Women using FAMs for contraception do not have vaginal intercourse during their fertile or "unsafe days" ? commonly called periodic abstinence. Or they use a barrier contraceptive during their "unsafe days." Determining your "unsafe days" is crucial.

Women who use the Fertility Awareness Method (FAM) monitor body temperature and cervical signs of pregnancy similarly to those who practice NFP. However, women using FAM may either avoid intercourse or use a backup nonhormonal method of birth control, such as a condom, during the fertile period.

Women using FAM monitor 3 primary fertility signs:

• basal body (waking) temperature,
• cervical fluid, and
• cervical position.

Basal body temperature before ovulation is considered to range from 97-97.5?F. After ovulation, temperatures rise to about 97.6-98.6?F and stay elevated until a woman?s next period, about 12-16 days later. Temperatures usually rise within a day or so after ovulation, so the rise in temperature generally means that ovulation has already occurred. A basal body temperature chart can be obtained from 4women.gov.

Cervical fluid qualities are also charted throughout a woman?s cycle. Cervical fluid qualities aside from during the menstrual period are designated as nothing/dry, sticky, creamy, or eggwhite. A woman is most fertile when her cervical fluid is like a raw eggwhite. During this time, cervical fluid is clear and stretchy.

The cervix becomes softer and opens around ovulation so that the sperm can pass through the uterus and to the fallopian tubes. The cervix also rises during this time during because of the effects of estrogen on the ligaments that hold your uterus in place.

For maximum effectiveness, FAM users follow 4 rules:

1. Intercourse is allowed in the first 5 days of the menstrual cycle (beginning with the first day of your period) if you had an obvious temperature shift 12-16 days before.
2. Before ovulation, intercourse is allowed the evening of every dry cervical fluid day.
3. Intercourse can resume the evening of the third consecutive day your temperature rises to postovulatory levels.
4. Intercourse can resume the evening of the fourth consecutive day after your peak cervical fluid day.

Intercourse is not considered "safe" for avoiding pregnancy unless all of these rules are met. It is recommended that 2 full cycles be charted before relying on this method.

Predicting Your "Unsafe Days"

Sperm can live up to to six days ? possibly seven ? in a woman's reproductive system, and an egg lives for about one day. In total, a woman has a good chance of becoming pregnant from unprotected vaginal intercourse over the course of about seven days of her menstrual cycle ? as long as five days before the release of an egg (ovulation), the day of ovulation, and, possible, the day after ovulation.

Fertilization is most likely to take place from intercourse during the six days that end in ovulation.

There are various methods that help determine when the fertile phase may occur and when a woman should consider it unsafe to have unprotected vaginal intercourse:

• For the basal body temperature method: Take your temperature every morning before getting out of bed. Your temperature rises between 0.4?F and 0.8?F on the day of ovulation. It remains at that level until your next period. Pregnancy may occur from vaginal intercourse during the six days before this rise in temperature.

• For the cervical mucus method: Observe the changes in your cervical mucus. You must do so all through the first part of your menstrual cycle, until you are sure you have ovulated. Normally cloudy, tacky mucus will become clear and slippery in the few days before ovulation. It also will stretch between the fingers. When this happens you are most fertile. You must abstain from vaginal intercourse or use a barrier contraceptive during this time. This method is sometimes called the ovulation method.

• For the calendar or "rhythm" method: Chart your menstrual cycles on a calendar. You may be able to predict ovulation if your periods are the same every month and if you chart many cycles before attempting to predict when you will ovulate. You must abstain or use a barrier method during your "unsafe days" before and after ovulation. It will be more difficult to predict the day of ovulation if your cycle length varies from month to month. In that case, you will have more "unsafe days." (It is best not to rely on this method alone.)

• The symptothermal method: Since these above methods alone are so inaccurate, it is best to combine the basal body temperature method, the cervical mucus method, and the calendar method. Using the information from more than one of these methods can help you predict the fertile phase more accurately, and you will have fewer days of needing to abstain or use a barrier method.

• For the Standard Days Method (SDM): Keep track of your menstrual cycle and do not have unprotected vaginal intercourse on days eight through 19. You may use the SDM only if you have regular menstrual cycles that are never shorter than 26 days and never longer than 32 days.

  You may use a special string of beads ? CycleBeads ? to help you with the SDM. Each color-coded bead represents a day. Move the rubber ring onto one bead each day. The red bead represents the first day of your period. Brown beads represent days when you are very unlikely to get pregnant. White beads represent days when you are likely to get pregnant. Do not have unprotected vaginal intercourse these days.

• For the post-ovulation method: Abstain or use a barrier method from the beginning of your period until the morning of the fourth day after your predicted ovulation ? more than half of your menstrual cycle.

How Well FAMs Work

FAMs do not provide protection against sexually transmitted infections.

Advantages of FAMs

• There are no medical or hormonal side effects.


• Calendars, thermometers, and charts are easy to get.

Who Can Use FAMs

• women in good health who have had careful instruction
• women whose sex partner is equally committed to the method

Women may not be able to rely on these methods if they have

• irregular periods
• irregular body temperature patterns
• uncooperative partners

How FAMs are Used

Possible Disadvantages of FAMs

• Some of these methods require months of training.
• Care is needed in keeping track and interpreting signs.
• Illness or even lack of sleep can cause "false" temperature signals.
• Vaginal infections or use of vaginal products ? like douches ? or medication may alter cervical mucus.
• You and your partner may be tempted to take risks during your "unsafe days."

Where to Learn About FAMs and How Much They Cost

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