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Fertility Awareness

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Fertility Awareness Methods:
Answers to Your Questions

What are fertility awareness methods?
Are they effective?
How do they work?
How do I use fertility awareness methods?
For all fertility awareness methods
For the calendar (rhythm) method
For the basal body temperature method (BBT)
For the cervical mucus method
Other instructions
Other information
What are the advantages and disadvantages of fertility awareness methods?
Are fertility awareness methods right for me?

The information provided here is meant to give you general information about fertility awareness methods and does not replace the need to talk to a health care provider if you would like to use fertility awareness methods for contraception.


What are fertility awareness methods?

Fertility awareness methods are ways to identify the days of the month when the woman is most likely to get pregnant. The couple do not have sexual intercourse on these days.

Are they effective?

Fertillity awareness methods are effective when they are used correctly.

NOTE: Fertility awareness methods do not provide protection against HIV infection and other STIs. Aside from abstinence, latex condoms offer the best protection against these infections.

How do they work?

There is a time each month when a woman can get pregnant. This is called the "fertile time" or the "unsafe time." A doctor, nurse, or counselor usually helps the woman learn how to determine the time of the month that she can get pregnant. The woman and her partner have sexual intercourse only during the time when she cannot get pregnant. This is called the "safe time."


How do I use fertility awareness methods?

As with any other method, you should talk to your doctor or a family planning counselor at a local clinic or hospital before using fertility awareness methods as a contraceptive method. The following instructions are provided to help you decide whether fertility awareness methods may be right for you.

For all fertility awareness methods:

The safest way to use a fertility awareness method is not to have sexual intercourse during the fertile time. If you do have intercourse during the fertile time, use a backup method of contraception until four days after you have detected ovulation.

For the calendar (rhythm) method:

How to tell when you may be fertile:

  • Write down the number of days in each of your last six menstrual cycles. Count the days in each cycle starting with the first day of your period until the day before your next period starts.
  • Now pick out the longest of the six cycles and the shortest of the six cycles.
  • Try to decide which part of the month is your fertile time, subtract 18 from the shortest cycle and subtract 11 from the longest cycle. For example, if your shortest cycle is 26 days and your longest cycle is 34 days, you need to abstain from sexual relations from Day 8 (26-18=8) through Day 23 (34-11=23).

For the basal body temperature method (BBT):

When to take your temperature:

  • Take your temperature every morning before you get out of bed and before you begin any kind of activity, including talking, eating, drinking, smoking, or sexual activity. You can use the thermometer either orally or rectally, but you must choose one site and use this same site every day. Oral temperature requires five minutes with the mouth closed; rectal temperature requires three minutes.

How to record your temperature:

  • Record your temperature every day on a special BBT chart. Connect the dots for each day so you can see a line going from Day 1 to Day 2 to Day 3, etc.
  • If possible, use a special expanded-scale BBT thermometer. A regular fever thermometer will not clearly show small temperature changes. If your temperature falls between two lines on the thermometer, record the lower number.

How to tell when you may be fertile:

  • Because this method only indicates when ovulation has already occurred, it is difficult to determine the beginning of the fertile period. The safest way to use BBT is to avoid intercourse or use a backup barrier method during at least the first half of your cycle until three days after your BBT has risen.
  • You can assume your fertile days are over when your BBT has risen about .2 to .5 degrees Centigrade (.4 to 1.0 degrees Fahrenheit) and has remained elevated for three full days. All three days should have higher readings than any of the previous six days in that cycle. Your temperature will stay elevated until your next period begins.

For the cervical mucus method:

How to tell when you may be fertile:

  • You may be fertile when you feel a sensation of wetness at the opening to your vagina or when you can see mucus on your finger, underpants, or tissue paper.
  • You may not see mucus until a few days after menstrual bleeding has ended. When mucus begins to appear, it is sticky, pasty, or crumbly, and may range in color from yellow to white. As the fertile time approaches, the mucus increases in amount, becomes clearer in color, wetter, stretchy, and slippery. The mucus resembles raw egg white and can be stretched between two fingers. After the fertile time, the mucus usually becomes sticky and pasty again and decreases in amount. After the fertile time, some women see no mucus for the remainder of their menstrual cycle.

How to record your mucus:

  • Use a charting system to keep a record of your daily observations, including your menstrual period, spotting, dryness, and mucus.

If you wish to prevent pregnancy:

  • Do not have sexual intercourse on any day that you feel or see mucus on your fingers, on tissue paper, or on your underpants.
  • Do not have sexual intercourse until the fourth day after the "peak symptom day." The peak symptom day is the last day of the wettest mucus.
  • Do not have sexual intercourse during your menstrual period, because the blood may hide the mucus.
  • Do not have sexual intercourse if you are unsure whether there is mucus. Spermicides, vaginal infections, some drugs, and sexual intercourse can all affect the normal pattern of a woman's mucus.
  • If you do have sexual intercourse at any of these times, use another contraceptive method, such as condoms.

Other instructions

Return to the health facility if:

  • You are not happy with the method.
  • You think you are pregnant.
  • You want information about, or want to start using, another family planning method.
  • You think there is any chance you may have been exposed to HIV infection or any other STI.

Other information:

Some natural family planning methods (the rhythm method and the basal body temperature method) are unreliable right after delivery or abortion. Once bleeding stops after delivery, the cervical mucus method can be used, but with some difficulty.


What are the advantages and disadvantages of fertility awareness methods?

Advantages:

  • Fertility awareness methods do not require medication or supplies.
  • Fertility awareness methods can be used to plan a pregnancy.
  • Fertility awareness methods are permitted by some religions and cultures that do not permit other methods of contraception.
  • Fertility awareness methods may be discontinued by the couple on their own.
  • Fertility awareness methods do not interrupt lovemaking.
  • Fertility awareness methods have no side effects.

Disadvantages:

  • Fertility awareness methods do not provide protection against HIV infection and other sexually transmitted infections.
  • Fertility awareness methods take time to learn.
  • The couple must keep careful records.
  • Couples may find it hard to always know when the safe time is.
  • Both the man and the woman need self-control during the unsafe time or they need to use another family planning method if they have sexual intercourse during that time.

Are fertility awareness methods right for me?

There are a number of factors that you should consider before deciding whether fertility awareness methods are right for you. These questions can help you determine whether fertility awareness methods might be effective contraceptive methods for you.


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