You might remember your first search for a long-term contraceptive. You may have even known beforehand what you wanted to use, thanks to passed-along info from friends, parents, and teachers. If you're like me, though, you might not have heard much about options beyond condoms or the pill. I began looking for my first birth control method when I was in a monogamous, STI-free relationship. I realized I was unwilling to use anything hormonal after hearing gripes from friends on the pill. I also wasn’t keen on taking drugs in the first place, even if they were “safe.”
I decided that two methods were my best bet -- ones that also happened to be high in effectiveness: the copper IUD and the sympto-thermal method of fertility awareness. Perfectly used, sympto-thermal is 99.6 percent effective, according to the Guttmacher Institute. ("Fertility awareness" is a blanket term for various methods that help you identify your fertile window in order to prevent pregnancy.)
Why fertility awareness scared the hell out of meI ended up getting the copper IUD first, but I also read a huge book on fertility awareness. I got excited about all the info and started charting my menstrual cycles. That lasted for half a cycle, until I went away for a weekend and purposely didn’t bring my thermometer or chart with me.
When I look back and ask what made me bail on charting my cycles that first time, the answer is fear. Despite the fact that I was wary of drugs and doctors, I had it instilled in me that birth control was someone else's job. That my reproductive system was a mystery. That I was too stupid to figure out how my own body worked. Once I started using the method in earnest (I got the IUD removed because I couldn’t handle the side effects), I realized not only how easy it was, but how essential this information was for other women.
So if you find yourself in the camp of women who hate hormonal contraception but are sick of using condoms, here's some of the information that wasn’t originally there for me.
What exactly is the sympto-thermal method of fertility awareness?“Fertility awareness based methods” is an umbrella term for a bunch of strategies that help show when you're fertile. With this knowledge, you can time unprotected intercourse outside of that window to avoid pregnancy. Unfortunately, the term is really unspecific, so it often confuses people. One fertility awareness based method is the rhythm method, which is, for the most part, totally ineffective and NOT a good option if you want to keep your uterus baby-free -- it does a poor job of determining your true fertile window.
The most commonly taught fertility awareness based method is the previously mentioned sympto-thermal method, which incorporates multiple signs of fertility -- which reveal what's happening with your hormones -- to determine your fertile window. These fertility signs are morning temperature, presence of cervical fluid (which you check when you go to the bathroom), and an optional sign of cervical position.
Checking your temperature is something we've all done when we're sick. But your temperature jumps after ovulation because of a hormone called progesterone. To observe the jump, you just take your temperature first thing in the morning, before you get out of bed (this ensures that it's not being influenced by activity). Cervical fluid is produced as your estrogen levels get higher, which happens before ovulation. Cervical fluid is also needed for sperm survival and ability to fertilize the egg, which makes it the primary fertility sign. You may have noticed your cervical fluid before -- around the time of ovulation it tends to get slick, clear, and stretchy. You can feel the difference in how easily the toilet paper glides when you wipe. To check your cervical fluid, you simply fold a piece of toilet paper flat, wipe at your vaginal opening, and see if there is anything you can collect between your fingers. Noticing the changes in your cervical fluid is the key to learning when you are fertile. With these two signs and a few other rules, you can figure out exactly when in your cycle you're capable of getting pregnant. And you can get an accurate fertile window based off only what your hormones are doing right then, instead of on calculations from past cycles. This means that even if you have irregular cycles, the sympto-thermal method can work.
Here’s the thing: If you want to use fertility awareness, you need to learn it well. One of the possible reasons for high user error is incorrect instruction. With all of today's Internet forums and blogs, you can piece together a lot of the information you need, but doing it that way isn't comprehensive enough.
If you use it, learn it well
This isn’t just about using an app to track your periods, or just taking your temperature every day. Your best bet is taking a few hours of introductory classes, practice, and personal follow-up with a qualified fertility awareness teacher. This will teach you the science behind the method, how to chart your cycles, and what in the world is happening with your body's fertility signs.
If you want to learn more and figure out if the method is for you, you can also pick up Taking Charge of Your Fertility by Toni Weschler, which will teach you how to chart your cycles and more.
What kind of birth control do you use? Have you ever thought about trying fertility awareness? Leave your thoughts in the comments.