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Fertility awareness methods, also known as natural family planning, involves working out when you are in the most fertile phase of your monthly cycle and avoiding unprotected sex during this time.
No hormones
No effect on mood
No protection against STIs
Invisible but works best with clear communication with your sexual partner(s)
Periods will stay the same
As long as you want
Skin will stay the same
Effectiveness depends how well you follow the method, if you’re taught by a practitioner and a number of other factors
It can take up to six menstrual cycles to know your fertile days. You will need to use another form of contraception in the meantime.
Daily monitoring and recording of fertility signs
Fertility awareness requires a high level of commitment and is only recommended for people with regular cycles who would be prepared to manage an unplanned pregnancy if it happened.
Fertility awareness works by observing and recording your body’s different natural signs each day of your monthly cycle. The main signs are:
Changes in these fertility indicators can help you identify your fertile time. During your fertile time, you avoid having sex or use additional contraception such as condoms if you don’t want to get pregnant.
Fertility awareness should be properly taught by a specialist teacher. The information included here is to provide an idea of what how this method works only. Visit Fertility UK at www.fertilityuk.org to find a clinic near you where you can receive this training which may involve a cost.
Your fertile period generally lasts around 8-9 days. This is because eggs can live for 24 hours (and there can sometimes be a second egg released after 24 hours) and sperm can also live inside the body for up to seven days, so if you had sex seven days before ovulation you may still become pregnant.
There are three main monitoring techniques that can help you work out when you are fertile so you can avoid sex or use contraception such as condoms during those days. It is recommended that you do all three of these methods to maximise its reliability.
Measure and record the length of your menstrual cycle. A menstrual cycle is on average 28 days. Measuring when it starts and ends will give you a rough idea of when you are fertile and when you will be ovulating. This by itself is not reliable enough to know when you are fertile.
There is a small rise in body temperature following ovulation. To track your basal body temperature (your temperature when your body is at rest), follow the steps below:
Your body temperature can be affected by many factors including sleeping longer or shorter, a lack of sleep, stress, alcohol, travel, medications, illness, the list goes on! If your life is regularly affected by any of these, this might not be the best method for you as your menstrual cycle and ovulation will be more likely to change each month and therefore harder to predict.
Your cervical mucus changes in colour, consistency and quantity throughout your menstrual cycle. It can be used to find out where you are in your cycle and whether you are fertile.
To check your cervical mucus place your middle finger into your vagina up to the middle knuckle, rub between your fingers to get an idea of its consistency. You should then record everything about your mucus for that day
What to look out for:
There are phone apps that you can use to record your temperature which will then calculate when you are fertile for you which can reduce the risk of human error. But the reliability and effectiveness of these apps are not known. Your menstrual cycle and ovulation signals (temperature) can be affected by many factors – for example, maybe you’ve gone on holiday and you’re in a different time zone, or maybe you’re stressed or ill – The app won’t know this and could then mistakenly give you the go ahead to have unprotected sex when you are actually fertile. If you are going to use this method, it’s best to have an understanding of your cycle and how it is affected by your lifestyle and use other fertility indicators as well (changes to cervical mucus) rather than relying on technology alone.
This method can be difficult to follow and its effectiveness is reduced by many factors. To be effective this method is best suited to someone that:
Other factors reducing its effectivenessEmergency contraception can bring your period forward or delay it Pain relief, antihistamines and some antibiotics can affect fertility indicators
The fertility awareness method may not be the most effective form of contraception, or may not be suited best to you and your lifestyle but understanding where you are in your menstrual cycle can be useful regardless of whether you’re having sex that could end up in pregnancy or not.
You can start the fertility awareness method whenever in your cycle. But it can take 3-6 months to fully understand your cycle and to confidently be able to predict your fertile days. This means you should use contraception in the meantime.
This adjustment time needed to understand your cycle may be longer if you have recently come off hormonal contraception. You should wait at least three complete cycles after coming off hormonal contraception or until your periods are regular and predictable before starting this method.
This method is not suitable if you are nearing the menopause, if you have irregular periods or if you have recently started your period.
This adjustment time needed to understand your cycle may be longer after pregnancy or you have recently come off hormonal contraception.
You can get pregnant from as little as three weeks after giving birth.
Your period and cycle can take a while to become regular again making this method unreliable until this time.
It is possible to use the Lactational Amenorrhoea Method (LAM) after pregnancy. This is only effective if:
If all of the above apply, you are unlikely to get pregnant as the hormone released to cause you to make breast milk can stop your body producing the hormones that control your periods. However, fertility can quickly return with any changes to breastfeeding and you can get pregnant before your period starts again.
You can become pregnant from two weeks after an abortion or miscarriage.
Your period and cycle can take a while to become regular again making this method unreliable until this time. You should use contraception until your periods and cycle has returned to normal pattern.
Always speak to your midwife, GP or nurse at a sexual health clinic to check this is the right method for you
If you have irregular periods it can be difficult to work out when you are fertile. it’s best to use a different method of contraception that will be more reliable and effective.
If you want to have sex during your fertile time, you should use contraception like condoms or avoid vaginal sex. If you’re ever unsure if you are fertile, it’s best to use contraception.
Note: Pulling out is not a method of contraception and is not an effective way of preventing pregnancy.
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