By: Michael Plessala, MD
Editor’s Note: Michael Plessala, MD, is currently an OB/GYN resident and took the FACTS elective during his first year of medical school. In this interview, he speaks with Kate and William about using a fertility awareness–based method (FABM) in the early years of marriage. Their experience shows how FABM education can help couples understand cycle tracking, address misconceptions, and make fertility a shared conversation about responsibility and intimacy. To ensure more medical professionals learn how to support couples using FABMs, please consider supporting scholarships for students to attend our virtual conference on November 20th an 21st.
Meet Kate and William: They are a couple in their mid-20s who primarily use the NaturalCycles app for family planning and health maintenance. I had a conversation with them about their experience using a fertility awareness-based method (FABM) for family planning and how using the NaturalCycles app has shaped their marriage, communication, and perceptions of reproductive health.
Initially, William and Kate sought a family-planning method that aligned with their faith, but they were also influenced by friends who had positive experiences with fertility awareness. At the same time, a physician at their church gave a lecture explaining the biological and practical aspects of natural family planning, and they learned about multiple FABMs. They decided to begin tracking with the NaturalCycles app because it was FDA-cleared and easy to use—not requiring a formal course with an instructor to learn how to track basal body temperature (BBT).
Kate began consistently tracking her cycle six to 12 months before they were married. This early tracking helped her learn her body’s patterns and allowed their chosen app to collect enough data to make accurate assessments of her fertility. Although NaturalCycles only used BBT in its algorithm to assess her ovulatory cycle, Kate also periodically assessed her cervical mucus and urinary hormones for her own assessment and documented her symptoms in the app.
At the beginning of their marriage, both Kate and William felt very anxious about whether the method would work. Prior to using these methods, their impression of FABMs were that their use was extreme, ineffective, and only used by very devout couples. They also heard stories of unintended pregnancy from other couples, which reinforced their skepticism. Kate’s anxiety was especially strong because she would physically carry any pregnancy while in law school, making the consequences of an accidental pregnancy feel particularly stressful. Early in their first year of marriage, even minor physical symptoms triggered fears of pregnancy and sometimes led to panic and reassurance-seeking through pregnancy tests.
Their perception of fertility awareness changed significantly over time as their lived experience contradicted their previous misconceptions about FABMs. They found the method they chose to be reliable, empowering, and surprisingly positive for their relationship. William also referenced large national-level research studies that reported higher relationship satisfaction, stronger communication, and greater sexual satisfaction among couples using natural methods, which reinforced their confidence that their experience was supported by broader scientific evidence rather than being an isolated case.
“Their lived experience contradicted their previous misconceptions about FABMs. They found the method they chose to be reliable, empowering, and surprisingly positive for their relationship.”
William and Kate explained that using an FABM has positively influenced their relationship largely because it promotes shared responsibility. They explained that unlike hormonal- or device-based methods to prevent pregnancy–which they view as placing the burden almost entirely on the woman–the FABM requires both partners to be continually involved. Kate shares her charting with William through NaturalCycles’s partner feature, and they engage in daily conversations about her physical symptoms, mood changes, and fertility timing. They described using humor and lighthearted language when discussing her cycle, often joking about ovulation timing or noticeable mood shifts in ways that made fertility awareness feel normalized and integrated into daily life rather than clinical or stressful. These regular, open conversations about fertility also helped both partners anticipate the other’s needs and respond with greater awareness, care, and patience. William contrasted this sense of shared responsibility with other areas of their marriage, specifically financial management–where responsibilities are more unevenly distributed and sometimes a source of tension. He explained that this comparison made him more appreciative of how balanced and collaborative their approach to fertility feels, since both partners are actively engaged and accountable. The couple views sexual intimacy as neither taboo nor casual, but as something they hold in high regard that is discussed openly with one another.
“These regular, open conversations about fertility also help both partners anticipate each other’s needs and respond with greater awareness, care, and patience.”
Kate and William acknowledged that a common misconception of FABMS is that they are restrictive and burdensome. Rather than feeling restrictive, they described their experience with tracking BBT as freeing and relationship-building. They said that it has strengthened their self-control and helped them broaden their understanding of intimacy, especially during fertile periods when abstinence is needed. During those times, they intentionally cultivate other forms of closeness, such as dancing together, planning thoughtful dates, and spending quality time together. The couple notes that their use of FABMs brings opportunities to deepen their emotional and romantic connection even while choosing to avoid pregnancy. This mindset has allowed them to experience greater intimacy and mutual respect rather than resentment and frustration. At the same time, Kate’s experience as a law student has not made the method feel burdensome or overwhelming. She described tracking as routine as brushing her teeth. Even during particularly stressful periods, including during exam season or when traveling, the method generally remains a stable part of her daily life. The occasional missed temperature readings did not significantly disrupt her overall confidence in the method.
“The couple notes that their use of FABMs brings opportunities to deepen their emotional and romantic connection even while choosing to avoid pregnancy. This mindset has allowed them to experience greater intimacy and mutual respect rather than resentment and frustration.”
Finally, William and Kate acknowledged that fertility awareness still carries social stigma and skepticism, even within religious communities. Family members sometimes have made jokes or dismissive comments, reinforcing the perception that the method is unreliable. Despite this feedback, they strongly believe FABMs deserve more serious consideration. They see it as a natural approach that avoids the physical side effects of hormonal contraception, increases male accountability, and encourages deeper communication between partners. Rather than viewing FABMs as fringe or outdated, they believe it is a modern, evidence-based option that aligns with their values and their lived experience of a healthier, more connected marriage.
*Names have been changed to respect the privacy of the interviewees. All information is shared with permission.
ABOUT THE AUTHOR
Michael Plessala, MD is an OB/GYN Residency in Baton Rouge, Louisiana. He graduated from LSU Health Sciences Center School of Medicine in New Orleans, Louisiana, and completed his undergraduate education at LSU in Baton Rouge, Louisiana. Dr. Plessala is interested in restorative reproductive and pregnancy care. He enrolled in the FACTS elective during his final year of medical school to better understand fertility awareness-based family planning methods and how to share them with future patients, so they feel more empowered in their health and reproductive decisions.
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