Your Guide To Getting Started With Charting Your Menstrual Cycle

One of the most common questions I get in my inbox is how to get started with the fertility awareness method. This post outlines all the different ways you can learn to chart. First and foremost, I will do a shameless plug for learning with me. My course opens in late September 2019. I will provide you with a materials packet and support for 3 cycles charting. I teach basal body temperature and cervical mucus (cervical position is a bonus sign). I also have postpartum and perimenopausal protocols available. You can find out more about this here.

For anyone who is able to chart multiple signs of fertility (temperature and mucus or temperature and cervix), I do suggest using two signs over using a single sign. This is because if one sign is obscured for some reason, you will still have the second sign to fall back on. In addition, charting temperatures will prevent you from having issues with double peaks. Charting temperatures also allows you to have unprotected sex during menstruation (only if you do not have short cycles); cervical mucus only charting does not allow intercourse on the days of heavy bleeding. The 99.6% perfect use efficacy rate that you may see quoted around is based on charting temperature, cervical mucus, and using a Doering rule to limit dry day usage. You can read more about this study here. STM charting also allows for barrier use in the fertile window, depending on whether you learn from a religious source or not.

However, using a single sign like mucus can be really great for postpartum charting and perimenopausal charting. Mucus only methods can also be used to pinpoint health problems. The method you pick should be based on your fertility intentions and what stage of life you are in. Notably, mucus only methods require abstinence in the fertile window because without abstinence penetrative sex could disturb the mucus sign. I like how this faith-based document explains “Your Right to Know” about multiple fertility signs.

What you will never see me suggest is using a device like Natural Cycles or Daysy to chart temperatures only. Temperature only charting is valid, but you do not need to shell out a bunch of money to do it. Temperature also cannot be relied on to open the fertile window. You need cervical mucus for that. Even if you want to only do temperatures, it will be much cheaper and arguably more effective if you get an instructor and interpret your own data.

First Step: Pick an Instructor

Sympto-Thermal Methods (STM)

Sympto-thermal methods require you to monitor at least two fertility signs. These signs are basal body temperature, cervical mucus, and/or cervical position. You can learn these methods from religious or secular sources.

Religious Organizations Who Teach STM

These methods may include some religious teachings in the text. Usually, this is Catholic teaching based on their theology.

Couple to Couple League USA

Price $135 USD. Both members of a couple can attend. Online options available. Some in person class offerings. Emphasizes abstinence in the fertile window.

SymptoPro USA

Price $110 USD. Online options available. Religious materials may be absent from the course but the organization is pretty open about its religiosity and beliefs. Emphasizes abstinence in the fertile window.

European Institute for Family Life Education

Price will vary widely. This includes information for most of the NFP organizations in Europe that partner with this institute. There is a chance that some of these may have secular teachings, but you would need to contact them to ask. Emphasizes abstinence in the fertile window.

Marquette USA

Price will vary. This method sometimes teaches temperatures in addition to mucus and hormone testing. Emphasizes abstinence in the fertile window.

Sensiplan France, Germany, Slovenia, Netherlands

Price will vary. Instruction available in person and online depending on the country. This is a Catholic organization. Emphasizes abstinence in the fertile window.

Secular Organizations Who Teach STM

Natural Family Planning Teachers Association Based in United Kingdom but teachers are located world wide

Prices will vary. Many teachers work online, but there may be in person classes available. Method does emphasize abstinence from genital to genital contact in the fertile window but no religion is present in the text. (I am certifying through this organization). Barrier method allowance will vary from teacher to teacher.

Justisse Method Based in USA but some teachers world wide

Prices will vary. Many teachers work online, but there may be in person classes available. This method can only be used as mucus only (from my understanding, please do ask a teacher). Barrier methods are allowed.

The Association of Fertility Awareness Professionals USA

Prices will vary. This includes Grace of the Moon and Justisse teachers. May or may not emphasize abstinence in the fertile window.

Fertility Awareness Method of Birth Control Instructor List World Wide

Prices will vary. This list includes teachers from random methods. Most teach online, but a few teach in person. Reach out to one to find out more. May or may not emphasize abstinence in the fertile window.

Mucus Only Methods

Billings Method USA and Woomb Billings Method Australia Likely world wide availability for teachers.

Prices will vary. Abstinence is required in fertile window. Religious in nature (Catholic).

Creighton Method World Wide and USA

Prices will vary. Abstinence is required in fertile window. Religious affiliations but may not be overt in materials. Connected with NaproTechnology doctors and may be a good choice for women with fertility problems.

FEMM USA but teachers are available online

Prices will vary, but can run as cheap as $75. This method includes mucus and LH strips. Abstinence is required in the fertile window. Secular, but the organization does have religious affiliations.

Rhythm Methods

These methods only involve tracking your cycle length. I do not recommend this to anyone who absolutely cannot get pregnant for health reasons or who absolutely does not want to get pregnant in general. If you are okay with the possibility of pregnancy, this may work for you. These methods also require you have to fairly regular cycles. This type of charting should really only be done if for some reason you cannot learn or are not able to track mucus or temperatures. These methods are not good for postpartum or perimenopause.

Dot (Free)

Cycle Beads ($12 USD)

Communities and Self-Teaching

If you plan on self-teaching, I highly recommend joining this community. I am a moderator in this group. I do not recommend self teaching unless you absolutely cannot afford instruction. We have no known efficacy rates for self-teaching; so, it will be sort of “uncharted” territory if you choose to rely on it. The reason I recommend an instructor is because many people do not know what they do not know. Missing key details in a self-teaching manual can result in an unintended pregnancy. If self-teaching, I recommend waiting 12 full cycles before using any dry days. Dry days are one of the easiest things to misinterpret if self-teaching. If you are going to learn, I suggest the book Taking Charge of Your Fertility. This is a single check sympto-thermal method for opening the fertile window, but a double-check for closing the fertile window. This puts it at closer to 98% perfect use and 88-90% typical use. You can see that this is less effective than the other STMs linked above. Check your local library to see if it has listings of the book. Here is a link to WorldCat which you can use to locate a copy near you. Click here to check out Taking Charge of Your Fertility on Archive.org.

Other Free Manuals:

Sympto

NFPTA Fertility Guides

Many people ask if there is a self-teaching manual for mucus only methods. Mucus only methods should not be self-taught. That would be incredibly risky. If you want to do this, select an instructor from the list earlier in this blog.

Second Step: Order a Thermometer and Pick a Way to Chart

Recommendations for Thermometers and Apps

I recommend the iSnow as my favorite basal body thermometer for charting. Whatever you do, make sure you do not have a fever thermometer. These are not suitable for charting. It must be a basal body thermometer. For as slightly cheaper thermometer with a back light and memory, I suggest Easy@Home.

For information on the only wearable basal body thermometer I am willing to suggest, please read this blog post.

For information on charting apps, please read this blog post.

Third Step: Start Charting

While it will take you some time to make the initial investment and learn the method, it takes less than 5 minutes a day to chart once you have learned the rules. Build good habits right away. Check for mucus at every opportunity. I highly suggest taking your temperature after at least 3 hours of sleep at the exact same time when you are first charting. Some people may find that the time they can take their temperature can vary and still give them clear charts, but others will find they need to take it at the same. It takes a few weeks to make a habit. Once you have your routine down, charting will get so much easier.

Why We Should Talk About Cervical Mucus: Breaking the Taboo, Femtech, and Understanding our Bodies

Fertility awareness is garnering more attention than ever before. Companies like Natural Cycles, Ava, and Daysy** have made FAM more mainstream through advertisements. These femtech companies lure women in with a promise of an alternative, natural method of contraception that doesn’t involve hormones. While I am thankful that these companies have gained FAM more attention, I am critical of their motives and whether they truly empower women to understand their bodies.

All three companies have something in common. They choose to ignore cervical mucus as a fertility sign. Instead, they rely on basal body temperature. Daysy relies on basal body temperature as the primary sign to open and close the fertile window. Natural Cycles also relies on basal body temperature, but LH testing can be added if the user chooses. Ava relies on basal body temperature, resting heart rate, and breathing rate.

I have to wonder. Why don’t these companies include cervical mucus?

Cervical mucus is vitally important. It allows sperm to survive. Without it, sperm cannot fertilize an egg. Ovulation only takes place over the period of about one day in women (two eggs may be released within a 24 hour period). Cervical mucus provides sperm the opportunity to survive long enough to meet an egg. According to a study done by Ferreira-Poblete, “Sperm would have a 5% probability of surviving more than 4.4 days and a 1% probability of surviving more than 6.8 days.” This potentially long survival rate of sperm in cervical mucus is what allows that sperm to make it to the finish line. As you can see, cervical mucus is an incredibly important part of reproduction.

Why would these companies leave out something so important? Could it be because they find the topic unsavory? Do they think women are afraid of touching their own bodies? Why not inform women on this incredibly important sign?

In “Sex Ed for Teens, Where’s the Mucus?,” Laura Wershler argues that cervical mucus is an important part of sex education. She discusses how some people fear that telling teens about their cervical mucus will make them engage in riskier behavior. She calls this a bad assumption, and I agree. I do not remember hearing anything about cervical mucus in sex ed. My mother certainly never brought it up. How are women expected to learn about this aspect of their body? (It seems like the answer is that they are not supposed to learn about it.)

In her book, In Our Control: The Complete Guide to Contraceptive Choices for Women, Laura Eldridge writes about the backlash that Toni Weshler, author of Taking Charge of Your Fertility, experienced when she published her book for teens called Cycle Savvy which includes information about cervical mucus and how cycles work. One “senior fellow” called the book “inappropriate” and said that doctors and sex educators should be teaching the “value of self control” instead of promoting the idea that teenagers are influenced by their hormones. As you can see, it’s been a long battle for women to have the privilege to understand their own bodies.

Recently, Facebook and Instagram began taking down pictures of cervical mucus. Cervical mucus is produced in response to estrogen and is totally non-sexual. However, Facebook and Instagram have flagged these as sexual content.

It really makes me question the motives behind these choices of social media companies and femtech companies. Why do companies like Facebook, Instagram, Ava, Natural Cycles, and Daysy all fear cervical mucus? (Daysy discusses it on social media but chooses not to include it in their fertility predictions). Why do femtech companies avoid discussing it? Why isn’t it something that we are all comfortable discussing? After all, fifty percent of the population experiences it. I wonder if it is because much of the world isn’t fully supportive of women understanding their bodies.

In particular, I want to point out that Ava, Natural Cycles, and Daysy all want to make profit off of women’s fertility. The Ava and Daysy devices are incredibly expensive. On top of that, they leave out a vital ingredient to understand fertility. As far as I can tell, these companies aren’t out to help women have true body literacy. Instead, they give women the minimum amount of information about their bodies (they don’t encourage self-interpretation) and leave them in the dark. Women can avoid pregnancy for a very low cost without these expensive devices. See my blog for more information.

I think it’s about time that we broke the taboo around cervical mucus, and many others are also taking important steps to make this happen.

Right now, there is a petition to Facebook and Instagram to let them know that taking down cervical mucus pictures is not acceptable. You can sign here.

Another great source is the Cervical Mucus Project. This is an online database with pictures of peak and non-peak cervical mucus. You can also submit your own.

Let’s start talking about our mucus! Mucus is a very important fertility sign in the sympto-thermal method of fertility awareness. In fact, it is the only fertility sign used in some methods.

We should embrace this sign that our bodies give us!

Some Peak Mucus to Celebrate!

**Daysy now includes cervical mucus in their app BUT it does not change the fertile window. This is sad, and it really defeats the point of including it.

Why I Do Not Suggest Using Natural Cycles

Natural Cycles costs around $10 a month, or $80 a year. The app claims to be able to tell you when you are and when you aren’t fertile by using basal body temperature (ovulation strips are optional).

This claim is not true. Natural Cycles only has a 93% typical use efficacy rating. After my experience, it seems even lower than that. I used Natural Cycles for 3 cycles and compared it with the sympto-thermal (STM) method that I use. The method I use is 98.2% effective with typical use.

As a long term charter, I use a doering rule (a rule to limit dry days). My last safe day for unprotected sex is day 5 of my cycle (usually the last day of my period) because of this rule. This rule is included in the high efficacy rates of the sympto-thermal method.

The charts that follow show when my method said I was safe versus when Natural cycles told me I was.

I have compiled 3 of my charts for comparison. During more than one cycle, Natural Cycles told me I could have unprotected sex on the day near my PEAK fertility. Peak day is the most likely day of ovulation, while not always the exact day of ovulation. Suffice it to say, the app told me that I could have unprotected sex on a day when pregnancy was still possible.

September Cycle (First with Natural Cycles)

On my very first cycle, without any knowledge of whether I had ovulated the cycle before, Natural Cycles gave me clearance to have unprotected sex during my period.

This is totally wrong. Without having confirmed ovulation the previous cycle, there is no way to know if this bleeding is safe or not.

The next BIG issue is that it told me I could have unprotected sex on the second day of my temperature shift (CD17). There is a huge chance that my egg could have still been viable and hanging at this point.

With the symptothermal method, you CANNOT confirm ovulation before 3 high temperatures.

The chart below has my actual safe days as calculated by doering. (Keeping in mind that I did confirm ovulation the cycle before so my period is safe. However, there is no way that Natural Cycles could have known that).

september 1

October Cycle (Second with Natural Cycles)

late september nc cycle

For the second time, Natural Cycles gives me a green light on the second day of a temperature shift in the morning. My egg could still be around! In fact, this green light was less than 24 hours after my peak day!

october 1 cycle

November Cycle (Third with Natural Cycles)

late october nc cycle

During this cycle, Natural Cycles decides that I’m not safe on CD 5 (I am).

It also gives me a green light on CD20. However, I would not be safe to have unprotected sex until the evening of CD21 due to peak day occurring on the first day of my shift.

oct 27 cycle

Conclusion

Natural Cycles does not follow the rules for STM charting.

When charting with STM, one must always wait until the evening of P + 3 and T +3 (three high temperatures and three days after peak). Both rules have to be met before you can have any unprotected sex. With weaker shifts, this wait can be a day longer.

Natural Cycles does not include cervical mucus. Since cervical mucus is what opens the fertile window (and not temperatures), this causes the method to lose efficacy. Cervical mucus is what allows sperm to survive and fertilize an egg. When cervical mucus dries up for 3 days and 3 high temperatures above the coverline occur, ovulation is confirmed for the cycle. Any app that leaves out cervical mucus, but still lets women have green days pre-ovulation, is misleading women and putting them at extra risk of pregnancy.

Another worrisome aspect of the app is that it frequently gave me a green light on the morning of the second high temperature. Temperatures can easily be disrupted, and new charters may not know their normal temperature ranges. Women need to be certain that ovulation is over before having unprotected sex. The third high temp (along with the third day after peak day) lets you know that ovulation is confirmed. Green lights after only one or two temps can put women at a risk of pregnancy, especially when cervical mucus isn’t taken into consideration. In fact, most STM methods require 4 high temps for women who don’t use cervical mucus (or cervical position). The reason that Natural Cycles may interpret shifts wrong is because of its static coverline. Some women may not see much of a change in coverlines from cycle to cycle. However, others may see a change. Having a static coverline can give users green days before they actually have a temperature shift.

Lastly, the app is misleading because it marks the day of ovulation. The only way to truly determine the exact day of ovulation is with a well-timed ultrasound. In fact, ovulation is most likely to occur over a period of about 4 days. Here is the link to the study that discusses which 4 days are the most likely. Since ovulation is likely up to day 2 of a temperature shift, this proves even further why it is so risky for Natural Cycles to give green lights on day 2 of a shift. In the other 9% of cases not hightlighted in the green box below, ovulation happened up to 3 or 4 days before a shift. This is why mucus is so important to record pre-confirmed ovulation. If there is mucus present, the sperm may live. Natural Cycles does not take enough factors into account when drawing its fertile window.

ovulation


If you are coming off of hormonal birth control or postpartum, this app may be an even worse choice for you. Those coming off hormonal birth control and postpartum may experience cycles changing in length and unexpected early ovulation even more so than people with regular cycles.

Anecdotally, I have seen many risky charts from Natural Cycles in the group I help moderate. You can find a link to this group here.

I highly recommend learning a real sympto-thermal method from an instructor and not wasting your money on the Natural Cycles app. I found it quite shocking that is was not very conservative when first learning about my cycles.

Check out my last post to learn how to start charting on a budget. Click here to sign up to learn to chart with me when my course opens in September 2019.

Here are some other articles on Natural Cycles that I recommend reading:

Natural Cycles’ FDA Approval: What’s The Big Deal?

5 Reasons I Don’t Use Daysy Or Natural Cycles

‘I felt colossally naive’: The Backlash Against the Birth Control App

How To Learn FAM On A Budget (And Why You Don’t Need Expensive Femtech to Chart)

When I first stumbled on the sympto-thermal method, I was lucky enough to find Groove‘s website. It intrigued me, and when I tried to learn more, I quickly came across Natural Cycles (an app recently approved by the FDA). I didn’t know much about fertility at the time, but the price of Natural Cycles turned me off. I also ran into into the Daysy thermometer and saw that it cost over $300.

It had me like…

Groove’s website had shown me that I could do the method for free. Luckily, a friend recommended Kindara to me soon after. Someone in the Kindara community told me to buy Taking Charge of Your Fertility and to join Fertility Awareness Method of Birth Control on Facebook. Thus, my charting journey began with a fifteen dollar book and a ten dollar thermometer. As a broke graduate student, it was an investment that I could afford.

I’m not alone in having Natural Cycles or Daysy catch my eye with an advertisement. Many women begin their charting journey when they are drawn in by the advertisements of femtech or “female fertility” devices. These devices promise to interpret a woman’s fertility for her. Rather than teaching women how to tell when they may be fertile, these devices rely on algorithms and ignore other vital fertility signs.

While I am glad that these devices get the word out about natural birth control, the problem with these devices is twofold. To begin with, the devices are pricey investments that many families may not be able to afford. Many people may be misled and believe that it costs hundreds of dollars to use a form of fertility awareness. Others may buy the device without realizing that the devices do not offer the same accuracy as a real sympto-thermal method. They don’t offer the close instruction that many women with troubling cycles may need (especially those confusing cycles that can happen post-pill).

Natural Cycles costs around $10 per month, or around $80 annually, while Daysy costs several hundred dollars. Neither app takes into account cervical mucus (the thing that keeps sperm alive, ie what allows pregnancy to occur). It is beyond me why they don’t think to educate women about this vital fertility sign, but it is my belief that women should be fully informed and able to interpret their own fertility signs. These devices don’t promote empowerment, but instead ask for women to blindly rely on femtech devices. It is easy to be misled by advertisements, and women may not run into many peer-reviewed studies if they aren’t looking. Recent studies have shed light on the true efficacy of devices like Daysy. Click here to read about a recent incident regarding how Daysy is misleading (and here to read the peer-reviewed study) regarding the efficacy.

Natural Cycles is very open about its 93% typical use efficacy rating, but why would women pay ten dollars a month for a lower efficacy than what they could achieve by working with an instructor? I think that sometimes when women buy these devices they have come into charting with little knowledge of their own fertility and may feel that they can trust technology over their own interpretations of their fertility. Ladies, we are smart. With a little help and guidance, we can learn to determine our own fertile windows with a more reliable method than this device. Fertility awareness can be really empowering, and knowing your own body is a fantastic feeling.

When women are taught by an instructor, the sympto-thermal method typical use efficacy rating is 98.2% (self-learning has not been studied for efficacy). By working under an instructor, women can achieve self-reliance when it comes to interpreting their cycle. Instructors can help clear up tricky charts, and help women understand their own cervical mucus. A one time investment in instruction can provide a woman with years of reliable birth control. After a major life event like the birth of a baby or during times of hormonal change, women may need support with charting again. Otherwise, learning how to chart can serve a woman until menopause. Finding an instructor and buying a reasonably priced thermometer is both cheaper and more empowering than using a femtech device.

So, what’s my point?

Ditch the femtech.

You can learn NFP, and you can do it on a budget without expensive devices (and it’ll be a more reliable method of birth control).

In this next section, I’ll show you the three first steps to get started.

The following advice is geared more towards those trying to avoid pregnancy or trying to achieve pregnancy without any special circumstances (not recently postpartum, breastfeeding). I also only point towards sympto-thermal resources. Look for a future post geared towards those charting with special circumstances.

Step 1: Find an Instructor

charitng

Symptopro and Couple to Couple League offer very reasonably priced courses that can be taken online or through video chat / phone calls. Both of these offer instructor support (all of these courses are around $75-$150, but rates may vary for individual teachers). These two organizations also offer their own app (or website) to use with the method.

Besides the organizations I listed, there are also many freelance NFP teachers. FAMBC offers a list of instructors. You may also stumble on a few on Instagram by searching for things like #naturalfamilyplanning and #fertilityawareness.

I have plans to offer services that are affordable to someone who makes minimum wage. My basic charting help and course will cost $75. It is my belief that all women should be able to afford to learn how to interpret their own fertility. It is such a vital skill for navigating our lives. If you would like to work with me when my courses open in the September 2019, please fill out this —> form <—

You may wonder why anyone would pay for an instructor if it is possible to self-teach. When I first started charting, I didn’t know that the perfect efficacy rating of NFP was based on the Sensiplan study which followed people who had been taught by an instructor. Women who are self taught and lack a community may not reach the perfect efficacy level. Similarly, when women trust femtech devices blindly, it may result in less than perfect efficacy rates. When women are taught by an instructor, the sympto-thermal method typical use rate is 98.2%.

Step 2: Get a Thermometer

thermometer

If you are looking for a thermometer, any basal body temperature (BBT) thermometer will do. Just make sure that it is not a fever thermometer. The precision of the BBT thermometer is necessary. Check your local pharmacies or look online. My personal favorite thermometer is the iSnow. It holds sixty temperatures, has a backlight, an alarm, and a pretty quiet beep. You can find multiple versions of it in the twenty dollar price range.

If you want a cheap thermometer without a backlight, the mabis is great. This was my first thermometer.

You can also use a glass BBT. These take a little longer to take your temperature. Check for them in stores near you or online.

3. Pick an App / Way to Chart

fertlity friend

If your method doesn’t come with an app, check out my blog post “Top 3 Fertility Awareness Mobile Charting Apps” to help you decide which one is right for you.

Look into paper charting. Pen and Paper Fertility releases some great journals. You can also find some free charts to download on TCOYF’s website.

You can also try spreadsheet charting. Look for my blog post on how to get started with Google Sheets.