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On the fertility awareness method, getting intimate with your cervix, and how long a sperm can set up camp in your vagina

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Writing about birth control these past few months, I’ve covered a wide variety of options.  The thing is, however, that nearly every one of them interferes in the process of a woman’s natural hormone signalling.  Those that don’t, such as the copper IUD, still as yet pose serious health concerns.

Smaller side effects such as headaches, nausea, weight gain, acne, mood changes, and sleep disturbances are nothing to laugh at.  Scarier risks such as blood clots, heart palpitations, muscle weakness, and sudden death even less so.  Some hormonal options of birth control are rightfully scary in the eyes of women concerned with natural, healthful womanhood.

So a lot of women turn to the fertility awareness method.  FAM has a bit of a bad rep.  It’s regarded in many circles as inconsistent and unpredictable, and therefore subject to high failure rates.  In other circles, it’s disregarded as that silly thing overly religious people do.  Neither of these could be farther from the truth.  Yes, some people practice FAM for the sake of their religious beliefs.  And yes, some people mess up and get pregnant.  But when practiced properly, FAM has success rates that equal and even surpass some of the conventional birth control methods.  1 percent is about the going rate.

So what is fertility awareness, and how does it work?

FAM is the practice of avoiding unprotected intercourse during the period in which a woman can become pregnant.   For this reason, the whole trick of FAM is identifying physiological markers of ovulation.  Ovulation is the time in which a woman’s ovaries release an egg, and so it is around ovulation that women need to step carefully.

The first day of a menstrual cycle is the first day of bleeding, and ovulation generally occurs ~two weeks later.

There are many significantly advanced methods for detecting ovulation.   Hundreds of dollars can easily be spent on costly and precise methods such as analyzing saliva for ovulation-indicative molecules, or monitors that track changes in electrical resistance in vaginal fluid.   This makes sense.  Lots of people are trying very hard to conceive children.  Yet more natural, and mostly free, methods also exist, and are quite effective.

1)  OPK Urine tests

Luteneizing hormone spikes in the urine around ovulation, so increasing LH levels can predict fairly accurately when a woman is on the precipice of ovulation.  Most test strips predict the onset of ovulation within 12-36 hours.   If you are interested in FAM but are either not quite comfortable with touching your cervix or enjoy confirmation that comes from computers and scientific tests, this might be a good method to have in your arsenal.

2) Basal body temperature

One way to detect ovulation is to monitor basal body temperature levels.   Tempreatures rise with progesterone levels, and will spike about 24 hours after ovulation.  They should remain this high until your next period.

The way to do so is to check your temperature (in your mouth is fine– just always be consistent with where and how you do it) the moment you wake up.  Chart your temperature over time, and notice the spike that occurs just after the middle of your cycle.  It should be between .4 and 1.0 degrees F.   You won’t feel the shift, but you can detect it by using a basal body temperature (BBT) thermometer.  BBT thermometers are just more precise than others, but still they come as cheap as ten dollars.

You are most fertile in the two or three days before your temperature hits its high point. A few experts think you may have an additional 12- to 24-hour window of fertility after you first notice the temperature creep up, but most say that at that point, it’s too late to make a baby.  At the very least, however, it becomes statistically less likely.

For this reason, it is best to chart your temperature for a few cycles, and start counting ovulation as the two days or so previous to your spike.  You can also use other ovulation-detection methods to confirm.

3)  Cervical mucus release

The appearance of cervical mucus and vulvar sensation are generally described together as two ways of observing the same sign.  In a menstrual cycle, it’s appearance, or thickening, marks the start of ovulation.

The production of fertile cervical mucus is caused by estrogen, the hormone that also prepares a woman’s body for ovulation.  Cervical mucus is produced by the cervix, which connects the uterus to the vaginal canal. Fertile cervical mucus promotes sperm life by decreasing the acidity of the vagina, and also helps guide sperm through the cervix and into the uterus.

By observing her cervical mucus, and paying attention to the sensation as it passes the vulva– that is, as you can actually feel it coming out of your vagina, a woman can detect when her body is gearing up for ovulation, and also usually when ovulation has passed.  This is because when ovulation occurs, estrogen production drops slightly and progesterone starts to rise. The rise in progesterone causes a distinct change in the quantity and quality of mucus observed at the vulva.

For some women, cervical mucus persists throughout the following week and its hard to tell precisely the difference.  Regardless, the start of ovulation has now become quite clear.  Your most significant discharge is your ovulatory period, and the start of it is the start of ovulation, which lasts 12-36 hours.

Your libido may also spike at this time (!).

4) Cervical position

The cervix changes position in response to the same hormones that cause cervical mucus to be produced and to dry up–estrogen and progesterone.

When a woman is in an infertile phase of her cycle, such as the first two weeks, the cervix will be low in the vaginal canal; it will feel firm to the touch (like the tip of a person’s nose, says Wikipedia); and the opening in the cervix will be relatively small, or ‘closed’.  As a woman becomes more fertile, the cervix will rise higher in the vaginal canal; it will become softer to the touch; and the opening surface will become more open. After ovulation has occurred, the cervix will revert to its infertile position.

The only way to track this is to feel around and see what’s up for a whole month.  It may take longer.  But as estrogen levels rise and drop, the whole vaginal environment changes, and– really, I can’t describe it nearly as well as you can interpret it as you feel it yourself– you can really sense the difference in your cervix.  The trick is to find it, but basically you just press as far back and up into your vaginal canal as it goes until you feel a change in tissue.   If the cervix is too high up there when you try, check again in a few days– perhaps you were ovulating or your estrogen levels were spiking.  If you cannot reach your cervix, ever, then it’s entirely possible you just have a high cervix, and you’ll have to rely on the other three methods discussed here.

5)  Your sex drive may rise during ovulation.

This point is self-explanatory, I think.

————————–

These are the primary methods by which women detect ovulation in their cycles.   One by one, you may be worried that they are inaccurate or you are reading the signal improperly, but together, you have pretty powerful evidence that ovulation is occuring in your body.   And over time, as you become more and more used to this method, you become more and more familiar with the shape of these feelings and fluctuations, and become more and more intune with yourself and accurate with your predictions.

These are wonderful ways to avoid the problems of hormonal birth control.  This is why FAM is so widely practiced by naturalistic and paleo-oriented women.   When done correctly, it really does prevent pregnancy.  You cannot get pregnant unless a sperm has met the egg in the fallopian tubes.

But how long can a sperm survive inside the vagina?

So a woman can only conceive once her egg has dropped into her fallopian tubes, and met with sperm there– and the egg is only there for 12-36 hours, yet ovulation is not the only time of having sex that she can get pregnant.    This is because sperm usually die off between 1 and 2 days after release into the vagina, but they can actually survive up to 5 (or on the safe side, 7) days. (!)

Human sperm travels at the staggering rate of up to 4 millimeters per minute, but many are as slow as 1 millimeter per minute.  You have to put this into perspective; human sperm are only 55 millionths of a millimeter or 55 microns in length, so a millimeter is a pretty big deal to the mini-me’s.

The average length of the journey to the fallopian tubes is 175 millimeters, which means the Road Runners of the team can get there in 45 minutes, but in practice the journey takes anything up to 3 days if they can make it that long.

For this reason, marking back from ovulation, women need to stop having unprotected sex 7 days beforehand, then count two whole days for ovulation, and then give it as many as seven days afterwards.  If she feels a bit risky she can push it on the edges of fertilization, but most women do not.

In this period, some women abstain from sex.  Others use barrier type birth control such as condoms, diaphrams, or sponges.

Unfortunately this blocks out about half of the woman’s cycle.  It is, however, the only way to have unprotected sexwhile being certain to prevent pregnancy.

Your chances of getting pregnant

A perfectly fertile and healthy couple statistically has a 1 in 4 or 1 in 5 chance of conceiving with every given act of intercourse during a woman’s fertile period.  This means that the vast majority of these couples conceive within a year.

That’s actually a pretty high statistic, so many women are very serious about the boundaries of their fertility awareness practices.

STI’s, etc.

And as a final caveat– note that all birth control methods outside of the condom do not prevent STIs.  They only prevent pregnancy, so get tested!  Both of you.

And best of luck moving forward figuring this out.  It’s a lot of fun–and a lot of women really love–getting in touch with your body and your cycle.

…………………..

What’s your experience?!  Your hopes?  Your doubts?  Your concerns?  Share away!  FAM is such a diverse and widely / differently practiced art.  I am super excited about hearing more about your personal experiences.

 

 

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Managing director of Paleo for Women and author of Sexy by Nature.

30 Comments

  1. Um, I think you meant to write that ovulation typically happens two *WEEKS* after the first day of your period, not two *DAYS*

    • hahaha, thank you.

      • Stefani– Has there been any research done regarding natural production of HGH as a result of IF?

        • Almost definitely not, (I’ve looked), but I’d love to see it.

          I’d guess — my bust guess is it would decrease because it’s production is routed through the hypothalamus and pituitary gland, two places hard hit by IF.

      • This compendium of information is what even college girls with high G.P.A.s do not get on 1 place. You are a Blessing for your work, and although I am not in a financial situation to be a philanthropist, if I were I would make sure you were paid well and I would put this that you have compiled out there free with a huge campaign to help get it into the hands of young girls who are subject to Doctords in H.M.O. plans that only give them less than a sliver of this information that they need and deserve. The natural way is the only way I think, but while girls attend college they are in need of this to make the temporary choices to use a birth control method. In a perfect world girls would have aunties and women who would love to see the girl have a child while she is young, and the off spring more than healthy due to the youth of their eggs being the stuff to make children with optimum health; but the truth is we have to wait for money to make a decision to have a child- such a loss for humanity. But, again you offer a real gift. god Bless You Ms. Ruper.

  2. I think you have a typo – 2 weeks perhaps, not 2 days. Feel free to delete comment after you fix.

    “The first day of a menstrual cycle is the first day of bleeding, and ovulation generally occurs about two days later.”

  3. I’m practicing FAM in an attempt to get pregnant, not avoid pregnancy. I REALLY wish I had been taught these things when I first started menstruating. I feel as though I really knew nothing about my body or my cycles for decades. Even worse (in my opinion), I masked my body’s signals with hormonal birth control so I had no idea how long my cycles were, how regular my cycles were, if I ovulated regularly, etc. etc. until I began using FAM.

    That said, if it were absolutely imperative that I NOT fall pregnant, my husband and I would likely use condoms until I had absolutely confirmed ovulation had already occurred. But even when I was on the pill, I always used condoms too–I was just convinced that I would be in the 1% of women who become pregnant on the pill.

  4. My husband and I successfully used the pullout method for about 2 years between kids. One nice side effect of this was that I always got to have my orgasm first! Now that my husband has had a vasectomy, we take turns. ;)

  5. One note: if you have low progesterone due to stress or any other reason (like moi), you will NOT find your temp spikes the day after ovulation, instead you will experience a slow rise in temp. Really important to track cervical fluid and position too.

    • Have you looked into natural progesterone supplements? I’ve had many friends use them. You can find NaPro doctors by googling that and see if there is one in your area if you are interested in checking them out.

  6. oh and there are tons of aps to help you track

    • Agreed. I use Fertility Friend on my phone and on the web to help me keep track.

      And this is a comment just for the reader who might not be very familiar with FAM. Many of the apps out there don’t actually use FAM but instead only track cycle length and then they make a guess of when your peak fertility days are based upon your cycle length. This can be fine if 1) you have an absolutely rock solid cycle and 2) accidental pregnancy wouldn’t be a big deal (because even the most “rock solid” cycles out there can vary due to stress or illness).

  7. I had great success preventing pregnancy for many years with FAM (using condoms during fertile days). Toni Wechsler’s book “Taking Charge of Your Fertility” should be recommended reading for all girls and women of reproductive age. I felt like crap on the pill and had no sex drive, which is why I started doing FAM. Really nothing beats being hormone-free.

  8. One important point for FAM is to NOT assume that your cycles are going to look exactly the same in length every month AND that it is the ovulation day that ends up being delayed if your cycle is longer than usual. The luteal phase is generally about the same length for a given women. I think a lot of people end up preggers when they think they have it all down pat and stop carefully tracking their fertility signs. Every woman is different and any cycle can be different from your previous cycles, even if you are normally very regular.

    Also, I like calling it cervical fluid instead of mucus. Just less yucky sounding.

  9. I have been using the calender method since I went off the pill in june. It has worked perfectly for us. Another tip I would like to add is paying very close attention to the slight cramps I feel when ovulating and marking the exact days also helps me plan better for the next month.

  10. Great article! I love “Taking Charge of Your Fertility.” It taught me a lot of what you outlined here and opened my eyes to what was going on in my body every month!

    I was an absolute B on birth control and never plan on using hormonal methods again. Ever!

  11. “and then give it as many as seven days afterwards”

    This statement seems a bit overly cautious as far as waiting that long after ovulation to prevent pregnancy. According to “Taking Charge of Your Fertility” (which I also highly reccomend) she states you can consider youself safe the 3rd consecutive day of your temperature shift or the 4th day after what you determine your “peak” day to be.

    I’ve been using a LadyComp for a year now to chart my cycles. They are pricey but I was able to find one on ebay for a bit cheaper. The alarm on it wakes me up every morning, I use it to take my temperature and it gives me a red, yellow or green light depending on my fertility. It’s good to also check your other signs but its a pretty foolproof little machine. It also has a lot of other features to help with getting pregnant if that’s your goal.

  12. LOL! I like the sentence “Your sex drive may rise during ovulation,” because that’s how the body works :) Ovulation is the body TRYING to get pregnant, of course your sex drive is going to increase!! When you get pregnant something went right, not wrong ;) Sometimes I think we have generations of people who have no concept that sex is the body’s way of trying to procreate…

    I really, really am so happy to see more women taking an interest in not only their fertility, but the way their body works. The female reproductive system and they way it works with the male’s (not just the act of intercourse, but pheromones, too) is the most interesting thing in the whole world. I have heard two talks in the past that explain the biology of having sex and attracting a mate, and they are JUST PHENOMENAL.

    I have used the Basil Body Temp FAM for 3 years, including before I was married. I have never put a chemical contraceptive in my body, thank God! I have about 13 couples of friends my age (in their 20s) who use ONLY FAM / Natural Family Planning. Many of the women have unpredictable cycles, reproductive problems (like PCOS, painful periods), and infertility. They have all found a particular method that works for them (like Creighton Model NFP) and the women with problems have been able to have their problems treated and rectified rather than just taking the pill to mask the symptoms. Many have used NaPro Technologies, who is really at the forefront of natural, chemical contraception-free research and practice, especially with problems and infertility (BTW, NaPro is all natural and has insane success rates for conception in infertile couples, compared to IVF, like IVF 20% and NaPro 60-80%, especially when coupled with Fertility Awareness).

    I had some serious medical problems which meant we had to delay conception for about 12 months since my fertility returned after my last pregnancy. We have been successful, through monthly abstinence during fertile times. Again, during this time we did NOT use any form of contraception.

    PLUS, one big bonus is that my husband and I kind of have a nice, dating period every month. You know, like going back to that thrilling and exciting time before you have sex for the first time. You date again and “get married” again once a month. I LOVE it.

  13. I used FAM twice and got pregnant without wanting to both times. It was definitely user error, but I write this to send a word of caution to those who are thinking of it. If you REALLY don’t want to be pregnant, track carefully EVERY month (as Stephanie said above) as your cycle can change, and, it goes without saying, but I’ll say it anyway: ALWAYS follow the rules (don’t eyeball it). I consider myself a relatively organized person, pretty good at following through, but tracking got tiring after years.

  14. Hi Stephanie,
    I just wondered whether you heard about the AVIVA method (I think english translation of Aviva Steiner’s book is available only since July) and what you think of it?
    For me it just seems extraordinary that by simply doing those exercises outlined in the book you can manage your hormones so that you can get your period back ovulate or avoid unwanted pregnancy etc. Success stories are amazing. I did the shorter version of exercises today as I don’t have my period since stopped taking the pill in December last year.

  15. Apologies! I misspelt your name I meant to write Stefani.

  16. I’m a fairly new reader but I’ve been so impressed at the quality of ideas you’ve been presenting on this blog, especially in your Love & Food Hacks.

    Then you go and plug FAM and I am even more grateful.

    Thank you thank you /for using this forum to increase awareness of this very woman-friendly form of birth control. I cringe when women equate (hormonal) birth control with female freedom, because I’ve learned in the last few years (with the breakdown of my health, and learning to rebuild) that systemic sickness is just as enslaving as any other force.

    I’ve had the privilege of teaching FAM to a few brides (some people just learn better from a human, I guess) and I am so grateful for the faith they show in their bodies, especially coming from our medicine-oriented culture. (I will admit to being a bit anxious for them the first several months, but in awe of their courage.)

    I hope many many more women will learn the freedom of FAM and that more girls will approach the birth control question with this as one of the many options– not as an embarrassing, back-of-the-closet thought.

    Looking forward to continued reading.

  17. Watch out for that libido spike when ovulating! its been proven that guys also tend to be more attracted to women when they ovulate… and lets say if you and your husband get slightly tipsy around ovulation, compromising your judgement.. and if a paleo diet has fixed your pcos… even though you had 1yr+ of success with FAM…you could end up 3months pregnant commenting on a blog post about it

  18. Any comments on Melissa’s latest takedown of your theory?

    http://paleodrama.tumblr.com/post/34205350363/and-yes-some-people-mess-up-and-get-pregnant

  19. Stefani, I suffer very heavy uncomfortable periods so before starting Paleo, I had a Mirena IUD inserted. I honestly feel like the Mirena gave me back my life. The loss of blood left me weak and tired, and I was using tampons and pads in order to prevent accidents. Nights were awful and also included sleeping on a towel.

    Interestingly, my periods disappeared shortly after getting the Mirena, however since being on the Paleo diet, they’ve returned- however, they last 2-3 days and are very light and manageable. I don’t know if my periods would be more manageable without the Mirena now, but I’m afraid to find out.

  20. My partner and I have also been experimenting with the pullout method, like the poster above it has it’s benefits :-)

    Thankyou for this forum, now I have found it and seen what great articles and wide diversity of posts it has, I will be returning

  21. I got pretty good at accurately predicting exactly when I ovulate by the cervical mucous method for almost a year before I tried t get pregnant and got pregnant in the first attempt. So will definitely continue to use fam to avoid or plan future pregnancies. Great post !

  22. Did I miss it or did you discuss injections like Depo-Provera?

  23. I was wondering is it normal for my cervix to be high up for 3 weeks straight and during my last so called period which only lasted 3 days it didn’t even come down and that’s not normal for me, I usually have to six or seven day period And my cervix has not come back down at all yet are there other reasons for your cervix to become high and stay high or does that usually only mean pregnancy I would be about 8 weeks approximately? I did do an EPT test but it came out negative and another equate test from Walmart but I’ve had five pregnancies and had issues with my home pregnancy test coming out negative in the past. but I’m really curious why has my cervix stayed up for the last 3 weeks actually almost a whole month now if I weren’t pregnant wouldn’t it have usually come back down by now if mine does come down after my cycle usually?

  24. Pingback: Paleo for Women | Hormonal Acne: Where It’s Coming From, and What to Do about It

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