Thursday, February 14, 2013

Fertility Awareness Method: Reliable Birth Control Without Hormones

After my horrendous experience with hormonal birth control on the Mirena IUD, you can imagine I was not eager to get on another type of hormonal birth control. It turns out there aren't many options out there, except for condoms which I'm not a fan of. And except for FAM, Fertility Awareness Method.

FAM is something that not many people know about, even among doctors. A few people are generally familiar with the concept, but only because they used it to get pregnant. Yes, in addition to being birth control, it can also be a great way to conceive.

Very basically: FAM is a way for the woman to know her body and to know when she's ovulating. When you're not ovulating or not about to ovulate, you can have as much sex as you want. If you don't want to get pregnant, then you either abstain or use another method of birth control (i.e. condoms) when you are ovulating.

If you want to get pregnant, you make sure to have sex when you're ovulating since that's the only time you can get pregnant. Many couple erroneously think they're infertile when in fact they're just not having sex at the right time of the month.

FAM is NOT the rhythm method.
The rhythm method presupposes that every woman has a 28 day cycle and every woman ovulates on day 14. This is obviously not the case, as cycles can vary from month to month and especially from woman to woman. FAM looks at each month's cycle to determine when you're ovulating and when you're not.

How safe is this?
The bottom line is that no one's going to use it unless it works. And it does. If used correctly, it has almost the same effectiveness as the pill, 98%. Reasons for pregnancy/not correct use? Having sex during ovulation and not understanding the rules used to determine when you're fertile.

How does this work?
You need to know where you are in your cycle at all times. Luckily, your body lets you know, as long as you know how to read the signs.

First, you need to take your basal body temperature every day, which is your temperature before you get out of bed in the morning. Eventually, you will see a pattern emerge. The first half of your cycle, your temperature is lower. It drops to its lowest point on the day before you ovulate, and then for the rest of your cycle, temperatures are up. The temperature drops down again when you get your period, and the cycle starts over. (So yes, this is a great way to know the day you're going to get your period!)

Example of fertility chart

Secondly, you need to observe your cervical fluid. This confused me greatly at first, but now I'm a whiz at knowing what my cervical fluid means. Without cervical fluid, sperm die a quick and hopefully painless death.  Sperm need cervical fluid to transport them to the egg. So if you're using FAM as birth control, you need to be careful when you start to get fluid.

There are a few different types of fluid, and you only get fluid when you're about to ovulate or when you're ovulating. Some fluid is more "fertile" than others, but I tend to abstain when there's fluid at all because sperm can survive for up to 5 days when there's fluid and I don't want them hanging around, waiting for my "fertile" fluid to appear.

There are a few other methods, but these are the two that I find the most easy to track and the most reliable. Google FAM, or check out Planned Parenthood's page here for more information on other methods.

How much does it cost?
FAM can be very cheap. Really, all you need is a basal body thermometer, which you can pick up at a drugstore for less than $10. There are other options, which I'll discuss in a future post, that cost more, but doing this on the cheap is definitely possible.

Who should not use FAM?

FAM, while perfect for me, may not be for you. You have to have the discipline to take your temperature every day. You have to have the discipline to check your cervical fluid. You have to have the discipline not to have unprotected sex when you're not experiencing a "safe" day.

Beyond that, it's not recommended for non-monogamous couples due to STDs and HIV/AIDS risk. It's also not recommended for those who binge drink regularly, as it raises your basal body temperature and can cause confusion when charting.

While FAM works for those with irregular cycles, if your cycle is very irregular (i.e. more than 40 days or less than 20 days apart), it may not work for you.

Really, how easy is it? It sounds like a lot of work.
When I first started charting, I was confused. For the first week, I wasn't sure I was taking my temperature at the right time, correctly (I know, I know, but I was nervous), or if it was "immediately" after I had woken up. (What if I was awake thinking for a few moments before I realized I was awake?)

I was also a little confused by the cervical fluid and all the various types, but once I read Taking Charge of Your Fertility, I became much more confident on all fronts, and now I think it's breeze. It takes me less than 30 seconds a day to know where I am and what my body will (probably) do that day. I love it and I don't see myself going back on any hormonal birth control any time soon.

Want to learn more?
Generally I recommend talking to your doctor, but make sure your doctor knows about FAM before making an appointment.

Definitely check out the book Taking Charge of Your Fertility by Toni Weschler. Despite appearing like a pregnancy book, this is actually perfect for every woman to learn how her body functions. Despite thinking I knew a lot about my body, I found that my knowledge really only skimmed the surface. Things that always seemed crazy or disgusting suddenly made sense, and I no longer view my body as an unpredictable foreign being that's out to get me.

More importantly, it will teach you how to chart your cycles which will help you know when you're fertile and when you're not. If you are trying to conceive and having difficulties, you will hopefully be able to bypass many of the tests and drugs from the infertility doctor because you'll already know which phase of your cycle is causing the problems. Truly, it should be required reading for every female (and most men, as well!).

1 comment:

  1. I just wanted to add that if you really don't want to get pregnant at all, and this is after you've read Taking Charge Of Your Fertility, stay away from any unprotected sex before ovulation. Fertile mucous can be on its way and when you check it, you may not realize that because it hasn't reached where you can reach it. You might just be a few seconds late to catch it and when all you find is the unfertile one...