Fertility awareness has a terrible reputation. Never mind the jokes - what about the statistics?
According to NHS Choices, the "typical" effectiveness rate for fertility awareness based contraception is only 75 per cent.
That means it fails one in four women. Not the best odds.
"Perfect use" is 99 per cent, but who's perfect? Not me.
So where does that 75 per cent figure come from, and is it fair?
It comes from the same place as the statistics for other kinds of contraception - this review of the evidence by James Trussell.
It's based on clumping together all the studies of women who use fertility awareness.
Over 80 per cent of those women used the calendar method of fertility awareness, rather than the more effective one where you also check temperature and fluid (the one I use and teach).
So no, I don't think 75 per cent is fair. But the researchers have their reasons, and things might change (see this blog by Chelsea Polis).
In the meantime, how do you get as close as you can to "perfect"?
Calendar + Temperature + Fluid
Use all three to check where you are in your cycle.
Calendar alone is not a great idea unless you have incredibly regular cycles.
Temperature alone or even fluid alone works for some, but the best thing is to use all three (and ovulation tests as well if you want).
Handle your fertile days
A fundamental part is using condoms or other precautions for at least ten days a month - more while you are learning, or if you have any cycles that are less than 26 days long.
Yes you can only get pregnant for about eight or nine days a cycle but you need to allow for things changing from month to month, and sperm surviving for up to seven days.
If using condoms for that many days fills you or your partner with horror, this is not the method for you.
Keep it simple
Official folk, for all sorts of well-meaning reasons, say that if you want to use fertility awareness “you can’t miss a single day”.
I've also seen people claim that taking your temperature 5 minutes late makes a difference - it doesn't.
An hour later or earlier than usual makes a difference but you can adjust for that.
Of course it is good to start with a few very sensible months where you do chart most days - and to continue if you can, or at least have a sensible month now and again.
Charting is not a massive burden if you compare it to how long you spend booking and attending appointments.
But if you're going to use this method long-term you probably want to keep it simple.
If that's you, you could simply record these things:
- Day one of your period
- At least ten waking temperatures (enough to confirm your temperature shift)
- The two or three days when you have lots (and I mean lots) of vaginal fluid
Learn the essentials
It's brilliant that there are so many fabulous books and other resources out there. Read them!
But there is a limit to how much to need to learn. These things are fundamental:
- Your cycle's amber, red and green days
- Why your waking temperature goes up every month
- Why you get all that fluid for a few days a month
OK, there's a bit more to it that that, but it's not that difficult to be "perfect".
Want to know more? Read my DIY guide - or skip straight to getting support.