What is FAM & other non-hormonal contraceptive options.

What options do we really have?

In terms of contraception, the pill is without a doubt one of the easiest ways to prevent pregnancy without having to think too much about it, while offering a 91-99.7% efficacy rate. But the conversation regarding the nasty side effects of the pill is getting louder and louder within the world of women’s health, and so many of you are asking “Well how else will I prevent an unwanted pregnancy?”

the pill.jpg

Honestly… us women don’t have many great options that don’t involve side effects or daily work. If you want to try to get in and interupt the powerful work of evolution (reproduction) while still enjoying your pleasurable intimacy with another human, you’re going to need something quite miraculous. And unfortunately, if you want there to be a high chance that your good times won’t result in a pregnancy, like your body innately wants to do, you’re going to have to sacrifice something. That might mean things such as putting up with side effects of the pill or an IUD, interrupting hot and steamy times to put on a condom, or taking the time to learn a fertility awareness method and then practicing it daily to avoid having intercourse during your fertile window.

I personally have tried almost every single form of contraception there is, and what has worked the best for ME is the Fertility Awareness Method (FAM). I wanted to introduce this method and explain it in my own words because there are so many mis-interpretations of it and misunderstandings, and I wanted to highlight to you that if you do not stick to the rules of FAM, yes, you could get pregnant. Just the same as if you don’t stick to the rules of taking your pill everyday, you could very well wind up pregnant.

So, What is Fertility Awareness Method (FAM)?

Back to basics – in order to become pregnant, you need a viable egg, viable sperm and a hospitable environment. Once ovulated, an egg can only live for 24-48 hours. Sperm can live inside a woman up for up to 5 days. (Given this information, don’t you find it funny how historically, the responsibility of contraception has largely be placed upon women, while men are actually more fertile on a day to day basis?)

Fertility Awareness Method (FAM) is practiced by tracking the certain biomarkers that your body has (cervical mucous, LH testing, Cervical position, Basal Body Temperature – see Tracking your cycle), and works by abstaining from sexual intercourse once you recognize signs of impending ovulation, all the way through until you have confirmed ovulation. Some people choose to use a barrier method of contraception during their fertile window, but the efficacy of Fertility awareness is based on completely abstaining during that window of time, and so if one does choose to use a barrier, the efficacy of preventing pregnancy would then revert to the efficacy of that method (for example, a male condom is 82-98% effective).

There are many methods of fertility awareness and if you’re new to FAM, I would recommend that you study and learn ONE method and practice it until you get a clear picture of your ovulatory pattern before switching or incorporating other forms.

The method I am training to become certified in right now is call the FEMM method, and we use observation of cervical mucous changes as well as LH testing strips to determine a womans fertile window. After the first few cycles, the rules are as follows: you can have unprotected intercourse during your PRE-ovulatory phase on alternate dry days (no cervical mucous), and anyday during your post-ovulatory phase. Other methods have slightly different rules.

Other methods can include but are not limited to: Taking Charge of your Fertility rules, Marquette, Sympto-Thermal, sensiplan, and the Creighton methods. The difference between these methods are simply the biomarkers you choose to observe and the rules are sometimes different as well.

I can’t speak for the other methods, but the FEMM method is 92-98% effective. With 1:1 online nurse management of the FEMM method, the efficacy rate increases slightly to 93-98% effective at preventing unwanted pregnancy.

Natural Family Planning (NFP)

Is very similar to FAM, except it is practiced from a religious standpoint, reserving sexual activity first and foremost for the purposes of reproduction. NFP does not allow any intercourse, even with the use of a barrier in the fertile window, unless trying to conceive. The Billings method is a popular method practiced by folks who are of catholic faith.

The efficacy of this method is the same as FAM as it uses the same principles.

calendar

Rhythm method

The rhythm method is what gives FAM its bad wrap – because people often get it confused with FAM. FAM requires you to be constantly interpreting your bodys biomarkers each cycle and only having intercourse during “safe days”. The rhythm method, also called the calendar method or standard days method, basically gives you a set of standards to follow based on the length of your cycle which tell you which days are safe and which are not (for example, if you have a 28 day cycle then your fertile window is day 10-16). It does not take into account any of your body’s biomarkers. The problem with this method lies with folks who really can’t stand to have an unwanted pregnancy because even in the most “regular” women, cycle lengths can vary. Rarely is a womans cycle ever the exact same number of days for all 12 cycles of the year (unless she’s on birth control, which of course then none of this applies at all because its not a real cycle). Stress, travel, weight changes, amoung many other things can budge a period backwards or forwards a few days, which means you fertile window also changes and if you use the same set of days as your “safe days” you could be very mistaken.

The efficacy of these methods range between 75%-99.9%.

daysy.jpg
^ The daysy fertility monitor ^

Daysy fertility monitor

“Daysy is a fertility tracker that uses the fertility awareness method by learning and tracking your menstrual cycle. Daysy calculates your fertile window: Your fertility status will be displayed either as a red (you are fertile) or green (you are not fertile) light.”

The daysy fertility monitor is based off of basal body temperature alone. Daysy will not give you any green days for at least three cycles, while it gets to learn your cycle. It has a corresponding app that you can sync your device to (the device is a thermometer) where it will display the temperatures.

*I am currently using my daysy monitor as my thermometer and interpreting my temperatures by myself*

Daysy claims to be over 99% accurate at calculating your fertile time.

Ladycomp (the real OG)

The lady comp was the first fertility device around (has been around for atleast 20 years) and also uses basal body temperature to give you a fertility status. It is physically bigger than the daysy and provides more information about your past and future fertility (when to expect your period, etc.)

Ladycomp claims to be 99.3% accurate at calculating your fertile time.

Natural cycles

Is and app that does sort of the same thing as the above two mentioned, but it has its own branded thermometer and you enter your temperatures into the app yourself. There is a large margin of error when it comes to this because it relies on the user to round her own temperatures and enter them, rather than it being read and kept by the device itself. I don’t recommend using this app if you are absolutely trying to avoid a pregnancy, as I have seen some big “oopsies” because the app miscalculated.

Natural cycles claims to be 93% effective at properly calculating your fertile time.

My thoughts & feelings on fertility devices:

While I think they are one of the best inventions since sliced bread, the downside to them is that the user does not ever gain the valuable knowledge about her body that she would if she were to learn and calculate her own fertility (BODY LITERACY!). Some women feel more confident to rely on a device to tell them when it is safe to have intercourse (and I can understand that), but what i’d really like to see happen is women really begin taking their health and fertility into their own hands. Contrary to popular belief, if a woman learns FAM properly and practices it well, she IS capable of preventing or achieving a pregnancy exactly when she wants to, if she wants to. We need to believe this for ourselves, too.

Lactational Amenhorrhea Method (LAM);

Can be used for up to six months postpartum in a mom who has not yet had her first period return and is exclusively feeding her baby at the breast – no bottles, no soothers, no schedules. This method has been very effective for some women – up to 99.5% effective in fact, however, again, if you are seriously trying to avoid another pregnancy I would be careful with this method because say your babe gets sick and misses one breastfeed, your ovulation could return and you could become pregnant.

Other non-hormonal contraceptive options

Copper IUD

Is a little T shaped device that is coiled with copper that gets inserted into your uterus by the doctor and stays there for 3-10 years. For years, doctors explained that “we don’t know how the copper IUD words, but we know it works well”, but now we know that the copper induces an inflammatory immune response within your uterus, making it an inhospitable place for a pregnancy to grow. The copper is also toxic to sperm, making it harder to conceive. With 99.4%-99.6% effectiveness, it can also be used as an emergency contraception if you can get it in within 7 days after unprotected sex. The copper IUD is a great non-hormonal option for women who don’t have the time or efforts to put into learning a method of FAM, and who need their birth control to be as effective as possible. However, don’t let the 99.4% effectiveness steal your attention, because there are side effects with the copper IUD.

I’m going to get real with the critical thinking for you all because I feel like this is an area that some people don’t realize – if a copper IUD can prevent a pregnancy 7 days after unprotected sex, then what it actually is capable of doing is aborting a pregnancy. It was for this reason that when I wanted one when I was 21, my doctor actually wouldn’t do it for me – he sent it to someone else – because it was “against his religious views”. There is the possibility that conception can occur but due to the inflamed, copper toxic environment, the pregnancy cannot really take off.

There are the rare risks of things such as dislodgement (5% chance) and implantation into the uterus (0.01% chance, although I have personally seen this in the operating room). Women who have an IUD tend to have more yeast infections, and another thing to consider is the fact that this is a foreign object in your body. This is important for folks who have an IUD and are struggling with inflammatory conditions. So long as you have an IUD in, your immune system is going to work harder than normal to try to attack the foreign “invader”.

Side effects involved with the copper IUD include (but are not limited to): Longer, heavier, more painful periods (the copper is increasing inflammation, remember..) So if this is you, keep an eye on your iron levels after having a copper IUD inserted! The copper IUD claims to not cause any weight gain, mood changes, nausea or sore breasts, but this is simply not true observationally. Many women do experience hormonal changes after having the copper IUD, so if you feel like its caused some changes for you, it may not be all in your head. More research is needed in this area to determine other side effects that may be associated with the copper IUD.

condom

Condoms

Are considered a barrier method: they physically keep sperm contained from entering the vagina. They come in two varieties: Mens & womens and are available In latex and non-latex (polyurethane). Condoms are generally not a couples favourite choice because they can decrease sensation for both partners, especially if a man has been circumsized. They’re also a bit of hassle to have to apply every time you want to have intercourse. They are however, the only form of birth control that protects against STI’s.

A note about lubricated condoms: the lube that comes in these is generally of low-quality, so they can cause irritation for some women. Some condoms also come with spermicide in them, which can cause issues for women (see diaphragm & spermicide below). If you choose to use your own lube with these, make sure it’s water based because oil-based lube will break down your condom!

Condoms are 85-98% effective at preventing pregnancy.

Diaphragm & spermicide

A diaphragm is a rubber cap-like object that you use by inserting into the vagina to cover your cervix prior to intercourse, so that sperm cannot travel into your uterus. It is also a barrier method. It is expected that you use it with spermicide, a jelly lubricant that kills sperm. In order for a diaphragm to be effective you need to have it fitted for you by a doctor. After intercourse, you need to keep it in place for 6 hours to allow the spermicide to kill the sperm. They do come in silicon as well, for those who are allergic to latex.

Spermicide (called nonoxynol-9) is actually quite irritating to the vaginal mucosa, and in fact health Canada has recommended that each woman re-evaluate whether she needs to use this or if there is a safer method. When the vaginal mucosa is irritated, it is more susceptible to contracting STI’s & HIV. Additionally, spermicide has been known to increase UTI’s in some women, so if you are prone to UTI’s, this isn’t for you!

 

I hope this guide has been somewhat helpful in answering your questions with regards to non-hormonal options for contraception. I also hope that conversations related to these topics continue to get louder and louder so that more research can be done and hopefully more options will become available to men and women trying to avoid pregnancy! 

THANKS FOR READING ❤

 

Photo credits for photos not taken by myself:

Photo by rawpixel on Unsplash
Photo by Simone van der Koelen on Unsplash
Photo by Charles 🇵🇭 on Unsplash

 

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