Contraception and Safer Sex

Birth Control Pills
Depo Provera
Emergency Contraception Pill
Female Condom (Reality Condom)
Fertility Awareness Methods
Hormonal Contraceptive Patch (Evra Patch)
Hormonal Contraceptive Ring (Nuva Ring)
Intrauterine Device (IUD)
Intrauterine System (IUS)
Male Condom
Tubal Ligation

Fertility Awareness Methods

What is FAM?
The fertility awareness method (FAM) is a way of tracking a woman’s menstrual cycle on a daily basis to determine when she is fertile.  FAM can be used either as a method of contraception (by avoiding unprotected vaginal sex during fertile periods) or as a means of encouraging pregnancy (by participating in vaginal intercourse during fertile periods).

How does FAM work?
FAM works by tracking when a woman is fertile. The woman records information such as her basal body temperature, the position of her cervix, and the consistency and texture of her cervical fluid to assess her fertility.  
FAM can be used to either prevent or encourage pregnancy:

If you are preventing pregnancy, you should avoid unprotected vaginal sex during your fertile period:   
- 5 days before ovulation 
- 3 days after ovulation 

If you are trying to get pregnant, you have the best chance if you have unprotected vaginal sex during your fertile period:
- 5 days before ovulation
- 3 days after ovulation

How effective is FAM?
If used correctly, FAM is between 80-98% percent effective in preventing pregnancy.  For typical or common use, FAM has a failure rate of 20% and a 1%-9% failure rate for perfect use.
* FAM does not protect against sexually transmitted infections*

How do I use FAM?
In order to know when you are fertile you need to observe and chart at least 2 out of these 3 fertility signs:
1) Cervical mucus
- Measure its wetness, stretchiness, and amount
- Can be charted, and must be noted at roughly the same times every day: before/after using the toilet, upon waking, before sleeping
- The more stretchy and similar to raw egg whites the fluid is, the better the indication of ovulation
- After menstruation, the fluid becomes drier and whiter
2) Basal body temperature
- Also known as “waking temperature,” a thermometer is inserted into the woman’s vagina and her internal temperature is taken within minutes of waking up (i.e., before she gets out of bed)
- Many things can affect internal temperature, such as illness, lack of sleep, allergies, travel, and ovulation
3) Position of the Cervix
- The cervix is the opening of the uterus and it feels like the tip of one’s nose
- Can hang lower or more upright, and can feel bigger and more open at ovulation
What are the advantages of using FAM?
Free or low-cost (depending on whether a basal body thermometer is purchased)
No hormones 
Both partners can be involved, and it may promote communication between partners
The woman and her partner can become more aware of her body
Can be used to prevent or promote pregnancy
No complications or side effects
Allows women to monitor pre-menstrual syndrome (PMS) symptoms
Can be a good option for couples with religious concerns related to other methods of contraception
If you wish to have vaginal sex during the fertile period you can use a barrier method (e.g. condom) to reduce the risk of becoming pregnant

What are the disadvantages of using FAM?
Does not protect against sexually transmitted infections (STIs)
Requires time in order to learn about FAM and about three months of consistent charting to learn the woman’s cycle
Comfort with one’s own body is optimal
Requires daily monitoring and dedication to recording the information
High risk of pregnancy if not monitored
Women cannot have vaginal sex during the fertile period unless another form of contraceptive is used if pregnancy is not desired
Stress/sickness may change a woman’s ovulation time
Women must have regular menstrual cycles
Can be difficult tracking signs and the information must be closely monitored

How can I get information on using FAM?
Effective use of FAM requires consistent tracking and charting of your fertility signs.  To use FAM most effectively, you should receive instruction from a person trained in FAM.  You can contact Planned Parenthood Ottawa or your doctor for more information or the many books and websites about FAM.

How much does FAM cost?
Free!   Although, if body temperature is one of the signs chosen to monitor, a basal body thermometer can cost from $20-50 at the pharmacy, depending on the brand.