Fertility Awareness For Partners – Common Questions and Answers

This article is for the husbands, boyfriends, spouses, or sexual partners of anyone using a form of fertility awareness for pregnancy prevention.

Charting cycles for pregnancy prevention is a big life change, especially for the female charter. While the charter has to learn to interpret their cycles, it is fundamental that they have a supportive partner in the process.

So, What is Fertility Awareness?

Fertility awareness involves tracking one or more bio-markers of the female cycle. These bio-markers include: cervical mucus, basal body temperature, cervical position, urinary hormones, and cycle start dates. The bio-markers are used to draw a fertile window. Fertility awareness has been studied scientifically for nearly a hundred years. There are a plethora of studies on the topic. Click here to read the 2018 Overview of FABMs. In general, you can expect approximately 98 to 99% efficacy across all modern fertility awareness methods.

Your partner will be tracking based on whatever method she chooses. A method is a way of categorizing bio-markers. For example, I teach the Billings Ovulation Method. This method tracks the bio-marker cervical mucus along with sensation felt at the vulva.

One of the first things you will learn when charting is that MALES ARE FERTILE 24/7. Females are fertile only cyclically, and on average the fertile window will be for less than 1/3rd of the female menstrual cycle.

In the beginning, there is sometimes a steep learning curve with tracking these signs. Your partner may forget to check cervical mucus at every restroom break or they may be erratic in taking their temperatures. Your role at this time is be supportive. If you are living with your partner, you can help remind her to take her temperature upon first waking (if they are choosing to chart this sign!) You may also want to take part in keeping the chart.

While it is relatively rare for the partner to help chart, it is encouraged that you learn how to help classify her fertility signs or read the chart if possible. In the very least, you need to learn to respect your partner’s fertile window and not expect to ejaculate inside the vagina in the fertile window. I’m being blunt here. You will get used to “TMI” with charting! You can learn to understand the cycle by taking a class together. This is a great activity for bonding, and so that you have more equal responsibility in your family planning.

An easy way to get involved in your partner’s charting routine is to use a paper chart. I keep a paper chart on the bedside table. It is always visible. My chart is pretty easy for my partner to read because the “baby” symbols mean possible fertility. You could do this with any method. Sit down together when you record the observations. Have your partner to explain what the fertility status of the day means.

This is an example of a paper chart on heavier cardstock. The days with babies are possibly fertile. Other days are available to use when the rules allow it. Charting on paper is a great way to share your chart with ease.

But Why Would I Attend a Class or Learn About Charting if I’m NOT the Female Partner?

Because you want to be a good, supportive partner!

When you understand your partner’s chart, you understand the chance of pregnancy that you both have. This can prevent mistakes from occurring if there is more than one set of eyes on the chart. When you become attuned to your partner’s menstrual cycle, you will also begin to realize why their mood might change throughout the cycle. This is fantastic for relationship communication. Your partner is not perfect. They may make mistakes when charting. Two is better than one for catching these!!

How Will We Avoid Pregnancy in the Fertile Window?

One of the first things you will learn when reading a fertility awareness book or taking a class is that you are expected to abstain from penis-in-vagina sex in the fertile window.

The reason for this is simple: it is only possible to get pregnant in the fertile window.

If you have penis-in-vagina sex in the fertile window, there will always be a chance of pregnancy. If you are avoiding pregnancy, this means that sex in the fertile window could result in an unintended pregnancy.

During this time, it is suggested that the couple work on other aspects of the relationship. Go on dates, cuddle, talk, play games.

If you decide to break the rules by having sex, you should be prepared for the possibility of pregnancy.

For Catholics, this is the only “licit” option for the fertile window.

For non-Catholics, oral sex and sex involving hands is safe in the fertile window as long as no semen ever gets near the vulva or the vagina. If semen touches this area, pregnancy can occur.

To determine how you will proceed in the fertile window, you and your partner should place yourself on the intentions scale. In the context of fertility awareness, intentions means how open you are to pregnancy.

The basic possible intentions follow. Select which is most appropriate to you as a couple. TTA means “Trying to Avoid” a Pregnancy.

TTA Seriously Avoiding: For these people, an unintended pregnancy may be devastating, whether to health, the relationship, or finances. A pregnancy is being avoided very strictly. These people should adhere to the rules of their method as closely as possible.

TTA Regular Avoiding: For these people, pregnancy is being avoided and the rules are followed. A pregnancy wouldn’t be convenient, but it would not endanger their life.

TTA Loosely Avoiding: For these people, a broken rule isn’t the end of the world. They may do strategic risk-taking like breaking rules on the cusp of the fertile window, or using something like the withdrawal method in the fertile window. They are not actively seeking a pregnancy, but they are okay with some chance of it happening.

TTW Whatever Happens: For these people, pregnancy would be okay whenever it happens. They break whatever rules they want. They aren’t actively timing sex for the most fertile days, but it might happen.

TTC Trying to Conceive: For these people, the rules do not have to be followed. They actively try to have sex in the fertile window.

You and your partner should discuss this scale and decide where you land before utilizing the fertility awareness method for sex.

What If We Decide to Use Barriers in the Fertile Window?

Remember, while you are fertile 24/7, your female partner is not. It is really important that if you are avoiding pregnancy that you respect your partner’s fertile window.

Some couples decide to use condoms, the withdrawal method, or diaphragms in the fertile window.

The most likely time for a barrier to fail is in your fertile window. After all, you aren’t using them at the other times of the cycle.

I personally believe that a couple has the right to make an informed choice in the fertile window. In particular, the male partner should realize that he is the one putting on the condom or pulling out. If he fails to do either correctly, a pregnancy can result. If you use these methods, do the research and inform yourself about how to use them correctly and what their efficacy is. If you are okay with this risk, you can use barrier methods. At the point you use a barrier method – you are outside of correct use for the fertility awareness method. Always remember that. An unintended pregnancy would be classified as a user error or barrier method failure.

How Long Does it Take to Practice Fertility Awareness Confidently?

On average, you will want to do at least 3 to 6 cycles of follow-up with an instructor to be completely autonomous and confident in charting. When you work with an instructor, you may be able to start utilizing the method to avoid pregnancy as sooln as the first cycle charting! (This is assuming that your partner has been diligent in their charting).

If you have PCOS, are coming off hormonal birth control, or are breastfeeding, you may need close instruction for longer. The Billings Ovulation Method recommends following up until the third ovulatory cycle postpartum. This could take a year or more if fully breastfeeding.

To Male Partners: What Advice Would You Give Male Partners Who Are New To Fertility Awareness?

These responses are taken from a 2019 survey I did on the male partners of FAM users. Enjoy!

“At first it seems backwards since science has a simple fix for conception: hormonal birth control. Some women are fine on hormonal birth control. Some can be really crazy on it. With some women, it can even kill their sex drive. With mine, she becomes so crazy that it kills both of our sex drives. So we’re doing this weird fertility awareness thing. Here’s my advice if you have a woman like mine. Even though she’s so beautiful and sexy that you just want to risk ejaculating in her to possibly get her off, you can’t do it with this. Yes, it puts more pressure on you to wear a condom and/or pull out, but at least your wife isn’t batshit crazy. And she’s still horny. So it’s worth it. Plus you learn a lot about the female body because I guarantee she’ll keep you up at night telling you about it lol. So don’t complain. We’re still getting laid. Unlike our friends who’s wives are on the pill or IUD. It just puts more pressure on us to prevent a baby. If she gets pregnant again, it’s probably our fault with this. And I’m ok with that. War Eagle!”

“You will wish you had always known this information. Test your pre-cum under a microscope for sperm if you are going to use withdrawal.”

“Knowledge is power and pleasure.”

“To do the research to fully understand the anatomy and physiology which will give you confidence in trusting the fertility awareness method.”

“Good luck m’a friend.”

“Embrace it.”

“Don’t be afraid to ask questions!”

“Be patient and understanding whilst always at least attempting to understand the technicalities surrounding the practice of the method.”

“Listen.”

“Read as much information as you can and stay informed.”

“Trust your partner, but do some cursory research as well. You both need to understand it to trust it.”

“Learn the actual science (as in the research literature) behind these technologies. Much of the medical establishment unfortunately has both insufficient and badly-outdated knowledge about FAM. Also, such will only be successful if the couple are both wholly on-board and possess the necessary knowledge, discipline, and self-control to utilize the method(s) correctly, whether trying to conceive or to avoid.”

“Get ya woman on it like yesterday.”

“Talk to your significant other and learn from her.”

“Learn about which days are the best to get pregnant; if you want to get pregnant together there is a way to learn the best days with a good degree of certainty. I think other men could benefit from learning this information about their partner.”

“Learn how the world works, and use that knowledge.”

“Listen to your woman and trust what she says about her observations. It’s not like the guy is the one using the method, but it’s good to be aware of it.”

“If you think it’s burdensome, remember the health and relationship benefits far outweigh the daily minor inconveniences. Encourage your SO to do the research to make sure they’re doing it right as well.”

“Shut up, pay attention.”

“If you are concerned about the well being of your partner, you’re more likely to succeed in supporting her and have an involved role in fulfilling both your reproductive goals through fertility awareness.”

“Be patient.”

“Take a lesson yourself or attend one with your partner, you are only going to trust it if you understand how it works yourself. When you actually see that it makes sense, it’s not some weird alternative thing, you can trust it a lot more.”

 

More Resources for Male Partners

Crash Courses in FAM

“The Rules of the Sympto-Thermal Method of Fertility Awareness” by Jennifer Aldoretta 

This resource is a simple overview of the rules with examples. It links to other resources on understanding the female and male reproductive system. This is a good, fairly quick read for men who want to understand the basic rules.

“Natural Contraception: Why I Haven’t Used Birth Control in Over a Year” by Jessie Brebner

Jessie discusses her symptoms that lead her to stop taking hormonal birth control. She then does a brief overview of how the fertility signs change throughout the cycle and how sperm life plays into fertility.

Men and NFP/FAM

“Straight Talk on NFP, Man to Man” by Couple to Couple League

This is a Catholic resource. Religious men may find this resource useful.

“Why Men Resent Natural Family Planning” by Gerard Migeon

This also leans religious but may be useful for men who are having trouble adjusting to avoiding unprotected sex in the fertile window.

“Use of Natural Family Planning (NFP) and Its Effect on Couple Relationships and Sexual Satisfaction: A Multi-Country Survey of NFP Users from US and Europe.” Front Public Health. 2017; 5: 42. Published online 2017 Mar 13. doi: 10.3389/fpubh.2017.00042

This is a recent scientific article that studied the effect of NFP on relationships.

“Fertility Charting: What’s a Guy to Do?” by Valerie Pokorny

How can men help with charting? How can they be supportive?

A Dive Into Resting Heart Rate and the Menstrual Cycle

I purchased a Fitbit device close to two years ago, and within months I noticed that my heart rate appeared to be correlating with the phases of my cycle. I’ve been charting resting heart rate since 2018, and I can say with confidence that it has lined up every cycle. This shouldn’t be too surprising because we already know that progesterone causes basal body temperature to rise, but heart rate does not exactly follow that pattern. Heart Rate also rises in response to high estrogen levels in the fertile window.

We have known about the possible connection between heart rate and the menstrual cycle for over a century, but in the last 50 years a few studies have taken a closer look.

Palmero (1991) studied 64 women for 3 consecutive months and created a PMS group versus a non-PMS group. They found that “in the premenstrual phase, PMS group showed significantly higher resting HR levels than NPMS group.”

Moran (2000) followed 26 women and found that “resting-heart rate was significantly higher in both ovulatory (P < 0.01) and luteal (P < 0.01) phases than in the menstrual and follicular phases.”

Shilaih (2017) followed 91 women and found that they “observed a significant increase in pulse rate (PR) during the fertile window compared to the menstrual phase (2.1 beat-per-minute, p < 0.01). Moreover, PR during the mid-luteal phase was also significantly elevated compared to the fertile window (1.8 beat-per-minute, p < 0.01), and the menstrual phase (3.8 beat-per-minute, p < 0.01).”

I want to highlight these last two studies in particular, because many of the other studies have an issue. Marco Altino explains why:

“The great majority of studies looking at HRV and the menstrual cycle collected one single data point during the follicular phase and one single data point during the luteal phase. I don’t have to tell you how little sense that makes, considering the high day to day variability in these parameters.”

This is an excerpt from his blog on heart rate variability in the menstrual cycle. Read the full blog here.

The 2017 study published in Nature by Shilaih, et al found that heart rate may rise up to 5 days before ovulation occurs. This means that heart rate could potentially be a used as a way to time intercourse for conception.

My results are so steady with resting heart rate that I dream of someone using it in a long-term study with other fertility signs. Wouldn’t it be cool if we could avoid pregnancy using heart rate too?

Below is an example of my results with resting heart rate. To convert my heart rate to fit in a fertility awareness app, I use a conversion. Essentially, one heart rate beat = .1 Farenheit change on my temperature scale. A heartbeat of 69 becomes 96.9, 70 becomes 97.0, 71 becomes 97.1 This preserves the original ratio, and it allows me to show the data with other fertility signs. For your own conversion, you may model this. If you have a lower heart beat rate, you can still convert, but you may need to do an additional equation.

My resting heart rate rose during the most fertile days of the cycle. Ovulation most likely occured on Cycle Day 15 or Cycle Day 16 on this chart. In addition, while I have not found evidence of this in the literature, I have observed that I tend to get a one day rise 3 to 4 days before the fertile window opens with cervical mucus. On this chart, that was Cycle Day 6.
A second example. Ovulation most likely occured on Cycle Day 14, 15 or 16. Heart rate rose on Cycle Day 14.

In conclusion, I believe that resting heart rate is a very unique sign to track, especially if you already use a wearable fitness tracker. I will note that a false heart rate rise can be caused by illness, alcohol or food close to bedtime, nightmares, and more! This is not dissimilar to what can obscure a temperature. I hope that in the future more studies are done so that we can see if heart rate can also be used for avoiding pregnancy purposes.

Selected Heart Rate Study Citations

Moran, V. H., Leathard, H. L., & Coley, J. (2000). Cardiovascular functioning during the menstrual cycle. Clinical physiology (Oxford, England)20(6), 496–504. https://doi.org/10.1046/j.1365-2281.2000.00285.x

Palmero, F., Choliz, M. Resting heart rate (HR) in women with and without premenstrual symptoms (PMS). J Behav Med 14, 125–139 (1991). https://doi.org/10.1007/BF00846175

Shilaih, M., Clerck, V., Falco, L. et al. Pulse Rate Measurement During Sleep Using Wearable Sensors, and its Correlation with the Menstrual Cycle Phases, A Prospective Observational Study. Sci Rep 7, 1294 (2017). https://doi.org/10.1038/s41598-017-01433-9

A Day in the Life of a Marquette User

Have you ever wondered what it was like to chart with the Marquette Method? This blog attempts to give an overview of what it is like to chart with the Marquette method (monitor/hormones only) for one cycle. Since I am in regular cycles, this is only an overview of what that looks like. Postpartum charting involves a whole lot more testing!

Day 1: Record Heavy Bleeding.

(This is an available day for safe sex based on my Marquette calculation rule. Marquette calculation rules rely on the earliest peak in the last 6 cycles minus 6. For me, this is Day 7, with Day 8 being automatically the first “unsafe” possibly fertile day. Any time of day is allowed within Marquette calculation rules).

Day 2: Record Heavy Bleeding.

Day 3: Record Heavy Bleeding.

Day 4: Record Medium Bleeding.

Day 5: Record Medium bleeding.

Day 6: Do absolutely nothing! My testing window opens on Day 8.

Day 7. Do absolutely nothing! My testing window opens on Day 8. This is my last day to have sex pre-ovulatory per the rules of the method.

Day 8: I wake up at 6:30am, pee in a cup, dip the stick for 15 seconds, and wait 5 minutes for the Clearblue Monitor to read my test. I get a “L” or low estrogen reading. The Clearblue monitor reads both estrogen and luteinizing hormones.

Day 9: I wake up at 6:30am, pee in a cup, dip the stick for 15 seconds, and wait 5 minutes for the Clearblue Monitor to read my test. I get a “L.”

Day 10: I wake up at 6:30am, pee in a cup, dip the stick for 15 seconds, and wait 5 minutes for the Clearblue Monitor to read my test. I get a “L”

Day 11: I wake up at 6:30am, pee in a cup, dip the stick for 15 seconds, and wait 5 minutes for the Clearblue Monitor to read my test. I get a “H” or high estrogen reading. This means that my real fertile window is likely opening and ovulation could be around the corner.

Day 12: I wake up at 6:30am, pee in a cup, dip the stick for 15 seconds, and wait 5 minutes for the Clearblue Monitor to read my test. I get a “H.”

Day 13: I wake up at 6:30am, pee in a cup, dip the stick for 15 seconds, and wait 5 minutes for the Clearblue Monitor to read my test. I get a “H.” Based on having high quality mucus (which is not required to notice for monitor only), I crosscheck with a LH test because I know ovulation is likely approaching soon.

Day 14: I wake up at 6:30am, pee in a cup, dip the stick for 15 seconds, and wait 5 minutes for the Clearblue Monitor to read my test. I get a “P.” This means the monitor has now detected my LH surge. I crosscheck this same urine with another LH cheapie test, and it is also positive.

This means I have peaked for the cycle! All other readings after the “P” are automatic, and I do not have to take any other tests. Marquette requires me to meet PPHLL before resuming intercourse on the day after the second L.

At this point, if I desired, I could be done charting for the whole cycle! This means that I only had to really chart for approximately 7 days this cycle. How easy is that?!

If I desire, I could also take a Proov progesterone test around the second L at the end of my count. This would provide proof that the hormone progesterone has taken over.

Close up of a Body Literacy Collective “Read Your Body” chart with Marquette markings.

Some of the downsides to this method could be:

  • The Monitor missing peak (happens in up to 10% of cycles and many people crosscheck with LH for this reason, or even add temperatures or Proov)
  • The Monitor will not tell you if you are going to ovulate early. The only way to detect earlier ovulation is to track cervical mucus very carefully.
  • The sticks are approximately $1.50 each. This could get very pricey for delayed ovulation!
  • The method may not be appropriate for people with very irregular cycles or elevated LH levels (some PCOS users may have elevated LH).

I personally crosscheck my monitor with Billings Method observations and Proov tests. You can read about charting with Billings here.

Disclaimer: Do not try to learn how to chart from this post. Everyone has their own unique cycle and this is just an example of charting with Marquette in a regular cycle. I recommend finding an official Marquette teacher here. Because the Marquette method uses the Clearblue monitor which is designed for trying to conceive, you will need to get instructions to use this monitor for avoiding pregnancy.

A Day in the Life of a Billings Ovulation Method User

Have you ever wanted to know what it is like to chart with the Billings Ovulation Method? This blog attempts to give an overview of what it is like for one individual to chart with the Billings Ovulation Method (BOM) over a single cycle. I go through each day of the cycle and explain my overall charting habits. All times are just approximate. I get personal and discuss some challenges I experience with natural family planning. BOM involves tracking sensation felt at the vulva along with the visible appearance of cervical mucus as a person goes about their day to day activities.

Day 1: Record heavy bleeding. Heavy bleeding feels wet. Done! Users are not allowed to use heavier days in the Billings method when avoiding pregnancy. This is a true day one of a cycle because it was preceded by a Billings peak day.

Day 2: Record heavy bleeding. Heavy bleeding feels wet. Done!

Day 3. Record medium bleeding. Medium bleeding feels wet. Done!

Day 4: Very light bleeding. It is now possible to observe my basic infertile pattern of dry.

8am: I feel dry and see a small amount of blood.

10am: I still feel dry.

8pm: I still feel dry. I see no mucus. Sex is allowed in the evening of this day. We use this day.

Day 5: Extremely light bleeding. Technically this day is not allowed for intercourse since I used the day before and Billings method rotates alternative evenings. We use this day anyway #rulebreaker

Day 6: I feel dry. I do not see anything. I record this day as “possibly fertile” since I broke a rule and used the day before. Every day after intercourse gets this white stamp in the pre-ovulatory time of the cycle.

Day 7: My basic infertile pattern of dry is still there! I notice nothing the entire day in the bathroom and my vulva sensation is dry. Sex is allowed in the evening. I consider my evening 8pm because I go to bed around 9pm on average. We use this day.

Day 8: I feel dry all day and see nothing. However, this day is not allowed since Billings alternates days. We skip this day.

Day 9: I feel dry all day and see nothing. However, we do not use this available day because we are both tired. It happens!

Day 10:

9am: I feel a bit moist. I don’t see anything when wiping in the bathroom.

11am: Still feel moist. I do not see anything in the bathroom.

2pm: Still feel moist. I do not see anything.

4pm: Still moist. Nothing seen.

4:45pm: Walking to my car from work. Still moist!

8pm: Overall observation for the day is moist. I record it. The fertile window has opened. This is known as the point of change.

Day 11:

7am: I feel moist as soon as I walk to the bathroom. I see very scant clear mucus on the tissue.

I do not see or feel anything for the rest of the day.

8pm: Overall observation for the day is “moist, clear”

Day 12:

7am: I feel moist, but see nothing.

10am: I feel moist, but see something white.

8pm: The feeling remains the rest of the day. I record “moist, white” for the day.

Day 13:

7am: I feel dry.

11am: I still feel dry.

1pm: I feel wet sensation when walking to my office. This is a change, so I keep that in mind.

I feel damp the rest of the day. I never see anything in the bathroom. I record “wet” as the most fertile sensation that day.

Day 14:

6:30am: I immediately feel moist.

9am: I see long clear strings when wiping in the bathroom.

11am: I have a wet sensation when walking around.

3pm: I walk around my work place. I still feel moist.

5pm: I see clear strings again.

8pm: I record “wet, clear strings” on my chart.

Day 15:

7am: I feel a gush as soon as I wake up. I do not see anything in the bathroom.

9am: I see scant, clear mucus on the tissue when wiping.

11am: I feel very wet walking around my work place.

1pm: I do not see anything on the tissue.

3pm: I do not see anything on the tissue.

5pm: I feel wet sensation while making dinner.

8pm: I record “wet, clear” as my observation for the day.

Day 16:

7am: I do not feel or see anything when waking up.

9am: I still do not feel or see anything.

12pm: I go for a 20 minute walk. When I get back, I feel slippery sensation. I go to the bathroom and see copious amounts of long, clear mucus.

8pm: I felt slippery the rest of the day. I record “slippery, long clear” on the chart.

Day 17:

6am: I feel dry when waking up.

8am: I don’t see anything or feel anything.

11am: I don’t see anything or feel anything.

8pm: The day was nothing felt, nothing seen all day. I record dry. This means yesterday was my peak day because it was a changing and developing pattern ending in slippery followed by an abrupt dry up to no longer wet or slippery.

Day 18 and Day 19:

I have the same experience as day 17. I pay attention all day and observe no mucus or sensation.

Day 20:

Ovulation is expected to be over and the cervical mucus plug has re-closed for the cycle. Sex is available any time for the rest of the cycle until day one of menstruation occurs. I can chart, but it is not necessary to wait until the evening and observations are less important as sex may interfere at any time.

Day 28: I record heavy bleeding and the rules restart.

Real Talk: Diffulties / Obstacles With Billings Not Seen on the Chart

These are things that I find can be difficul in my own personal experience. I know that people in really long cycles or with other irregularities may have different issues than me.

Challenge One: Alternative evenings only can be a struggle, and it seems even harder for me right before the fertile window opens due to my mood at this time of the cycle. This follicular phase is much longer for me than my luteal phase on average, and this means alternative evenings is the rule for most of my cycle. If someone has a partner with a conflicting schedule, this can especially be offputting. I think anyone who is going to practice this method should consider whether this is practical for their lifestyle.

Challenge Two: Expected abstinence in Billings can be hard, and I have fairly short fertile windows on average. I originally practiced sympto-thermal, and I switched to Billings when I realized that overall consecutive abstinence was much less overall (for my own cycle, Billings: 9 days, Sympto-Thermal: 14+ days). I tend to break some rules still, but this is much more suitable for my fertility intentions level than sympto-thermal.

Look out for my next blog on “A Day in the Life of a Marquette User.”

Disclaimer: Do not try to learn how to chart from this post. Everyone has their own unique cycle and this is just an example of charting with Billings in a regular cycle. Please reach out to me if you would like to learn this method with me as your guide. Alternatively, you can find a teacher here.

An Honest Review of Kegg

The kegg device draws a fertile window to give you the best days for conceiving a pregnancy based on the electrolyte levels present in the vagina. To use this device, someone would insert kegg into the vagina in the same two hour period of time during the day. kegg takes approximately two minutes to give the user a reading on the graph. As a bonus, it also gives you the opportunity to do kegel exercises while using it. Click here to read an article on the science behind kegg.

This product is an exciting development in the femtech field because it actually does read a real-time fertility sign. Cervical mucus is completely necessary for natural conception to occur. Without the presence of cervical mucus in the cervical crypts, sperm cannot to get to their destination to reach the egg. For this reason, anyone trying to conceive needs to track cervical mucus or use an alternative device such as Kegg (or a device that reads estrogen levels) in order to time intercourse for when they are most likely to conceive.

Here’s what Kegg looks like!
My kegg values compared to my Billings Ovulation Method cervical mucus observations. I believe that the kegg was highly correlated with my actual fertile window based on a traditional fertility awareness based method!

Who is Kegg right for?

It is important to know that kegg is not suitable for avoiding pregnancy. It is designed to find the most suitable days for conception. For those avoiding pregnancy, the fertile window has to be much longer than the window what the kegg gives. Until kegg has been studied for pregnancy avoidance, I cannot recommend it as an alternative to cervical mucus checks which must be made multiple times of day until the evening when someone is strictly avoiding pregnancy.

kegg may be right for someone who wants to conceive without needing to take a class or read a book on cervical mucus. In my experience, for the most part, it detected my most fertile days in a way that would likely lead to conception if used.

kegg may not be right for you if you have a very erratic schedule. Because it has to be used in the same two hours and cannot be used up to 8 hours after sex, this may make Kegg harder to use.

Click here to purchase your kegg!

Customer service with kegg has been excellent. The team is very reachable. If you would like to see more kegg charts and learn from fellow keggsters, you may join the kegg facebook group for conception or for those using it along with other fertility signs to avoid.

One Cycle Seven Ways: Experimenting with Marquette (Clearblue Monitor), Billings Method, Sympto-Thermal, Daysy, Kegg, DOT, and more!

Over the last several months, I have been testing multiple femtech products (such as Daysy Fertility Tracker, Kegg, DOT) and comparing them to charting methods like Marquette, Billings Ovulation Method, and Sympto-Thermal (NFPTA). These products and methods rely on different fertility signs such as basal body temperature, cervical mucus, urinary hormones, electrolyte levels, and calendar dates.

Disclaimer: Do not attempt to learn to chart using this post. My own experience may not reflect your unique cycles. My fertility intentions may not be your intentions.

Keep in mind that different methods may change safe days over time. The following data is only a snap shot of what fertility windows for avoiding pregnancy could look like. In particular, the Daysy thermometer only has 4 cycles of data on me.

Expected Consecutive Abstinence Over 3 Cycles

Cycle 52

  • Billings Ovulation Method: 15 (9 consecutive)
  • Marquette: 13
  • Sympto-thermal: 16
  • DOT: 12
  • Daysy: 15

Cycle 53

  • Billings Ovulation Method: 14 (8 consecutive)
  • Marquette: 13
  • Sympto-thermal: 13
  • DOT: 12
  • Daysy: 14

Cycle 54

  • Billings Ovulation Method: 16 (9 consecutive)
  • Marquette: 15
  • Sympto-thermal: 19
  • DOT: 12 (EXTREMELY RISKY)
  • Daysy: 15

From this data, you can see that sometimes the amount of expected abstinence does not differ from method to method, and sometimes it differs a whole lot! On my last cycle with DOT, it ended my avoidance window on the day after peak fertility occured. Fertility is still potentially high on the 3 days following this date.

Billings method almost always had the least consecutive abstinence because it relies on real-time fertility signs to open the window. However, because it rejects calculation rules and relies on one primary sign, only alternative evenings are ever allowed for pre-ovulatory sex. In addition, heavy days of menstruation are not allowed due to the possibility of early ovulation, and the bleeding obscuring the opening of the fertile window.

Other methods like Daysy, Sympto-thermal, DOT, and Marquette do allow pre-ovulatory consecutive sex, but most of that falls during menstruation for my cycle ranges (25 to 30 days).

Whatever method works best for someone is very dependent on their lifestyle and what someone is willing to diligently track.

The Same Chart Seven Ways

The highlighted days represent days to not use in order to avoid pregnancy with these methods.

My hearts are left on to show the fertile window and for authenticity. Do not use these charts to try to learn the rules of any method or to determine when sex is safe. You will see some broken rules based on my own personal intention level and on the fact that not all fertility signs will show the same window.

The Billings Ovulation Method draws the fertile window based on vulva sensation and cervical mucus. Any heavy bleeding is considered potentially fertile because it obscures readings and ovulation can always happen early. It requires alternating evenings for sex during the established basic infertile pattern.
This is the Marquette Method while using only urinary hormones and calculation rules. Fertile window opening determined by calculation rule based on last 6 cycles or first “H” reading on the Clearblue monitor. Clearblue measures estrogen and luteinizing hormone. My first window is also closed by a progesterone test in addition to meeting PPHLL rules.
This is the double-check sympto-thermal method per Natural Family Planning Teachers Association (NFPTA) rules. It opens the fertile window based on the shortest cycle in the last year minus 20. It closes the fertile window based on cervical mucus and basal body temperature.
This is a chart with the Daysy Fertility Tracker. This basal body thermometer learns your patterns over time and opens the fertile window based on past cycle data. The fertile window changes with time, and this is technically my 3rd Daysy cycle. Caution days and Red X days are for avoiding intercourse. Daysy does not allow the user to mark temperatures questionable, but I have marked two days questionable because I drank alcohol or had the heater on.
This example chart includes my cervical mucus notes for more context. DOT is a calendar based method that looks at the last 12 cycles of data. Only people in regular cycles can use DOT. Black moons are days available for intercourse based on the calendar method. In the next line, I also have included Kegg. Kegg predicts ovulation for trying to conceive purposes only, so I am including it as a bonus comparison. By reading the electrolyte levels in my cervical mucus, it determined that these 3 days were the most fertile days of the cycle. A full Kegg review is forthcoming in December 2020.
This is a resting heart rate chart. Resting heart rate has been shown to correlate with the menstrual cycle. I convert my heart rate like this: 69 = 96.9, 70 =97.0, 71 = 97.1, etc to be able to fit it onto the graph. You can see that it very closely followed my ovulatory pattern.
Here is my chart with all the data in one. It is so cool how different fertility signs draw the fertile window!

Unfortunately, my Mira Fertility sticks were flawed, so I had to remove that data from this experiment. In the future, I will do a comparison post also using this device. I am currently still testing the Kegg device, and a review with full Kegg charts is forthcoming in December. Kegg cannot be converted to display on the Read Your Body app, so I could only include the fertile days in this post.

Do you have any questions about all of these methods?

Consider coming to my free Instagram Live on femtech on November 28th. You can find me @chartyourfertility.

On December 12th, I’m offering a “pay what you can” introduction session that is minimum $5 to $30 USD on regular FABM methods and what the main differences are. Reach out to me if you would like to come.

Finally, a special shout to the Body Literacy Collective and the Read Your Body app for making this post possible by creating the most versatile charting app on the market!

Why You Should Be Cautious About Calendar-Based Methods (Daysy, Natural Cycles, DOT)

Calendar methods get a really bad rap in the fertility awareness communities. A lot of this is for a very good reason. When the calendar rhythm method was discovered in the 1930s, it was revolutionary. However, since then, we have discovered real-time fertility signs such as cervical mucus, basal body temperature, and urinary testing.

To illustrate why calendar-based rules can be both risky and occasionally line up with real-time signs, I charted with three calendar-based methods for opening the fertile window versus a method with real-time fertility signs only (specifically I used the Billings Ovulation method for my real-time method).

In the first line, you will see the Natural Cycles method. This method relies on basal body temperature as its only required real-time sign. Unfortunately, basal body temperature can only tell you when your fertile window closes, not when it opens. Temperature has no predictive qualities for letting you know if you are going to ovulate at a different time than normal.**

With only 3 cycles of my previous data, Natural Cycles gave me until day 8 as safe for this cycle. What Natural Cycles doesn’t know is that my cycles range from 24 to 30 days long over a calendar year. For this reason, it can be quite risky some cycles for me to be allowed safe sex until day 8. The fact that this cycle happened to line up is merely a coincidence! This coincidence can cause a confirmation bias when people use this app and do not get pregnant. If you are seriously avoiding, be wary of any method that doesn’t allow you to crosscheck the opening of your fertile window.

Natural Cycle also closed my fertile window in an incredibly risky manner. It told me I was safe on the morning after my real-time sign of “peak” day. In fertility awareness based methods, “peak” is the highest level of fertility you can get in a cycle. The two days following Peak day also have a significant chance of ovulation occurring. Every time I have used Natural Cycles (here is my previous try with it last year), it gives me a very risky closing to the fertile window.

Here is my full chart from Natural Cycles this time:

Natural Cycles app

Next up on the chart above illustrating my safe days is the Daysy thermometer. Daysy is a thermometer that relies on calendar based rules and potentially earliest temperature shift based rules to open the fertile window. In my two experiences with Daysy, it has been much more conservative than Natural Cycles. Daysy does learn over time, so it is possible I could have a risky day with it in the future, but so far I have not had any risky days with Daysy.

You can see in the image above that Daysy confirmed ovulation last out of all of the methods. I believe this is because my temperature shift was a bit erratic and because the device does not allow the user to mark temperatures questionable (I had two that were marked questionable for my own manual interpretation).

Daysy does not rely on anything except cycle length and temperature shift timing to open the fertile window. For this reason, Daysy can be risky if you ever have a very early ovulation. It can also be risky if the user is not careful about only taking their temperature when it is not disturbed, or if the device misreads a temperature shift. In my experience, Daysy tends to be much more cautious than Natural Cycles.

Daysy Chart

My third line is a true calendar only method. DOT has over a year of my data; however, the prediction has only given me one extra safe day during my whole use of the app. DOT is entirely based on the calendar method. However, interestingly DOT got higher efficacy than Natural Cycles in their study. Here is my DOT chart below

While I do not recommend the calendar method to most charters, this app can be useful for period prediction or for birth control if you are okay with an unintended pregnancy if you were to suddenly have a longer or shorter cycle. Users for DOT must have no more than 8 days variation in their cycle per calendar year.

In the example above, DOT actually gave me no risky days whatsoever. Again, this is a coincidence that it seemingly lined up with other signs. At any time, cycles can always change.

DOT the app

Finally, my main method is the Billings Ovulation Method. Billings relies only on real-time fertility signs. This means that they reject any calendar-based thinking, including the idea that menstruation is automatically safe. My Billings chart was based on when cervical mucus opened the fertile window (cervical mucus is what helps sperm survive) and when cervical mucus peak rules closed the window (when sperm can no longer access the cervix because ovulation is over and the cervical mucus plug has closed).

I always recommend real-time fertility signs to anyone who wants very high efficacy, the least amount of consecutive abstinence, who may be in regular or irregular cycles, and who want to understand their body and their health on a more deeper level. Here is an example of a Billings method chart. The babies represent possibly fertile days.

Conclusion:

I hope this post helps you think critically about whether calendar-based methods for opening the fertile window are right for you!

Here is a breakdown of efficacy for these methods:

Daysy: Claims 99.4% perfect use, but their study was retracted.

Natural Cycles: 98% perfect use, 93% typical use.

DOT app: 99% perfect use, 95% typical use.

Billings Method: 97.8 to 100% perfect use, typical use varies depending on country.

**Some modern fertility awareness methods use the Doering Rule to set the opening of the fertile window. This can be very safe and yield high efficacy. Doering is based on the earliest temperature shift of all time (not just the last year).

Perceived Risk Taking and FABM Use: User’s Perspectives

The following data was collected with permission from 255 total FABM users. Select responses that are representative of the data have been included. At the end of this article, I will draw some possible conclusions from the data. The intentions data in this survey were based on this document.

For FABM instructors:  I hope this article helps you think critically about the types of intentions that people have when coming to FABMs.

For Users of FABMs: I hope this article helps you place yourself on the intention scale and make informed choices with your partner.

255 total FABM users took this survey. The questions included: what FABM method was used, how long they had been using a FABM, whether they used phase 1 and phase 3, and reasons for using barrier type methods in the fertile window.

Approximately 62% of respondents were taught by an instructor, while the remaining 38% were self taught users. 85% of people who responded were aware that Phase 1 and Phase 3 are included in the efficacy of the method. 69% used both Phase 1 and Phase 3 for unprotected sex. Out of the 15% who were not aware that Phase 1 and Phase 3 are included in efficacy studies, 76% were self taught.

40% of respondents do NOT abstain in the fertile window. This is across the board from TTA0 to TTW. 60% of respondents do abstain in the fertile window. 

Breakdown of FABM use in 255 respondents

  • Roughly 17% used a single check STM
  • 34% used a sympto hormonal method
  • 29% used a double check method
  • 10% used Billings (primarily sensation mucus method)
  • 8% used Creighton (mucus only)

How long have they used a FABM?

  • 20% less than a year
  • 15.3% one year+
  • 14.5%  two years+
  • 10.2% three years+
  • 7.8% four years+
  • 23.9% five years+
  • 8.2% ten years+

TTA 0: Not taking risks, would take all measures to end a pregnancy

Users who are TTA0 identify themselves as someone who would take all measures necessary to end a pregnancy. 25 survey takers identified themselves as TTA0. 16 of the 25 were self taught using a sympto-thermal method. Only 3 out of 25 who responded used a method other than sympto-thermal. Only 10 abstained in the fertile window. Multiple respondents replied that access to abortion or confidence in barrier method usage was why they chose not to abstain in the fertile window. 

Here is a sample of the overall responses from TTA0:

Why Barriers:

  • I do not believe that abstaining is a healthy choice for consenting adults in a committed relationship. We use a combination of femcap with contragel and “perfect withdrawal” or occasionally femcap with contragel and he completes in my anus. 🙂 We did the math on this combination and are more protected this way than we would be using the pill so we find it acceptable. 
  • Usually on the days where I am THE MOST fertile, we will not have PIV sex, but overall, I trust using condoms as we are good about using them consistently and properly, and also usually use WD as a backup alongside condoms, especially during the weeklong fertile window. 
  • I abstained in the fertile window for 1.5 years. But we’re been using condoms for 5 years and never had a break so I’m developing a trust in them.
  • Years of experience with condoms, proper and careful use of them, and some ability to check for failure/holes. I’m already a TTA0, but abstaining instead of barriers would often give only 6-7 safe days per cycle. (We often use barriers the whole time instead of FAM, technically, due to lazy or unsure charts.)
  • Personally, as TT0, I use protection in phase 1, abstain during the fertile window, UP in phase 3. If I was TT1 I would be ok with condoms in the fertile window.
  • We have excellent barrier usage, I use it with other partners as well so I need to ensure STI protection, and my partners with dicks have been given condoms 101 by me so I know they know what to do
  • I would not feel secure with barriers during the fertile window at all. We conceive far too easily. 
  • I would probably abstain if I didn’t want a pregnancy and was against aborting and also if I lived somewhere with no safe and legal access to abortions.
  • I’m confident in using barriers because my partner respects my body and our intentions. We are TTA0 right now. We don’t see any reason for abstaining because we use barrier methods responsibly. 
  • I feel comfortable using barriers, despite their failure rate being high but will only use condoms and a diaphragm together, not diaphragm alone due to the low failure rate (15% ish). I do tend to avoid intercourse more during my fertile time if possible, but will use two barriers correctly to reduce anxiety or reduce needing emergency contraception if a breakage happens. 

TTA1: Not taking risks, and would possibly give baby up for adoption if pregnancy happened

Only 9 people identified themselves as TTA1. 5 out of 9 still used barriers in the fertile window even though intentions were low.

Why Barriers:

  • Still newish (charting since Jan but stuck on nexplanon which has expired and in that time only had two ovulatory cycles) but I will use days where I’m on my period in phase one if I feel up to it, but I am more comfortable with UP in phase 3.
  • It is literally the ONLY time I have interest in my spouse or can orgasm. Unable to orgasm in Phase 3.
  • I live in a country with great accessibility to emergency contraception as well as to health care to terminate an unwanted pregnancy, so even if my intentionality was lower I would not abstain.

Why Not Barriers:

  • Because we simply can not afford a child

TTA 2: Not taking risks.  Would need some time, maybe counseling. Ultimately keeping the pregnancy.

37 people identified themselves as TTA2.

Why Barriers:

  • I use a double-check and have an abnormal CM pattern that has it almost always starting just after my period. My husband won’t have period sex so it is extremely rare for us to fit in unprotected sex. Even if I tell him we can, he might not trust it because he doesn’t have enough knowledge of FAM. I might have abstained if I used a FABM in college or may have used condoms plus withdrawal. I was a Super Zero, meaning that even having an abortion would have been a burden, as I didn’t have any of my own money or a car. I was still a zero later in life but had more resources.
  • I only use condoms on very low risk days, so if one were to fail, there’d be plenty of time for plan B and/or pregnancy would be fairly unlikely anyways. Peak mucus days I will generally abstain or use outercourse.
  • I generally don’t enjoy sex during my period but my current partner is okay with it so I’ve been doing it more. I tend to ovulate early and rarely have dry days so I generally don’t use that rule. I am planning to use Doering once I have 12 charted cycles (starting over because I’m newly PP). We generally only want to go UP in Phase 3 though.We don’t use barriers but we do use perfect withdrawal during Phase 1 and 2 and sometimes Phase 3. I do not like any barrier method which is why we don’t use them.
  • Because of the doering rule I open my fertile window really early, but most of the time I ovulate later than those early ovulations that set my doering day so I’m ok with going UP until then because it most probably will be far ahead from ovulation. If not I know I’m still safe though.Im doubling up thats what makes me confident enough, I was a TTA0 when I started doing this
  • We don’t rush and always have great communication. And we could be TTA0 and still wouldn’t abstain because we enjoy sex.

Why Not Barriers:

  • Being extra conservative to avoid pregnancy. Not confident in my BIP (yet).
  • Since I’m self taught (charted 7 cycles) I know for sure I’m safe after I confirm ovulation. But my partner and I ALWAYS use condoms anyway and abstain during fertile window. If I were to not use protection, it would only be during luteal phase

TTA3: Not taking risks. “Oh NO how did this happen?! but everything will be okay” Surprise pregnancy would eventually be welcome.

Largest percentage of responses were from this category. 90 people identified themselves as TTA 3.

Why Barriers:

  • I don’t feel safe using phase one without protection (condom) because I am not as confident with my knowledge of the rules for that time (first 5 day, dry day rules, etc) (Self Taught)
  • I would have to be 2 or lower to abstain. We use withdrawal. I’m definitely okay with an oopsie, my partner thinks we need to wait until school is done so about a year from now we can be TTW.
  • No barriers but use withdrawl IF we have sex at all during follicular phase.
  • During the fertile window, we always use condoms and withdrawal. I’m confident in this because I feel that the chances of both the condom and withdrawal failing at the same time are very low. I don’t think my intentions would ever be low enough to abstain.
  • We have never had issues with barriers before. Abstinence for us would have less to do with intentions and more with discomfort caused by barriers / less enjoyable. We’ll never be below TTA2 I think and last time we were I felt safe with condoms too.
  • I’m confident in using barriers because I use perfect withdrawal, my partner and I have very good communication, and we’re a TTA3. My intentions would need to be TTA2 or lower to abstain.

Why Not Barriers:

  • Phase I – Cycle history shows I ovulate later. We could utilize up to day 11, but typically only use up to day 6 or 7. Phase III – confident when confirming ovulation, many months/years of practice including postpartum. No surprise pregnancies!
  • We use a double check method and learned with an instructor, so we feel safer in the 1st phase.
  • N/A my religious views (Catholic) do not allow for using barriers.
  • Barriers don’t feel worth it for us given the added risk of conceiving and less satisfying experience. Better to wait so we can increase effectiveness of method and have a better time during infertile phases.

TTA4: Not taking risks.  Currently content with family size but a surprise pregnancy would be welcome.

59 people identified themselves in this category. On the intentions scale, this is the highest category available before “Trying to Whatever” kicks in.

Why Barriers: 

  • I am confident in using condoms plus withdrawal on fertile days, and lately only use a condom. I am okay with the possibility of the condom breaking at a 4. I would need to be a 0-2 to abstain during the fertile window.
  • Religious. Orthodox Jews abstain during period and one week after, so by that time – around cd12 – I’m usually in my fertile window.
  • I don’t use barriers but use withdrawal during the fertile window. I’m aware of the risk but we did several looks at pre-ejaculate under a microscope and there were no sperm. Partner is very controlled with ejaculating so we are comfortable with our ability to manage the risk
  • We strive for perfect condom use every time and have never had a condom break, so we trust them. If we were lower on the intentions scale, I don’t think we would abstain, but would probably opt for adding extra methods like diaphragm+spermicide and/or withdrawal in addition to condoms.
  • We use withdrawal in the fertile window. Being so high on the TTA scale, we do not worry about any pregnancies resulting from failed withdrawal. Even so, it has worked for 4 years (we did the pre-ejaculate microscope test and there were NO sperm multiple times). I would never fully abstain regardless of intentions. Non Penis in Vagina Sex is always a safe option when done correctly! 

Why Not Barriers:

  • I have a longer cycle,usually 34-36 days so feel fairly confident in using the first part of phase 1. We’re currently pregnant (totally planned) but prior to that when we were TTA, we succeeded in avoiding for 9 cycles (plus 11 months pp without cycles but testing pp with Marquette).

TTW / NTNP: Pregnancy welcome but not activity trying:

29 total responses and only one person in this category used a form of a barrier, everyone else abstained or had sex when they wanted to.

Why Barriers:

  • Haven’t had any failures using withdrawal and since I’m trying to whatever with things now, I don’t mind getting pregnant if withdrawal fails 🙂

Conclusion:

Fertility intentions are not only “I want a baby” or “I do not want a baby.” There is a ton of nuance involved in how the couple feels and decides to behave in the fertile window. Intentions directly effect how someone uses a method. Almost all FABM methods discourage genital contact in the fertile window. However, this does not mean that users will follow this advice. While many users abstain due to religious reasons, others do not abstain due to their own religious beliefs or because they are secular users. With informed choice, fertility awareness users can decide based on their specific intentions what is right for them. Maligning barrier methods as a terrible choice does a disservice to an informed user of a barrier method who has made their decision based on their unique fertility intentions.

As far as I am aware, at least three methods have included barrier method usage in their studies: the Sensiplan Study (2007), the Klaus Billings Study (1979), and at least one Marquette study. The Sensiplan study and the Billings study found that there was not a signficant difference between barrier method usage and abstaining when it comes to failures. Sensiplan found a .2% lowering of efficacy. Users should be aware that incorrect barrier method usage can lead to pregnancy; however, many people are high enough on the intentions scale that this lowering of efficacy may be okay with them.

One of the most ridiculed methods is “withdrawal” or pulling out. However, even this has a place in many people’s family planning intentions, especially those higher on the intention scale or for those who wish to increase diaphragm or condom efficacy. Some people even use withdrawal to attempt to increase efficacy in infertile times of the cycle. There is much misinformation about withdrawal, including accusations of all pre-ejaculatory fluid containing sperm. For a nuanced look at what we know about withdrawal, please read this link. For information about doubling up on barrier methods and efficacy, visit this link.

Shout out to Antonela Vuljan for helping me organize this data!

What is Walking Sensation?: How to Check for Vulva Sensation While Going About Your Day

This article was originally published on fertilityawarenessmethodofbirthcontrol.com


While some fertility awareness based methods use wiping sensation, a large majority of sympto-thermal methods (as well as mucus-only methods such as the Billings Ovulation Method) use some variation of walking sensation.  Walking sensation is the feeling someone experiences at the vulva while going about their day to day activities. A good way to think about it is what it feels like to feel menstruation begin. Most people understand that this causes a wet feeling at the vulva without even needing to look to see the blood. Likewise, walking sensation can be felt at the vulva without needing to look for visible mucus. 

This feeling might feel like something is falling out of your vagina. It could feel moist, wet, sticky, lubricative, slippery, or similar terms. Some people describe trickles and bubbles. This sensation opens the fertile window even if no visible mucus is seen. In fact, it is common to have walking sensation open the fertile window before any mucus is seen. It is also common for slippery / lubricative / wet sensation to be set as peak day (depending on your method rules!). Again, this would count as a fertile day even without visible mucus being seen.

Walking sensation is a practice in mindfulness. It involves tuning into the nerves at the vulva as you go about your day. Notice how it feels when you walk around, exercise, or otherwise move throughout the day. Wearing tight pants or synthetic fabric underwears can make it harder to feel. If you are having trouble tracking walking sensation, consider wearing a skirt or dress for a full cycle.

Another common suggestion to help learn it is to “chart blind” for one full cycle (obviously you will need to refrain from unprotected sex if changing up your method!). Charting blind means charting your sensation without looking at your visible mucus. This forces you to rely on the feeling at the vulva. Note that the Billings Ovulation Method which relies on walking sensation as the primary sign has done small studies with blind women who were able to chart their patterns with it while never being able to see visible mucus. 

For those who haven’t tuned into these nerves before, I suggest meditation. Throughout the day, take the time to sit down (or walk around) and concentrate on your vulva.

If you are interested in learning more, reach out to an instructor. If you want to use it as a part of a mucus-only method, the Billings Ovulation Method focuses more on it than any other existing method. I personally teach this sensation in my Billings Ovulation Method class.

In Defense of Mucus-Only Methods (Specifically Billings Ovulation Method)

In the fertility awareness world, there are many misconceptions about mucus-only methods. While I cannot speak to mucus-only methods that I have not trained in, I can speak for what I have learned in training in the Billings Ovulation Method. There is so much history of the development of the method that I cannot touch on everything here. For those wanting to learn more, this document goes over some of the history of the method. Outside of that, WOOMB has many useful links.

First and foremost, the usual criticism leveled at mucus-only methods is that they have a low efficacy rating when compared to the sympto-thermal method. However, this is much more nuanced than it may appear at first glance. Let’s look at the most often quoted study for Billings.

This section of statistics is copied directly from a WOOMB International breakdown found here:

1976-78 an independent trial was conducted by the WHO, in five countries (India, the Philippines, New Zealand, Ireland and El Salvador).

This study had two phases:  
869 couples entered the three-month ‘teaching phase’,
725 couples continued in the 13-cycle ‘effectiveness phase’,
with a total of 10,215 cycles in the entire study.

The teaching phase showed that in the first cycle of charting, 93.1% of women were able to record an identifiable ovulatory mucus pattern denoting fertility, and that by the third cycle of charting, 97.1% of women had an excellent or good interpretation of the method.

The results for the entire study were:
2.2 pregnancies/ hwy    (per 100 woman years)  –  method-related pregnancy rate
22.3 pregnancies/hwy  (per 100 woman years)   –  total pregnancy rate

The total Pearl Index  – 22.3/hwy  comprised:
• Conscious departure from the rules of the method: 15.4/hwy.
• Inaccurate application of instructions: 3.9/hwy.
• Method failure: 2.2/hwy.
• Inadequate teaching: 0.3/hwy.
• Uncertain: 0.5/hwy.”

The first thing you should notice is that perfect use was 97.8%. This is pretty high. The second thing you should notice is that typical use includes people who knowingly broke the rules! All typical use always includes this. This statistic of 22.3% typical use failure is used to scare folks away from mucus only, especially when compared to one specific sympto-thermal trial by Sensiplan. However, the Thyma double check sympto-thermal had a 35% typical use rate in one trial. No method is impervious to bad typical use rates because this is dependent on how open someone is to pregnancy, as well as cultural factors. This is a flaw (depending on your perspective) of all FABM methods; someone can choose to achieve pregnancy because fertility is not suppressed.

The next thing to consider is that the older statistics of the Billings Method were based on a different peak rule, a very similar peak rule to which all sympto-thermal methods have adapted. As Billings continued to develop, the method was strengthened by over 850,000 hormonal assays completed by Dr. Brown which tested estrogen, follicule-stimulating hormone, progesterone, and luteinizing hormone. These tests were matched to Billings Ovulation Method charts. The method has been scientifically validated in over 10 total trials.

As the method was studied, the peak rule was changed to help women recognize patterns of fertility and infertility. They discovered when the specific peak rules were met, a changing and developing pattern of discharge and sensation <more specific rules apply to this>, ending at a slippery sensation felt at the vulva 《with walking sensation》and followed by an abrupt change to no longer slippery or wet, that a woman could detect a false mucus patch build up without the need for temperatures. Because of the science that Dr. Brown, Dr Evelyn and John Billings, and Dr. Odeblad verified through numerous studies, they were able to strengthen the mucus only method enough to no longer rely on temperatures without fear of double peaks. The most recent Billings study in China found a 100% perfect use rate and a 99.5% typical use rate when users were very strictly avoiding and highly motivated with the rules.

In short, the Billings Ovulation Method is very effective and for careful charters does not suffer the problem of false peaks. Again, I have barely scratched the surface of all the trials and science involved. I recommend researching Erik Odeblad and the pockets of shaw for more information.

So why do mucus-only methods get such a bad wrap? In the secular communities, I think there are a few main reasons.

1. The methods must be learned through a teacher. Learning these methods takes dedication and regular live (or online) meetings with a real person. Most folks don’t feel like making this effort or think they can’t afford it. Billings has a policy to never turn anyone away in need. Many do free services or payment plans when asked. There is also a charity associated with Billings that can sponsor Catholic couples to help them afford classes.

2. The next reason is that many sympto-thermal users have fundamental misunderstandings of what Billings is. As a certified sympto-thermal teacher and someone who has read about fifteen books on sympto-thermal, it is dissapointing how much of the original science of fertility and the cervix is left out of our materials. My mind was blown when I discovered how things really work when learning a mucus only. From the pockets of shaw to the functions of the cervical crypts, there is so much to learn that is not included in Taking Charge of Your Fertility. This does a great disservice to sympto-thermal charters.

3. Due to these misunderstandings, they think the method cannot be used by those with irregular cycles. They also may think that a non dry basic infertile pattern is not possible due to a misunderstanding of the science of the cervical plug and the effect of estrogen in the vagina.

Potential Cons of Mucus Only:

I do not say any of this to say that the Billings Method is right for everyone. It takes dedication and a willingness to follow the rules if strictly avoiding pregnancy. In addition, there are a few cons to mucus only.

1. A yeast infection or bacterial vaginosis would obscure observations and cause abstinence. However, arguably even a sympto-thermal user would need to abstain when they have an infection.

2. Women who are careless with mucus observations may end up with an unintended pregnancy. If you don’t want to track mucus carefully, this is not the right method for you. If you can’t follow the rules to safely have intercourse, such as evenings only during basic infertile pattern on alternate evenings in the pre-ovulatory time of the cycle, this method may be too restrictive for you.

3. A weak mucus patch that does not fulfill the stringent peak rules may cause more abstinence without a temperature shift to confirm. However, this often signals a potential health issue and should be investigated.

4. Mucus only methods do encourage abstinence when avoiding pregnancy. However, most sympto-thermals do the same. Anyone who is okay with an elevated risk due to barriers or alternative protected sex can always do what they want to do but should be prepared to face the consequences if a barrier method fails.

Conclusion:

Mucus only methods can be highly effective choices for avoiding pregnancy. Recent trials of Billings consistently show 99% or better with perfect use. In some cases, they may reduce abstinence because they allow women to identify false mucus build ups that do not lead to ovulation and non-dry basic infertile patterns. For women who want to eliminate barrier method usage, they offer a way to identify fertility in real time when in irregular cycles due to PCOS, postpartum, or perimenopause. This eliminates much of the extended abstinence or barrier method usage that sympto-thermal users may experience.