Fertility Awareness Methods

What are fertility awareness methods (FAMs)?

These are methods where people become aware of the signs of fertility and learn to detect when they are most likely to become pregnant.

This information can then be used to:

• increase the chance of becoming pregnant by knowing when you are more likely to be fertile
• reduce the risk of pregnancy by avoiding sexual intercourse when you are more likely to be fertile

How does it work?

FAMs work by:

• learning to recognise the signs of when you are more fertile (symptoms-based methods).The most useful signs of ovulation are regular monthly changes, such as cervical mucus and body temperature
• monitoring the days of the menstrual cycle (calendar-based methods)
• not having unprotected vaginal intercourse during the more fertile times of the cycle

How effective are FAMs?

These methods rely on the motivation, experience, commitment and cooperation of all sexual partners to be effective for contraception or conception.
Effectiveness as contraception can range from 76-99% depending on the type of FAM used and whether they are used perfectly.
It is important to be taught how to use these methods by a trained educator.

When can I use FAMs?

FAMs mainly rely on the changes within your current cycle. Regular periods make these changes more predictable.
At times when your menstrual cycle is irregular it can be more difficult to predict your fertility. These times include at puberty, after childbirth, when breastfeeding, during peri-menopause and after stopping hormonal contraception.
If you wish to have a baby, fertility awareness methods can increase your chance of getting pregnant.

What are the benefits of FAMs?

• You understand your menstrual cycle better.
• If you wish to have a baby, you are aware of when you are most fertile which can maximise your chance of conception.
• There are no physical side effects because there are no medications or devices.
• These methods can be used where other contraception is not desired on personal grounds.
• May be used with other non-hormonal contraception such as diaphragms and condoms.
• They are cost effective.

What are the disadvantages of FAMs?

• All FAMs require an understanding of the menstrual cycle.
• Require motivation, experience, commitment and cooperation by all sexual partners.
• Require daily action in recognising the changes associated with the fertile phase of the cycle.
• Require periods of abstinence from sex if fertility awareness is the only contraception used.
• Can be less effective when there is difficulty identifying the fertile times.
• May not be suitable for people with irregular cycles.

There are many other factors that can influence the interpretation of the various changes associated with fertility (e.g. stress, illness, medications, alcohol, sleeping habits). Lack of control or understanding of these influences can make these methods less reliable.

People using FAMS should receive advice and support from expert trainers in the method, however such experts can be difficult to find.

Lactational Amenorrhoea Method (LAM)

LAM is the use of breastfeeding as contraception. Breastfeeding can cause a delay in the return of regular ovulation after having a baby. It is 98% effective in people who are within 6 months of having a baby if they are fully breastfeeding and their periods have not returned. Fully breastfeeding means there are no long breaks between feeds (no more than 4 hours during the day and 6 hours at night). LAM may also be less effective if expressed milk is regularly used.

Withdrawal

Although not recommended, withdrawal is a method of contraception where the penis is withdrawn (pulled out) from the vagina before ejaculation (cumming).
As sperm can be present in pre-ejaculation fluid (pre-cum) there is a risk of pregnancy even if the penis is withdrawn before ejaculation. Withdrawal is between 80-95% effective and this often depends on the experience and motivation of the people using this method.
Other methods of contraception offer greater effectiveness.

Further information

Australian Council of Natural Family Planning
www.acnfp.com.au