively prevent or achieve pregnancy?
Would you believe me?
When I first read these claims about the Fertility Awareness Method in Toni Weschler, Mph's book Taking Charge of Your Fertility*, I couldn't believe my eyes.
I was in the middle of my hypothalamic amenorrhea recovery (I wasn't cycling at all), at a turning point in my own hormone regulation journey, and I honestly didn't know how the menstrual cycle worked. Weschler's argument gave me critical insights to understand my body and convinced me that we can manage our fertility goals by simply listening to the loud signals our bodies send us each day. But, with 400+ pages of deep insights in Weschler's book and hundreds of podcast episodes discussing the same topic on Fertility Friday (great pod*) there's just a ton of content out there to dig through to decipher how to use FAM. So, today, I want to share my super-simplified guide to FAM.
What's the Fertility Awareness Method?
Per the definition above, FAM, sometimes referred to as the symptothermal method of contraception, is a super simple way to track fertility, based on just three key body signals, that change at key moments throughout the menstrual cycle.
FAM can help you:
Make sure you don't get pregnant
Make sure you do get pregnant
Find cycle abnormalities,
Track existing health conditions, like PCOS,
Determine your typical menstrual cycle duration and intensity,
Understand how your hormones impact your mood, energy levels, and physical symptoms
Feel at ease knowing when your period will come
Determine when you need to take a pregnancy test
Maximize your workouts and diet to different parts of your cycle,
And so much more!
FAM has personally changed my life by offering a non-hormonal, non-invasive way to take control of my cycle. After 18 months without a period, charting my symptoms using FAM was the most helpful tool in recovering from HA and getting my period back.
How Do I Chart Using FAM?
As mentioned, FAM uses three primary fertility signs to help you determine on which day of your cycle you are most likely to ovulate:
Your basal (waking) body temperature
Your cervical mucus / fluid
Your cervical positioning
The basic activity you'll need to do consistently each day to engage safely in FAM is to chart those three symptoms. There are many apps* and even wearables available today that help women monitor and chart, but I use a simple and free Google Sheet along with a $15 thermometer from the drug store. This system is (basically) free, my data is private, and it's totally customized to me.
Step 1: Charting Your Temperature
In my new Google Sheet, I start by writing out the dates of the month in a row. Next, I add my typical waking body temperature range down the length of the far left column, so that a cross-section of my basic chart looks like this (abbreviated for simplicity):
Remember - your cycle starts with the first day of your period, so you'll start your new Google Sheet (or page in your notebook) with your first day of bleeding as day 1.
To populate the appropriate temperature square for each day, it's important that you stick the thermometer in your mouth at approximately the same time each morning, right after you wake up. This will deliver the most accurate read on this vital sign; you'll get pretty off results if you deviate by taking your temperature at a later time. For those who have wildly inconsistent sleep schedules, wearable trackers, like TempDrop, might offer you a greater sense of control.
Step 2: Logging Your Cervical Mucus (CM)
Below your body temperature chart, you'll next add a row to track cervical mucus (CM) each day. Charting CM will look like the screenshot, below:
Unlike basal body temperature, charting your cervical mucus is best done after a full day's observation, checking your underwear or toilet paper after using the bathroom. I usually reflect on the prior day and chart CM a day late. CM can't be quantitively scored like temperature can, but there are four basic "levels" of CM you can observe: your period, and levels 1, 2, and 3, described below:
Step 3: Documenting Cervical Position and Texture
Third and finally, you can chart changing qualities of your cervix throughout your cycle, by physically sticking a clean finger up your vagina and checking its position. Admittedly, I rarely do this, as I find my temperature and cervical mucus give me clear and strong signals each month. But, for women who don't see as much variation in temperature or CM, this third sign can be critical.
Your cervix position can be categorized as low and hard, medium, or high and soft (L, M, or H in charting language), shown on the chart below:
You'll also note in that last screenshot, that you can include several other rows describing symptoms or lifestyle factors each day, added below the cervical position row in your chart. Personally, as shown above, I like to include elements like whether or not I drank alcohol, or experienced insomnia, as these can correlate with higher waking temperatures and help decipher whether an abnormally high temperature is cycle-related or not.
What Do These Signs Tell Me?
So, now that you know how to log the three symptothermal indicators in FAM, let's talk about what they mean and how to interpret your chart. This is the most important part of FAM - after all, data is only useful if it can be accurately interpreted and acted upon. Below, I'll discuss how each indicator tells you you're ovulating. It can't be understated: if you're using FAM as contraception, you want to avoid sex or use additional (barrier method) protection during your ~ 6-day fertile window to avoid pregnancy.
Sustained higher BBT means you've (already) ovulated
Based on our understanding of the menstrual cycle, basal body temperatures are lower during the follicular phase and higher post-ovulation, during the luteal phase. Not surprisingly, the increase in waking temperatures has everything to do with which fertility hormone is "at the wheel" on a given day. Estrogen reigns during the follicular phase, while progesterone rules the luteal phase. Progesterone drives your temperature higher, which is why those who chart their BBT will see a sustained elevation in their temperatures after ovulation and before menstruation. (Need a friendly reminder of how your period hormones actually work? Refer back to my guide, here.)
But, of course, your temperature has daily fluctuations even within these phases, which is why, as you chart, it's important to look at overarching trends, rather than day-to-day fluctuations. To more concretely understand when you have ovulated using FAM, you'll need to note at least 3 back-to-back BBT readings that are more than 0.2 degrees (F) higher than the preceding 6 days. Highlight those previous six days, find the highest temperature among them and then use that temperature as your "cover line". After at least three higher temperature days in a row, you'll likely see temperatures remaining above that cover line in the luteal phase.
It's important to note that temperature is a retrospective signal - for those trying to conceive, waiting to "try" until your temperature increases will be a failing tactic - you'll have missed your actual ovulatory window every time. That's why we have two other signals to watch! Anyway, your temp spike should look something like this:
Egg-White-Like CM is Your Most Fertile
Onwards to cervical mucus! Okay, so I could nerd out on CM for about a thousand words all on its own, but for those uninterested in the ~80-bajillion sub-types of CM and how they hang out in your "cervical crypts" (a literal scientific term), I'll be concise.
Cervical mucus is the key indicator of fertility during your cycle. It's a shame that hormonal birth control (HBC) really dampens this key indicator, because for a lot of women post-pill, seeing white liquid in their underpants can seem gross or downright scary. Not so! CM is completely normal, beautiful, and - dare I say it - almost magical. It truly gives us the best evidence of upcoming ovulation out of all the three FAM signals, so you'll want to make friends with your mucus. There are three main stages in your CM cycle that you need to watch out for as indicators of fertility:
Dry days (type 1) mean you're not in a fertile window
Creamy, sticky or even lotion-like (type 2) days should indicate a change towards fertility - for women using FAM as birth control, you should use secondary protection during sex, even on these days
Slippery, clear, almost raw-egg-white-like (type 3) days are your most fertile and indicate impending ovulation. There are far fewer of these days than the other types of days for most women; and again, if using FAM as birth control, you'll want to either abstain entirely during this period or use additional precautions.
Why is a 'raw egg white' textured liquid so fertile, you ask? Not to get too graphic (although, get excited for the cervical positioning section), but if you think of the path from your vagina to your awaiting ova (hanging out all the way up in your fallopian tube area) as typically treacherous, rocky, tight, and dry for sperm, that slippery egg-white-like CM acts as not just a slip-n-slide lubricant for any sperm, but also the raft or binding agent to carry those spermies up the proverbial river.
A High and Soft Cervix Indicates Ovulation
Finally, onto the pearly gates of the welcoming cervix - a sentence I always hoped to type! Like I mentioned at the top of this post, a lot of women are not *excited* about sticking a finger up into their vagina on the regular to see whether their cervix has changed positions. But, indulge me for a minute, because you should care about this sign and use it for FAM to be most effective.
Of course, most of us know that the cervix is what dilates during childbirth, but how wild is it that it changes significantly throughout the course of your cycle without any sort of obvious indication to you? What other major organ physically moves (and significantly so) as a matter of course? It's pretty incredible, if you ask me.
The cervix acts as kind of the gate keeper to the uterus and, ultimately, the fallopian tubes and ovaries. On your infertile days (most of your cycle) the cervix acts as a mean bouncer, not letting anyone into the club. On your fertile days those gates are open and soft, ready for that egg-white-like CM to usher in sperm and partayyy.
Make sense?
Basically, low, hard cervix = not ovulating and high, open, soft cervix = ovulation party time.
Naturally, you won't know the different stages of your cervical positioning immediately, so it's recommended that you check every day around the same time (might I suggest in the shower, when you're hands are already squeaky clean?) for several days to get the gist. Once you know what each stage feels like, then checking cervical positioning really doesn't have to be an everyday activity; it can more so be that confirmatory "gut check" (ew, too literal) to back up the other charting signals.
And ~*bing, bang, boom*~, that's how FAM is done. Of course, there's tons more detail we could talk about with each of these sections, but that's your crash course.
Finally, before I leave you, I want to restate the most important takeaway a little louder for those in the back:
If you're using FAM as contraception, when you're in your fertile window you should abstain from sex, or use a barrier method of contraception
*Resources:
The Fertility Awareness Method is shown in a longitudinal study from Germany to be 99% effective when implemented perfectly, meaning that abstinence or a barrier method of contraceptive is used during the fertile window.
Taking Charge of Your Fertility, by Toni Weschler, mPH
Fertility Friday Podcast with Lisa Hendrickson-Jack (I'll create a list of top episodes soon!)
Interested in charting using an app? Here's a compiled list of the best charting apps.
Save this article to Pinterest
