Fertility Awareness

Family Planning, Natural, Natural Family Planning

Results

Generally, your most fertile days begin 5 days before ovulation and end on the day of ovulation. Pregnancy can occasionally occur after ovulation, but it is less likely than in the days before ovulation.

Calendar (rhythm) method

If your menstrual cycle is 28 days long, you are most likely to ovulate about 14 to 15 days after menstrual bleeding begins.

If you do not want to become pregnant, the calendar method of birth control is not the best choice for women who have short, long, or irregular menstrual cycles. For this reason, the calendar method alone is never recommended for birth control. It must be used in combination with other birth control methods.

Standard days method (SDM)

The SDM works best for women who have cycles between 26 and 32 days long. If you have more than one cycle in one year that is shorter than 26 days or longer than 32 days, you need to use another method to avoid pregnancy.

Basal body temperature (BBT) method

Your basal body temperature usually drops about 0.4°F (0.2°C) below your normal temperature 1 to 2 days before ovulation. It then increases the same amount or more above your normal temperature 1 to 2 days after ovulation and stays high until just before your menstrual period begins. Since the rise in BBT does not occur until after ovulation, it is possible to become pregnant if you have sex just before or during ovulation.

Many women do not have a regular temperature pattern, so it can be hard to use this method to know when ovulation occurs.

Cervical mucus method (Billings method)

After your period, you will not have much cervical mucus and it is thick, cloudy, and sticky. Just before and during ovulation, you will have more cervical mucus and it is thin, clear, and stringy. It may stretch about 1 in. (2.5 cm) before it breaks.

For the 2-day method of checking your cervical secretions, ask yourself if you have secretions today and did you have secretions yesterday. For all days that you answer "yes" to one of these questions, it is likely that you are fertile and can become pregnant if you have unprotected sex. If you answer "no" to both questions on any day, you are not likely to become pregnant.

Hormone monitoring

Home ovulation tests measure the amount of luteinizing hormone (LH) in the urine and display the results on a test strip or a small computer unit.

Combined (symptothermal) method

Many women have symptoms such as breast tenderness, swelling of the vulva, bloating, belly pain on one side, or increased sexual desire around the time of ovulation.

Fertility awareness is most effective when all the methods are used together. The number of unplanned pregnancies is 25 out of 100 women who typically use these methods.

If you have had a baby in the past 6 months or if you have an irregular menstrual cycle, it may be hard to use this method to know when ovulation occurs.

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Author:	Jan Nissl, RN, BS	Last Updated: April 20, 2006
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology
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