Condoms and other precautions
Using fertility awareness as contraception means using condoms or other precautions for at least 11 days a month.
Women are only fertile for around 9 days a cycle but those days move around, and are difficult to predict. You need buffer days to avoid pregnancy.
For some people the number of condom days is a deal breaker. Others take it in their stride.
Some couples enjoy the varied approach to avoiding pregnancy and the chance to share responsibility for avoiding pregnancy.
You can change your approach depending on how fertile you are, and on how much you want to avoid pregnancy.
On your most fertile days you could choose to abstain or use your imagination. On your might-be-fertile days you could use condoms, or you could even use a combination of methods. For example a Caya diaphragm and pulling out.
Here's more about your options:
Women are only fertile for around 9 days a cycle but those days move around, and are difficult to predict. You need buffer days to avoid pregnancy.
For some people the number of condom days is a deal breaker. Others take it in their stride.
Some couples enjoy the varied approach to avoiding pregnancy and the chance to share responsibility for avoiding pregnancy.
You can change your approach depending on how fertile you are, and on how much you want to avoid pregnancy.
On your most fertile days you could choose to abstain or use your imagination. On your might-be-fertile days you could use condoms, or you could even use a combination of methods. For example a Caya diaphragm and pulling out.
Here's more about your options:
- Abstinence. Avoid sex completely. Strictly speaking, if you abstain from all sexual activity during your fertile time you're using natural family planning, which is the Catholic version of fertility awareness.
- Imagination. Work it out between yourselves. Could mean more orgasms if you're a woman. In case you're wondering, I don't mean anal sex. Women are not built for it and it can lead to health problems.
- Condoms. A popular but underrated way to avoid pregnancy. Can be 98% effective with correct use, 82% with typical use. For tips on correct use check my condoms skills page.
- Diaphragm or cap. This fits over your cervix and stops sperm getting in. Use with a spermicide, like Caya gel, and leave in place for six hours after having sex. 92 to 96% effective with correct use.
Avoid using a diaphragm or cap around ovulation. Peak fluid and a shorter than usual cervix, might mean it slips out of place. If that happens, you're more likely to get pregnant as this is when you are at your most fertile.
A diaphragm or cap has to be the right size. Ideally it will be fitted in a sexual health clinic and a member of staff will make sure you know how to insert it. Book ahead to make sure there is a member of staff with suitable skills.
- Caya is a "one size fits most" version of the diaphragm. Your height is a way to tell if you are in the "most" category. If you're unusually tall or short it might not fit. Ideally get it checked at a sexual health clinic (see above).
Here's how to use Caya. Some sexual health clinics supply it, or you can buy from Amazon. - Withdrawal, also known as pulling out. An unforgiving method but can be up to 95% effective with correct use. Fails one in 5 women with typical use.
To improve effectiveness combine with a diaphragm and spermicide, or condoms. And know your limits. Some men are leakier than others.
- Potentially helpful: OK so this really is fringe but men are told to avoid saunas, steam rooms, hot baths and tight underwear when their partner wants to get pregnant. So these MIGHT help women avoid pregnancy. BUT heat-based contraception is still in development. Only use alongside other methods, not instead of them.
Emergency contraception
Emergency contraception doesn't always work, especially when you are at your most fertile, but still it use if a condom falls off or splits.
Act quickly and keep a "just in case" supply. Buy it yourself, or get a free supply from your GP, nurse or sexual health clinic. EllaOne is generally considered more effective than Levonelle.
After taking the emergency contraception pill, assume you're fertile until you've had both a period and a sustained shift from lower to higher temps (see green days).
The most effective form of emergency contraception is the copper coil. It can be fitted up to 5 days after unprotected sex and needs to be left in for 3 weeks. After that you can get it removed. Or or you can leave it in and switch to using it as contraception.
Act quickly and keep a "just in case" supply. Buy it yourself, or get a free supply from your GP, nurse or sexual health clinic. EllaOne is generally considered more effective than Levonelle.
After taking the emergency contraception pill, assume you're fertile until you've had both a period and a sustained shift from lower to higher temps (see green days).
The most effective form of emergency contraception is the copper coil. It can be fitted up to 5 days after unprotected sex and needs to be left in for 3 weeks. After that you can get it removed. Or or you can leave it in and switch to using it as contraception.
Stress reduction
Much as I love fertility awareness as contraception, I know it can be stressful. Here's some ways to reduce the stress:
If you want a child sometime soon, watch out for random broody, or curious, moments. It's very easy to flip your knowledge and use it to help you get pregnant.
If your ultimate backup plan is to have an abortion, avoid crisis pregnancy centres. They sound like they'll give you neutral advice but they won't.
Abortion isn't easy. Many women are shocked by how long it takes to get one, by how painful it is and by how long they bleed for. There's often complicated emotions involved as well. But it's an important and hard-won option. One in three women in the UK will have an abortion by the time they are 45.
- Get support. The NHS website suggests getting support from a practitioner (like me) on the Fertility UK list. Some of us are NHS-funded, many offer a sliding scale (including me).
- Understand the evidence base so you can fend off the stress caused by lectures from well-meaning people in your life, or the media.
- Read Ejaculate Responsibly: The Conversation We Need to Have About Men and Contraception. A fabulous call to arms. Heavily biased against fertility awareness (see above), but still worthwhile.
If you want a child sometime soon, watch out for random broody, or curious, moments. It's very easy to flip your knowledge and use it to help you get pregnant.
If your ultimate backup plan is to have an abortion, avoid crisis pregnancy centres. They sound like they'll give you neutral advice but they won't.
Abortion isn't easy. Many women are shocked by how long it takes to get one, by how painful it is and by how long they bleed for. There's often complicated emotions involved as well. But it's an important and hard-won option. One in three women in the UK will have an abortion by the time they are 45.
Fertility awareness forever?
You might become a massive fan of fertility awareness who would never dream of using another method of contraception. And you might not.
Check in with yourselves every so often. Is fertility awareness still right for you or is one of you getting fed up?
Unplanned pregnancy, or even frequent use of emergency contraception, might mean you need to rethink your approach.
You could decide to become a more diligent user of fertility awareness, and get support, or maybe it's time to consider another kind of contraception.
I'm a big fan of fertility awareness but I don't want anyone to feel it's their only option, there are others.
Check in with yourselves every so often. Is fertility awareness still right for you or is one of you getting fed up?
Unplanned pregnancy, or even frequent use of emergency contraception, might mean you need to rethink your approach.
You could decide to become a more diligent user of fertility awareness, and get support, or maybe it's time to consider another kind of contraception.
I'm a big fan of fertility awareness but I don't want anyone to feel it's their only option, there are others.
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Affiliate links - this page includes some affiliate links which means I get a (very) small payment. You don't pay anything extra and I only link to products I like.