A Perfect Fit: FEMM for Family Planning & Health
By: Rebecca Simon, DO
Director’s Note: Fertility awareness-based methods (FABMs) are growing in popularity for both family planning and clinical applications. In this interview, former FACTS elective participant Dr. Rebecca Simon shares the story of Rachel,* an FABM user who tried multiple methods before landing on Fertility Education and Medical Management (FEMM) as the perfect fit for her goals. Although long-term, peer-reviewed studies of the method’s effectiveness to avoid and achieve pregnancy have not been published, FEMM has multiple benefits for reproductive and health monitoring. Rachel’s experience speaks to the myriad applications. To learn about the various evidence-based FABMs, visit our website.
At 26 years old, Rachel* has been committed to using FABMs for years. She first learned about the Creighton Model from her OB-GYN. Her interest in Creighton stemmed from her own struggle with PMS-related symptoms, including acne, fatigue, and mood disturbances. She had also noticed darker hair on her stomach and chin. Rachel had labs drawn which indicated normal testosterone levels, but low progesterone.
“Her interest in Creighton stemmed from her own struggle with PMS-related symptoms, including acne, fatigue, and mood disturbances.”
In terms of medical history, Rachel had never experienced heavy bleeding or pain with her periods. She had no family history of polyps or endometriosis, but her father was recently diagnosed with Type I diabetes and her mother had Type II diabetes. She also mentioned that her sister, who was overweight, only had two to three periods a year. Rachel had never been sexually active before marriage and had never used any forms of contraception. To her knowledge, no one in her family had experienced fertility issues.
Using Rachel’s lab work to guide her treatment, her OB-GYN placed Rachel on progesterone and introduced her to charting with the Creighton method. She had some difficulty charting at first because she noted mucus outside of her fertile window, and she was not sure how to record that properly. Rachel felt that a method relying solely on cervical mucus, such as the Creighton model, would not work well for her. Eventually, a friend introduced her to FEMM. Finally, Rachel had found a way to better track her cycles, and she began making lifestyle modifications. After being placed on progesterone, she also started exercising regularly and adopted a healthier diet. Amazingly, she noted her symptoms began to improve dramatically.
After trying various methods of tracking her cycle, Rachel started incorporating the measurement of her urinary luteinizing hormone (LH) in her FEMM charting, which she has been doing for two years now. Her preferred method currently includes LH testing, in addition to cervical mucus recordings. Tracking her cycles not only led Rachel to relief from her PMS symptoms, but it also became useful once she started dating her now husband and was considering options for family planning in the future.
After Rachel and her husband were married, the couple decided to use the method to avoid pregnancy. She recently started graduate school in psychology and wanted to focus on finishing school in 2024 before starting a family. Tracking her cycle with a FABM has helped Rachel identify her fertile window to avoid an unintended pregnancy. She is more confident knowing that her menstrual period is regular and that she is ovulating every month.
“Tracking her cycle with an FABM has helped Rachel identify her fertile window to avoid an unintended pregnancy.”
Rachel was also able to ensure healthy cycles by tracking her biomarkers, in anticipation of the time when she and her husband decide to try to conceive. Tracking her cycle and knowing her fertile days have allowed her to maintain intimacy with her husband without worrying about an unintended pregnancy. FABMs can be valuable tools for any young woman looking to identify cycle abnormalities, discuss them with her physician, and receive treatment. These methods allow women to optimize their reproductive health and plan their pregnancies.
“FABMs can be valuable tools for any young woman looking to identify cycle abnormalities, discuss them with her physician, and receive treatment.”
Within the FACTS elective, I learned the different applications for the use of FABMs — from general reproductive health to family planning. I also realized women and couples use FABMs for various reasons. Some people may have religious beliefs that preclude the use of artificial contraception, and these methods provide a way to naturally avoid pregnancy by avoiding sexual contact during the woman’s fertile time. Furthermore, these methods can also allow young women to identify hormonal imbalances or other abnormalities with potential implications for their future fertility, enabling them to seek treatment early by an FABM-trained physician or fertility specialist.
*Names have been changed to respect the privacy of the interviewee and her family. All information is shared with permission.
ABOUT THE AUTHOR
Rebecca Simon, DO
Dr. Rebecca Simon is a Pediatric Resident Physician at Broward Health Medical Center in Fort Lauderdale, FL. She completed her undergraduate education at Florida Atlantic University in Boca Raton, FL and completed her Master’s in Physiology & Biophysics at Georgetown University in Washington, DC. She plans on completing her pediatric training and possibly pursuing a fellowship in Child Neurology. She enrolled in the FACTS elective to gain a better understanding of natural family planning methods and teaching patients about their reproductive health in order for them to take better control over their bodies and maintain their overall health.