menstrual cycle – 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.

An Honest Review of Fitbit for Menstrual Cycle Tracking

You may know that the Fitbit app has some built in menstrual cycle tracking features, but many people do not know that it has other features that may be useful for menstrual cycle tracking. In this article, I will review the pros and cons of the Fitbit app as it relates to cycle tracking for people who ovulate. For context, I use a Fitbit Charge III.

The most basic feature that Fitbit offers for cycle tracking is recording bleeding dates of menstruation and then displaying a predicted fertile window based on average cycle length.

The pink bar represents the length of menstruation. The blue bar represents a predicted fertile window. The flower symbol represents predicted ovulation.

The user needs to remember to input menstuation each cycle. Once it is inputted, Fitbit will generate the blue fertile window. This fertile window should NOT be used for avoiding pregnancy, as it is only based on cycle length and not real-time fertility signs like cervical mucus or basal body temperature.

Once menstruation is entered, it will also begin a countdown until your next predicted menstrual cycle.

Countdown until menstruation in the app.

Unfortunately, I do not find this basic feature very useful for anyone who has any cycle variation. Even though my cycle length has increased over the last year, Fitbit has not automatically updated my cycle lengths. The app does not appear to be very adaptive without user input.

In addition to tracking bleeding the app offers options for:

Mood
Plan B (morning after)
Ovulation tests (better called luteinizing hormone tests)
Cervical mucus (Taking Charge of Your Fertility categories)
Cyclical symptoms like acne

It is rather disappointing that the app does not include options to mark pregnancy when it occurs, especially since we know that this changes daily calories burned and heart rate, to name just two effected areas of the app.

A really cool feature that I do like is the ability to show cycle trends like flow intensity and cramps. The same screen that displays this will also let you scroll through all past cycle lengths.

In the settings of this screen, you can also decide to toggle off predictions. For people avoiding pregnancy, I do recommend either ignoring or toggling off predictions in the Fitbit app. The app allows you to choose your current birth control method as well.

Outside of the designed menstrual cycle tracking features, I want to highlight resting heart rate as a potential exciting thing to track for those who are not taking hormonal contraception. Why do you need to not be taking hormonal contraception to utilize the heart rate feature for menstrual cycle tracking? Hormonal contraception suppresses ovulation, and ovulation changes our heart rate charts!

To learn more about resting heart rate and the menstrual cycle, read my previous post here.

You can see my heart rate falling during menstruation around April 10th, and then rise during my fertile window and luteal phase.

Menstruation began when my heart rate dipped below 70 on this chart. Ovulation likely occured around the third raised heart rate in this close-up.

Heart rate in people who are ovulating is at its lowest point during menstruation, rises during the fertile window, and continues to be elevated in the luteal phase.

When heart rate begins to drop again, this is an excellent way to predict menstruation will soon occur. For example, I have been tracking my heart rate in Fitbit for 2 years, and I always bleed when my heart rate dips back down to 70 beats per minute after my luteal phase!

I do think this feature is worth tracking for anyone interested in a more precise period prediction than cycle length. If you have Fitbit premium, you can also find a setting for sleeping heart rate under restoration. This may be more steady than resting heart rate for some individuals.

The red line is sleeping heart rate converted to fit on a charting graph, and the blue line is resting heart rate. They rose near the time of possible ovulation as indicated by the positive LH tests on the chart.

Lastly, I want to address Fitbit temperature for menstrual cycle tracking. Unfortunately, wrist temperatures are not a compatible parameter for fertility awareness when it comes to avoiding or achieving pregnancy. It can be incredibly erratic. When we track temperature, we want the temperature as closest to the core as possible.

Fitbit does not give precise temperatures, instead it gives deviations from a range. I likely ovulated near 18, 19, or 20 on the photo above. While Fitbit did detect a slight shift, it is not particularly clear, and it dropped back down.

As depicted above, my luteal phase the previous month was extremely undefined, and I could not determine a confirmed temperature shift with it.

For now, I do not recommend Fitbit for precise temperature tracking. Instead, I recommend a basal body thermometer.

Conclusion

Fitbit offers some really unique options for cycle tracking, but it should not replace your birth control or fertility awareness method. The heart rate feature may be useful for identifying cycle phases, but the temperature readings are not suitable for tracking cycle phases.

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.

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.

Shortcut charting, or “Wait… I don’t have to take my temperature every day?”

Many people come into FAM overwhelmed by all the data that they have to collect daily. It can be a bit of a turn off for those new to the method. They may wonder why they have to check their cervical mucus ALL day and then set an alarm on top of that.

When you first begin charting, it is vitally important to try to get the information down every day so that you can get into a habit and make sure that you are following the rules. Missing information will leave you with less complete charts that could leave you confused as to whether ovulation is confirmed or not.

However, once you have been charting for a significant amount of time and become confident, you can stop recording fertility signs once you have confirmed ovulation.

I am headed into chart number twenty-two successfully avoiding pregnancy with FAM, and I have been shortcut charting most of the time for about seven cycles now. I personally recommend confirming ovulation in 12 cycles before shortcut charting. This is so that you know how early you ovulate, your normal temperature levels, and how to tell whether something abnormal is going on in your cycle (ie sickness causing temperatures to be higher than normal or an abnormal cervical fluid dry up due to cold meds or some other medication).

Toni Weschler, author of Taking Charge of Your Fertility, recommends that women have several months of experience in the standard rules before taking any shortcuts. She offers some modified guidelines to follow and emphasizes that “contraceptive efficacy won’t be compromised as long as both your fertility signs have confirmed that ovulation has already been confirmed for that particular cycle.”

The Modified Rules

Temperature Taking

You don’t have to take your temperature during your period. Toni explains that these temps may be unreliable anyways. However, if you have short cycles with early ovulation, you may need those temps in order to confirm ovulation. If you have a temperature shift CD12 or sooner, you will need some period temps in order to have enough temperatures to draw a coverline.
You don’t have to take your temperature after you confirm ovulation with temperature rules. This means at least 3 high temperatures with a standard shift. If you have weak shift or a fall back rise, you must have the extra temperatures needed to fulfill those rules before you stop taking your temperature. Some people take their temperature again a day or two before they expect their period since it can (but not always) give an indication that menstruation is approaching.

Cervical Mucus

You don’t have to check cervical mucus after you confirm ovulation. You will need to check until you meet peak rules (P + 3) and crosscheck this with 3 high temperatures before you can stop checking for cervical mucus. Again, if you have a weak shift or fallback, you will need to check until you meet the rules.
From the day after your period until the day you observe peak type fluid, you should check cervical mucus continuously throughout the day and follow all rules for mucus checks. However, you don’t have to check cervical mucus multiple times a day once you observe peak fluid. If you observe peak fluid first thing in the morning, there is no need to keep checking. You have already recorded your most fertile observation for the day.

Those are the basic changes when short cut charting.

Here is an example chart.

This woman does not take her temperatures during her period. She begins taking her temperature on CD6 when menstruation ends. She checks her cervical mucus multiple times a day and follows the rules for checking until CD11. On CD11, CD12, and CD13, she observes eggwhite mucus first thing in the morning and doesn’t check again. On CD14-CD17, she checks mucus multiple times a day because she knows she needs at least a 3 day dry up (P + 3) to confirm ovulation. On CD 15, she has her temperature shift. CD16 is above the coverline. CD17 confirms ovulation because it is at least .4 F above the coverline. Ovulation is officially confirmed with both peak and temperature rules met. She takes her temperature again on CD26 to see if she gets a temperature drop indicating that her menstruation may begin soon.

People Who May Want to Think Twice about Short Cut Charting

Not everyone is suited to short cut charting.

Charting for Health: If you are charting for health, you may want to record your signs every day. Odd cervical mucus patterns and temperatures can indicate health issues. If this is your goal for charting, short cut charting may not be right for you.
Using Tempdrop: Tempdrop says to wear the device every day. If you don’t, it could disrupt the algorithm. As far as I know, they do not recommend short cut charting at this time. If you use this device, you may not want to short cut chart if you are worried about being at risk of pregnancy.
You aren’t confident in charting: If you are not confident in your ability to chart, you should NOT short cut chart. You should be 100% confident in your abilities before attempting this.
You are sick: If you are sick, you may want to chart more diligently and stay protected if you are uncertain about your chart interpretation.
You are only charting one sign: You NEED two signs in order to short cut chart. If you pick just one, you may be putting yourself at risk of unintended pregnancy. Ovulation must be confirmed with two signs.

Why Fertility Awareness Can Be a Feminist Choice

In this blog, I’m going to refute some of the arguments against fertility awareness. At the risk of losing some of my audience immediately, I have included the word feminist in this blog title. A while back, I got into an argument in a Facebook comment section with someone who was offended by this article that questioned the pill and it’s effect on women. The argument went nowhere fast, but it got me thinking.

In many circles, questioning the birth control pill is tantamount to attacking women’s rights. I have been told that I’m not a good feminist if I don’t support the pill. As someone who fully supports women and their choices, and as someone who only wrote about women in my graduate degree (I did a lot of gender studies topics), this assertion really hurts.

I know that the birth control pill changed many people’s lives. It brought women into the public sphere more than ever before. Women could now work and have sex without fear of pregnancy. It is considered a great achievement. What’s better than that?

The problem is that not many women are not fully informed about what their birth control options are before being put on the pill. In addition, women are put on the pill for reasons other than birth control (things like heavy bleeding, endometriosis and PCOS). However, we now know there there are alternative forms of birth control, and that the pill does not treat gynecological conditions (it masks them).

I was put on the birth control at age 15. I suffered from heavy bleeding, and mostly my mom just wanted me on it out of pregnancy fears. My doctor did not give me any information about the pill or expected side effects. (Some may point out that the packet comes with information, but freshman year aged me from high school did not think to read my birth control pack in depth). I was switched between at least 4 different types of birth control that I remember. The pill gave me migraines with aura (which I recently learned means I should have gotten off of it immediately, there is a link with having a stroke and migraines with aura while on the pill). I would lose vision while at work and had other disturbances in my vision. I also had pretty regular nausea, weird bleeding, depression, and digestive issues.

When I came off the pill for the first time at age 21, everything felt different. My emotions felt different, and my relationships changed. However, I was left with little alternatives for contraception. To me, taking the pill had become synonymous with being responsible, and I felt like I was failing at being a responsible woman and controlling my fertility.

At the same time, I felt so great coming off of it that I knew it wasn’t an option for me any longer. I felt truly like myself for the first time. One line in particular from a short film called Birth Control Your Own Adventure really resonated with me. This film is about how one woman struggles to find the right hormonal birth control. At one point a friend asks her, “How do you even know who you are if you’ve always been on the pill?” And, truly, I don’t think I knew myself while I was on it.

In my search for a better birth control, I stumbled upon fertility awareness methods. I found out that it was possible to track my cycle and determine daily whether I was infertile or infertile. Charting my cycle helped me learn when to expect a period. I had no idea that you could literally count high temperatures after ovulation in order to know when to expect a period. This feeling felt revolutionary, and I wanted to tell everyone.

When I try to share the joy I have found in this method, I often hear a few retorts. I’ve listed a few below along with my responses to these arguments.

The Arguments Against Fertility Awareness

Why should I have to plan sex? It seems kind of sexist that you expect women to wait to have sex at certain points in their cycle. On the pill, I can have sex whenever I want.

With fertility awareness methods, you don’t really have to “plan” to have sex. You can, however, choose to have unprotected sex during the infertile times of the cycle. If you are using a secular form of fertility awareness, you can also use condoms or other barriers during other points of the time in the cycle (keeping in mind that these barrier methods have their own efficacy rates).

I think it’s also worth noting how often the average couple has sex. A 2017 study found that the average American couple only has sex once a week. My window for abstaining or using backup protection is only about 9-11 days long. That’s a little over a week and a half a month. (I’m aware that some women have longer fertile windows. This aspect of fertility awareness is very individual and based on your own unique cycle). So, are these women really missing out on having unprotected sex a little less often?

Finally, yes, you can have sex on the pill whenever you want. However, the pill has been known to lower women’s libido and testosterone. Read this article to find out more. So, while you can have sex any time you want on the pill, doesn’t quality of sex matter? You can still have sex pretty often while using fertility awareness, and you may find you enjoy it more too.

This method seems really irresponsible. It only takes one time for a woman to get pregnant. What if she decides to have sex in her fertile window?

If someone is fully informed and taught by an instructor, they will know when their fertile window is. Yes, it only takes one time to get pregnant but if you are using fertility awareness, you know when that window is. If she decides to have sex in her fertile window, she may consider a barrier method. Anyone who has sex during their fertile window should be cognizant of the risks of pregnancy. By the way, at a typical use rate of 91%, someone could also have sex in their fertile window without knowing it while on the pill. At least fertility awareness lets women know what is going on in their own body.

Isn’t that a super religious method? I don’t care for that. It’s my body and I can have sex when I want.

Natural Family Planning is based in religious teachings. Fertility Awareness is not. Women can pick what they feel comfortable with based on their intentions. You can also still learn from NFP resources even if you aren’t religious. The method works the same regardless of any ideology attached to it.

Isn’t that like the rhythm method? You can ovulate at any time!! That’s not gonna work!

No, it’s not. There are many scientific studies on fertility awareness. Here is one. Here is a recent article reviewing all the studies done on FAM.

Women cannot ovulate at any time. Once ovulation has been confirmed in cycle, it is almost totally impossible for it to happen again. Some people say, “What about superfetation??” This is so rare, and almost impossible to prove. If you are confirming ovulation with a double check method, then you can be safely assured that ovulation will not happen again. At the beginning of a cycle before ovulation is confirmed, it could happen at any time. However, there are rules to follow so that women know when to stay protected.

The typical use rates of fertility awareness (when abstinence is practiced in the fertile window) is higher than the typical use rate of the pill. See my about section for more information.

But women need the pill for medical conditions, you know like endometriosis? Do you want women to suffer?

Obviously, I don’t want that. What’s important to know here is that the pill doesn’t actually treat endometriosis, or PCOS, or anything else really. It just masks the problem. If you have extreme period pain, you need expert care. The pill may mask problems that would eventually hurt a woman’s health and fertility. In particular, I want to note that if you are suffering from endometriosis, there is help. Join Nancy’s Nook Endometriosis Education to learn what your options are. For PCOS, Alissa Vitti is a great resource. Here is her website.

Isn’t it kind of anti-feminist of you to promote this? Women should be able to control their fertility however they choose.

Ah, my favorite question. I do agree that women should be able to control their fertility however they want. My whole shtick is that they should be fully informed in order to make this decision. With the dearth of good sexual education programs in the USA, almost no one is informed enough. Even doctors aren’t informed enough. Many only take one measly birth control class. Fertility awareness instructors do more than that, and they aren’t even in medical school. If more women knew that fertility awareness methods actually worked, they could make the decision to learn more about their body. I believe that all women should learn about fertility awareness methods as soon as they have their first cycle. It is so useful for girls to know what’s going on in their bodies!

I also argue that we have a #righttoovulate. I saw Dr. Lara Briden post this hashtag a while back, and I love it. Ovulation is amazing. And actually, I think it’s sort of anti-feminist to take that away from women, especially if they don’t understand what they are missing. Women are only fertile for around 24 hours a cycle (men’s sperm life makes up the rest of the fertile window). This is such a small window. Don’t we deserve the benefits of ovulation? Read Dr. Lara Briden’s article, “Ode to Ovulation” to learn more. In addition, some people have argued that it takes 7 years to develop fully healthy hormonal cycles, shouldn’t we be able to do that too? Putting women on birth control when they are young prevents so many of those benefits.

**I will note that I understand that hormonal birth control can be invaluable in domestic violence situations, or when a woman really cannot do FAM, or is forced on HBC for unrelated medical conditions. I just want the average woman to know that she has other options.

Conclusion

Most of the arguments against FAM are from uniformed people who don’t know what they don’t know. Fertility Awareness is actually feminist, and it’s certainly not anti-woman. It allows women to take control of their own fertility (here’s a great book on that). What’s more feminist than fully owning and living in your own body, while also avoiding pregnancy and planning it as you choose? Why should women subdue their own fertility when their fertile window is so short?

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