There were a few periods of time in my life when I would cry every week. Frustrated, I’d shed even more tears over being so weepy. I felt powerless; but one day I realized I could actually control this.
I lived with this emotional side effect of hormonal birth control because I felt it was the safest, most effective way to prevent pregnancy. How did I know birth control was to blame for my tears? Because every time I took a break from the pill, the patch, or the ring—yes, I tried them all—I felt like myself again. I'm a fan of natural beauty products and whole foods, but I realized that pumping synthetic hormones through my body was exactly the opposite of that. For me, the idea of "all-natural" living had to go beyond eating organic and clean and slathering coconut oil on skin and hair.
I'm lucky that emotional downpours were the worst of my symptoms; some women develop life-threatening blood clots, deep depression, and fits of rage—all in the name of birth control. While many women can certainly thrive while using hormonal methods, I decided that I personally needed to stop being emotionally hijacked by hormones. But most of the non-hormonal methods didn't feel right for me. Not the IUD—I wasn’t willing to live with a foreign object in me at all times. As far diaphragms and cervical caps—that's a lot to think about in the moment.
Instead, I mustered the courage to dive in to a method many are afraid to try. It's not exactly effortless, but totally worth being happy and hormone-free. "Fertility awareness methods of birth control are extremely safe, but it does require commitment between two people to abstain from sex during fertile times, or to use barrier methods of contraception," says obstetrician and gynecologist Dr. Vanessa Cullins.
Interested? Here’s what you need to know about the symptothermal fertility awareness method of birth control.
Basically, it involves tracking cervical mucus and basal body temperature (the temperature of the body at rest) in tandem to anticipate and confirm, respectively, when you ovulate. You refrain from unprotected intercourse on and around the ovulation day—when the ovary releases a mature egg, and it's prime time for conception. Start with this calendar to begin tracking your ovulation.
The average menstrual cycle is 28 days, starting on the first day of your period; but some cycles could be between 21 and 35 days. (Irregular cycles can make this method challenging, but your gynecologist can help.) Typically, on the 14th day in a 28-day cycle, or 14 days before the next period start day, you ovulate. This is your most fertile day each month—healthy women have about a 25 to 30 percent chance of getting pregnant on this day, according to Dr. Cullins.
Following the end of your period and leading up to ovulation, check for cervical mucus everyday. You will typically have a few “dry days” without mucus after your period. As soon as cervical mucus starts appearing (on your underwear or on toilet tissue), you’ve entered a fertile window—ovulation can occur a within a few days. (You want to start abstaining from unprotected sex at this time.) Sperm can live in the vagina for up to five days, so if it manages to hang around come ovulation day, pregnancy could be fair game.
Cervical mucus will first appear as tiny, sticky or pasty yellow or white balls. Rising estrogen levels will increase water content in your cervical mucus over the next few days, and mucus will go from sticky, to more creamy like lotion—and then to a raw egg white-like or clear and slippery texture. This peak wetness indicates ovulation and your most fertile days. Definitely avoid unprotected sex on these days and about four days after, while you monitor your basal body temperature (BBT) to confirm that ovulation occurred.
Before ovulation, your BBT will typically be around 97.0 to 97.6 degrees Fahrenheit. After ovulation, the body produces progesterone, which raises BBT to between 97.7 and 98.3 degrees Fahrenheit. (This only happens when NOT on hormonal birth control, since progesterone will consistently be in the body when on hormonal methods.) So when BBT rises and stays consistently high for at least three days, you'll know you've ovulated. Technically, chances of getting pregnant the day after ovulating are slim to none, according to Dr. Cullins, but monitoring BBT and abstaining until confirming ovulation is precautionary.
To track BBT, get a specific basal body thermometer from the drugstore. (They’re pretty affordable.) Every morning, after sleeping for at least three hours, take your temperature before doing anything else at all—don’t even roll over and say good morning to your S.O. or drink water—since any activity will raise your BBT and result in an inaccurate reading.
Your BBT will lower again around 14 days after ovulation, which—major bonus—signals the start of menstruation and a new cycle. So, the morning you notice your BBT comes back down to previous levels, you know to expect your period—no more surprise visits from Aunt Flo.
Monitoring and logging cervical mucus and basal body temperature gives a bird’s eye view of your fertility cycle. After a few months of doing this, you become very familiar with your body’s natural patterns. There are even amazing apps like Glow and Kindara that make it totally easy to log all of your findings.
All right, I know you want to know: What happened once I made this switch? Well, no pregnancies, no weight gain, lighter periods than ever before, and no more crying at the drop of a hat. I feel like a pro when it comes to being attuned to my own body. The one side effect for me: I broke out pretty badly for a while since I didn’t have the acne-fighting benefit that some hormonal birth controls boast. But it’s nothing a bunch of rosehip seed oil couldn’t fix. (And here are some more tips for fighting adult acne.)
This fertility awareness method does require due diligence. "It's extremely difficult to predict ovulation," says Dr. Cullins. "Through understanding your body's fertility patterns, you can make decisions that are best for you, your partner, and your family." Be sure to consult your gynecologist and be meticulous about learning everything there is to know about how to practice this method effectively. Tracking data is key. And in the long-run you'll be better aware of your fertility when you are ready to consider getting pregnant.
If having children isn't want you want, there are a lot of options, and that's a great thing. Each individual needs to make the choice for herself what works best for her body and her values.
Illustration by Katherine Prendergast