Fertility Awareness-Based Methods (FAMs)

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  What Are Fertility Awareness-Based Methods?

  Fertility awareness-based methods (FAMs) are ways to track ovulation — the release of an egg — in order to prevent pregnancy. Some people call FAMs "natural family planning."

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  How Do Fertility Awareness-Based Methods Work?

  FAMs work by keeping sperm out of the vagina in the days near ovulation, when a woman is most fertile — most likely to become pregnant.

  To prevent pregnancy, women can abstain from vaginal intercourse on their fertile days. Or they can use withdrawal, a condom, a sponge, a diaphragm, or a cap on those days. Or they may enjoy other kinds of sex play instead of vaginal intercourse on their fertile days.

  Emergency Contraception If you have unprotected sex on a day that you may be fertile, emergency contraception is a good option. Emergency contraception can prevent pregnancy if started up to five days after unprotected intercourse. The sooner you start it, the better it will work.

  UNDERSTANDING YOUR FERTILITY PATTERN

  In order to know when you are most likely to get pregnant, you have to become familiar with your menstrual cycle.

  Before pregnancy can begin, a woman's egg must join with a man's sperm. For a healthy woman, there are days when that can happen. There are days when it can't. And there are some days when it's unlikely — but still possible. To begin a pregnancy, a woman can have vaginal intercourse — without protection — on one of the days when it's possible that the egg and sperm will join. We call those days your fertile days.

  A woman's fertile days depend on the life span of the egg and the sperm. Her egg lives for about a day after ovulation. Sperm can live inside her body for about six days. The egg and sperm are more likely to join when intercourse happens before or during ovulation. They are less likely to join when intercourse happens after ovulation. They are most likely to join when intercourse happens during the five days before the egg is released or on the day of ovulation. The joining of egg and sperm is called fertilization.

  A woman has a chance of her egg joining a sperm about seven days of every menstrual cycle.

  • This includes the five days before ovulation.
  • It includes the day of ovulation.
  • It also includes the day or two after ovulation — even though it's less likely to happen then.

  Knowing when your fertile days will happen can help you avoid a pregnancy. It can also help you plan one. The key is to figure out when you will ovulate. This will let you figure out the other fertile days that come before and after you ovulate. Then you can track your fertility pattern — the days of the month when you are fertile and the days of the month when you are not. You must do this carefully. Women don't all have the same fertility pattern. And some women have different patterns from one month to the next.

  Ovulation Predictors Test kits that attempt to predict ovulation are available for home use. They may be useful for planning pregnancies. But they are not reliable for preventing pregnancy.

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  What Are the Different Fertility Awareness-Based Methods?

  There are several methods you can use to predict when you will ovulate.

  • Temperature Method — You will take your temperature in the morning every day before you get out of bed.
  • Cervical Mucus Method — You will check the changes in your cervical mucus every day for the first part of your cycle until you are sure you have ovulated.
  • Calendar Method — You will chart your cycles on a calendar.

  It is most effective to combine all three of these methods. Together, they are called the symptothermal method.

  • Standard Days Method — You will track your cycle for several months to be sure that your cycle is always between 26 and 32 days long. Never longer or shorter. Then, you will not have unprotected vaginal intercourse on days 8–19.

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  How Effective Are Fertility Awareness-Based Methods?

  Effectiveness is an important and common concern when choosing a birth control method. Like all birth control methods, fertility awareness-based methods are more effective when you use them correctly.

  Between 12 and 25 out of every 100 couples who use FAMs each year will have a pregnancy if they don't always use the method correctly or consistently. Always practicing these methods correctly will make them more effective.

  How well FAMs work depends on both partners. That's why it is important for both to learn about the methods and support each other in their use.

  These methods can work best for you if you

  • have received careful instruction
  • have only one sex partner and he is as committed to FAMs as you are
  • have the discipline you need to check and chart your fertility signs
  • don't mind abstaining or using withdrawal, a cervical cap or diaphragm, a sponge, spermicide, or latex or female condoms on your unsafe days

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  How Safe Are Fertility Awareness-Based Methods?

  FAMs are very safe — there are no side effects.

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  What Are the Benefits of Fertility Awareness-Based Methods?

  • They cost very little.
  • They are safe.
  • They can be stopped easily to plan a pregnancy.
  • Calendars, thermometers, and charts are easy to get.
  • Medication is not needed.

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  What Are the Disadvantages of Fertility Awareness-Based Methods?

  Many of us like to weigh the benefits against the risks of a birth control method. Now that you're familiar with the benefits, let's look at the possible disadvantages.

  FAMs may not work for you if you

  • have more than one sex partner
  • have a sex partner who isn't as committed to FAMs as you are
  • don't want to keep close track of your safe days
  • are not able to abstain or use another method for at least 10 unsafe days during each cycle
  • take medicine that may affect reading the signs of these methods

  Do not depend on tracking your fertility if you

  • have irregular periods
  • have a partner who is not cooperative
  • have a sexually transmitted infection or frequent abnormal vaginal discharges
  • cannot keep careful records

  It may be more difficult to track your fertility if you are breastfeeding, are a teenager, or are getting close to menopause. The hormone shifts may make the signs unpredictable.

  Don't switch to a fertility awareness-based method after using a hormonal one, such as the pill. The hormones will affect your cycle. Use a method without hormones while you're learning to track your fertility.

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  How Do I Learn How to Use a Fertility Awareness-Based Method? How Much Does It Cost?

  Couples can learn how to use FAMs by taking a course. Or they can be taught by a specially trained health professional. Both partners should learn the methods together. This way, both will know exactly what needs to be done to make the methods work. This will make them work better. And many couples report that they become more intimate by sharing responsibility for birth control.

  Classes on charting fertility patterns and keeping ovulation calendars for contraception are offered by women's health centers, church-affiliated instructors, and Catholic hospitals. There is often little or no cost.

  You can find instructors in certain religious settings. But they may not give you information about other methods. And they may not allow the use of barrier methods. For instruction that is not associated with a religion, ask for a referral from a women's clinic with no religious association. Or contact your state or county health department or your nearest Planned Parenthood health center.

  Fertility charts or ovulation calendars cost little or nothing. They are easy to get from women's health centers and from private instructors and organizations. You can also print out this fertility pattern chart. Basal body temperature thermometers cost about $10 to $12. You may have to pay a fee for classes to learn FAMs. In some states, Medicaid will cover the cost of classes taken at a clinic or when authorized by a private physician.