One size doesn’t fit all when it comes to contraception. In recent blog posts, we’ve been spotlighting various available contraceptive options, because while everyone and her mother may like one method, that doesn’t mean it’s the one for you. And that’s okay. Take your time. Consider your options. And find what works for you.
For this spotlight, we are looking at Fertility Awareness-based Methods or FABMs. Curious about how they might help you? Here’s the scoop.
What is a FABM?
A Fertility Awareness-based Method, FABM, is a natural kind of method that helps you determine when your fertile days occur during your cycle. With this information in hand, you can take measures to avoid pregnancy on risky days. A FABM also helps you forecast when to expect your next period. And this is all without taking a pill, getting a shot, or having an IUD inserted into your uterus.
These methods have taken a beating the press, because they get mistaken for the old “rhythm method”. They are also mischaracterized as being for people with certain religious beliefs. But modern fertility awareness-based methods have gone far beyond these outdated stereotypes. They may be an option for you, if you’re interested in using a natural method, and especially if you also what know what in the world is going on with your body.
A Bit of History
So where did FABMs originate? Until the 1920s and ‘30s, the timing of a woman’s ovulation and fertile days was little understood. Couples used periodic abstinence in an attempt to avoid pregnancy. But without knowing specifics about a woman’s fertile time, there were a lot of “oopsies” and it was not very effective in preventing pregnancy.
The big insight came when two doctors (Ogino and Knaus), each studying human ovulation separately, discovered that menstruation usually occurs 12 to 16 days after ovulation and that the ovum itself does not survive longer than 24 hours after it is released from the ovary. This was a huge breakthrough! These revelations spawned efforts to calculate fertile and “sterile” phases of the menstrual cycle. From this early research came various forms of the “rhythm” method.
Ever since then, much more has been learned about the menstrual cycle and how to accurately determine when ovulation and the fertile time occur. Scientific research in the 1950s and ‘60s gave us the Ovulation Method and the Sympto-thermal Method. In the 2000s came the Standard Days Method, the TwoDay Method, and the Marquette Model. And now in the 2010s, sophisticated algorithms are integrated into smartphone applications like Dot and are adding another element to predicting key points in a woman’s cycle. These are all advancements with scientific research behind them giving us the modern methods we have today.
So which methods are the scientifically tested methods that you can rely on? So far, there are the five mentioned above and they’re all a bit different. If you’re interested in a natural method, you’ve got choices!
1) Ovulation Method
The Ovulation Method, also called the Cervical Mucus Method or the Billings Method, is a method based on daily observation of cervical secretions. You assess the quality and quantity of secretions, then note your observations on a chart. You apply a set of rules to the observations so that you know the days you are fertile and your likely ovulation. This method is an effective way to prevent pregnancy when you abstain or use condoms on fertile days.
2) Sympto-Thermal Method
The Sympto-Thermal Method also uses observation of cervical secretions and it adds basal body temperature (BBT). The secretions signal fertile days, while a certain shift in BBT confirms whether or not there has been ovulation. You keep track of both of these pieces of information on a chart and apply a set of rules to define when you are fertile and when you are not.
3) Marquette Model
The Marquette Model, also called the Sympto-Hormonal Method, uses observations of cervical secretions, BBT, and it adds the Clear Blue monitor, a testing device which detects hormone levels in urine. Like the Ovulation Method and Sympto-Thermal Method, a set of rules is applied to the information to determine fertile days.
All three of these methods should be used after adequate instruction from trainer well-versed in the methods.
4) TwoDay Method
The TwoDay Method uses observations of cervical secretions to determine fertile days. It is based on the fact that cervical secretions follow a cyclical pattern and that regardless of quality are an indicator of the fertile phase your cycle. When using this method, you ask yourself each day, Did I note secretions today? And, Did I note secretions yesterday? If the answer is Yes to either of these questions, then you are at risk of pregnancy today. The observations can be noted using the TwoDay app or on a TwoDay card or on a calendar.
5) Standard Days Method
The Standard Days Method uses only your period-start date for determining your chance of pregnancy. Research in the development of this method determined that women with cycle lengths in the range of 26 to 32 days are most likely to be fertile during days 8 through 19 of their cycle and not fertile outside of those days. A simple tool called CycleBeads was developed to track days and make the method easy to use.
A sixth method, Dot, is also an evidenced-based FABM, which is currently being tested in a scientific study to determine its effectiveness. It uses an algorithm and period-start dates to determine your pregnancy risk for each day of your cycle. In that way it’s similar to the Standard Days Method, but it adjusts the fertile window to match your individual cycles. This method is currently used with the Dot app.
To avoid pregnancy with any of these methods, you and your partner need to use condoms or avoid intercourse during the fertile days.
There are quite a few pros to using scientifically proven FABMs. The main thing is that they are hormone free, so you don’t have to worry about harsh side effects that often accompany other types of birth control. They require no surgeries, pills or extra stuff to put in your body.
They are effective. All of these methods have been found to be over 95% effective in perfect use and also effective in typical use.
When using these methods, you become attuned to what is normal for your body. By knowing what’s normal, it can help you and your doctor identify problems, if health issues pop up.
And they’re cheap! Once you know how to use them, the expense is low. No prescriptions necessary. Condoms are over-the-counter. There are smartphone apps for free or minimal cost.
FABMs are effective, but they are not right for everybody. If you want a method that you don’t have to think about, then a FABM may not be for you. You need to be aware of your fertility status and make sure to take action to avoid unprotected sex on risky days to prevent pregnancy.
As you weigh the pros and cons of FAM, Dot is here to help. Our app is designed to help you track and monitor your cycle whether you ultimately choose to use it for your birth control or not.
Want to get started with an accurate, easy way to try a fertility awareness method? Check out the Dot app!
CT EduSeries: Experts Discuss Fertility Awareness-Based Methods