What is the Fertility Awareness Method?

The Fertility Awareness Method (FAM) refers to practices that allow women to determine the fertile and infertile phases of their monthly cycle. FAM can be used to either avoid pregnancy, to achieve pregnancy, or as a way to monitor reproductive health.

Fertility and the Monthly Cycle

Women throughout the ages have watched the changes in their bodies during the monthly cycle, but science is just now giving us the deeper understanding of these changes. FAM is not the same thing as Natural Family Planning or the Rhythm Method. It is rather very specific monitoring of three physiologic changes in the woman’s body that occur when she is fertile including changes in:

  • Her basal body temperature, measured with a special thermometer
  • Her cervical mucus quality and quantity (as noted by the woman); and
  • Her cervical position and shape (as felt by the woman with her finger).

FAM as Birth Control

For the days that a woman may be fertile, FAM users need to either abstain or use a barrier contraceptive such as a condom. FAM is most effective when used after ovulation and before menstruation with failure rates (conception occurring) only 1% of the time per year. Using FAM throughout the month results in a failure rate similar to the condom alone with < 5% failure (and as low as 2% in experienced women). In contrast, the Rhythm Method has about a 10% failure rate. That said, I did get pregnant with my first child using FAM, not because the method didn’t work, but because I ignored the symptoms of fertile EWCM and had unprotected intercourse when I should not have. My body was speaking I just chose to ignore it!

FAM for Trying to Conceive

FAM is an extremely effective system for trying to conceive. Several studies have shown some of the best chances of conception occur for women who know how to identify their peak fertile days based on cervical and temperature changes. Using FAM can help couples target days to have sex versus exhausting themselves when there is little chance of conception. I consistently used FAM to track my fertility when TTC child #2.

To learn more about FAM for trying to conceive or for pregnancy avoidance read Toni Weschler’s Taking Charge of Your Fertility. She also has an excellent book for teens to teach them this awareness for overall reproductive health “Cycle Savvy.”

Sadly, many docs, even those working in reproduction, do not understand FAM or how it differs from other natural fertility methods.

Additionally, many of them don’t understand the changes in cervical mucus during the woman’s cycle. This is another of those areas where you may need to learn so you can teach your physician and help them know about the valuable resources you find, such as Toni’s books.

- Dr. E

Science can help us nurture and enjoy our sexual selves. 


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