Natural Family Planning: Benefits, Risks & Methods

The menstrual cycle is the natural process by which your body prepares for a potential pregnancy. The cycle begins on the first day of your period and continues until the first day of your next period.

Typically, one’s cycle lasts approximately 28 days, give or take a few days on either side. For this day-by-day breakdown, we will use that measurement.

Day 1

This is the first day of your period. The uterus has begun shedding blood and tissue.

The power players- estrogen and progesterone- are at a low point are at a low point, and you may feel irritable or depressed. The doom and gloom can be the pits, but rest assured it’s normal.

Days 2-5

While most women will still be menstruating on days two through five, action is taking place within the ovaries. Follicles (fluid-filled pockets) are forming and each of these follicles contains an egg ⁽⁶⁾.

Fatigue and cramping are common during this time. Hold tight ladies, it won’t last long and relief is on its way.

Days 6-8

Most likely your bleeding will stop at some point within these three days. One of the follicles will continue to grow, except in the case of twins where two lucky eggs will thrive, but the ovaries will reabsorb the others. Your estrogen levels start to rise and relief from the bad moods will likely be felt.

Day 8

The remaining follicle is growing larger, and your estrogen levels continue to ramp up. Once again, the lining of your uterus will begin to thicken and grow, preparing itself for the possibility of an impending embryo. With the influx of estrogen in your system, you may feel more energized and happy.

Days 9-13

Your uterine lining continues to grow to create a safe space for the embryo to land. As you get closer and closer to day 14, your estrogen levels will peak. LH, or the luteinizing hormone, will rise sharply, an indication that an egg is on the way.

Day 14

The excess LH in your system will cause the follicle to burst and your egg to be released into the fallopian tube. You are now ovulating and your egg is prime for pregnancy for the next 12 to 24 hours. As a result of these changes, you may be feeling at your best during this time. Some women notice that their sex drive peaks when they are close to ovulation– it’s like nature’s trick to get you pregnant.

Days 15-24

These are the travel days for your egg. Fertilized or unfertilized, it will make its way down the highway of fallopian tubes and into your uterus.

The rupturing of the follicle will cause your body to produce more progesterone, speeding up the process. At this time, the lining of the uterus will continue to thicken, preparing for implantation.

If a sperm happens to meet your egg while in the fallopian tube, that fertilized egg will then have a cozy place to land once in the uterus. Once attached, pregnancy has begun.

Days 24-28

If your egg was not fertilized, it will start to break apart once it reaches the uterus. Your estrogen and progesterone levels will go back down, and you may feel the effects of PMS, including irritability, anxiety, and bloating. Have no fear though, this most likely means you aren’t pregnant.

The unfertilized egg will then prepare to exit your body, along with the lining of your uterus, and you’re back to day one when bleeding occurs again.

Now that you’ve had a quick refresher course about what happens during your cycle, let’s look at NFP planning methods, beginning with the calendar method.

Also known as the rhythm method, this is a little complex and can take six to 12 months of prep work ⁽⁷⁾. You will need to track the start date and finish date of your period each month, in order to accurately predict your most fertile days.

Since eggs only live for 24 hours, there is only a single day of the month when you can get pregnant. But before you get too excited, sperm can live in the body for up to five days and lie in wait for the incoming egg ⁽⁸⁾. To avoid pregnancy, you would need to abstain from unprotected sex for a specific amount of time, determined by a calculation.

Once you have your baseline data, you apply the calculation. For explanation purposes, we will use 25 days as the shortest cycle and 31 days as the longest.

The rhythm-method calculation:

1. Find your shortest cycle of the months you were tracking (25 days) and subtract 18. This gives you seven.
2. Subtract 11 from the longest period day count (31 days), which gives you 20.
3. In this instance, your first “fertile day” is 7 days after the start of your period, and your last “fertile day” is 20 days after the start of your period.
4. You and your partner will then abstain from unprotected sex during those “fertile days.”

This method requires you to be exact with your record keeping. However, keep in mind that your period can vary slightly. You will need to update your calculations each month.

If you are thinking about using any of these methods, start tracking your period. It makes everything more manageable if you’re going into this armed with data! Everyone should be familiar with their menstrual cycle.

Some medical conditions can affect your cycle and the possibility for success with this method. If you have an eating disorder or thyroid disease, we recommend trying something else. For those who are breastfeeding or have recently stopped using hormonal birth control, speak with your physician first.

If for any reason, you tend to lose or gain weight rapidly, it may not be a good fit either. Other factors include regular strenuous exercise, like a professional athlete would take on, which may also prevent accurate readings.

If you’ve had difficulty remembering to take the pill, this method may take some discipline as well. The best way to make it work is to use it in conjunction with one of the other methods included here.

Your body’s natural month-to-month variations might make your calculations inaccurate. Getting the days wrong can happen. There is a 24 percent chance this method will fail and you’ll find yourself pregnant ⁽⁹⁾.

While 24 percent is an impressive number, typical use of male condoms has a 13 percent fail rate, respectively. (source) It’s all about what risks you are willing to take. If you go without contraception, there is an 85 percent chance that you WILL become pregnant!

Women, who have migraines with vision changes, cannot be on hormonal birth control due to their risk of stroke. However, pregnancy can be an equally dangerous condition for some. The risk is relative to your medical history and comfort level.

For some women, natural family planning is the right choice. In my case, I am a personal fan of fertilityfriend.com!

Editor's Note:

Caitlin Goodwin, MSN, RN, CNM

To use the calendar method, you can use a regular calendar or journal, or you can download a tracking app, which we will discuss further on.

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This method incorporates a daily temperature reading, to indicate when you may be ovulating. To make this method most effective, you will need a basal thermometer.

This type of thermometer is necessary because it has accurate results to the 1/100th of a degree. Due to the need for strict accuracy, ear or forehead thermometers won’t be precise enough ⁽¹⁰⁾.

Ovulation can cause your temperature to go up by nearly a whole degree. On the days following ovulation, your temperature may go down by 0.4 degrees Fahrenheit.

To create an accurate record, you will need to take your temperature with the basal thermometer every morning. It needs to be done immediately upon waking and before you get out of bed. You shouldn’t eat or drink anything before taking your temperature.

These daily measurements will be used to track your averages. It could take several months to see the subtle fluctuations.

The basal temperature method does have a few flaws. On days you are ill, especially with a fever, your temperatures won’t fit accurately into your record keeping.

Plus, it is a sensitive measurement. Other factors could disrupt your normal temperature cycle. We’ve listed a few here:

• Waking at different times for various reasons.
• Drinking alcohol the night before.
• Sleeping in a room that is hotter or cooler than usual.

All the lifestyle and systemic fluctuations make this difficult to use on its own. It could easily pair with another natural planning method as a double-checking measure, though.

Similar to the other methods listed so far, good record keeping is necessary here. You will need to check the mucus coming from your cervix on a daily basis to estimate where you are in your cycle.

How to check your cervical mucus:

1. Start with washed hands. Your fingernails should be trimmed short.
2. Find a comfortable position. Some prefer lying down or sitting on the toilet.
3. Insert your finger into your vagina until you can feel your cervix. Your finger will likely be inserted up to the middle knuckle.
4. Touch the side of your cervix and then remove your finger.
5. Assess your cervical mucus for consistency and color.

The changes in your cervical mucus will typically be progressive:

• Immediately after your period: This is the lowest point of mucus production. You may not notice any mucus at all, or it might be cloudy and slightly sticky.
• As ovulation nears: The mucus production is picking up, and it will feel more moist. It might be creamy in appearance.
• During ovulation: Immediately before you ovulate, mucus production is at its best. It will be clear and similar to egg whites, stretchy. If you have cervical mucus on one finger, you can touch the other finger to it and pull apart. It should stretch between the two fingers.
• Post-ovulation: As you move further away from your fertile days, the mucus production declines and becomes thicker in consistency again.

Some women do not produce much cervical mucus. If you fall into that category, it may be difficult to assess it for your record-keeping efforts. There are a few things that can affect your mucus production:

Staying hydrated is crucial. Make sure you drink water throughout the day. There are also dietary supplements, like “FertileCM,” that can be taken to stimulate production ⁽¹¹⁾. One thing to note, improving cervical mucus is also a tactic used to better your chances of conceiving, so watch out.

Using a spermicide or douching can change the consistency and appearance of your cervical mucus. It can also wash it away. Plus, they are prone to mess with your body’s natural pH, increasing your risk of infection.

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If you choose to breastfeed after giving birth, you may be practicing the lactational amenorrhea method without even realizing it. Lactational amenorrhea is the suppression of naturally-occurring hormones and a normal menstrual cycle due to breastfeeding ⁽¹²⁾. It’s triggered by the sucking of the nipple.

It generally only lasts for the first six months of breastfeeding and, for some women, their periods stop completely. If you are exclusively breastfeeding your baby, this method may be for you.

To keep your hormones from restarting your cycle, you’ll need to breastfeed, not breast pump, often. You should average every four hours in the daytime and at least every six hours at night. If you keep up the rigorous schedule, your body probably won’t release any eggs ⁽¹³⁾.

However, it’s important to note this method will become completely unreliable once the baby is six months old. Plus, once you introduce food other than breastmilk, or you start your period, it is no longer viable.

This probably isn’t news, but the withdrawal method is when the man withdraws the penis from the vagina before he ejaculates. The goal is to keep the sperm from ever getting a chance to enter inside.

People use this method because it is free. Also, it doesn’t have any side effects, and it doesn’t require a prescription. It doesn’t require any record keeping or monitoring of the body’s systems.

Unfortunately, it also isn’t highly effective. It requires a lot of awareness and self-control on the part of the male. Plus, it is also possible that the second round of intercourse without urination in between has sperm present in seminal fluid.

The statistics aren’t good on using this one alone. As many as 28 out of 100 women will become pregnant when this is their primary form of birth control ⁽¹⁴⁾.

That said, the withdrawal method combined with another natural family planning method could increase the effectiveness of both methods.

The sympto-thermal method of natural family planning is a combination of three of the methods described above. It includes the calendar, basal temperature, and cervical mucus methods.

When using STM, you chart all the fertility signals required of the methods listed above. You then use the combination of the three different signals to show you the entire picture. Being able to see all the signs will give you more confidence in plotting your fertile days.

Using this method will take a lot of diligence and accurate record keeping. Do you have any of the factors that make your readings inaccurate? As stated above, issues like having irregular periods or traveling often mean this method may not be as accurate for you.

Statistically, however, when used accurately, this is the most effective form of natural family planning, with a 99 percent success rate in avoiding pregnancies.

Just like everything else in the world, when it comes to tracking ovulation, there’s an app for it! If you’d like to involve technology, there are a lot of apps for tracking your cycle.

The majority of the apps focus on helping you conceive, but you could easily flip the data to avoid conceiving. Here are a few of the most popular apps:

• Kindara: Focuses primarily on basal body temperature, and it can sync automatically with a smart thermometer.
• Clue: Collects data about your fertility signs and mood to make its calculations. You can use it with your Apple Watch.
• Natural Cycles: Uses your temperature readings to create an algorithm to predict your fertility. This app is marketed as a birth control app.

You could consider these apps as supportive in determining your most fertile days. As always, we recommend you use them in conjunction with other natural family planning methods, not instead of them.

Natural Family Planning (NFP) is not specific to any religion, but it is often associated with and promoted by the Catholic Church as a natural method of birth control in line with its teachings.

However, people of various religious backgrounds or those with no religious affiliation use NFP for health, ecological, or personal reasons.

No, Natural Family Planning is not hormonal. It’s a method of birth control that involves tracking a woman’s menstrual cycle to determine fertile and infertile periods.

It relies on observations of signs like basal body temperature and cervical mucus, not on hormones or pharmaceutical interventions.

While the FDA does not approve methods like Natural Family Planning in the same way it approves medical devices or drugs, certain fertility awareness-based apps used for NFP have been FDA-cleared. These apps help track fertility signs to aid in NFP.

The main disadvantage of Natural Family Planning is that it requires strict daily tracking of fertility signs and a high level of commitment.

It’s less effective than other forms of contraception, especially if not used perfectly, and it does not protect against sexually transmitted infections (STIs).

The most reliable Natural Family Planning method is typically the symptothermal method, which combines monitoring basal body temperature, cervical mucus, and other fertility signs. Its effectiveness largely depends on consistent, accurate tracking and user understanding.