No dry days? You may qualify for a basic infertile pattern!

After menstruation, the majority of women will experience dry days. For these women, their basic infertile pattern is dry. Other women may experience a pattern of unchanging mucus, sensation, and discharge after menstruation. For women who experience this same UNCHANGING discharge, mucus, sensation pattern for three cycles in a row following menstruation, they may have a non-dry basic infertile pattern. The keyword here is unchanging; any changing pattern would not indicate a basic infertile pattern. This type of pattern should only be established under an instructor if someone is seriously avoiding pregnancy. For women who establish this pattern with a mucus-only instructor (either Billings or Creighton are options), this pattern has the same level of efficacy for avoiding pregnancy as a dry pattern. Some examples of this pattern may be continuous moist days, continuous sticky days, continuous white mucus, or others!

DO NOT try to use these days for unprotected sex without establishing it for a minimum of 3 cycles with an instructor (it may take longer than this). When using these days, intercourse should be rotated to every other day in the evening before bed. 

What causes this pattern? In cycles less than 35 days, it is caused by bits of the G mucus plug breaking off. While the plug is breaking off, it causes the visible mucus or sensation. However, the rest of the plug is still blocked. This means this time of the cycle can be considered infertile if an instructor works with you to make sure it is the G mucus plug breaking off. In cycles longer than 35 days, it can be caused by a combination of the G mucus plug breaking off and estrogen’s effect on the vaginal walls causing a sloughing effect. Read more about the types of mucus here.

Sympto-thermal methods like Taking Charge of Your Fertility also mention a “sticky” dry basic infertile pattern. Methods like SymptoPro claim that women do take on an elevated pregnancy risk when using these days. As sympto-thermal methods are not as strenuous on mucus observations as mucus-only, consider this risk when deciding to utilize this pattern. Again, ideally if someone is avoiding pregnancy, they should reach out to an instructor before using these.

In either of these cases, experiencing any dry days following menstruation means that you do not qualify for a basic infertile pattern of non-dry in regular cycles. This pattern needs to be re-established with an instructor following hormonal birth control usage or pregnancy. 

Irregular Cycles

For postpartum, perimenopausal, or people with cycles longer than 36 days, it is also possible to have a basic infertile pattern of non-dry after 14 days of the same UNCHANGING discharge, mucus, sensation. In addition, a combined basic infertile pattern is possible in the Billings Method. This should only be established with an instructor. For these transitions, the Billings Method is highly recommended. 

In both regular and irregular cycles, working with an instructor can help you get more safe days for unprotected sex if you are experiencing a non-dry pattern.

An Honest Review of Fitbit for Menstrual Cycle Tracking

You may know that the Fitbit app has some built in menstrual cycle tracking features, but many people do not know that it has other features that may be useful for menstrual cycle tracking. In this article, I will review the pros and cons of the Fitbit app as it relates to cycle tracking for people who ovulate. For context, I use a Fitbit Charge III.

The most basic feature that Fitbit offers for cycle tracking is recording bleeding dates of menstruation and then displaying a predicted fertile window based on average cycle length.

The pink bar represents the length of menstruation. The blue bar represents a predicted fertile window. The flower symbol represents predicted ovulation.

The user needs to remember to input menstuation each cycle. Once it is inputted, Fitbit will generate the blue fertile window. This fertile window should NOT be used for avoiding pregnancy, as it is only based on cycle length and not real-time fertility signs like cervical mucus or basal body temperature.

Once menstruation is entered, it will also begin a countdown until your next predicted menstrual cycle.

Countdown until menstruation in the app.

Unfortunately, I do not find this basic feature very useful for anyone who has any cycle variation. Even though my cycle length has increased over the last year, Fitbit has not automatically updated my cycle lengths. The app does not appear to be very adaptive without user input.

In addition to tracking bleeding the app offers options for:

  • Mood
  • Plan B (morning after)
  • Ovulation tests (better called luteinizing hormone tests)
  • Cervical mucus (Taking Charge of Your Fertility categories)
  • Cyclical symptoms like acne

It is rather disappointing that the app does not include options to mark pregnancy when it occurs, especially since we know that this changes daily calories burned and heart rate, to name just two effected areas of the app.

A really cool feature that I do like is the ability to show cycle trends like flow intensity and cramps. The same screen that displays this will also let you scroll through all past cycle lengths.

In the settings of this screen, you can also decide to toggle off predictions. For people avoiding pregnancy, I do recommend either ignoring or toggling off predictions in the Fitbit app. The app allows you to choose your current birth control method as well.

Outside of the designed menstrual cycle tracking features, I want to highlight resting heart rate as a potential exciting thing to track for those who are not taking hormonal contraception. Why do you need to not be taking hormonal contraception to utilize the heart rate feature for menstrual cycle tracking? Hormonal contraception suppresses ovulation, and ovulation changes our heart rate charts!

To learn more about resting heart rate and the menstrual cycle, read my previous post here.

You can see my heart rate falling during menstruation around April 10th, and then rise during my fertile window and luteal phase.
Menstruation began when my heart rate dipped below 70 on this chart. Ovulation likely occured around the third raised heart rate in this close-up.

Heart rate in people who are ovulating is at its lowest point during menstruation, rises during the fertile window, and continues to be elevated in the luteal phase.

When heart rate begins to drop again, this is an excellent way to predict menstruation will soon occur. For example, I have been tracking my heart rate in Fitbit for 2 years, and I always bleed when my heart rate dips back down to 70 beats per minute after my luteal phase!

I do think this feature is worth tracking for anyone interested in a more precise period prediction than cycle length. If you have Fitbit premium, you can also find a setting for sleeping heart rate under restoration. This may be more steady than resting heart rate for some individuals.

Lastly, I want to address Fitbit temperature for menstrual cycle tracking. Unfortunately, wrist temperatures are not a compatible parameter for fertility awareness when it comes to avoiding or achieving pregnancy. It can be incredibly erratic. When we track temperature, we want the temperature as closest to the core as possible.

Fitbit does not give precise temperatures, instead it gives deviations from a range. I likely ovulated near 18, 19, or 20 on the photo above. While Fitbit did detect a slight shift, it is not particularly clear, and it dropped back down.

As depicted above, my luteal phase the previous month was extremely undefined, and I could not determine a confirmed temperature shift with it.

For now, I do not recommend Fitbit for precise temperature tracking. Instead, I recommend a basal body thermometer.

Conclusion

Fitbit offers some really unique options for cycle tracking, but it should not replace your birth control or fertility awareness method. The heart rate feature may be useful for identifying cycle phases, but the temperature readings are not suitable for tracking cycle phases.

My Experience Becoming a Certified Billings Ovulation Method Teacher

I recently completed my teaching certification for the Billings Ovulation Method through the Billings Ovulation Method Association in the USA (BOMA). This is a cervical mucus / sensation only method that has been taught for over fifty years in over 120 countries.

I began this certification having been quite dissatisfied with my previous certification in the sympto-thermal method. I found the sympto-thermal method inadequate for irregular cycles or postpartum cycles, as well as for any cycles with continous mucus.

This certification 100% cleared up all doubts I had about being able to teach people in these situations! I love that Billing’s motto is “Keep it simple.” Ultimately, this certification gave me the confidence to give up temperature taking as a part of my fertility awareness routine.

First Step:

Before beginning the certification, I took an introductory class with my spouse in the method. This gave me about 6 months to try to apply the principles to my charts before beginning training. I had previously certified in a “Billings-based method” but learned quickly that authentic Billings is a different creature altogether.

I recommend that anyone who is going to train in this method learn to practice it first for at least 6 to 12 cycles under the guidance of an accredited teacher. Joining this program without learning the method first is going to leave you lost on your charts – when you should be confident in your charts before helping others.

Second Step:

The class began in December 2019 and ran through September 2020. We met once a month for approximately an hour (sometimes a little more or less). Inbetween meetings, we were expected to read one to two chapters of material and complete 5 or more worksheets that included chart evaluation and quizzes.

I really appreciated the live classes because my previous certification had no live component. I’m a strong believer that synchronous connection is really important for learning something new.

During class, we were shown PowerPoints and given time to ask questions about the homework. Hearing from long-term accredited teachers about different charting circumstances did wonders for my existing knowledge base. It was incredibly valuable.

Full disclosure: It is important to know that Billings was founded by and is primarily run by Catholics. These meetings often began with prayer or referenced God. Teachers are not required to teach the religious component of the PowerPoint. That means that Billings can be presented in a secular manner. The WOOMB International head organization notably does not include religious elements in their presentation of the method. The science of the method is solid regardless of any ideology attached to it.

Third Step:

The next step after passing an exam on the material was to begin practicum. Practicum is the supervised portion of the certification where you teach 6 to 10 clients minimum in the method while submitting charts and questios to a supervisor selected for you by the organization.

This graphic is how long it took me to finish the practicum portion of the course. Most people take 1.5 to 2 years to finish the program. I went a little faster because I taught larger group classes and had clients lined up before it began.

Practicum was the most enriching part of the experience, and I recommend that anyone who does the training utilize this time to your best advantage. I learned how to help people identify complex basic infertile patterns where they never have dry days. This was not possible in my previous method. I was able to support multiple postpartum women as well as folks with PCOS or who were trying to conceive. I learned so much by meeting with my clients and sending charts to my supervisor.

The follow-ups and classes in Billings are mandatory live meetings (video calling, phone call, or in-person). The follow-ups generally last 15 to 30 minutes depending on the client and how early they are in the process. Follow-ups and classes are required to be live, and this is based on what was done to reach efficacy in the Billings studies. We generally meet with clients seven or more times in the first 6 months, and then every 1 to 3 months. Some people may have more or less follow-ups depending on when they reach autonomy and things like cycle characteristics (postpartum people tend to meet up until the third ovulatory cycle after return of fertility.)

Fourth step:

After having enough clients in different situations (postpartum, trying to conceive, trying to avoid, regular and irregular cycles), I had a final meeting with my supervisor. Before this, I had to compile a document of every client chart. This was a bit laborious as the Billings charts cannot be exported to PDF without losing part of the chart. I had to screenshot segments of the charts and then re-assemble them. This meeting with my supervisor lasted about two hours, and we discussed all of my client charts and any corrections that needed to be made.

Following that, I was recommended for the final step. I recieved a mailed in exam that involved correcting a full paper chart and writing why I made those changes and what mistakes were originally made.

I turned in this exam to two graders. They then met with me and discussed the chart and any necessary corrections. They approved my certification at the end of the meeting.

The Future

Billings Ovulation Method teachers are required to do continuing education to maintain their certification. This is an investment of approximately $300 to $600 every three years. While this is costly, it is really important to attend further training where the teacher can see more advanced charting techniques and learn about health conditions, efficacy, and more!

My Final Thoughts

I would recommend this certification program to anyone who is interested in having an in-depth understanding of cervical mucus charting. The Billings Method teaches about things like the “pockets of shaw” and the cervical mucus crypts. My previous certification did not include close study of the patterns of cervical mucus. This program fundamentally changed my thinking about temperatures always being a necessary part of charting. I ended up dropping temperatures completely after 3 years of using basal body temperature.

Billings allows teachers to order all supplies, including digital materials, for clients. This means I do not have to produce my own materials, and it is super useful for quickly mailing clients what they need.

To make the most of out of this program, I recommend also reading the scientific studies on the side. Unfortunately, the program did not go into a lot of depth on the previous research studies. As someone in academia, I really like understanding all the different correct use and typical use statistics. I’m often questioned about efficacy, and I want to be able to answer people’s questions. If this also describes you, I recommend the following articles:

The Discovery of the Different Types of Cervical Mucus

Use-effectiveness and client satisfaction in six centers teaching the Billings Ovulation Method.

Field trial of billings ovulation method of natural family planning.

A prospective multicentre trial of the ovulation method of natural family planning

A Trial of the Ovulation Method of Family Planning In Tonga

A Response: In Defense of Truth in the Science of the Billings Ovulation Method

Misrepresentation of contraceptive effectiveness rates for fertility awareness methods of family planning

Fertility Awareness For Partners – Common Questions and Answers

This article is for the husbands, boyfriends, spouses, or sexual partners of anyone using a form of fertility awareness for pregnancy prevention.

Charting cycles for pregnancy prevention is a big life change, especially for the female charter. While the charter has to learn to interpret their cycles, it is fundamental that they have a supportive partner in the process.

So, What is Fertility Awareness?

Fertility awareness involves tracking one or more bio-markers of the female cycle. These bio-markers include: cervical mucus, basal body temperature, cervical position, urinary hormones, and cycle start dates. The bio-markers are used to draw a fertile window. Fertility awareness has been studied scientifically for nearly a hundred years. There are a plethora of studies on the topic. Click here to read the 2018 Overview of FABMs. In general, you can expect approximately 98 to 99% efficacy across all modern fertility awareness methods.

Your partner will be tracking based on whatever method she chooses. A method is a way of categorizing bio-markers. For example, I teach the Billings Ovulation Method. This method tracks the bio-marker cervical mucus along with sensation felt at the vulva.

One of the first things you will learn when charting is that MALES ARE FERTILE 24/7. Females are fertile only cyclically, and on average the fertile window will be for less than 1/3rd of the female menstrual cycle.

In the beginning, there is sometimes a steep learning curve with tracking these signs. Your partner may forget to check cervical mucus at every restroom break or they may be erratic in taking their temperatures. Your role at this time is be supportive. If you are living with your partner, you can help remind her to take her temperature upon first waking (if they are choosing to chart this sign!) You may also want to take part in keeping the chart.

While it is relatively rare for the partner to help chart, it is encouraged that you learn how to help classify her fertility signs or read the chart if possible. In the very least, you need to learn to respect your partner’s fertile window and not expect to ejaculate inside the vagina in the fertile window. I’m being blunt here. You will get used to “TMI” with charting! You can learn to understand the cycle by taking a class together. This is a great activity for bonding, and so that you have more equal responsibility in your family planning.

An easy way to get involved in your partner’s charting routine is to use a paper chart. I keep a paper chart on the bedside table. It is always visible. My chart is pretty easy for my partner to read because the “baby” symbols mean possible fertility. You could do this with any method. Sit down together when you record the observations. Have your partner to explain what the fertility status of the day means.

This is an example of a paper chart on heavier cardstock. The days with babies are possibly fertile. Other days are available to use when the rules allow it. Charting on paper is a great way to share your chart with ease.

But Why Would I Attend a Class or Learn About Charting if I’m NOT the Female Partner?

Because you want to be a good, supportive partner!

When you understand your partner’s chart, you understand the chance of pregnancy that you both have. This can prevent mistakes from occurring if there is more than one set of eyes on the chart. When you become attuned to your partner’s menstrual cycle, you will also begin to realize why their mood might change throughout the cycle. This is fantastic for relationship communication. Your partner is not perfect. They may make mistakes when charting. Two is better than one for catching these!!

How Will We Avoid Pregnancy in the Fertile Window?

One of the first things you will learn when reading a fertility awareness book or taking a class is that you are expected to abstain from penis-in-vagina sex in the fertile window.

The reason for this is simple: it is only possible to get pregnant in the fertile window.

If you have penis-in-vagina sex in the fertile window, there will always be a chance of pregnancy. If you are avoiding pregnancy, this means that sex in the fertile window could result in an unintended pregnancy.

During this time, it is suggested that the couple work on other aspects of the relationship. Go on dates, cuddle, talk, play games.

If you decide to break the rules by having sex, you should be prepared for the possibility of pregnancy.

For Catholics, total abstinence is the only “licit” option for the fertile window.

For non-Catholics, oral sex and sex involving hands is safe in the fertile window as long as no semen ever gets near the vulva or the vagina. If semen touches this area, pregnancy can occur.

To determine how you will proceed in the fertile window, you and your partner should place yourself on the intentions scale. In the context of fertility awareness, intentions means how open you are to pregnancy.

The basic possible intentions follow. Select which is most appropriate to you as a couple. TTA means “Trying to Avoid” a Pregnancy.

TTA Seriously Avoiding: For these people, an unintended pregnancy may be devastating, whether to health, the relationship, or finances. A pregnancy is being avoided very strictly. These people should adhere to the rules of their method as closely as possible.

TTA Regular Avoiding: For these people, pregnancy is being avoided and the rules are followed. A pregnancy wouldn’t be convenient, but it would not endanger their life.

TTA Loosely Avoiding: For these people, a broken rule isn’t the end of the world. They may do strategic risk-taking like breaking rules on the cusp of the fertile window, or using something like the withdrawal method in the fertile window. They are not actively seeking a pregnancy, but they are okay with some chance of it happening.

TTW Whatever Happens: For these people, pregnancy would be okay whenever it happens. They break whatever rules they want. They aren’t actively timing sex for the most fertile days, but it might happen.

TTC Trying to Conceive: For these people, the rules do not have to be followed. They actively try to have sex in the fertile window.

You and your partner should discuss this scale and decide where you land before utilizing the fertility awareness method for sex.

What If We Decide to Use Barriers in the Fertile Window?

Remember, while you are fertile 24/7, your female partner is not. It is really important that if you are avoiding pregnancy that you respect your partner’s fertile window.

Some couples decide to use condoms, the withdrawal method, or diaphragms in the fertile window.

The most likely time for a barrier to fail is in your fertile window. After all, you aren’t using them at the other times of the cycle.

I personally believe that a couple has the right to make an informed choice in the fertile window. In particular, the male partner should realize that he is the one putting on the condom or pulling out. If he fails to do either correctly, a pregnancy can result. If you use these methods, do the research and inform yourself about how to use them correctly and what their efficacy is. If you are okay with this risk, you can use barrier methods. At the point you use a barrier method – you are outside of correct use for the fertility awareness method. Always remember that. An unintended pregnancy would be classified as a user error or barrier method failure.

How Long Does it Take to Practice Fertility Awareness Confidently?

On average, you will want to do at least 3 to 6 cycles of follow-up with an instructor to be completely autonomous and confident in charting. When you work with an instructor, you may be able to start utilizing the method to avoid pregnancy as sooln as the first cycle charting! (This is assuming that your partner has been diligent in their charting).

If you have PCOS, are coming off hormonal birth control, or are breastfeeding, you may need close instruction for longer. The Billings Ovulation Method recommends following up until the third ovulatory cycle postpartum. This could take a year or more if fully breastfeeding.

To Male Partners: What Advice Would You Give Male Partners Who Are New To Fertility Awareness?

These responses are taken from a 2019 survey I did on the male partners of FAM users. Enjoy!

“At first it seems backwards since science has a simple fix for conception: hormonal birth control. Some women are fine on hormonal birth control. Some can be really crazy on it. With some women, it can even kill their sex drive. With mine, she becomes so crazy that it kills both of our sex drives. So we’re doing this weird fertility awareness thing. Here’s my advice if you have a woman like mine. Even though she’s so beautiful and sexy that you just want to risk ejaculating in her to possibly get her off, you can’t do it with this. Yes, it puts more pressure on you to wear a condom and/or pull out, but at least your wife isn’t batshit crazy. And she’s still horny. So it’s worth it. Plus you learn a lot about the female body because I guarantee she’ll keep you up at night telling you about it lol. So don’t complain. We’re still getting laid. Unlike our friends who’s wives are on the pill or IUD. It just puts more pressure on us to prevent a baby. If she gets pregnant again, it’s probably our fault with this. And I’m ok with that. War Eagle!”

“You will wish you had always known this information. Test your pre-cum under a microscope for sperm if you are going to use withdrawal.”

“Knowledge is power and pleasure.”

“To do the research to fully understand the anatomy and physiology which will give you confidence in trusting the fertility awareness method.”

“Good luck m’a friend.”

“Embrace it.”

“Don’t be afraid to ask questions!”

“Be patient and understanding whilst always at least attempting to understand the technicalities surrounding the practice of the method.”

“Listen.”

“Read as much information as you can and stay informed.”

“Trust your partner, but do some cursory research as well. You both need to understand it to trust it.”

“Learn the actual science (as in the research literature) behind these technologies. Much of the medical establishment unfortunately has both insufficient and badly-outdated knowledge about FAM. Also, such will only be successful if the couple are both wholly on-board and possess the necessary knowledge, discipline, and self-control to utilize the method(s) correctly, whether trying to conceive or to avoid.”

“Get ya woman on it like yesterday.”

“Talk to your significant other and learn from her.”

“Learn about which days are the best to get pregnant; if you want to get pregnant together there is a way to learn the best days with a good degree of certainty. I think other men could benefit from learning this information about their partner.”

“Learn how the world works, and use that knowledge.”

“Listen to your woman and trust what she says about her observations. It’s not like the guy is the one using the method, but it’s good to be aware of it.”

“If you think it’s burdensome, remember the health and relationship benefits far outweigh the daily minor inconveniences. Encourage your SO to do the research to make sure they’re doing it right as well.”

“Shut up, pay attention.”

“If you are concerned about the well being of your partner, you’re more likely to succeed in supporting her and have an involved role in fulfilling both your reproductive goals through fertility awareness.”

“Be patient.”

“Take a lesson yourself or attend one with your partner, you are only going to trust it if you understand how it works yourself. When you actually see that it makes sense, it’s not some weird alternative thing, you can trust it a lot more.”

 

More Resources for Male Partners

Crash Courses in FAM

“The Rules of the Sympto-Thermal Method of Fertility Awareness” by Jennifer Aldoretta 

This resource is a simple overview of the rules with examples. It links to other resources on understanding the female and male reproductive system. This is a good, fairly quick read for men who want to understand the basic rules.

“Natural Contraception: Why I Haven’t Used Birth Control in Over a Year” by Jessie Brebner

Jessie discusses her symptoms that lead her to stop taking hormonal birth control. She then does a brief overview of how the fertility signs change throughout the cycle and how sperm life plays into fertility.

Men and NFP/FAM

“Straight Talk on NFP, Man to Man” by Couple to Couple League

This is a Catholic resource. Religious men may find this resource useful.

“Why Men Resent Natural Family Planning” by Gerard Migeon

This also leans religious but may be useful for men who are having trouble adjusting to avoiding unprotected sex in the fertile window.

“Use of Natural Family Planning (NFP) and Its Effect on Couple Relationships and Sexual Satisfaction: A Multi-Country Survey of NFP Users from US and Europe.” Front Public Health. 2017; 5: 42. Published online 2017 Mar 13. doi: 10.3389/fpubh.2017.00042

This is a recent scientific article that studied the effect of NFP on relationships.

“Fertility Charting: What’s a Guy to Do?” by Valerie Pokorny

How can men help with charting? How can they be supportive?