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The lowdown on using the Fertility Awareness Method as birth control


With access to reproductive rights as fraught as ever, women can’t have too many alternative options for our contraceptive needs. Some are more effective than others, but I’ve recently learned that the Fertility Awareness Method (colloquially known as ‘FAM’) is a lot more reliable than I used to believe it was.

For straight women in monogamous relationships or those who have more than one trusted, tested partner (but for whom pregnancy is not an option) FAM, when practiced properly, can be an incredibly effective way to master one’s fertility — and avoid an unwanted mini-me.

I’ve always been hyper-aware of my cycle, even as a teenager, thanks to hormonal migraines and mega-cramps. The upside of this painful history is that I got to know a lot more about my reproductive system than I might not have otherwise. I’ve long been known as the friend who quips, “Oh, I’m ovulating today” at brunch, dishing out TMI details about my current cervical position.

When I wrote my book Eco-Sex a few years ago, I learned even more about a variety of natural birth control options, but I only had a glancing knowledge of the Fertility Awareness Method’s many benefits. Here’s the thing: Even though I can give you the basics here, experts recommend that you don’t start using FAM to prevent pregnancy unless you’re truly committed to learning how to do it properly, or else it can have a failure rate as high as any other method.

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Failing to read your fertility signs carefully is just as dangerous as failing to take a few of your pills in any given month. As with every contraceptive method (other than the IUD, which allows you to insert and forget it unless there’s a problem) some degree of vigilance is necessary. But if you want to get off hormonal birth control, can’t afford an IUD, and don’t want to use a barrier method for whatever reason — FAM, when used appropriately, is pretty ideal.

The FAM bible is Taking Charge of Your Fertility by Toni Weschler. If you’re considering FAM seriously, you should read this book. But there are many FAM experts who can guide you through the process too. (I spoke to two of them for this article.)

The most important thing to know is that FAM is not the rhythm method, that oft-derided technique used by super religious folks that often ends up with two red lines on a stick.

Although FAM and its adjuncts like the Billings Method have been around for years, they’re still often confused with the RM, which is basically counting back the days from your last period to guess when you might be fertile. According to Ilene Richman of the Fertility Awareness Center, “The Rhythm Method is a statistical method that uses past cycles to predict future fertility. Fertility Awareness based methods are observational and do not ‘predict’ fertility but rather interpret body signs to make determinations about the body’s fertile status in real time.”

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Here’s why FAM works when counting back the days since your last period simply does not: Your cycle can change any old time it wants to. Even if you’ve had a perfect 28-day track record with Aunt Flow for years, she can change the game at any moment. If pregnancy isn’t an option for you, it’s best not to take chances with your cycles.

Birds and Bees 101

Ovulation is triggered by a series of complicated chemical reactions including the release of estrogen and luteinizing hormone and the creation of a dominant follicle, which must be fertilized by a fast-swimming sperm at the perfect moment. But sperm can live in the fallopian tubes for up to five days (those sneaky mofos) so if you have a short cycle — meaning you ovulate early — you can even get pregnant when you have sex during your period. Don’t forget this: Even if you don’t usually have short cycles, anything from stress to travel to a new partner or weird food can throw it off at any time.

This is why people who swear by the ‘pull-out’ method are mostly kidding themselves. Pulling out in combination with close attention to FAM-based fertility signals is quite effective. While pulling out without carefully timing ovulation might slightly reduce your chances of ending up preggers, it’s quite the penis roulette you’re willing to play. Unless your man is snipped, I wouldn’t take that chance, unless a pregnancy wouldn’t be the end of the world.

According to Petra Schenke, a German FAM-expert with 30 years of experience using this method, the majority of her clients have used the method to avoid pregnancy, and then, when ready, to use their knowledge of fertility signals to start a family at the right time. She recommends the Sensiplan, a highly effective and well-documented FAM program popular in Europe.

So, how do you know when you’re fertile?

FAM considers three major markers of fertility — basal body temperature, cervical mucus and cervical position.

The word “mucus” might gross you out, but I invite you to get all up in there and learn about the variety of cool liquids percolating up there in your cervix. At a certain point in your cycle you’ll begin to produce slippery “egg-white” mucus — this is one of the telltale markers of impending ovulation. After you’ve ovulated and you’re no longer fertile, this mucus will dry up and go away. (Here’s a fun experiment — pay attention to your EWCM and notice when you’re horniest. You’ll see that these two events often coincide.)

After your fertility peaks at ovulation, your temperature will rise by around .03 degrees, thanks to progesterone, the dominant hormone during the second part of your cycle. This is why ‘temping’ — using a basal body thermometer first thing in the morning, can tell you when you’ve ovulated. There will usually be a noticeable bump in temperature the day after ovulation. Recording a few cycles of your temps on your favorite period app (or using something like the Daysy fertility monitor, which I will write about in a future column) can tell you a tremendous amount about your fertility.

Your mucus is typically sticky during the second half of your cycle, but can range from dry during your period to watery right after, then creamy and egg-white, as above, at peak fertility. Really, check it out, it’s so cool. If you don’t want to insert clean fingers, just look at the toilet paper when you wipe. C’mon — it’s not as icky as you think it is — it’s your very own miraculous body.

I note my daily temperature in my go-to app each morning, and the changes in my cervical mucus as well. After the last two years (since I started charting this specifically) I know exactly when I’m fertile, when I need to use a barrier method, and when I’m good to go.

The position of your cervix also changes throughout your cycle. As you get closer to ovulation, your cervix gets soft, high, open and wet. You can gently put your finger into your vagina to check this (or make it a fun game and ask your partner to check it out, too). Your cervix feels as soft as your lips close to ovulation, then hardens afterwards, feeling more like the tip of your nose.

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You can use ovulation predictor kits to back up your FAM practice — just to make sure you’re really fertile when your body is giving off signals. (Ovulation predictor kits are available in drug stores — they’re pee-on-a-stick just like pregnancy tests.)

So even if you’re going through a dry spell and not actively avoiding (or attempting) pregnancy, FAM has something to offer. Getting to know your body’s magical fertility signals is something every adult woman should do.

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