This method (also known as the Fertility Awareness Method) involves recognizing the periods during the month to avoid sex and when to have sex without contraception with reduced risk of pregnancy. It requires a good understanding of the body's ovulation cycle and consistent record-taking of between 6 to 12 months of monthly menstrual cycles.

Ovulation is said to occur when a woman's egg cell (Ovum) is released from the ovaries. It occurs once a month, at about 12 - 16 days after menstruation(The first day of menstruation usually signals the start of the monthly cycle). Although the female ovum can probably be fertilized for only a few hours after ovulation, the male sperm because of its lifespan, can fertilize the ovum for several days after entering the cervical canal; thus, conception can actually result from sex that occurs up to 5 days before ovulation.

To track menstrual cycle, determine ovulation and fertility period of a woman, three types of the natural family planning method are frequently used, namely;

  • Calender Rhythm Method
  • Measurement of Basal Body Temperature Method
  • Cervical Mucus Method
  • Symptothermal Method

Calender Rhythm Method 

This method uses accurate records of past menstrual cycles (at least 6 months record of menstrual cycle). To determine fertility, the female subtracts 18 days from the length of her shortest recorded cycle (this tells the first day fertility time commences) and 11 days from the longest recorded cycle (this tells the last day of the fertility time). The duration of time thus obtained from the first day fertility time commences to the last day of the fertility time (as determined from the calculation) is her fertile period.

Couples are to avoid sex during this fertile period or compulsorily use a condom/diaphragm if sex cannot be avoided to prevent conception.

The calender rhythm method is the least effective of the natural family planning methods due to variance in menstrual cycle lenghts. On the average, women with monthly cycle lengths between 26 - 29 days must abstain from sex from the 8th day of menstrual cycle all through to the 18th day. Greater differences in cycle lengths will increase the required periods of abstinence from sex,

Measurement of Basal Body Temperature Method

The measurement of basal body temperature is an effective method used in determining ovulation and fertile period in a woman as basal body temperature rises by about 0.5°C (or 0.9°F) after ovulation.

To do this the woman measures her body temperature with a thermometer  before getting out of bed everyday. Temperature readings must be taken same time every morning and recorded. She should watch for a rise in her body temperature by about 0.5°C. This occurs immediately after ovulation. 

The couple are to avoid sex for at least 72 hours after this rise in temperature. 

Cervical Mucus Method

The cervical mucus method serves as an accurate indicator of fertility period as an increase in cervical mucus usually occurs near the time of ovulation. The hormone that controls menstrual cycle in women also makes the cervix produce mucus. This mucus which collects in the vagina undergo changes in quantity and quality just before and during ovulation.

To use the cervical mucus method the woman needs to recognize these changes and mucus patterns. They include;

  • At start of menstrual cycle, menstrual blood flow covers mucus, so no mucus is seen.(Unsafe period)
  • After menstrual blood flow end, there are a few days without mucus (dry days). These are infertile (safe) periods if a woman has long menstrual cycle (not safe if menstrual cycle is short)
  • Once an ova (female egg cells) starts to ripen at the ovaries more mucus is produced. It appears at the vagina as a thick, cloudy, yellow or white coloured mucus. They also feel sticky.(Unsafe periods)
  • Mucus secretion is highest just before ovulation and it appears like raw egg white, easily stretched with the fingers. The days this occurs are refered to as wet days and signifies the fertility (Unsafe) period in the woman.
  • Wet days last for about 4 days (Unsafe period). After that mucus secretions become cloudy again and feel sticky until it finally dries out (dry days). These (dry days) are infertile (safe) periods until the next menstrual bleeding starts.

It must be noted that  the woman's mucus secretions is often altered by breastfeeding, hormonal contraceptives, emergency contraceptives and sexually transmitted infections. These change agents should be avoided when using the cervical mucus method

Once all these changes are understood, the woman will have sex during the safe periods and abstains from unprotected sex during the unsafe periods (as indicated above). 

Symptothermal Method

This is the most accurate of the natural family planning methods as it combines the measurement of basal body temperature method and the cervical mucus method with other fertility signs such as presence of breast tenderness and ovulatory pain in determining fertility and periods of abstinence from sex. 

Couples avoid sex between the first day of menses and either the fourth day of peak cervical mucus secretions (wet days as explained above) or the third day after the rise in basal body temperature.

The symptothermal method, when implemented correctly is 90% effective as a contraceptive method.


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