FREQUENTLY ASKED QUESTIONS

What is “Fertility Awareness”?

I talk about it on the Bodies podcast at KCRW radio. The website Swell published this Q&A with me! It can answer a lot of your questions. For more specifics, see below … or schedule a phone call with me.

Fertility Awareness is a powerful practice of tuning in to our fertility signals, hormonal cycles, and sexuality. One way to do this is through cycle charting, sometimes called the Fertility Awareness Method (FAM): a practice of observing, recording, and interpreting your body’s signals so that you know when you are fertile and when you are not. The practice also helps you gauge your overall health. 

Many people come to Fertility Awareness with a desire to prevent or achieve pregnancy, but often the “awareness” opens up many realms for exploration. It can be life changing.

How can I use my cycle charts?

Prevent pregnancy without hormones or devices:
I can teach you the rules to follow the symptothermal Fertility Awareness Method of contraception (sometimes called FAM) which can be more effective than the pill. 

Conceive on your timeline, when you’re ready:
Use your charts to guide fertility-focused sex. Typically, your charts will identify more potentially fertile days than an ovulation predictor kit (OPK) will. 

Monitor your health:
Your charts provide clues to underlying health and fertility challenges, including patterns that correlate polycystic ovarian syndrome (PCOS), estrogen dominance, insufficient progesterone, hypo- or hyperthyroidism, adrenal fatigue, and other issues — many of which can be addressed with holistic health practices. Charts can also alert you when you’re burning out or burning the candle at both ends for too long. A wobble in your charts often means a wobble in your health or well being.

Navigate transitions:
Charts can show returning fertility after childbirth or hormonal birth control use or show that fertility has not yet returned. They can signal the beginning of the menopausal transition. They provide great information to help you navigate these and other changes.

What signals do I need to observe?

We start with tuning into the secretions and sensations at the vulva and building a habit of taking a morning basal body temperature reading. Charting these two observations (with optional cervix observations) and learning to interpret the charts gives a very accurate indicator of fertile and infertile days. 

Often, other cyclical changes become obvious. These might include the classics, like breast tenderness, headaches, acne, cravings, etc. They can also include increased libido, vivaciousness, breast fullness, etc. I encourage clients to get curious and chart as many of these signals as they find useful or intriguing.

How difficult is it to learn and use Fertility Awareness?

It takes a few cycles to learn the practice thoroughly and develop the habit of making your observations. It takes a few minutes each day to chart the observations and determine whether you are fertile that day. Once you’ve got it down, it becomes second nature. You’ll always have it.

If you want to use the method to prevent pregnancy, you also need to be able to abstain, use barriers or withdrawal, or practice creative outercourse (no penis-in-vagina or anal sex) during the learning phase AND on the fertile days you observe each cycle thereafter.

How many days am I fertile each month?

You are fertile only a handful of days per cycle. The FAM rules for contraception typically require that you consider 9-12 days per cycle potentially fertile. I can help you strategize about how to handle this “fertile window.” For example, some of these days will be more risky than others, so some people choose to abstain on their two or three days of peak fertility (the most risky days), and they use barrier methods on the other potentially fertile days. 

When you’re trying to conceive, you can use your observations to time sex on your fertile days. For most women, this includes a few days BEFORE an ovulation predictor kit (OPK) gives a positive reading. Plus, your charts can reveal fertility issues that you’ll want to address, such as a short luteal phase or frequent anovulatory cycles.

Does cycle charting or the Fertility Awareness Method (FAM) really prevent pregnancy?

Yes. The CDC (the U.S. Center for Disease Control)  recently updated the efficacy rates cited for Fertility Awareness Based Methods (FABMs) of contraception to “a range of typical use failure rates of 2-23%.” There are many ways to practice Fertility Awareness for contraception, including Natural Family Planning (NFP) methods often associated with religious practice. The CDC lumps all these methods together, under the heading FABMs. This wide range of failure rates reflects the efficacy of a wide variety of methods. 

The method I teach closely follows the Sensiplan method, which has the very low failure rate of 2%, and the method outlined in Toni Weschler’s book Taking Charge of Your Fertility.

However, you should know that the effectiveness depends a lot on the users. Women in the Sensiplan study all received thorough education with a Fertility Awareness educator.  (You can read that study here.) They understood how to chart their cycles and carefully followed the rules for contraception, including the rule that states no unprotected intercourse on potentially fertile days.

You can read a scientist’s summary of the pros and cons of different FABMs here and see a chart comparing them here. I can also answer any questions you might have.

Is Fertility Awareness really better than an OPK when you’re trying to conceive?

Yes! It can be. You are potentially fertile for a few days before an ovulation predictor kit (OPK) lets you know ovulation is about to happen. Don’t miss those days!

An OPK detects the surge in luteinizing hormone (LH), which typically spikes a day or two before ovulation. However, most women have fertile fluids a day or even a few days before the OPK gives a positive reading. So, there’s a good chance of conceiving from intercourse a few days before the OPK says “go.”

Can I use Fertility Awareness for contraception even if my cycles are irregular?

Yes! A sophisticated practice will allow you to manage fertility even with irregular cycles, because you make decisions about your fertility based on your daily observations in real time. This is unlike the Standard Days method, Cycle Beads, or the algorithms in many fertility apps, which use past cycles to try to predict when you will be fertile in your current cycle. 

A sophisticated Fertility Awareness practice can also help you sort out what’s going on during your irregular cycles. Cycle charting allows you to track initiatives—like diet changes, the use of supplements and herbs, or changing sleep or exercise patterns—to see whether they help alleviate undesired symptoms and irregularities. I can help you with the basics and also refer you to excellent holistic healthcare providers who specialize in reproductive health if your symptoms are severe or persistent. 

When cycles become more regular, it can be easier to use Fertility Awareness for contraception. Healthier cycles also increase your chances of conception and a healthy pregnancy. And healthy cycles are a sign of overall health.

I already use an app and I’ve read about Fertility Awareness. Why do I need a class or consult?

Maybe you’ve read Taking Charge of Your Fertility or you’re using an app to track your cycles. That’s great! Then you probably have a good start and maybe even some data to work with. Your phone can be a great data collection tool, but the FABM studies with the highest contraceptive efficacy rates were done with women who had gotten a thorough, standardized education and support from a live teacher.

In my opinion the apps, which typically use some kind of algorithm to predict your fertile days, can act as an obscuring filter between you and your fertility signs. Some apps are little more than a digital version of the old fashioned rhythm method. 

I want you to know how to interpret your personal data and not have to rely on software engineers somewhere telling you what to think about it. Whatever your goals, I think it’s best to learn the science and technique of the method really well, with the support of a certified educator, so that you become the expert in your body’s signals and what they mean. 

Do I have to chart on paper?

It’s really up to you.

I like people to chart on paper in the beginning. Apps can be like filters obscuring or distorting your understanding. Additionally, not all apps are created equal. I can help you evaluate an app’s strengths and weaknesses and decide whether it might work for you. Some apps and devices have had their research called into question. They may not be as effective as they claim. I also don’t think it’s a great idea to share all your personal data with the tech companies that make apps. 

The Body Literacy Collective is designing an app I’m pretty excited about. It’s in beta testing now. I’ve worked with the founder on projects at the Association for Fertility Awareness Professionals. She’s an awesome woman whose judgment I trust. The app promises many improvements on what’s out there today. User data will be private; you’ll be able to design your own categories for fluid observations or use their standardizations; and it promises to be highly customizable. It also allows you to interpret your charts so you decide each day whether or not you are fertile. In other words, it puts you in charge. Stay tuned!

What is your training?

I’m certified to teach by the Association of Fertility Awareness Professionals, an organization that works to ensure access to evidence-based, high-quality Fertility Awareness instruction that supports people’s goals, relationships, and identities — regardless of reproductive choices or religious affiliations. 

I practiced Fertility Awareness for contraception for several years before training for AFAP certification with Sarah Bly at The Well (formerly Grace of the Moon). See my bio for more.