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An Introduction to Different Fertility Awareness Methods

People who are just entering the world of fertility awareness based methods (FABM) may be surprised to find out that there are a variety of methods to choose from. These methods can be divided into five types

  • symptothermal,
  • hormonal,
  • mucus only,
  • temperature only, and
  • calendar.
An Introduction to Different Fertility Awareness Methods: Temperature Only, Calendar, Symptothermal, Hormonal, Cervical Mucus Only

How Effective Are They?

However, I will only cover the first three - symptothermal, hormonal, and mucus-only - for important reasons:

  1. Most temperature-only methods use expensive monitors and/or apps. These rely on proprietary algorithmic predictions, which means that you aren't actually learning much about your body. You aren't learning what the temperatures mean, or how to recognize something - good or bad - the algorithm didn't catch. It goes against the ethos of learning about your body, which is the foundation of FABMs.
  2. As well, I won’t cover calendar, or “rhythm,” methods because they are based on “average” or “normal” cycles and have notoriously low efficacy rates. Some methods use an average cycle from an individual, which will be slightly more effective, while others use averages from the whole population - talk about generalizing! These methods tend to give FABMs a bad name.

Instead, we will only mention those methods - symptothermal, hormonal, and mucus-only - that have been independently evaluated, have transparent methodologies, known effectiveness, and are based on daily observations of temperature, cervical mucus, hormonal changes, or a combination thereof. These methods are the core of the science surrounding FABMs and are slowly - but deservedly - changing popular perception for the better.

  1. Hormonal FABMs
    Hormonal methods detect production of key fertility hormones with daily at-home urine tests and an electronic fertility monitor. Cross checking with daily cervical mucus observations is also encouraged in many of these methods. Examples of hormonal methods include the Marquette Method and FEMM. Hormonal methods are 88-90% effective with typical use.
  2. Mucus-only FABMs
    Mucus-only methods teach users how to observe and chart changes in the color and consistency of cervical mucus in order to determine the phases of the menstrual cycle. Examples of mucus-only methods include the Creighton Method, the Billings Ovulation Method, Justisse, Family of the Americas, and the Two Day Method. Mucus-only methods have a typical use effectiveness rating of 83-97% according to these two studies of the Creighton Model and the Billings Method.
  3. Symptothermal Fertility Awareness Based Methods
    Thermometer
    The sympto-thermal method (STM) is based on the observations of cervical fluid, basal body temperature (waking temperature), and biological signs (i.e. changes in the cervix). Examples of sympto-thermal methods include Taking Charge of Your Fertility, the Couple to Couple League, NFP International, SymptoPro, the Boston Cross-Check, the Roetzer Method, Sympto, Serena, and Sensiplan. As there are a lot of methods, not all of them have been studied. An ongoing Sensiplan study (conducted on those learning under a qualified instructor) shows Sensiplan to be 98-99.4% effective in avoiding pregnancy. Other symptothermal methods likely fall in line with that efficacy.

How to Get Started

If you're interested in starting to chart your cycles, the first step is to pick a method. It can be a little bit difficult, but speaking with qualified instructors and current users can help you narrow down your choice.

Note that at Tempdrop, we recommend our users use the sympto-thermal method and base our effectiveness rates on regular and perfect use of the sympto-thermal method. After all, why shouldn't you strive after the highest efficacy rate?

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Once you've picked a method, charting is pretty simple! It only takes a few minutes each day, but the benefits of understanding your body better are enormous. Happy charting!

If you'd like to learn more about FABM, including how to chart your cycle and identify your fertility window, download Tempdrop's free Introduction to Fertility Awareness, a beautifully-designed guide written by seven certified fertility educators (including Johnna!).

Johnna Wilford teaches women to get in touch with their bodies, take control of their health, and feel confident through fertility awareness. Johnna is the founder and CEO of Risa Fertility, a women’s health company focused on making fertility information more accessible for women everywhere.

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