What is Fertility Awareness?

Fertility Awareness is the practice of observing certain body signs that change throughout the menstrual cycle and indicate one’s fertility.

What are Fertility Awareness-Based Methods?

Otherwise known as FABMs, this is an umbrella term that refers to various means of contraception that stem from observing and monitoring one’s fertility, based on the menstrual cycle.

FABMs aim to help you identify your fertile window; the limited time within a cycle where it is possible to fall pregnant. By identifying this phase, you can make empowered and informed sexual decisions, based on your desire to avoid or achieve pregnancy. 

Examples of FABMs include the SymptoThermal Method, Symptohormonal Method, The Billings Ovulation Method, The Rhythm (Calendar) Method, Temperature Method and more.

How do FABMs work?

Sperm cells have a limited survival time in your reproductive tract. After ejaculation, they can live between 5 to 7 days in ideal conditions within your uterus and Fallopian tubes.

On the other hand, your egg cell (released once per menstrual cycle), is able to be fertilised for 12 to 24 hours.

These two factors considered make up your fertile window. A female can only fall pregnant if sperm is present at the time of ovulation, or up to 24 hours after. You’re most fertile in the 7 days leading up to ovulation (to account for sperm survival), and the day after ovulation (to account for egg viability).

Using menstrual cycle tracking and charting specific biomarkers that indicate fertility, you can identify this fertile window and your most fertile days, and either abstain from intercourse during this time, or use an alternative contraceptive, like a barrier method (e.g. condom, diaphragm, cap)

What are the specifics of the SymptoThermal Method of Fertility Awareness?

Specifically, the SymptoThermal Method relies on tracking 2 body signs:

1. Cervical Mucus

2. Basal Body Temperature

Cervical mucus changes in response to hormone fluctuations leading up to ovulation. Your cervical mucus is key to sperm’s survival & passage to a potential egg.

Basal Body Temperature responds to a different hormone and measurably increases after ovulation. This allows you to confirm ovulation and know when your fertile window has closed for the cycle.

How effective is it?

The effectiveness of the SymptoThermal Method relies on how a couple uses it and applies the rules correctly.

With perfect use, including avoiding PIV intercourse during the fertile window, there is a pregnancy rate of 0.4% per year. This means that about one pregnancy occurs per 3250 menstrual cycles (assuming 13 cycles per year), leading to an effectiveness of 99.6%.

Effectiveness is similar for users who rely on a barrier method (e.g. male condoms) used correctly during the fertile window.

The effectiveness drops slightly with typical use, which includes intercourse occurring during the fertile window, withdrawal, and inconsistent charting (7.5% pregnancy rate per year).

Who can practice the SymptoThermal Method of Contraception?

If you have ovaries, a uterus and a period (even if it’s not regular), you CAN practice the SymptoThermal Method.

There are specific circumstances that will change how you need to practice the method (e.g. if you have PCOS, insomnia, or are on certain medications) and a trained Fertility Awareness Instructor can guide you through this.

It may be easiest to practice in a monogamous partnership but can be applied in various circumstances (open and poly relationships). It’s important to note that the SymptoThermal Method is not protective against STIs, and protective barriers such as condoms will always be recommended with new partners or those with unknown STI history.

Contrary to popular belief, Fertility Awareness Methods are not just applicable to certain religious or cultural groups. The Sympto-Thermal Method, specifically, is based on the science and physiology of your menstrual cycle and hormones, and is available to women from all walks of life.

When is practicing this method not suitable?

• If you are on hormonal birth control, you will not be able to practice the method.

• If you have recently stopped hormonal birth control. You must wait for your natural cycles and hormonal rhythm to return before relying on this method for contraception.

• If you’re pre-menopausal (experiencing perimenopausal symptoms or irregular cycles), the method can be more challenging to utilise, but still possible.

• It’s important to note that partner cooperation is important for best use of the Sympto-Thermal Method.

What if I still have an IUD or implanon?

You can learn the theory behind the method at any time, however, you will need to have these removed and allow your natural cycles to resume before practising the method.

A hormonal IUD (such as the Mirena and Kyleena) will disrupt your natural hormones & cycles, so it is not reliable to practice the method with these present.

A Copper IUD is non-hormonal, so you can practice the method with one inserted, although it can obscure cervical mucus.

What if I’m postpartum or breastfeeding?

Fertility Awareness can be used even if you’re postpartum. However, rather than the Sympto-Thermal Method, a method such as the Lactational Amenorrhoea  Method (LAM) is best to use.

How long will it take me to learn the SymptoThermal Method?

I recommend a minimum of 3 complete cycles of charting your cervical mucus and basal body temperatures, after we go through the theory together (which is 3 sessions over 6 weeks). For each cycle, we go over your charts and assess how you’ve applied the rules of the method, troubleshooting and correcting where need be.

During this learning period, barrier methods (condoms) or abstinence are recommended; but this will always come down to where you fall on the scale of intentions to conceive, and recommendations will be tailored to you.

At the end of 3 cycles, we’ll discuss where you’re at and how confident you feel to go unprotected during your infertile phases of your cycle, based on your progress & accuracy with applying and interpreting the rules to your own charts.