By Kyra Harames-Woodbury, DO
Editor’s Note: As a FACTS elective medical student, Kyra Harames-Woodbury wrote this piece highlighting how fertility awareness-based methods (FABMs) extend far beyond family planning. Through a patient’s journey, she illustrates how female cycle tracking can help women better understand their reproductive and overall health while supporting informed decisions to achieve or avoid pregnancy. As we celebrate National Natural Family Planning Awareness Week, this reflection underscores the importance of recognizing fertility as a vital sign of health and the many ways FABMs empower women, strengthen patient-clinician partnerships, and support personalized reproductive health care.
When I interviewed Sarah,* a 33-year-old teacher and mother of two, I expected to learn about how she used fertility awareness-based methods (FABMs) for family planning. What I did not expect was to come away with a deeper understanding of how closely fertility literacy is tied to overall health and how empowering it can be for women to understand their bodies on such a detailed level.
Sarah first learned about FABMs after she stopped using hormonal contraception due to mood swings, low libido, and headaches. Her physician mentioned nonhormonal options but offered little detail. A few months later, a friend introduced her to the Creighton Model, and curiosity led her to attend an introductory session.
Through that process, she began charting her cervical mucus and other physical signs related to her cycle. She realized that charting gave her more than a tool for family planning.
“It was like learning a language I never knew I spoke,” she said. “I could finally connect how my energy, emotions, and physical symptoms fit together throughout the month.”
“She realized that charting gave her more than a tool for family planning: ‘I could finally connect how my energy, emotions, and physical symptoms fit together throughout the month.’”
Her instructor, a nurse trained in the Creighton Model, helped her identify consistent patterns of limited mucus and shorter luteal phases, a likely indication of low progesterone levels. Sarah brought her chart to her physician, who confirmed the imbalance with lab work. With progesterone support and lifestyle adjustments, her premenstrual symptoms improved, and she conceived successfully a year later.
“I went from feeling frustrated and dismissed to feeling seen and understood,” she said.
Listening to Sarah, I was struck by how much physiological data a woman can observe through daily charting. FABMs such as Creighton, Billings, and Sympto-Thermal methods are grounded in reproductive physiology. Cervical mucus reflects estrogen activity, while basal body temperature rises with progesterone after ovulation. When taught correctly, these observations can provide reliable information about fertility and hormonal health.
“Creighton, Billings, and Sympto-Thermal methods are grounded in reproductive physiology. Cervical mucus reflects estrogen activity, while basal body temperature rises with progesterone after ovulation.”
High quality research studies support Sarah’s experience. Modern FABMs can be highly effective for both achieving and avoiding pregnancy when used properly. Beyond family planning, they can also help identify endocrine disorders, polyendocrine metabolic ovary syndrome (PMOS), thyroid dysfunction, and luteal phase defects. One review found that many couples struggling with infertility were able to uncover treatable causes through FABM charting and directed medical evaluation.[1]
As a medical student, I have often seen fertility discussed only in terms of pregnancy prevention or intent to conceive. This interview helped me appreciate fertility literacy as a broader measure of health. A well-documented cycle offers insight into stress, nutrition, thyroid function, and hormonal balance. For Sarah, this awareness became a tool for self-understanding, not just reproductive management.
Another part of our conversation that stood out to me was how FABMs encouraged shared responsibility between partners. Sarah described charting as “a team effort.” Her husband asked about her observations, and together they made decisions based on her chart.
“It changed how we communicated about intimacy,” she said. “It became less about restriction and more about understanding.”
That shift in communication and trust seemed just as valuable as the health benefits themselves.
“Another part of our conversation that stood out to me was how FABMs encouraged shared responsibility between partners. Sarah described charting as ‘a team effort.’”
This experience shifted my perspective and showed me the power of a medical practice that works with the body’s natural physiology instead of against it. Fertility literacy invites both physicians and patients to view fertility as a sign of health rather than a condition to suppress. It also emphasizes partnership and informed decision-making, which lies at the heart of family medicine.
This conversation reminded me that the body holds meaningful data when we learn how to read it. For Sarah, charting was not about limitation but discovery.
“It helped me trust my body again,” she said. “That trust changed everything.”
*Names have been changed to respect the privacy of the interviewee. All information is shared with permission.
References
[1] Duane M, Stanford JB, Porucznik CA and Vigil P (2022) Fertility Awareness-Based Methods for Women’s Health and Family Planning. Front. Med. 9:858977. doi: 10.3389/fmed.2022.858977
ABOUT THE AUTHOR
Kyra Harames, DO, is a family medicine resident physician at Northwest Washington Family Medicine Residency in Bremerton, Washington. She earned her medical degree from Noorda College of Osteopathic Medicine in Provo, Utah. Her professional interests include women’s health, lifestyle medicine, osteopathic manipulative treatment, and integrating fertility awareness into patient education to promote holistic and informed care.
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