Fertility awareness methods

Natural family planning, fertility tracking.

Methods of tracking signs of fertility throughout your menstrual cycle and avoiding unprotected sex on days when pregnancy is more likely to occur.

• Preventing pregnancy.

FAM involves monitoring various bodily signs to help you identify the days you are most likely to become pregnant (your fertile window). This window is around the time you are ovulating (eggs being released from the ovaries).

After ejaculation, sperm can live in the body for up to 5 days. After ovulation, the egg released survives for only 12–24 hours. This means a person who menstruates is usually fertile for around 7 days of every menstrual cycle: the 5 days before ovulation, the day of ovulation and a day or two after. This is the fertile window.

Identifying your fertile window is done through:

• tracking your menstrual cycle (calendar-based methods) — these methods estimate fertile days based on fertile days in previous menstrual cycles
• checking changes in cervical mucus (discharge) — cervical mucus changes during your menstrual cycle and can help you identify when you are ovulating
• measuring basal body temperature — basal body temperature rises after ovulation and can help you identify when your fertile window is over
• using ovulation (LH) testing sticks — these detect hormonal changes that occur shortly before ovulation

Avoiding unprotected sex during your fertile window reduces your chance of becoming pregnant.

You can start tracking your menstrual cycle with FAM at any time, but it is not immediately reliable for preventing pregnancy until you have learned to accurately identify your fertile window. This can take a few months so it may not be reliable contraception at first.

Effectiveness improves over the first few cycles and depends on consistent tracking using one or more fertility signs.

Extra care is needed in the early months, as the risk of pregnancy is higher while you are learning your personal fertility signs and patterns.

Typical use: 76–98% effective.

Perfect use: 95–99.6% effective.

• Use a combination of fertility signs to learn how to recognise your fertile window.
• Track fertility signs every day, consistently and accurately
• Record observations carefully (there are apps available to help you keep track).
• During your fertile window, use condoms when having sex, or avoid sex completely.
• Reassess your fertile window each cycle, as timing can change due to illness, stress, travel or routine changes.

FAM is most effective when two or more methods are used to identify your fertile window. More information on how to use different methods to recognise your fertile window can be found here.

FAM is less effective if unprotected sex occurs during the fertile window. This is most likely to happen if:

• the fertile window is not identified accurately
• another form of contraception (such as condoms) is not used correctly and consistently during the fertile window.

The effectiveness of FAM can be impacted by:

Tracking the menstrual cycle (calendar-based methods)

• Effectiveness decreases if cycles are irregular or change over time, as this can make it harder to predict ovulation accurately.

Checking changes in cervical mucus

• Effectiveness decreases if changes in cervical mucus are missed, misinterpreted, or not checked consistently.
• Cervical mucus patterns can be affected by illness, medications or vaginal infections, which may make fertile days harder to identify.

Measuring basal body temperature

• Effectiveness decreases if temperature changes are relied on alone, or if measurements are inconsistent or affected by factors such as poor sleep, illness or alcohol.

Using ovulation (LH) testing sticks

• Effectiveness decreases if testing is not done correctly or consistently, or if ovulation timing varies from cycle to cycle.
• Ovulation sticks do not show when the fertile window has fully ended and should not be relied on alone.

No.

Internal and external condoms are the only types of contraception that protect against STIs.

These methods require daily actions, such as tracking your cycle, observing cervical mucus, taking your temperature, or testing for ovulation.

Some tools, like ovulation (LH) sticks, are single use, while others, such as thermometers, can be reused.

It is possible to be discreet while using FAM; however, it works best when all sexual partners are aware of and supportive of the method being used.

These methods rely on avoiding unprotected sex during fertile days, which requires shared understanding and cooperation between partners. Partners may need to agree on using condoms or avoiding sex during the fertile window. Open communications can make it easier to use the method consistently and effectively.

Tracking cycles means recording changes in your body, which can be done discreetly in a diary or an app.

FAM is not suitable for people who do not have control over if, when or how sex happens.

No. There are no side effects associated with FAM.

FAM may not be suitable if you:

• have just stopped using a method of hormonal contraception, and your menstrual cycle hasn’t settled back into its natural rhythm yet
• have irregular or unpredictable menstrual cycles
• have conditions that affect ovulation or hormones, such as polyendocrine metabolic ovarian syndrome (which used to be called polycystic ovarian syndrome or PCOS)
• are breastfeeding or recently gave birth, as fertility signs can be harder to interpret
• are approaching menopause, when cycles and fertility signs often change
• have frequent vaginal infections or changes in discharge that make cervical mucus difficult to interpret
• experience frequent illness, sleep disruption, shift work, or travel, which can affect basal body temperature readings
• are unlikely or unable to maintain consistent monitoring of your fertility signs – this can be a lot of work, and some people find this challenging
• are using medications that are known teratogens (which can cause birth defects)

To use FAM, you just need to start tracking your fertility signs. No prescription or appointment is required, but some types of FAM require certain tools.

Fertility tracking apps are available that are specifically designed to help you use FAM. There are many that exist, but one has been approved by the Therapeutic Goods Administration in Australia for contraception, called Natural CyclesOpens in a new tab. You can also track your fertility signs manually (without an app).

Ovulation (LH) testing sticks and basal body temperature thermometers are available from pharmacies and on online stores.

If you are unsure how to use FAM, you can speak to a healthcare professional for information and guidance.

FAM can be low-cost.

• Fertility tracking apps have both free and paid subscription options.
• Ovulation (LH) testing sticks range in price. As they are a single-use item, it is more affordable to purchase them in bulk online. They come in both digital and non-digital varieties.
• Basal body temperature thermometers range in price but can start at $10–15.

No, FAM does not have any impact on your future fertility. You could fall pregnant as soon as you stop using this method.

FAM can be used after having a baby. However, having a baby and breastfeeding can make your menstrual cycle unpredictable. This makes FAM harder to use, because it is harder to identify your fertile window during this time.

If you are exclusively breastfeeding, you may meet the criteria to use the lactational amenorrhea method (LAM).