Fertility Awareness-Based Methods for Women's Health and Family Planning

Abstract

BackgroundFertility awareness-based methods (FABMs) educate about reproductive health and enable tracking and interpretation of physical signs, such as cervical fluid secretions and basal body temperature, which reflect the hormonal changes women experience on a cyclical basis during the years of ovarian activity. Some methods measure relevant hormone levels directly. Most FABMs allow women to identify ovulation and track this “vital sign” of the menstrual or female reproductive cycle, through daily observations recorded on cycle charts (paper or electronic).ApplicationsPhysicians can use the information from FABM charts to guide the diagnosis and management of medical conditions and to support or restore healthy function of the reproductive and endocrine systems, using a restorative reproductive medical (RRM) approach. FABMs can also be used by couples to achieve or avoid pregnancy and may be most effective when taught by a trained instructor.ChallengesInformation about individual FABMs is rarely provided in medical education. Outdated information is widespread both in training programs and in the public sphere. Obtaining accurate information about FABMs is further complicated by the numerous period tracking or fertility apps available, because very few of these apps have evidence to support their effectiveness for identifying the fertile window, for achieving or preventing pregnancy.ConclusionsThis article provides an overview of different types of FABMs with a published evidence base, apps and resources for learning and using FABMs, the role FABMs can play in medical evaluation and management, and the effectiveness of FABMs for family planning, both to achieve or to avoid pregnancy.

Understanding the perspective of women who use the Billings Ovulation Method®: a focus group study

“…An advantage of FABMs is that they avoid using hormones or devices that may cause side effects or religious concerns. In addition, they may help the user better understand their own body, monitor health, and avoid or achieve a pregnancy [ 4 ]. FABMs are compatible with the teachings of major world religions, unlike other family planning methods [ 5 , 6 ].…”

Oh Baby! A Content Analysis of Contraception Pins on Pinterest

“…FAMs, however, may not be as effective as hormonal methods based on typical use. With typical use, FAMs may result in 2 to 23 unplanned pregnancies per 100 woman-years, with rates varying between the different approaches (Duane et al, 2022). For example, the efficacy rate is higher for sympto-thermal and sympto-hormonal methods than older calendar methods (Pallone & Bergus, 2009; Urrutia & Polis, 2019).…”

“…FAMs require monitoring and recording different fertility signals, such as basal body temperature and cervical mucus, during the menstrual cycle to track fertility windows (Urrutia & Polis, 2019). These methods lack the potential for side effects as they rely on behavior change informed by correct identification of the fertile window rather than synthetic hormones (Duane et al, 2022). FAMs can be used to facilitate the likelihood to conceive in addition to avoiding pregnancy (Thijssen et al, 2014), and may also be used to help identify health conditions that impact the menstrual cycle (Duane et al, 2022).…”

Sociodemographic and Medical Characteristics of Women Applied for Emergency Contraception—A Retrospective Observational Study

“…Over the past few decades, there has been a remarkable and discernible upswing in women’s enthusiasm for gaining a comprehensive understanding of and actively monitoring their menstrual and reproductive cycles [ 21 , 22 ]. Notably, this trend aligns with the explosive growth of mobile health applications, surpassing hundreds of applications dedicated to cycle tracking in the last years [ 22 ].…”