May 11, 2023
National Women’s Health Week
Your Body Is Talking: Are You Listening?
By: Kaitlyn Eckert
Director’s Note: As we continue to celebrate National Women’s Health Week, we are featuring an interview with Megan,* a long-time user of fertility awareness-based methods (FABMs), who used the Sympto-Thermal Method (STM) both when growing her family and while monitoring her reproductive health. Kaitlyn Eckert, a former FACTS elective participant, interviewed Megan about her story and why she is grateful for the myriad benefits of FABMs. In addition to family planning and medical management applications, using the method benefitted her relationship with her husband.
With constant technological advancements urging us to upgrade to the newest version or the next fancy gadget to fix our problems, is it possible that that approach is exactly the opposite of what we need? Our fast-paced American lifestyle often relegates personal health lower down on the priority list. However, what if instead of looking to our external environment for answers to our healthcare concerns, we were to take a more introspective approach observing our daily signs to better understand our bodies? We may be able to minimize the invasive diagnostic procedures and expensive treatments in favor of the simple biomarkers and restorative approaches offered by fertility awareness-based methods (FABMs). With straightforward steps and basic education, FABMs can be an empowering tool for women and couples alike.
FABMs are most commonly discussed within the context of natural family planning (NFP), but to stop there would be abating their full potential as a tool for medical management. A better understanding of the cycle biomarker observations improves reproductive and fertility literacy, as well as provides an individualized approach to optimize our health. Megan,* an FABM user of 14 years, has reaped many additional benefits from her FABM of choice, the Sympto-Thermal Method (STM). She can predict when she is getting sick, foresee when her cycle will be off by a few days, and even identify common causes of these irregularities, such as recent travel. In addition to utilizing an FABM to prevent and achieve pregnancy and monitor her reproductive health, Megan has found it also strengthened her relationship with her spouse.
“A better understanding of the cycle biomarker observations improves reproductive and fertility literacy, as well as provides an individualized approach to optimize our health.”
How it Works
STM utilizes two biological signs to help a couple understand their fertility. “Sympto” represents the changes a woman’s cervical fluid undergoes throughout each reproductive cycle, and “Thermal” refers to her basal body temperature (BBT). This temperature, measured with a basal body thermometer upon waking, rises by about 0.2oC (0.5oF) for three days after a woman ovulates.  Cervical fluid is most fertile (clear and slippery) at times of high estrogen, and BBT rises in response to high progesterone. These are the two main hormones responsible for a female’s reproductive capabilities, and STM provides data to directly interpret both. To provide the most accurate insight into a woman’s health and fertility, these signs should be tracked daily.
Compared to most hormonal birth control, FABMs require more education and a daily commitment to use a chosen method. Megan explained, “Keeping track of temperatures and mucus was challenging at first. But once you do it for so long, it is just second nature. I am coming to appreciate it even more now as my daughter is going to be hitting puberty soon. I am glad that we can use NFP to help teach her about her body.”
Since Megan used oral contraceptives before marriage, she has a unique perspective given her experience with both natural and synthetic forms of family planning. As her reproductive years continue, rather than feel burdened by the daily requirements, Megan appreciates the value of the information gleaned. Adolescence can be a challenging time as teenagers may commonly experience irregular cycles for two to three years. Instilling young females with the knowledge and capability to confidently predict menstruation presents a valuable benefit of FABMs for these girls. For Megan, this is an enormous advantage; she recalls difficulties managing her cycle when she was young. Her experience reveals how FABMs can empower women to first understand their reproductive health on an individual level and then pass this wisdom on to their children. Examining her long-term FABM experience and improved health literacy, Megan has grown to appreciate her body and “how amazingly it was designed.”
“Instilling young females with the knowledge and capability to confidently predict menstruation presents a valuable benefit of FABMs among this population.”
Communication and Support
For Megan, the decision to pursue an FABM was not one she made on her own; her husband also expressed his desire to practice a method of natural family planning. She and her husband learned STM via the Couple-to-Couple League from a couple who ultimately became friends and a great resource. They consider this a blessing, as finding healthcare professionals trained in FABMs can be difficult, a barrier faced by many women and couples.  At first, when Megan could not find a healthcare professional with FABM knowledge, her use of a natural method was commonly met with concern. When Megan finally found FABM-educated medical professionals, she felt better understood and cared for as a person. Megan’s reported experiences highlight the inequity of care available to patients who desire to use natural methods. Presently, modern day medicine still falls short for many patients in this sector of reproductive health.
Reflecting again on her FABM journey, Megan shared that her husband actively assists her with tracking her cycle. He remarked: “NFP requires constant communication. Every month, you need to decide if you are trying to achieve or avoid pregnancy, which means you must have open conversations about it. We have to work as a team when it comes to our fertility.”
“NFP requires constant communication. Every month, you need to decide if you are trying to achieve or avoid pregnancy, which means you must have open conversations about it. We have to work as a team when it comes to our fertility.”
Megan always refers to their NFP approach in terms of “we,” exemplifying the vulnerability and collaboration a couple must learn to embrace as they manage their fertility. She continues, “Our bodies are amazing and can tell us so much. When we know how to listen to what our body is telling us, there is no need for artificial birth control. Yes, it can be challenging But when you and your spouse are going through these challenges together, it makes you closer and stronger.”
FABMs foster deeper conversation and unity, not just between couples but also with their instructors.  Although Megan has struggled periodically to find a trained FABM instructor, the couple was fortunate to find a couple within their community that could educate them in STM. While there remains a need for more trained healthcare professionals to ensure patients have access, it is encouraging to hear from Megan how they ultimately found a supportive community during their transition to NFP. FABMs can create an environment that supports a woman throughout her reproductive life, strengthens the bond between a couple, and empowers both men and women with improved knowledge and control of their shared fertility.
“FABMs can create an environment which supports the woman throughout her reproductive life, strengthens the bond between a couple, and empowers both men and women with improved knowledge and control of their shared fertility.”
In closing, Megan shared her advice to couples considering or just starting FABMs: “Once you start FABMs, just stick with it. It takes some time to get used to, but you will be amazed by what you can learn about your body and how it can bring you and your spouse closer.”
*Names have been changed to respect the privacy of the interviewee and her family. All information is shared with permission.
 Alspaugh A, Barroso J, Reibel M, Phillips S. Women’s Contraceptive Perceptions, Beliefs, and Attitudes: An Integrative Review of Qualitative Research. J Midwifery Womens Health. 2020 Jan;65(1):64-84. doi: 10.1111/jmwh.12992. Epub 2019 May 28. PMID: 31135081.
 Frank-Herrmann P., Heil J., Gnoth C., et al. “The effectiveness of a fertility awareness-based method to avoid pregnancy in relation to a couple’s sexual behaviour during the fertile time: a prospective longitudinal study.” Human Reproduction 22 (2007): 1310-1319.
 Choi J, Chan S, Wiebe E. Natural family planning: physicians’ knowledge, attitudes, and practice. J Obstet Gynaecol Can. 2010;32(7):673-678. doi:10.1016/s1701-2163(16)34571-6
About the Author
Kaitlyn Eckert is a fourth-year medical student at Ohio University Heritage College of Osteopathic Medicine. She completed her master’s degree in nutrition at Tufts University and a bachelor’s degree in exercise science at Ohio Wesleyan University. Staying true to the osteopathic philosophy and her enthusiasm for preventative medicine, Kaitlyn’s goal is to optimize the body’s natural healing of itself through comprehensive, holistic care. She participated in the FACTS elective to broaden her scope of practice in being able to educate and empower her patients to better understand their bodies. Kaitlyn specifically aims to advocate for underserved populations and work to improve healthcare access equity, owing to her motivation in learning sustainable, low-barrier approaches to family planning and reproductive health.