Features and Occasionals

Fertility Awareness

By Giuliana Serena

Fertility awareness (often referred to as the Fertility Awareness Method or FAM) is a practice of making real-time observations of a variety of fertility signs made by the female body, to determine one’s likelihood of fertility on any given day of the cycle. Is it effective? Rates are often cited as low as 75%* for typical use, in fact, the US Department of Health & Human Services cautions that “if preventing pregnancy is a high priority, more effective methods of birth control should be chosen.”

On the other hand, those who are taught the Sympto-Thermal Method by trained educators and follow the rules can see success rates up to and above 99%**, rivaling condoms, and hormonal and surgical techniques.

It’s not for everyone, obviously. But neither is the patch, pill, IUD, ring, shot, implant or surgery, right? The practice takes commitment, self-restraint, an upfront investment in education, and it most definitely requires cooperation and conversations in relationships with intimate partners.

Technology has advanced so far with regards to birth control, and fortunately, many of those who choose hormonal and surgical methods are happy with their outcomes. Others suffer significant side effects, from the mildly irritating to the fatal. These are important personal decisions, and not inconsequential. Every choice we make (or don’t) having to do with achieving and avoiding pregnancy is a significant one, with benefits and caveats. So don’t just take my word (or anyone else’s) for it; do your research and find what’s best for you.It may take multiple methods before you land on the right fit.

If you’re wanting to avoid synthetic hormones or surgery, and any side effects whatsoever, if you’re ready to commit to learn how your body works, if you have strong will power and the ability to exercise restraint, and you have the support of your partner/s, fertility awareness is well worth considering.

On the flip side, if you’re looking to conceive naturally, you can determine when you’re most likely to be fertile and/or if your body is experiencing infertility. Excellent results always require the investment of learning the method, and diligently following its rules.

Fertility Awareness Methods: An Overview

Sympto-Thermal Method: This combination of observing cervical fluid (mucus), basal body temperature, and cervical position offers the most comprehensive and effective method of fertility awareness, and is a great way for anyone to learn the intricacies of the menstrual cycle.

Ovulation / Billings Method: The fertile window is calculated based on the daily observation of cervical fluid (mucus). This includes identifying the “peak day” of fertility. Women are considered likely to be fertile for three full days after the peak day.

Two-Day Method: Simplified version of Billings: Instead of observing the quality of cervical fluid, a woman asks herself two questions: “Did I notice any secretions today?” and “Did I notice any secretions yesterday?” If she noticed any secretions yesterday and today, she is potentially fertile. If she did not notice any secretions either yesterday or today (two consecutive days with no secretions), her probability of becoming pregnant is very low and it is safe to have intercourse that day. This method is not as effective as more comprehensive methods, but is widely taught to those with limited education and literacy skills due to its simplicity.
The Standard Days Method: Involves counting fertile days based on calculations from past cycles instead of observation of fertility signs. For those with “regular cycles” that are always 26-32 days long. If your cycles are ever longer or shorter, it won’t work.

So what about the Rhythm (Calendar) Method? It’s a predictive model that uses past cycles to estimate future cycles, and no signs of fertility are observed. This assumes the cycles are like clockwork, and that ovulation will occur on the same day each time, which we know just isn’t the case for the vast majority of women. Many factors influence precisely when ovulation takes place: stress, illness and perimenopause, among others. Counting days alone just doesn’t suffice for most people.
Giuliana Serena is a local ceremonialist, rites-of-passage facilitator and menstrual cycle educator. This month she is presenting a workshop at the Biennial Conference of the Society for Menstrual Cycle Research in Boston. For a free moon phase calendar, quick guide to charting your cycle and more, visit her at MoontimeRising.com.

Additional resources for learning fertility awareness methods (FAM)

Taking Charge of your Fertility: www.tcoyf.com, Justisse Healthworks for Women: www.Justisse.ca, Online courses: www.HolisticHormonalHealth.com, Private lessons via Skype: www.LovelyFertility.com

* U.S. Dept. of Health & Human Services (2015) “Natural Family Planning Fact Sheet”
** P. Frank-Herrmann et al (2007) “The effectiveness of a fertility awareness-based method to avoid pregnancy in relation to a couple’s sexual behaviour during the fertile time.” Oxford University Press

Menstruation as a Vital Sign

“The menstrual cycle is a fine-tuned symphony, a fascinating interplay of hormones and physiological responses.”

—Toni Weschler, Taking Charge of Your Fertility (2006)

“No woman would menstruate if she did not have to.”

—Germaine Greer, The Female Eunuch (1970)

These sentiments express a broad spectrum of thought about menstruation in our culture, spanning the gap between awe and indifference. It’s a fact that most people who menstruate—an experience which can span half or more of a lifetime —don’t enjoy the process, or aren’t truly happy with the products they use, for bleeding or for birth control.

Most people don’t really understand the menstrual cycle at all, other than perhaps that during puberty, girls periodically start bleeding and it has something to do with getting pregnant, or proof that you’re not, and it’s a real hassle and it hurts and it’s embarrassing, and lots of pads and tampons and chocolate and space are required, and eventually, after 30-50 years you get all hot and bothered and struggle though menopause and it’s all over.

However, there’s so much depth to the phases of the cycle, ovulation, menstruation, hormones, reproductive organs and the elegant endocrine system. A growing minority of researchers, clinicians and health care practitioners are coming to see the value of observing and supporting the entire menstrual cycle, not only the “period” itself. In 2004, with a scientific forum titled “The Menstrual Cycle is a Vital Sign,” the Society for Menstrual Research affirmed that the cycle is a powerful indicator of overall health.

PMS, painful menstruation, heavy bleeding, scant or total lack of bleeding, nausea and significant loss of energy are symptoms of various reproductive health issues. While all too common, they frequently express some kind of imbalance, a dis-ease in the body (such as endome­triosis polycystic ovary syndrome). By bringing our attention to where things hurt, we can learn more about the root causes, and find ways to support our bodies to heal in ways that popping pain (and/or birth control) pills can never address.

If you’re suffering from any of the above-mentoned conditions or symptoms, please know that it doesn’t have to be that way! Getting better begins with you and your relationship with your body and your cycle. The more you understand what’s going on, the more informed decisions you can make. This leads to more effective conversations with your partners and health care providers around your reproductive health, your cycles, your sexuality, your fertility, your potential of pregnancy and how to avoid and achieve it.

There are many practical ways to support menstrual health: diet and nutrition, movement and exercise, a healthy (active) sex life, ritual and ceremony and rites of passage, attention and mindfulness, alternative products, beliefs and thought patterns, and acceptance and appreciation of the seasons of womanhood. I’ve seen first hand through my work how drastically women’s lives can change with a little education and inspiration—and how much more enjoyable life can be when we’re not suffering through our cycles.

One of the most effective ways of having a better experience menstruating, conceiving and avoiding conception is to practice some form of fertility awareness.

Giuliana Serena is a local ceremonialist, rites-of-passage facilitator and menstrual cycle educator. This month she is presenting a workshop at the  Biennial Conference of the Society for Menstrual Cycle Research in Boston. For a free moon phase calendar, quick guide to charting your cycle and more, visit her at MoontimeRising.com.

This article was originally published on May 30, 2015.