Once I began charting my cycle almost five years ago, I’ve used two fertility awareness methods (FAMs)—Creighton and FEMM—and I liked FEMM enough to become an instructor. Now, however, I’m using Marquette to chart my own cycles, as a recent diagnosis has made using FEMM impossible, at least for now. While the major fertility awareness methods have high effectiveness ratings, they aren’t necessarily equally effective for an individual woman or couple. Even if your biomarkers are all consistent and trackable, your own preferences will influence which method is best for you, and those preferences may change over time. With that in mind, here are four reasons you may need to switch methods—and how to make the switch. (If you’re new to fertility awareness methods, this article provides an overview of five common methods to help you pick one to start with, or you can take this fun Natural Womanhood quiz to help you find the method that’s right for you.)
Reason #1: Your season of life makes your current method difficult
A woman’s body goes through many hormonal changes over the course of her reproductive years, from puberty to menopause. These changes may dictate which method will work for you. For example, a lot of women switch FAMs in the postpartum period, particularly if they are breastfeeding. As a woman’s body attempts to begin ovulating again (which can and does happen while breastfeeding), she will often see confusing signs, particularly when it comes to her cervical mucus. Most methods, including methods like Creighton and FEMM that use cervical mucus as the primary or only biomarker, have protocols in place for the postpartum period, including if a woman is breastfeeding. However, some women in this situation prefer to switch to a method that does not rely on cervical mucus.
Similarly, the postpartum period almost universally involves a lot of getting up during the night and at variable times in the morning, which can make tracking basal body temperature (BBT) as with the symptothermal method (STM) challenging. Using temperature as a useful crosscheck for fertility awareness and family planning requires that the woman get a consistent amount of sleep, consistent wake times, and a full night’s sleep. Unless a woman uses a wearable device like a TempDrop (which monitors her temperature throughout the night and uses an algorithm to calculate her BBT), she may choose to switch to a method that does not use BBT as a biomarker.
What to use instead:
If you no longer want to chart cervical mucus, you can try a sympto-hormonal method that does not require this biomarker:
- Marquette has a protocol for using cervical mucus only or cervical mucus plus hormone monitoring, but it also has a protocol for only monitoring hormone levels or for monitoring both hormone levels and BBT.
- Boston Cross Check teaches women and couples to chart all biomarkers (cervical fluid, BBT, and hormonal), and users can pick which ones they want to use.
If you no longer want to chart BBT, there are many methods to choose from:
- Sympto-hormonal methods like FEMM (which tracks cervical mucus and luteinizing hormone, or LH, levels), Marquette, and Boston Cross Check.
- Mucus-only methods like Creighton and Billings, which track only cervical mucus.
Reason #2: You can no longer rely on a particular biomarker
Changes in your health may mean that a certain biomarker is no longer a reliable indicator of where you are in your cycle. Cervical ectropion, for example, is a condition in which cells from inside the cervix grow outside it. It can cause continuous discharge, including cervical mucus, in which case a cervical mucus-based FAM may no longer be a reliable form of family planning (because cervical mucus wouldn’t necessarily reflect fertility). Conversely, some prescription medications, like certain antidepressants and anti-seizure drugs, may dry up cervical mucus altogether, making cervical-mucus-only method charting impossible.
What to use instead:
See No. 2: If you can no longer use cervical mucus as a biomarker, using a sympto-hormonal method protocol that does not include cervical mucus (Marquette or Boston Cross Check) is your best option.
Reason #3: You need to see a certain medical provider
Two FAMs, Creighton and FEMM, have specific medical protocols (NaPro Technology and FEMM medical management) and educational programs to train doctors and nurses in those protocols. Many women (myself included) select Creighton or FEMM in order to easily work with a NaPro or FEMM medical provider.
However, there aren’t NaPro or FEMM medical providers in every state, so even if you have one near you now, if you move, you may not have access to one. While many providers offer telemedicine, if you are also having children or planning on having children, you may prefer your obstetrics provider be the same person who provides your gynecologic care. Some NaPro providers are able and willing to interpret FEMM charts, and vice versa. Other gynecologists with a restorative approach may be, as well. If, however, you are in a situation where the only restorative reproductive health provider you have access to uses a certain method, you may decide to learn that method instead.
What to use instead:
Of course, you can always opt for telemedicine or traveling for gynecologic care, and see a local provider when you are pregnant. If you’d prefer in-person or local care, however, you may have a couple other options.
If you were previously using Creighton and seeing a NaPro provider, consider looking for a FEMM medical provider in your area, and learning to use FEMM. It’s a sympto-hormonal method whose primary biomarker is cervical mucus, so it will be an easier transition for you, and FEMM is the other main FAM that has a corresponding medical management protocol. FEMM also offers telemedicine. Conversely, if you’ve been seeing a FEMM provider, you might want to look for a NaPro provider in your area, and learn to use Creighton.
The Marquette Method requires its instructors to be trained medical professionals. While your instructor may not be your medical provider, he or she will be able to help you work with a medical provider who doesn’t necessarily know the Marquette Method, giving you language to use in your appointment to help explain the method to your local provider. The instructor may also be able to identify possible medical issues in your chart and help you find medical help to diagnose and treat them.
Reason #4: You don’t have many “usable” days
Some FAMs are a bit more conservative than others, but if you’re finding that you don’t have as many “usable” days (i.e., days outside your potentially fertile window, when you and your partner can have sex without getting pregnant if you’re in a season of “TTA,” or trying to avoid pregnancy), the issue may not be that the method is too conservative. As Emily Frase, co-founder and president of FAbM Base and a fertility awareness coach, told me, “Wanting more usable days is actually not a good reason for switching methods. What needs to be addressed is why there aren’t more usable days, and then address other factors that will impact whether or not a method is a good fit.”
Frase offered an example. “Let’s say a woman has an irregular cycle, with the possibility of ovulating sometime between day 11 and day 19. This will likely result in a lot of abstinence. What she needs is a method that will help her identify the reason for the irregularity so she can address it, and doing so will give her more usable days by working towards achieving a regular cycle. But which method that is will be unique to her, depending on her lifestyle, personality, family life, partner support and other health needs.”
In other words, if the method isn’t giving you “enough” usable days because it’s not helping you find and address the root causes of irregularity with the goal of having a healthy, regular cycle, then you may need to switch methods. But the point isn’t that the method itself doesn’t work; it’s that it might not work for you.
Adjusting your mindset during the transition
Switching FAMs, particularly if you liked the one you can no longer use, can be a difficult adjustment. If you like data, reading up on the research behind your new method might help you (and your partner) feel more comfortable. If you want to meet other women who use the method, check whether there is an online community, like a Facebook group, of users. If you and your partner have to abstain more than you’re used to while you learn the new method, Natural Womanhood has some resources that can help (see the articles here, here, and here, for starters). Most of all, be patient with yourself. Remember the learning—and trust—curve you experienced when you learned your first method. You made it past that curve, and you’ll make it past this one, too.
Additional Reading:
FAM Basics: what is a fertility awareness method and how do you start charting with a FAM?
Yes, you can chart with a fertility awareness method while breastfeeding!
Can you really use breastfeeding as natural birth control?
“Isn’t NaProTechnology just charting?” and other questions: a Natural Womanhood NaPro FAQ
