For the past eight years I have been battling severe endometriosis. Three surgeries, two rounds of medical menopause, and four doctors later: I am pregnant.
But getting here wasn’t easy. Because of my endometriosis it was automatically assumed that I would have a difficult time getting pregnant and therefore my doctor wanted to put me on Clomid. Given that I had just gotten over another round of menopause-inducing hormones, I wasn’t about to add more synthetic hormones to the mix. So I refused the prescription and decided to try to conceive for at least six months before taking a serious fertility drug.
During the last round of menopause I read Taking Charge of Your Fertility, a book that has changed my life. Unlike what most gynecologists will tell you, not every woman’s body is the same and therefore not every woman has a 28-day cycle with ovulation occurring on the 14th day. It’s hogwash.
Only in some imaginary, fairy-tale world would every woman magically ovulate on the same schedule. Reality check:
Every woman’s body is different. Some women have 20-day cycles while others have 32-day cycles. Some women don’t ovulate during each and every cycle. The same woman can have one cycle lasting 28 days and the next a 42-day cycle. So how the hell do women a) get pregnant or b) keep from getting pregnant if we are fed the wrong information?
The answer is easy — maybe. I mean it may be easy for most women who are fortunate to not be plagued by medical problems where unfortunately, FAM cannot help — although it can help some women pin-point their problems in conceiving. For those who aren’t dealing with infertilty or known medical conditions, practicing Fertility Awareness Method can be fantastic. Since studying and practicing FAM I feel so unbelievably in control of my body.
To use FAM, you chart your three primary fertility signs:
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- Waking Temperature
- Cervical Fluid
- Cervical Changes
Waking Temperature
Your waking temperature, or basal body temperature, is your body temperature when you are fully at rest. To track your waking temperature: 1) be sure to keep a digital thermometer by your bed and double check that the batteries are working; 2) set your alarm so that you wake up at around the same time every day, including weekends; 3) when you wake up, reach over and grab the thermometer and pop it in your mouth; 4) record or remember your temperature to record it later.
It is important to note a few important things: use the same kind of thermometer so your results are not skewed and do not get out of bed (or do any other vigorous movement in bed, including sex) before taking your temperature — even slight movement can elevate your temperature. Also, drinking alcohol the night before or going to bed significantly later than normal can alter your results. On those mornings still record your temp but make note of anything out of the ordinary that would cause a slight temperature change in your chart.
It is important to chart your temperature because the day after you ovulate your temperature will increase.
It is important to chart your temperature because the day after you ovulate your temperature will increase. For example, my waking temperature usually goes up and down between 96.4 and 97.0 degrees but the day after I ovulated, my temperature jumped to 97.6. I know the change seems small but it is a great indicator of the tiny signals your body gives off before and after ovulation. This is of course helpful to know in the greater plot of trying to conceive but doesn’t tell you exactly when to have intercourse. It’s more like ovulation insurance.
Cervical Fluid
For me, this was the coolest part about FAM. It is amazing how your cervical fluid changes throughout your cycle in preparation for ovulation! For many women, your cervical fluid follows a pattern of appearance and texture after menstruation:
- Dry or no fluid
- Sticky, tacky, crumbly or gummy
- Creamy, lotiony, cloudy or milky
- Egg white, stretchy, clear or watery
Paying attention to your cervical fluid is critical to charting. When explaining the complexities of the daily variations in cervical fluid and why it matters I like to tell folks a simple rule: sperm need stretchy and/or watery cervical fluid in order to be able to swim up to the cervix. When you have no cervical fluid or when it is clumpy or pasty, the sperm can’t swim and therefore getting to the cervix is pretty darn hard. Our bodies are so amazing because during the few days before, during, and after ovulation (the exact number of days vary on an individual basis, hence the need to chart) we secrete cervical fluid that is comparable to egg white and can even stretch four inches or more — perfect for sperm!
Our bodies are so amazing because during the few days before, during and after ovulation we secrete cervical fluid that is comparable to egg white and can even stretch four inches or more — perfect for sperm!
Throughout each day, observe your cervical fluid either by inserting your finger into your vagina or sampling what is present on your underwear and record this on a chart. Be sure that you stick to the same method — don’t use your undies one day and then insert your finger the next. Also, it is important not to just look at the fluid, but to rub it between your fingers to accurately gauge the consistency of it. It may take a while for you to get the hang of what your personal cervical fluid is like and how to judge where it falls when charting. Again, for pregnancy achievement the highest-quality fertile cervical fluid is stretchy and wet, like egg white — this means you will ovulate soon if your temperature hasn’t already spiked. This fluid is a great indicator that you should have sex if you are trying to conceive.
Also, charting your cervical fluid can help detect potential fertility problems, since some women simply don’t produce quality cervical fluid due to underlying problems. Charting can give you extra evidence to show your care provider — and can help you avoid unnecessary tests.
For women on clomid or other fertility drugs it is important to note that these drugs can cause your cervical fluid to dry up, making it difficult to track your changing cycle (and ironically more difficult for sperm to get to your egg). Also, some antibiotics can affect cervical fluid, so if you are on a certain medication and charting you should note a change in medications as it can skew results.
Cervical Position
Just like cervical fluid, the cervix changes position throughout a woman’s cycle. When a woman is most fertile the cervix will rise higher in the vaginal canal and the os, the opening in the cervix, will widen with the cervix itself feeling soft to the touch. When a woman is infertile her cervix will be lower in the vaginal canal, the os more closed, and will feel firm to the touch.
Unfortunately, I was unable to chart the position of my cervix throughout my cycle because my cervix, even at my most fertile moments, is WAY up in my vaginal canal and it takes most gynecologists a while to find it even when they are using a speculum and a flashlight! So, needless to say I can’t feel my cervix with my finger. However, if you are able to feel your cervix I strongly encourage you to chart its changes since using the three primary fertility signs together when charting is the best way to maximize your chances of becoming pregnant.
Secondary Fertility Signs
In addition to waking temperature, cervical fluid and cervical position, other fertility signs including ovulation pain and vaginal sensation. Some women feel sharp pains in the lower abdomen before and during ovulation. Also, as your cervical mucus gets wetter and stretchier you may feel a slippery or moist sensation. If you notice these two occurrences, you can chart that as well and it will help to double-check your primary signs. Also, a benefit of knowing the secondary signs is that you can document the signals your body puts off just before ovulation which helps you get to know your reproductive system even better!
For a visual of what charting looks like, I have my chart below. The purple squares represent the increase in cervical fluid. The hearts are when we had sex, you can see the temp spike and first green vertical line when I ovulated, and the plus sign and second green vertical line for when I got my positive pregnancy test!
The other great thing about charting is that because I knew when I ovulated I was able to take a pregnancy test super early instead of waiting for a missed period, AND my due date will be more accurate.
A Note on Sex
It is important to note that when you have sex semen can alter your cervical fluid. For pleasure-only intercourse, afterwards it is best that you go straight to the bathroom and do kegels to rid your vagina of any semen so that the next day (or during the day, depending on when you do it) your cervical fluid isn’t affected by the semen. For pleasure-and-baby-making intercourse you should make sure you lie on your back with a pillow propped under your butt (pillow optional but I found it more comfy) for at least half an hour to ensure the sperm have adequate time to swim up to the cervix and make their way to your egg. After you’ve waited a while you can go and rid your vagina of the semen.
Also, some men have lower sperm counts than others and FAM proponents will sometimes recommend that you have sex every other day so that your partner has time to build up a good sperm count. If you don’t have confirmation of a low sperm-count then I recommend starting out by having sex daily during days you have your fertile-quality CF, and if nothing happens after a few cycles you can try alternating days.
This is only one person’s experience — there are numerous resources out there (like Taking Charge of Your Fertility and Honoring Our Cycles. For more about charting, be sure to read How to track your cycles and chart your fertility without going super insane.
Even if you aren’t trying to conceive, charting is a great way to get to know your body better. I LOVE not being surprised by my period anymore. It’s also kind of nerdily satisfying. You mean I get to make a chart, with data, about myself? Sweet!
You can also start charting without reading the book (I did for about 6 months.), but reading it will give you a deeper understanding about why your body acts the way it does.
Definitely agree. One of the first things my mother did when I started having periods was give me a little pocket calendar (there’s probably an app for it now) and tell me to keep track of my periods and what they were like and how I felt (crampy, grumpy etc).
Knowing what my normal was from a fairly young age really helped me feel more in control.
I figured everyone did it, now I know to give extra kudos to my mum. I wonder if she read the book.
I soooo wish I could just do this. Unfortunately, I flatline in temperature and my cervical mucus is ridiculously variable. Plus I practically never ovulate without outside intervention.
Stupid PCOS.
But yeah, this is totally cool for people with more ‘normal’ fertility situations.
Try looking for fertilaid and fertilaid CM! It has great reviews and I think people use it that has PCOS and find great results! People that try for 6 years take this natural supplement for a month and get pregnant!! Seriously, my husband and I are going to try it! I’ll let you know how it works, but I really think you could benefit from it!
I read TCOYF a few years ago, and I’m now a doula and studying reproductive health (and preparing to get preggo in about a year).
Something REALLY important to remember about all this (and I’m pretty sure it was discussed in the book), is that the egg really can only be fertilized for about 12 hours after it’s released, while sperm can survive in the vag for 5/6 days. When trying to conceive, the most important sign, then, is cervical fluid. If you wait until your temperature spikes (at ovulation), you may miss that 12h window, but if you had sex yesterday because your cervical mucous looked good, fertilization is more likely to occur.
Um, that’s 5 or 6 days, not five-sixths of a day.
Jennifer: what do you mean, “studying reproductive health”? Is this a degree you’re taking? This is a topic that fascinated me and that I want to get involves in, so I’d love to know what you’re studying! Thanks!
I’d always considered myself pretty self-aware when it came to my cycles. Right now I’m charting for interest than anything else, using an app on my phone. The first month I was convinced I was [unexpectedly] pregnant when I wasn’t getting any signs of a period at 28 days. One negative test and a few cycles later, I now know my average cycle is 32 days at minimum. Can’t believe I went so long without knowing that.
I love that book and wish I could have been taught that in High School instead of the same old “your cycle is 28 days long and you ovulate on the fourteenth day”
Unfortunately there are still a lot of girls out there who think that they can’t possibly know their bodies that well. Even Disney realized that there wasn’t anything weird about womens cycles (I don’t know if this video has been posted here before but it is interesting http://www.youtube.com/watch?v=_l9qhlHFXuM
Love Taking Charge of Your Fertility! Reading it the first time was like finally finding the owner’s manual to my female body.
This article is a good summary of the concepts and practices presented in the book but definitely read the book too if you’re interested.
I bought TCOYF a few years back to learn how to AVOID getting pregnant, when it became very apparent my body can’t tolerate hormonal birth control st all. It has been a godsend. I started charting my cycles in 2006, and have never had a pregnancy scare.
Next year I’ll use the same methods to help P knock me up 🙂
I agree with what everyone has said about learning more about your body whether it is helping you get pregnant, not get pregnant, or solve health issues. I would also recommend “Endometriosis: A Guide to Healing Through Nutrition” even if you don’t have endometriosis. The book is a crash course on the interplay of hormones, the reproductive system, and how chemicals and nutrients affect it. It has totally changed the way I eat even though I was already a “healthy” eater.
That chart looks awesome and complicated. Did you make it yourself? Is there an app for that?
There are several sites that will let you make a chart like that. tcoyf.com has a free membership, and I know a lot of people use Fertility Friend. The Taking Charge of Your Fertility book comes with a CD with the software for charting which I think has some additional features. You can also chart on paper.
For more about charting, be sure to read How to track your cycles and chart your fertility without going super insane
FemCal is (i think) the only app that will let you export your results (including temp etc) in a readable form so you can print them etc. I don’t use it as I’m not charting for any reason right now and already have loads of data in the one I’ve got, but my research suggests that’s a good one if you need more complex data.
I did it online. The book I referenced in the post has a website: http://www.tcoyf.com and you can sign up and when you enter your info like cervical mucus, etc. it puts it in the chart for you. You can even change the colors to make it look however you want aesthetically 🙂
This is seriously the single greatest entry I’ve read explaining fertility awareness. I had charted my cycle for years and knew my cervix like the back of my hand – I consider it absolutely no coincidence that we got pregnant on the first try!
I’ve bookmarked this for future reference for the next time a friend tells me she’s trying to get pregnant. This is so well-written, it’s a great resource and better than my own yammerings on!
I used this to avoid getting pregnant for a long time — like another commenter, hormonal birth control doesn’t work for me (makes me super-anxious and kills my libido). Then, when we said, “Okay, let’s try making a baby,” it made things a lot easier.
I love this book! When I’m not on BC I have a 18-20 day cycle, which means I ovulate at least a week earlier than the norm. When I had my suprise pregnancy, I charted my due date based on what I had learned from this book and got Oct 1st. My doctor using the standard 28 days had Oct 14-16th and I told him he was wrong… after I had my daughter on Sept 28th he went out and got himself a copy!
Congrats to you on your pregnancy & all the best for the future!
I had a different due date than my Dr. and midwife as well. I had used TCOYF a few years ago, but basically got lazy about it. My fertility awareness is pretty much the extreme PAIN of ovulation! Of course, like someone said before, by the time you ovulate you should have already had sex the day before to give the sperm time to get there.
Thank goodness for breatfeeding! It gives me a break from all this for a couple years.
Thank you for confirming I am not the only woman to get ridiculous stabby pain during ovulation.
The first time it happened, I thought I might actually be dying until I called my mom (an RN).
We (I’m in nursing school) had a lecture about fertility and menstrual cycles and that it was important to know that far from every woman have a 28 day cycle. One student asked “but if my cycle is longer or shorter, how will I know when I ovulate if I don’t _want_ to chart my fluids”. The professor looked at her and said “oh, when you get your period you’ll know that your ovulation happened about two weeks ago. Maybe.” Very helpful. 🙂
She basicly told us that if you want to stop guessing and start knowing, you’d better start charting 🙂
But she also said that if charting is’nt an option and your cycle is fairly regular but not 28 days, stop thinking “ovulation on day 14” and start thinking “ovulation 14 days before bleeding”. For me, that’s on day 23 and I’m fine with just guessing. But if my cycle was irregular and I wanted to really know and not just estimate, I’d most likely read up on the fertility awareness method.
Actually, the “period 2 weeks after ovulation” thing is another myth. The Luteal Phase (time between ovulation and period) can vary widely from woman to woman. Mine is usually 10 days, not 14. Some women’s are longer than 14. A very short Luteal Phase can make it difficult to conceive.
You don’t have to chart your cervical fluids to know when your ovulation date is, either. Fluids are a very good thing to watch if you’re trying to get pregnant, but if you’re just charting for info’s sake, basal body temperature should give you enough information to know when you’ve ovulated. Though, you won’t know until after it’s happened and you’ve seen your temperature spike.
You can chart when you ovulate based on your temperature. Your cervical fluid tells you when you are fertile. The temperature shift tells you when you ovulated.
Love love love fertility awareness. I don’t care for hormonal birth control, and I love doing something that’s green and natural. I see a doctor who works especially with folks doing natural family planning, and from my year of charting, we were able to figure out that because of my super low basal temperature (like, 96.1…which my chart system didn’t even have), my borderline hypothyroid levels really required some medication, which seemed to help with my endometriosis and PCOS as well. We postponed a little one for about 2 years successfully and despite the beast of endo/PCOS, we had the happy blessing of conceiving the first time we tried using fertility awareness…awaiting our little guy’s arrival any day now! Thanks for your great descriptions of this system!
It worked for us! I have endo and PCOS, and it only took us five months with FAM. TCOYF is a really eye-opening and empowering book, even if you’re not using it for conception or birth control.
I started doing this because I suspected PCOS (and blood tests did reveal high testosterone), but ended up being pregnant less than a month later. My alarm clock broke while I was charting, and I got a two-alarm clock. I found it super helpful to always have one alarm set to my temperature taking time and be able to use the other freely for days when I got to sleep in a bit but still needed an alarm. (I have a variable work schedule.)
I also thought the book was great, and am so grateful that I will have such a strong knowledge base for figuring out what in the world my body is doing after the baby is born.
I love charting, and have used it for prgenancy avoidance for years before using it for pregnancy achievement. I started after realizing that hormonal birth control made me feelout of touch with my body, as well as killing my libido, and making me pack on the pounds. Using FAM also helped me know that after I quit the hormones, I still didn’t ovulate for 3 months.
i charted for 9 months using TCOYF and will agree that the book is a great ‘owners manual’ and i’ve recommended it to many people. however, i didn’t get pregnant.
i decided that charting every morning and crying every month when i got my period was driving me insane so i stopped charting to gain my sanity back, vowing that i would start again in a few months. and of course, two months later i got pregnant.
I sat in a cafe with a friend in late April 2010 bemoaning the fact that there was ‘no way I could be pregnant this month’ because ‘we hadn’t had sex at the right time’ (ie on day 10 not 14). Was awfully confused in early May when my period still hadn’t appeared… And in January 2011 I went into labour!
It was weird, it was only when we started to become pregnant that I realised how little I actually knew about my own body. Full marks to you for not just taking everything the doctors said at face value and doing your own research to make an informed choice! I found reading Childbirth Without Fear changed my life in a similar way, opted to have a home birth and had a genuinely fantastic experience. It doesn’t matter what choices you make as long as you’re making an informed choice, I feel. Good for you!
Thank you for this post! I am in my first cycle since stopping the pill and this synopsis is great!
Thanks for writing this. I have Endometriosis, lost my left ovary because of this disease and have also been through chemical menopause twice. We plan on trying this August. You gave me inspiration, and helpful hints on what to do! Thanks!
i got ‘Taking Charge of Your Fertility’ for a birthday present a couple of years ago and have been charting religiously ever since. i love how empowering it is knowing what my body is doing throughout my cycle. i grew up being terrified of my period because i never knew when it was going to show up. turns out, i’m one of those women who have such varied cycles every month, from a 19-day cycle to a 56-day cycle, not to mention that i don’t ovulate every time either. and i only know this now because of this book. this is a great synopsis of the book and the process of charting. thanks for writing this post. 🙂
Yes! Tcoyf is awesome 🙂 I first checked it out from the library and then immediately bought my own copy.
Also, my preferred app is ovuview…it lets you track a lot of different things and can export to email, etc.
I ‘ve never been diagnosed with any fertility issues, but have always been super irregular and would often go for months and sometimes years without ovulating or menstruating…When we decided to ttc, I happened to mention those issues to my chiropractor who started doing “pelvic adjustments”…each time I would ovulate within 3 days of those adjustments and it has now led to 2 pregnancies (hopefully the current one is successful). Just another natural route that my o.b. never mentioned and I never would have thought about (but have now seen other similar anecdotes online). Not saying it will work for everyone, but it’s worth a try if you’re struggling with irregular cycles.
So, I’m a nurse which means waking up at the same time each day is 100% impossible. Shift work just doesan’t allow for it – on Monday I might be waking up at 0445, then on Thursday I’m off to bed at 0700. Will I still be able to track my temperature?