cervical mucus – Leslie at Chart Your Fertility

Can I get pregnant on my period?

Many people think that having sex during menstruation cannot lead to pregnancy, but the answer is much more nuanced than that. It is possible to get pregnant during bleeding episodes, some of which may not be menstruation!

Was the bleeding truly menstruation?

Charting evidence-based fertility signs like cervical mucus, basal body temperature, and urinary tests are the best way to determine if you are ovulating. True menstruation should follow about 10-16 days post ovulation as indicated by a temperature shift or positive PdG test.

If you are not charting your cycle with a fertility awareness based method, your bleeding may not really be menstruation. Estrogen breakthrough bleeding may appear very similar to menstruation and is often indistinguishable without charting. This bleeding can be fertile, and pregnancy could result.

Day one of a true menstruation marks the beginning of the cycle.

Day 1 is true menstruation because it followed a proven luteal phase. The current cycle confirms the next bleed will be menstruation because of the positive progesterone tests. This app is Read Your Body.

How long are your cycles? Better yet, approximately when do you usually ovulate?

If your cycles were 26 days or longer for the last year, it is unlikely you will become pregnant with sex during the first five days of the cycle.

Dr. Josef Roetzer monitored 5,807 cycles. He observed only one pregnancy before day 6 of the cycle. Her cycles were 22-27 days long.

Dr. Roetzer estimates that using the first five/six days is 99.8% effective for avoiding pregnancy. It is important to note that all of his cycles monitored had a temperature shift preceding menstruation. If you do not have proof that you ovulated before a bleed, it becomes more likely to conceive during bleeding.

Another way to determine the last infertile day at the beginning of the cycle is to use Dr. Doering’s rule. Dr. Doering subtracted 7 from the earliest first high temperature in the last year. For example, Sarah’s earliest first high temperature was day 13. Day 13 – 7 = Day 6 as the last infertile day of the cycle. This rule is always crosschecked with cervical mucus. Sperm may survive up to 5 days in cervical mucus, and any presence that has not been determined to be infertile through instruction should open the fertile window. The Doering rule is more personalized than automatically assuming the first five/six days are infertile.

In Dr. Frank-Hermann’s double-check sympto-thermal study from 2007, all three method failures were from day 5 intercourse. This study used the first five day rule and Doering rule. This study yielded an efficacy of 99.6%.

So am I safe to have sex during my period? Ask yourself these questions.

Did you confirm ovulation with basal body temperature, PdG strips, or a blood draw in the previous cycle?
Are your cycles longer than 26 days on average? Have you ever had a peak day before day 13 of the cycle?

If the answer to both of those is yes, you can probably have safe sex up to day 5 of your cycle.

If your answer is no, then you have a possibility of pregnancy.

What if I want to be more conservative?

Some methods like Billings, FEMM, and Creighton suggest not having sex during heavy days of bleeding when cervical mucus cannot be observed.

If you have a history of short cycles (less than 26 days) or want to add an extra layer of protection onto the beginning of the cycle, I recommend beginning observing vulva sensation and cervical mucus as soon as your bleeding has lightened enough to no longer need a tampon, cup, or regular pad. If you need only a panty liner or are only experiencing light spotting, you should beginning checking your cervical mucus and sensation throughout the day. At the end of your day, if you have observed no cervical mucus or sensation outside of your determined infertile pattern, this day is safe for sex. (DO NOT DO THIS WITHOUT LEARNING A METHOD. THIS BLOG IS NOT ENOUGH INFORMATION TO AVOID PREGNANCY WITH ALONE).

What if I bleed for more than 5 days?

If your menstruation lasts longer than five days, you should follow the instructions from the paragraph above. It is NOT safe to consider past day 5 automatically available if you are bleeding. You need proof by using cervical mucus or urinary estrogen tests that your fertile window has not yet opened past day 5 of the cycle.

What if I randomly have a short cycle?

Checking cervical mucus is your best back up. Cervical mucus should appear when the fertile window is opening for most charters. Many methods suggest no longer considering menstruation safe once you enter peri-menopause (can occur up to 10 years before menopause) because cycles may shorten at this time. If you notice that your cycles have grown shorter than 26 days, you may want to become more vigilant and stop automatically considering the first 5 days safe.

Conclusion

For the majority of people menstruating, using the first five days of a true menstrual cycle will not result in pregnancy. For a very small percentage, it may. I recommend charting with a real fertility awareness method (Sensiplan, SymptoPro, FEMM, Billings, Marquette, etc) to determine if your bleeding is actually menstruation!

Works Cited

Boetze, Iosef. “Further Evolution of the Sympto-Thermal Methods.” International Review of Natural Family Planning 1 (1977): 139-150.

Raith-Paula, Elisabeth, et al. Natürliche Familienplanung heute. Springer Medizin Verlag Heidelberg, 2008.

Breastfeeding and return of fertility in natural family planning studies

During the postpartum period of time, fertility is in a unique state. For those fully breastfeeding, it may be months or years before they begin ovulating again regularly and with fertile cycles. This article talks about some of the data we have on what return of fertility looks like. This information may be of particular interest to those charting with a method of natural family planning or fertility awareness. Charting at this time may be difficult, and for highest efficacy should be done closely with a certified natural family planning educator.

Breastfeeding as Birth Control

Breastfeeding has been shown over numerous studies to have an effect on return to fertility and ovulation. Kennedy et al (1989) reviewed 10 studies from multiple countries to come to a consensus on what full-breastfeeding means.

Fully breastfeeding or at least partially fully breastfeeding
Fully breastfeeding meaning the infant gets all or as close to all as possible of their nutrition by suckling at the breast directly, no bottles or pumping
Small bites of regular food or water do not disqualify for full breastfeeding
No bleeding past day 56 postpartum until the 6 month mark postpartum.

Some methods suggest going no longer than 6 hours at night without breastfeeding. While this was not mentioned in the study, it is generally used as the standard in fertility awareness based methods to see if someone qualifies to rely on the lactational amenorrhea method (LAM).

LAM is 98% effective for avoiding pregnancy when all criteria is met up until 6 months postpartum. After that, efficacy drops precipitously.

What about ecological breastfeeding?

Ecological breastfeeding requires even stricter criteria and may delay fertility for much longer. Bleeding past day 56 does not disqualify someone for ecological breastfeeding. Ecological breastfeeding should not be confused with LAM! Ecological breastfeeding was coined by Dr. Sheila Kippley. You can buy her book here.

The criteria include:

Breastfeed exclusively for 6 months
Pacify your baby at your breast
No bottles or pacifiers
Sleep with your baby for night feedings
Sleep with your baby for a daily-nap feeding
Nurse frequently day & night. Avoid schedules.
Avoid anything that would separate you from your baby / prevent regular nursing

Symptothermal Method Studies on Breastfeeding

For the first part of this overview, I am going to cover a few symptothermal studies that followed breastfeeders from birth to return of fertility. Symptothermal charters record cervical mucus and basal body temperature daily in order to track their fertility and determine when the fertile window is opened and when it is closed.

In “Breastfeeding and the Symptothermal Method,” Kennedy et al. followed 73 women who charted with a symptothermal method in Australia, Canada, England. While this is a small sample size, the team collected a ton of data: 22,538 diary sheets, 9,428 urinary vials to measure hormones, and 1,600 follow-ups with the women (Kennedy 1995).

Kennedy et al. reported the following data regarding the wait to return of fertility:

Only 25% of first ovulations postpartum had “adequate luteinization.” This means over three quarters of first ovulations were likely infertile (Kennedy, 110).
In retrospect, up to 51% of possibly fertile days identified by sympto-thermal would not have lead to conception (Kennedy, 112). The study standard for this was 5 day sperm life.
They found that 94-99% of the time, the sympto-thermal method correctly identified when a day was really infertile. This means that around 1-6% of the time it didn’t identify a day that may have lead to pregnancy (Kennedy, 112).
They recorded four adequate ovulations with those fully breastfeeding for their first ovulation. This was defined as a 10 day or greater luteal phase with adequate progesterone levels. (Kennedy, 112).
Abstinence was expected per the rules for about 50% of the charted days included in the study (Kennedy, 113).

Bonus Information for Cervical Mucus Fans: Fertile mucus in this study was considered anything cloudy, opague, clear, translucent, stretchy, strands, wet, lubricative, moist, or unusually abundant.

Zinaman and Stevenson in the USA followed 25 women until they had 3 ovulatory cycles postpartum (1991).

They found the following data regarding return to fertility:

20% of ovulations in the first ovulation postpartum during the first 6 months were considered fertile (ie a luteal phase longer than 10 days) (Zinaman and Stevenson, 2037).
Basal body temperature appeared inadequate to capture the first ovulation, occurring up to 4 days after the LH peak, but it improved in later cycles (Zinaman and Stevenson, 2037).

Percentage	Time to Return of Fertility From Birth
25%	Less than 200 days
25%	200 to 300 days
35%	301 to 400 days
15%	More than 400 days

Time to return of fertility among 25 breastfeeding women in Washington, DC. Created from page 2037 in Zinaman and Steveson (1991).

In an article in the International Review of Natural Family Planning, Parenteau-Carreau presents data collected from 43 postpartum women charting with the Serena Canada method.

Parentau-Carreau reports the following data on postpartum charting:

65% of first bleeds were preceded by a thermal shift (35).
The collection of charts confirmed the theory that 4 high temperatures should be used postpartum, as there were instances of 3 raised temperatures that were not true shifts (36).
Among temperature shifts during the first 6 months postpartum, 75% lasted 8 days or more (37).
For babies who sucked their thumb or used a pacifier regularly, their mothers experienced return of fertility an average of 13 days earlier than those who only breastfed for soothing purposes (37).
The basal body temperature curve tended to become more steady or regular in the one to two weeks prior to the first ovulation (38).

What can we conclude from all this data?

Breastfeeding and meeting the criteria for LAM is highly effective for avoiding pregnancy in the first 6 months postpartum.
Most first ovulations postpartum are infertile (defined as a luteal phase less than 10 days long).
It is possible to chart during postpartum to avoid pregnancy.

What methods work best postpartum?

I recommend practicing either the Billings Ovulation Method or Marquette postpartum. I do not recommend sympto-thermal method because temperatures are not useful until fertility returns. I only recommend taking your temperature before the 6 month mark to those who are not breastfeeding. In addition, the sympto-thermal method offers less complex mucus patterns than Billings does.

Billings Ovulation Method involves charting sensation at the vulva and appearance of mucus to create a basic infertile pattern. It allows only alternate evenings of the basic infertile pattern for sex until return of fertility (IE ovulation) occurs. It is approximately 98% effective with correct use postpartum.

Subjective fertility signs (sensation and appearance)
Only alternate evenings for sex
Very affordable (Billings will work to set you up with a free instructor if you absolutely cannot afford one)
No re-occurring cost
One-time cost for instruction (ideally, please pay your educator if you can! Some instructors may charge after 1-2 years pass)

Marquette Method involves charting urinary hormones using the Clearblue monitor. This monitor reads estrogen and LH levels. This method is going to be more expensive than a cervical mucus only method, so I only recommend it to those who can afford approximately $30 USD a month or more postpartum. Unfortunately, the stick costs fluctuate up to $50 USD or so for 30 sticks, but I have seen them as low as $30 USD. Marquette is approximately 98% effective with correct use.

Objective fertility signs (monitor does the reading for you)
Any time of day sex when available
Expensive by some standards. Sticks cost twice as much in Europe. May not be available in some countries at all.
Re-occurring cost
One-time cost of the monitor ($50-$130 USD depending on if buying new or used)
One-time cost of instruction (unless you go over the year mark, you may need to pay twice)
I have heard that some instructors may offer scholarships, but you would need to contact individual instructors or organizations to learn their policies.

References

Kennedy, K; Rivera, R; McNeilly, A. (1989). Consensus statement on the use of breastfeeding as a family planning method. , 39(5), 0–496. doi:10.1016/0010-7824(89)90103-0

Kennedy, K., Gross, B., Parenteau-Carreau, S., Flynn, A., Brown, J., & Visness, C. (1995). “Breastfeeding and the Symptothermal Method.” Studies in Family Planning, 26(2), 107-115. doi:10.2307/2137936

Parenteau-Carreau, S. (1984). “The Return of Fertility in Breastfeeding Women.” The International Review of Natural Family Planning. Vol. 8(1). pp. 34-38.

Zinaman, Michael; Stevenson, Wilma (1991). Efficacy of the symptothermal method of natural family planning in lactating women after the return of menses. American Journal of Obstetrics and Gynecology, 165(6), 2037–2039. doi:10.1016/S0002-9378(11)90575-4

Which method of fertility awareness is right for me? A decision making tool

It can be hard to choose the right method for you. In this graphic, I have simplified the main signs, times of intimacy, and efficacies for the four methods that I am most familiar with.

As part of my charting journey, I have personally compared and charted with Billings, sympto-thermal, and Marquette. You can view my charting comparisons here.

The graphic is intentionally simplified. Method rules will vary, particularly if you are using a different protocol of the method or combination of signs. My Marquette example is for monitor-only rules.

Time of day for intimacy is very important to consider as a part of the decision making process. If you and your partner’s schedules don’t mix well, this may sway you towards another method!

Some couple like intimacy to feel spontaneous. If you never want to worry about time of day, Marquette is likely the best method to choose.

On the other hand, if you want your fertile window to be defined by cervical mucus, you may want to sacrifice any time of day sex for the flexibility of opening the fertile window that may come with using alternative evenings of the basic infertile pattern in Billings.

I recommend interviewing an educator and telling them your unique situation before committing to a method.

To find an instructor, I recommend using the Read Your Body Educator directory linked here. You can use it to find an instructor based on the fertility signs you want to chart, your location, price range, and more!

No dry days? You may qualify for a basic infertile pattern!

After menstruation, the majority of women will experience dry days. For these women, their basic infertile pattern is dry. Other women may experience a pattern of unchanging mucus, sensation, and discharge after menstruation. For women who experience this same UNCHANGING discharge, mucus, sensation pattern for three cycles in a row following menstruation, they may have a non-dry basic infertile pattern. The keyword here is unchanging; any changing pattern would not indicate a basic infertile pattern. This type of pattern should only be established under an instructor if someone is seriously avoiding pregnancy. For women who establish this pattern with a mucus-only instructor (either Billings or Creighton are options), this pattern has the same level of efficacy for avoiding pregnancy as a dry pattern. Some examples of this pattern may be continuous moist days, continuous sticky days, continuous white mucus, or others!

DO NOT try to use these days for unprotected sex without establishing it for a minimum of 3 cycles with an instructor (it may take longer than this). When using these days, intercourse should be rotated to every other day in the evening before bed.

What causes this pattern? In cycles less than 35 days, it is caused by bits of the G mucus plug breaking off. While the plug is breaking off, it causes the visible mucus or sensation. However, the rest of the plug is still blocked. This means this time of the cycle can be considered infertile if an instructor works with you to make sure it is the G mucus plug breaking off. In cycles longer than 35 days, it can be caused by a combination of the G mucus plug breaking off and estrogen’s effect on the vaginal walls causing a sloughing effect. Read more about the types of mucus here.

Sympto-thermal methods like Taking Charge of Your Fertility also mention a “sticky” dry basic infertile pattern. Methods like SymptoPro claim that women do take on an elevated pregnancy risk when using these days. As sympto-thermal methods are not as strenuous on mucus observations as mucus-only, consider this risk when deciding to utilize this pattern. Again, ideally if someone is avoiding pregnancy, they should reach out to an instructor before using these.

In either of these cases, experiencing any dry days following menstruation means that you do not qualify for a basic infertile pattern of non-dry in regular cycles. This pattern needs to be re-established with an instructor following hormonal birth control usage or pregnancy.

Irregular Cycles

For postpartum, perimenopausal, or people with cycles longer than 36 days, it is also possible to have a basic infertile pattern of non-dry after 14 days of the same UNCHANGING discharge, mucus, sensation. In addition, a combined basic infertile pattern is possible in the Billings Method. This should only be established with an instructor. For these transitions, the Billings Method is highly recommended.

In both regular and irregular cycles, working with an instructor can help you get more safe days for unprotected sex if you are experiencing a non-dry pattern.

6 Cycle Comparison: Marquette Versus Billings Versus DOT Fertile Windows

Have you ever been curious what your fertile window would look like in multiple methods?

In this blog, I show 6 cycles with various fertility signs and method interpretation including: the sympto-thermal method (Sensiplan rules), Marquette method, the Billings Ovulation Method, and DOT (a calendar method that was recently purchased by Clue app and is a new FDA approved birth control). I chose to include representation for only studied methods of fertility awareness: sympto-thermal, sympto-hormonal, mucus-only, and calendar method.

All charts are from the Read Your Body app, a flexible app for all methods that I highly recommend!

Some things to know before reading:

Marquette allows sex any time of day within their rules. My calculation rule lasts until the end of day 7.
Sympto-thermal method allows sex any time of day during first 5 days of menstruation, but the first safe day in the luteal phase must be used in the evening. My calculation rule is day 5.
Billings Ovulation Method allows sex in the evenings only and on rotated days in the pre-ovulatory time of the cycle. Days of bleeding where mucus cannot be observed are not allowed. However, since you can have sex any time of day post-ovulation with Billings, sometimes cycle day 1 is available if you have sex before bleeding occurs.
DOT allows sex any time of day within their rules. It automatically opens my window on day 7.

Cycle 53

Consecutive Fertile Window for Expected Abstinence:

Billings: 8 days

Sympto-thermal: 12 days

Marquette: 12 days

DOT: 12 days

General remarks: This is an extremely standard cycle in length and mucus patch (the average person will have a 5 to 6 day mucus patch when charting). I believe this is a great example of what methods would look like for someone of the average cycle length.

Cycle 54

Consecutive Fertile Window for Expected Abstinence:

Billings: 9 days

Sympto-thermal: 21 days

Marquette: 15 days

DOT: 12 days

General comments: My average coverline is 96.8 to 97.0, so regardless of earlier high temperatures and some illness I felt confident marking this coverline and temperature shift. Due to continous long, clear-ish mucus, my sympto-thermal peak was extremely delayed. Billings is a sensation focused method so I was able to mark my peak at an earlier time and have less expected abstinence.

DOT gave me a very risky day on this one. It is possible I could have been ovulating near the safe day. However, that would have only left 9 to 10 days for implantation and I had spotting, so whether this truly could have ended in pregnancy is up in the air. Even with well-timed sex, pregnancy will not always occur.

Cycle 55

Consecutive Fertile Window for Expected Abstinence:

Billings: 6 days

Sympto-thermal: 12 days

Marquette: 12 days

DOT: 12 days

General comments: This small fertile window in Billings might look scary to some, but it is not possible to get pregnant when the cervical mucus plug is truly closed. I have about one cycle like this every 13 cycles. I was also using the Kegg device during this cycle which is placed internally and reads electrolyte levels to determine the fertile window. It gave me the same 3 day dip for a fertile window, so I feel even more confident that those days were truly dry. I am missing temperatures on this one because my thermometer glitched and would not give me readings on these days. Sex day 1 was allowed because menstruation didn’t start until 5pm.

Cycle 56

Consecutive Fertile Window for Expected Abstinence:

Billings: 8 days

Marquette: 11 days

DOT: 12 days

General Comment: This was an extremely heavy period so I had no period days available in Billings. Even though the other methods gave me available days, I couldn’t have used them due to the pain, so ultimately the other methods didn’t really help out on more safe days.

Cycle 57

Consecutive Fertile Window for Expected Abstinence:

Billings: 10 days

Marquette: 14 days

DOT: 12 days

Cycle 58

Consecutive Fertile Window for Expected Abstinence:

Billings: 9 days

Marquette: 11 days

DOT: 12 days

General Comments: Marquette monitor missed my peak on this cycle. It misses peak on up to 10% of cycles. I relied on meeting LH rules instead of the monitor. Sex day 1 was allowed because menstruation didnt start until 1pm.

Reflecting on What’s Best for Me

I’m currently on cycle 59 charting, and I have tried a ton of methods. Right now, my ideal method is Billings and LH tests as a bonus marker.

While it may appear that Billings gives less safe days in some instances, what is most important to me is having the smallest consecutive fertile window. Having less expected abstinence actually makes me more likely to follow the rules. I was completely unsatisfied with only being allowed period sex in the sympto-thermal method because I have period pain issues. That means that I basically had no safe days at all in reality before ovulation with sympto-thermal.

I originally felt very enthusiastic about Marquette method. However, after 6 cycles of using the Clearblue Fertility Monitor, I realized that it always caught my LH surge after the cheap LH tests. In addition, it missing my peak even once is frustrating for the cost of the product. For that reason, I have decided to stop using the monitor when I run out of tests. I can use a 15 cent LH test and get the period prediction aspect (LH is my most steady indicator).

The DOT app tends to give me a risky cycle whenever I ovulate late and have a shorter luteal phase. I do not rely on this for pregnancy prevention. Overall though, DOT has not given me many risky ways. I use it for long-term period prediction, and it is the most accurate period predictor I’ve ever used for planning months in advance.

What to Consider Before Switching Methods

1. Why are you unsatisfied with your current method? Is it the amount of safe days, or is it the routine that you don’t like?

2. Do you have medical needs that could be addressed by another method?

Sometimes the grass isn’t greener on the other side, but if you are like me and can’t have period sex or don’t want to have period sex, methods like Billings without calculation rules will almost always include more safe days if you are dedicated enough to learn the method and chart it accurately.

Folks in irregular cycles like in postpartum time or with PCOS may benefit from more flexible methods without calculation rules

*DISCLAIMER: DO NOT TRY TO LEARN FROM MY CHARTS. MY CHARTS ARE NOT YOUR CHARTS.

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.

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.

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.

Why did I choose to become a fertility awareness instructor?

Why did I choose to become a fertility awareness educator?

Fertility awareness is the sex education I wish I learned in middle school.

When women actually learn how their fertility works, they learn that getting pregnant is not as easy as the drop of a hat. We learn to appreciate and live with rather than work against our fertility.

Almost every person who I’ve seen read #takingchargeofyourfertility or take a FAM class comes out of the experience saying, “Why have I not always known this information? I wish I could have known this when I was younger!” Learning fertility awareness changed my life, and I know it can change yours too.

Do I believe FAM is the right method of birth control for every woman?

No, it is probably not.

But I do believe that every woman should be taught how to understand her own body. What she does with that information is up to her.

Fertility awareness gave me the ability to avoid pregnancy on my own terms. It gave my spouse more knowledge about my body and the changes I experience during my cycle. It has strengthened my relationship in more ways than I can name.

If you want to learn FAM, I suggest getting an instructor. Check out this website for a list of instructors.