Fertility awareness and natural family planning can help you understand your menstrual cycle, recognize when you are most fertile, and make informed decisions about pregnancy.
Key Takeaways
- Fertility awareness involves learning to recognize the body’s signs of fertility.
- Methods may track cervical mucus, basal body temperature, menstrual cycles, or a combination of signs.
- Fertility awareness can be used when trying to become pregnant or as part of a plan to avoid pregnancy.
- Natural family planning generally involves using fertility awareness to make decisions about sex during fertile days.
- Effectiveness varies significantly between methods and depends on correct and consistent use.
- Period-tracking apps alone are not necessarily the same as a structured fertility awareness method.
- Breastfeeding, irregular cycles, certain medications, and other circumstances can make fertility signs harder to interpret.
- Fertility awareness methods do not protect against sexually transmitted infections.
- Learning a specific method from a qualified instructor can help you use it correctly.
- Your midwife or OB/GYN can help you decide whether fertility awareness fits your health needs and family planning goals.
For some women, understanding their menstrual cycle is useful when they are trying to become pregnant. For others, tracking fertility signs can be part of a plan to avoid pregnancy without using hormonal birth control.
Fertility awareness and natural family planning are sometimes used interchangeably, but there are some differences in how the terms are used. Both involve paying attention to the body’s natural signs of fertility and identifying the days when pregnancy is more likely.
These methods can be a good option for some women, but they require learning, consistency, and careful attention to the body’s changing fertility signs.
What Is Fertility Awareness?
Fertility awareness-based methods involve learning to recognize the days of the menstrual cycle when pregnancy is possible.
Depending on the specific method, you may track:
- Menstrual cycle dates
- Cervical mucus or vaginal secretions
- Basal body temperature
- Changes in cervical position
- Other physical signs associated with ovulation
The Centers for Disease Control and Prevention (CDC) describes fertility awareness-based methods as approaches that identify fertile days by observing fertility signs or monitoring cycle days.
Once you understand your fertile window, you can use that information to help plan or avoid pregnancy.
What Is Natural Family Planning?
Natural family planning, often called NFP, generally refers to using fertility awareness to avoid pregnancy without using contraceptive methods during the fertile portion of the cycle.
For example, a couple may choose to avoid vaginal intercourse during the fertile window or use another method, such as a barrier method, depending on the specific approach they follow.
The terminology can vary between healthcare providers, educators, and organizations. The important part is understanding exactly how a particular method works rather than assuming all fertility awareness methods have the same effectiveness.
How Does Fertility Awareness Work?
The menstrual cycle is not simply a predictable pattern of having a period every month. Fertility changes throughout the cycle, and ovulation does not necessarily occur on exactly the same day every month.
Fertility awareness methods attempt to identify when ovulation is approaching or has occurred by observing physical signs.
Cervical Mucus
Cervical mucus changes as hormone levels change during the menstrual cycle. As ovulation approaches, cervical mucus often becomes wetter, clearer, more slippery, and more stretchy.
These changes can indicate that fertility is increasing. After ovulation, cervical mucus typically becomes thicker and less abundant.
Learning to recognize these changes is an important part of some fertility awareness methods.
Basal Body Temperature
Basal body temperature is your body’s resting temperature, usually measured first thing in the morning before getting out of bed.
After ovulation, progesterone causes a small increase in basal body temperature. Tracking this change over time can help identify that ovulation has already occurred.
Because the temperature rise generally happens after ovulation, temperature tracking alone may not provide enough advance notice to identify the beginning of the fertile window.
Menstrual Cycle Tracking
Keeping track of when your period begins and how long your cycles last can provide useful information about your individual pattern.
Calendar-based methods use cycle length and specific rules to estimate fertile days. However, these methods may be more difficult to use when cycles are irregular. Fertility awareness methods include both symptoms-based approaches and calendar-based approaches.
What Is the Fertile Window?
The fertile window is the portion of the menstrual cycle when pregnancy is possible.
Sperm can survive for several days under favorable conditions, while an egg can be fertilized for a relatively short period after ovulation. Because of this, pregnancy can occur from sex that happens in the days before ovulation as well as around the time of ovulation.
This is one reason simply predicting ovulation based on an average 28-day cycle is not always reliable. Your fertile window can vary from cycle to cycle, particularly if your periods are irregular.
Can Fertility Awareness Help You Get Pregnant?
Yes. Fertility awareness can be useful for people who are trying to conceive because identifying the fertile window can help couples understand when pregnancy is most likely.
Some couples use cervical mucus changes, cycle tracking, ovulation predictor tests, basal body temperature, or a combination of these approaches to identify fertile days.
If you are trying to become pregnant, your healthcare provider can also help you understand your menstrual cycle and address concerns about ovulation, irregular periods, or fertility.
Can Fertility Awareness Prevent Pregnancy?
It can, but effectiveness depends heavily on the specific method and how consistently and correctly it is followed.
The CDC reports a typical-use failure rate range of approximately 2% to 23% for fertility awareness-based methods overall. That wide range reflects the fact that different methods have different effectiveness rates and require different levels of training and adherence.
For example, the Standard Days Method requires avoiding unprotected sex on days 8 through 19 of the menstrual cycle and is intended for people whose cycles generally fall within a particular range. The CDC reports that about 13 out of 100 users become pregnant during the first year with typical use.
If avoiding pregnancy is particularly important because of your health or circumstances, talk with your healthcare provider about whether a fertility awareness method provides the level of pregnancy prevention you need.
What Makes Fertility Awareness More Effective?
Learning the method correctly is important. Simply using a period-tracking app or estimating when you ovulate is not necessarily the same as using a structured fertility awareness method.
Effectiveness can be improved by:
- Learning from a qualified fertility awareness educator
- Tracking your fertility signs consistently
- Understanding the specific rules of your chosen method
- Recording information accurately
- Having a plan for fertile days
- Using a barrier method or avoiding sex during fertile days when pregnancy is not desired
- Getting professional guidance when cycles or fertility signs are difficult to interpret
The CDC notes that certain medical conditions and life stages can make fertility awareness methods more complicated and may require additional counseling.
What Can Make Fertility Awareness More Difficult?
Fertility awareness does not look exactly the same for everyone.
Certain circumstances can make fertility signs harder to interpret, including:
- Irregular menstrual cycles
- Breastfeeding
- The postpartum period
- Perimenopause
- Vaginal infections or unusual discharge
- Certain medications
- Illness or fever
- Conditions that affect ovulation
- Sleep schedules that make consistent temperature tracking difficult
This does not necessarily mean fertility awareness cannot be used. It may mean that you need additional instruction or a method specifically suited to your circumstances.
If your cycles are unpredictable or you have concerns about your fertility, talk with your midwife, OB/GYN, or another qualified healthcare professional.
Can You Use Fertility Awareness After Having a Baby?
The postpartum period requires special consideration. Ovulation can return before the first postpartum period, which means pregnancy is possible before you have another menstrual cycle.
Breastfeeding can also affect fertility signs and menstrual cycles. Additional caution is recommended with fertility awareness-based methods during the postpartum and breastfeeding periods because fertility patterns can be difficult to interpret while cycles are returning.
If you recently had a baby and want to avoid another pregnancy, talk with your healthcare provider about postpartum contraception options that fit your needs.
Do Fertility Awareness Methods Have Side Effects?
One reason some women choose fertility awareness is that these methods do not involve hormones or a device placed in the body. However, that does not mean they require no effort.
Depending on the method, you may need to take daily observations, record information, abstain from sex during fertile days, or use condoms or another barrier method during that time.
Some couples appreciate this level of involvement, while others find it difficult to maintain consistently.
The best contraceptive method is one that fits your health needs, preferences, lifestyle, and ability to use it correctly.
Do Fertility Awareness Methods Protect Against STIs?
No. Fertility awareness methods do not protect against sexually transmitted infections, including HIV.
If STI protection is needed, condoms can reduce the risk of many sexually transmitted infections when used correctly and consistently.
Is Fertility Awareness the Same as the Rhythm Method?
Not exactly. The rhythm method is an older calendar-based approach that estimates fertile days based primarily on previous menstrual cycles.
Modern fertility awareness-based methods may use multiple signs of fertility, such as cervical mucus and basal body temperature, rather than relying only on calendar calculations.
Because different methods use different rules, it is important to learn the specific method you plan to use rather than relying on a general fertility calendar.
Is Fertility Awareness Right for Everyone?
There is no single birth control method that is right for everyone. Fertility awareness may appeal to women who want to understand their cycles, avoid hormones, or use a non-device-based approach to family planning.
It may be more challenging for someone who has very irregular cycles, cannot consistently track fertility signs, or needs a highly effective method for preventing pregnancy.
Your healthcare provider can help you compare your options based on your individual circumstances.
Contraceptive choices should be based on voluntary, informed choice, taking factors such as effectiveness, safety, availability, side effects, and personal preferences into account.
Frequently Asked Questions
Can fertility awareness be used to avoid pregnancy?
Yes. Fertility awareness-based methods can be used to identify fertile days so couples can avoid unprotected sex or use a barrier method during that portion of the cycle. Effectiveness varies considerably among methods and with typical versus correct use.
Is natural family planning effective?
Some natural family planning and fertility awareness methods can be effective when learned and followed correctly. However, effectiveness varies by method, and typical use can be less effective when the rules are not followed consistently.
Do I need regular periods to use fertility awareness?
Not necessarily, but irregular cycles can make some fertility awareness methods more difficult to use accurately. A qualified provider or fertility awareness educator can help determine which approach may be appropriate.
Can fertility awareness help me get pregnant?
Yes. Understanding when you are most fertile can help you identify the days when intercourse is most likely to result in pregnancy.
Can I use an app for fertility awareness?
An app can be useful for recording cycle information and fertility signs, but not every period-tracking app is designed or validated as a contraceptive method. If you are relying on fertility awareness to prevent pregnancy, learn the specific method and rules behind the system you are using.
Can I use fertility awareness while breastfeeding?
It can be more difficult to use fertility awareness during breastfeeding because menstrual cycles and fertility signs can be unpredictable as ovulation returns. The CDC recommends special caution and counseling during the postpartum and breastfeeding periods.
Does fertility awareness protect against sexually transmitted infections?
No. Fertility awareness methods do not protect against STIs. Condoms can help reduce the risk of many STIs.
Where can I learn fertility awareness?
Some fertility awareness methods are taught by trained instructors who can teach you how to identify and record fertility signs. Your midwife or OB/GYN can also discuss your options and help determine whether fertility awareness is appropriate for you.
This information is not intended to serve as medical advice. For questions about or help with fertility awareness and natural family planning, we recommend you speak with one of our women’s health care specialists.