Fertility Awareness Methods

The fertility awareness method, also known as periodic abstinence or natural family planning, is a way of monitoring the natural changes a woman's body goes through during the course of her normal menstrual cycles. This method can assist in determining approximately when ovulation occurs. Hence, a couple can time when they have sex, in an effort to either become pregnant or avoid an unwanted pregnancy. With fertility awareness, couples must be willing to either refrain from sexual relations or use an alternative contraceptive method, such as a condom and/or diaphragm, for 8 to 16 days out of every menstrual cycle. Periodic abstinence is not the best birth control method, since it is only effective 76 percent of the time. Unplanned pregnancies result in 25 out of every 100 women who use the fertility awareness method. However, it is considered to be very helpful in the timing of a planned pregnancy.

Overview of the Fertility Awareness Method

The fertility awareness method is also referred to as periodic abstinence or natural family planning. It is a way to monitor the changes a woman's body goes through during her normal menstrual cycle, to assist in determining when ovulation occurs. In this way, a couple can time sexual intercourse, in an attempt to either become pregnant or to try to avoid an unwanted pregnancy. A female is typically fertile for approximately five days a month. Generally, ovulation takes place anywhere from 12 to 16 days before a menstrual period starts. As an example, ovulation is likely to occur around day 14 of a regular 28 day cycle. Sperm can survive for as long as five days within a woman's reproductive tract. Hence, it is possible for a pregnancy to result even if a female has sex two to three days before she ovulates.

In order for the fertility awareness method to be utilized as effective contraception, a couple must refrain from sexual relations, or use a barrier method like a condom or diaphragm for eight to 16 days of every menstrual cycle. Natural family planning is not considered to be the best birth control method because it is only 76 percent effective.

Different Methods of Fertility Awareness

There are several different methods of determining the time of ovulation. Fertility awareness will actually be most effective when all of these natural methods are used in combination. However, they should be used to monitor a woman's bodily changes for three to four months before using them as safe contraceptive options.

  • Calendar (Rhythm) Method: Basically, a woman guesses her ovulation time, after monitoring several months of menstrual cycles. The most fertile days begin five days prior to ovulation. This method is fairly effective if menstrual cycles are regular, as ovulation is very likely to take place on certain days of the month. However, very few women have 28 day cycles. Even those who normally have regular cycles can sometimes have irregular periods. Hence this method, on its own, is not the most reliable indicator of ovulation.
  • Standard Days Method (SDM): This method works best for those with menstrual cycles from 26 to 32 days in duration. A specially colored string of beads is used to keep track of the monthly cycle. The red bead represents cycle day one, while a dark brown bead indicates day 26, and the last brown bead before the red bead stands for cycle day 32. If a woman has more than one menstrual cycle shorter than 26 days, or longer than 32 days during a year, another birth control method is advisable.
  • Basal Body Temperature Method (BBT): The lowest daily body temperature a healthy individual has is called their basal body temperature. Hormonal levels during a menstrual cycle typically cause a female's BBT to drop one to two days prior to ovulation as well as increase one to two days post ovulation. Careful measurements and recordings of BBT, each morning before rising, can give a fairly accurate estimation of when ovulation occurs.
  • Cervical Mucus Method: The quantity, consistency, and appearance of cervical mucus fluctuate during any menstrual cycle. Close observation and recording of this information for several cycles can also estimate ovulation time. Right before and during ovulation, more cervical mucus is produced and it will be clear, thin, and stringy in texture.
  • Monitoring Hormone Levels: Home ovulation kits help determine the most fertile days of a menstrual cycle. Using urine test strips, these kits monitor a woman's luteinizing hormone (LH) level. This level is markedly elevated just before ovulation.

Advantages of the Fertility Awareness Method

There are several reasons why a couple may choose to use the fertility awareness method. The advantages include:

  • Religious beliefs do not allow artificial methods of birth control.
  • Desire a "natural" method, free from drugs and/or contraceptive devices.
  • Willingness to closely monitor the woman's monthly cycles.
  • Willingness to either refrain from sex or to utilize another form of birth control during possible fertile days.
  • Willingness to deal with an unplanned pregnancy, if the fertility awareness method is not effective.
  • Prevention of STDs is not an issue.


  • National Institute of Health (2013). What are the different types of contraception? Retrieved from: http://www.nichd.nih.gov/health/topics/contraception/conditioninfo/Pages/types.aspx#barrier
  • WebMD (2013). Fertility awareness. Retrieved from:http://www.webmd.com/infertility-and-reproduction/fertility-awareness

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