The Sympto-Thermal Method (STM), AKA the Fertility Awareness Method (FAM), is a simple practice of observing your body's natural fertility signs. When used correctly, it can be a highly effective tool to avoid or achieve pregnancy and keep track of your health. At its best, the method is an empowering life style choice, which can give you confidence in your body, sexuality and intuition and support you in making the best health care decisions for you.

How does it work?

The method involves a simple daily habit of taking your temperature first thing when you wake up (1 minute), checking your cervical fluid before you use the bathroom (10 seconds), and making sure to record your observations at the end of the day (2 min). This information indicates where you are in your cycle and whether you can become pregnant.

The components of the Sympto-Thermal Method are hidden in its name:

"Sympto" refers to the symptoms of fertility we can observe every day, particularly healthy cervical fluid, which changes in quality as we approach and complete ovulation. In the first half of the cycle, under the influence of increasing estrogen, cervical fluid gradually becomes more watery, clear, stretchy and lubricative. It also becomes more alkaline, allowing sperm to live up to 5 days. As soon as an egg is released and ovulation is completed, the hormone progesterone takes over and dries up fertile cervical fluid, encouraging the body to create thick, acidic mucus that blocks the entrance to the uterus and kills sperm.

"Thermal" refers to your daily temperature, taken in your mouth first thing after waking up. The fancy term for this is basal body temperature. In the first half of the cycle, the hormone estrogen keeps basal body temperature low to promote the development of eggs. As soon as ovulation is complete progesterone takes over, driving the basal body temperature up to bake any bun that might be in the oven. Your waking temperature will normally stay high until a day or two before your first period when hormone levels drop.

The Facts

As a nurse, what I love about this method is that it's based on biological facts:

Fact 1: Sperm can live up to 5 days in fertile cervical fluid

Fact 2: An egg can live up to 24 hours, for the sake of argument let's say 48 hours in case you release two eggs (like fraternal twins)

That means at most there are only 7 days per cycle that pregnancy is possible, where a sperm and egg are alive long enough to meet each other.

What does this method really involve?

  • Taking your temperature first thing upon waking, while still snuggled up in bed. This is done before doing anything else, using a basal body thermometer for 30-60 seconds.
  • Being aware when you're wet. Have you ever felt a gush and wondered if your period just started, only to run to the bathroom and find nothing but a watery spot? Chances are you were feeling fertile cervical fluid. Noticing wet or dry sensation throughout the day is one piece of this method.
  • Checking your cervical fluid at least 3 times a day when you're already in the bathroom. This includes taking a look at whats on your panties, and checking at your vulva or vaginal opening. This is flexible to your comfort level and can be as simple as wiping from front to back before you go pee and observing whats on the toilet paper, touching just outside your vaginal opening, touching just inside your vagina or for those who want to have a fuller picture, reaching in to check at the cervix, just be consistent.
  • *Optional* Checking your cervix for changes in height, softness and openness. This is easily done in the shower when you're already naked, warm and relaxed. Under the influence of increasing estrogen the cervix opens, softens and rises, after ovulation progesterone causes it to close, harden and drop lower.
  • Charting at the end of the day. Most women are now using apps that make charting incredibly fast and easy. Some apps even come with thermometers that automatically chart your temp for you using blue tooth! I recommend new users get comfortable charting on paper for at least 6 cycles before jumping to high tech methods, so they can become confident in their own analysis of their data and hone their critical thinking skills. Either way you are essentially recording the same thing: your temp that day, a word or two to describe your cervical fluid and any other notes or secondary signs you want to remember (high libido, sore boobs, PMS symptoms...etc).

How do I start?

Using the Sympto-Thermal Method correctly requires an initial commitment to learning the basics of reproductive and hormonal systems and becoming comfortable with the rules. Once you lay this foundation of knowledge, the STM is a free tool that you can use for the rest of your life in less than 5 minutes a day.  If you're interested in learning more, a great place to start is by reading Taking Charge of Your Fertility by Toni Weschler. You could teach yourself the method practically for free by learning this book inside and out. But we all know there is no comparison between book learning and real life experience with professional guidance. I highly recommend, that you seek classes or consultations with a Certified Fertility Awareness Educator such as myself. Studies suggest that the effectiveness of the method as birth control is highest when users have been trained by a professional. I believe this also applies to increased effectiveness for conception.