FAMnerd

If the answer to this question were better understood, FAM would be more well-known and respected – especially by the medical community.

As a natural form of birth control, FAM is continually lumped in with the Rhythm Method, even though Rhythm has been essentially defunct and discredited for over 20 years. This is especially frustrating considering FAM’s impressively high effectiveness rate, which is on par with that of the birth control pill.

So let’s settle this thing once and for all. What is the difference between FAM and the Rhythm Method? Is it possible for systems of natural birth control to be fundamentally different, or are they all the same? What could makes FAM highly effective and Rhythm justifiably laughable?

First, let’s define our terms.

For a detailed description of the Fertility Awareness Method, read our What is FAM? page.

How does the Rhythm Method work?

From Wikipedia:

To find the estimated length of the pre-ovulatory infertile phase, nineteen is subtracted from the length of the woman’s shortest cycle. To find the estimated start of the post-ovulatory infertile phase, ten is subtracted from the length of the woman’s longest cycle. A woman whose menstrual cycles ranged in length from 30 to 36 days would be estimated to be infertile for the first 11 days of her cycle (30-19=11), to be fertile on days 12-25, and to resume infertility on day 26 (36-10=26).

Another variation of Rhythm has you count back 14 days from your period, assume that this was the day you ovulated in your previous cycle, and assume that this is the cycle day when you will ovulate again in the current cycle. (There’s a lot of assuming going on here.) You then avoid unprotected intercourse around the time when you think you will ovulate.

Hopefully you can see some obvious problems with this.

So what is the difference between FAM and the Rhythm Method?

1) FAM is a symptoms-based method while Rhythm is a calendar-based method.

FAM uses biological symptoms of fertility (including basal body temperature, cervical fluid and cervical position) to assess day-to-day fertility. Scientifically proven rules are then used to interpret the symptoms and inform your choice of whether or not unprotected intercourse is safe.

Rhythm uses past cycles to predict future fertility. There is no day-to-day assessment of fertility. Rhythm hinges on future cycles proceeding exactly like past cycles. Any cycle length variation outside of a narrow range can cause Rhythm to fail.

2) The requirements of Rhythm are not realistic for most women. Because Rhythm doesn’t account for natural fluctuations in cycle length, it can require long periods of abstinence or using a barrier method.

Lifestyle factors such as stress, travel and exercise all affect cycle length. I have had cycles as short as 28 days and as long as 52 days, with the long cycles easily attributed to stress, travel or intensive exercise training. If I were to follow the requirements of the Rhythm Method, I wouldn’t be able to consider myself infertile until cycle day 42. Considering that the vast majority of my cycles are only 30-something days long, this really doesn’t make any sense.

FAM allows you to assess your fertility on a day-to-day basis. The length of previous cycles doesn’t affect your assessment of your current cycle (unless you are using a Doring-based rule, but that is another discussion). Having previous cycle history can be helpful in knowing how your cycles usually progress, but ultimately your decision of whether you are fertile or infertile is based on your current cycle and your current biological symptoms.

3) FAM also allows you to choose the rules that best fit your situation and need for efficacy. If you definitely need to avoid pregnancy, you can choose very strict rules. If you aren’t as concerned about a potential pregnancy and want to allow yourself more days of unprotected intercourse, you can choose rules that are less strict. Rhythm only has one set of rules that aren’t especially conservative.

Example: In the first new cycle after we got married, I had an unusually short cycle that was 28 days long. According to Rhythm I would have been safe through cycle day 10, but in reality I ovulated only 4 days later. Since sperm can survive for up to 5 days in ideal conditions, this would have been close enough for pregnancy.

Ultimately FAM and Rhythm are different because FAM is conservative and flexible enough to deal with cycle variations, and Rhythm is not.

Once in the midst of a FAM-related conversation, I was faced with a challenging statement from a friend: this method can’t possibly work because I know that you can get pregnant at any time in your cycle.

Let’s deconstruct this and see if this is true.

What is required for pregnancy to occur?

1. A mature, live egg

2. Live sperm

Without both of these factors at the same time, pregnancy is impossible. You don’t hear stories of virgin girls becoming pregnant (Mary aside) because although they may be ovulating, their ovulated eggs are not exposed to live sperm. As an ovulating female, there is no chance for you to get pregnant until live sperm are introduced to your body. Neither do men become pregnant in themselves by just producing sperm. There has to be a live egg available for fertilization. I think we can all agree on this, yes?

After maturity, healthy men produce sperm every day of their lives. They are fertile every single day. That means any day a woman has intercourse, she is exposed to live sperm. In ideal conditions inside a woman’s body (determined primarily by the quality of the woman’s cervical fluid), sperm can live up to five days. In less than ideal conditions, their lifespan is much shorter.

A woman’s fertility, however, is different. She is not fertile every single day because she doesn’t have a mature, live egg available in her body every single day. An egg is matured in an ovary once per cycle, bursts out of the ovary and is available for conception for 24 hours. After 24 hours the egg is dead and can no longer contribute to a pregnancy. In rare cases double ovulation can occur, in that two eggs are released in the same cycle. This is rare, but it can happen. If this does happen, the second egg is always released within 24 hours of the first one. This is not controversial or disputed; this is basic biology.

So at the very most, a woman’s body contains a mature, accessible, live egg for a maximum of 2 days. Combine this with the understanding that healthy, live sperm can survive inside a woman’s body in ideal conditions for 5 days, and you have a total fertile phase of 7 days.

Outside of these 7 days, the woman can not get pregnant. With no live egg present, pregnancy cannot occur. The only time pregnancy can occur is in the days around ovulation.

So can you get pregnant at any point in your cycle? No.

The better question, though, and the one I didn’t think to ask until after the fact is: if you are not charting, how do you know what point of your cycle you are in? You don’t.

You may know what day your cycle began if you record the date your flow started and understand the difference between spotting and bright red flow. But even that somewhat obvious sign can be misleading.

Was it truly a new cycle with the flow originating from the shedding of the uterine lining?

Was it mid-cycle spotting?

Was it anovulatory bleeding?

Was it implantation spotting?

Was it bleeding completely unrelated to your cycles, caused by a medical condition?

If you’re not charting, you don’t know. You can guess, but you don’t know. It is nearly useless for women who don’t chart to speculate about the progression of their cycles. Without charting, you don’t know any of the above questions, nor do you know the length of your follicular phase, ovulation date or length of your luteal phase. You may know that there is blood coming out of your vagina, or that you haven’t had blood come out of your vagina in a while, and surprise, you’re pregnant.

You cannot get pregnant at just any time in your cycle. But more importantly, if you’re not charting, you cannot know what part of your cycle you’re in.

Cycle day 39. No ovulation in sight. If I weren’t practicing the Fertility Awareness Method, I would be panicking.

Even if I ovulate within the next day or two, this will end up being a 55-60 day cycle. According to the 28-day cycle myth, I should have started a new cycle, accompanied by flow, 11 days ago. If I weren’t charting, I would think I was pregnant.

Au contraire. In fact, since I am charting and practicing FAM, I know that there is no possible way I could be pregnant – because without ovulation there can be no pregnancy.

So although this cycle has been weird and a little frustrating because it has been so long, I haven’t had to worry about a life-changing pregnancy. We will choose to have children eventually, but we aren’t to that point in our life plan yet.

And on the other hand, if we were trying to achieve pregnancy, all the intercourse in the world in the last 39 days would not have gotten me pregnant. If I weren’t charting, we wouldn’t know that I haven’t ovulated. With no signs of a new cycle, I would think we had successfully acheived pregnancy. And at about day 60 I would be disappointed.

FAM allows you to both avoid pregnancy and know when you are most fertile for achieving pregnancy. Using FAM means there’s no need to panic.

The laundry list of benefits of using the Fertility Awareness Method (FAM) is long, not the least of which is that it’s hormone-free.

Because FAM involves simply monitoring your body’s natural functions and making careful decisions based on that information, it is safe for all women to use. There are no products to cause allergic reactions, no pill to cause side effects and reduce your sex drive, no metal to puncture your organs. Why would we knowingly bring these things upon our bodies?

Here are some of the side effects of the birth control pill:

• Breakthrough bleeding
• Blood clots
• Stroke
• Decreased libido
• Decreased vaginal lubrication
• Hypertension (high blood pressure)
• Acne
• Gallstones

What are the side effects of using FAM?

…Uh, nothing. Unless you include greater knowledge and appreciation for the natural functioning of your body.

Experience highly effective birth control while keeping your body hormone-free with FAM.

I looked into LadyComp and wasn’t too impressed. I looked at a study that compared the number of potentially fertile days (yellow days in LadyComp) using FAM vs. LadyComp, and LadyComp required you to consider more days as potentially fertile. That means more days abstaining or using a barrier method. No fun.

At $485 USD, the LadyComp is basically a really expensive thermometer. The effectiveness rates of LadyComp and FAM are comparable, but you can get much more information with much much less expense when charting with FAM.

P.S. Charlie calls the LadyComp the Ladytron 2000.