Can’t tolerate the side effects of the pill? Not quite ready for something permanent like tubal ligation? You aren’t alone.
Many women want to avoid pregnancy without pumping their bodies full of hormones. Whether it is for health, religious, or personal reasons, Natural Family Planning (NFP) offers a chemical-free alternative.
It takes a bit of research and body awareness, but it doesn’t have to be overwhelming. We’re here to break down the methods, the commitment involved, and how to track your cycle effectively. Step by step, you might realize you have more control over your fertility than you thought.
What Is Natural Family Planning?
Natural family planning, often called fertility awareness, is a group of contraceptive methods that doesn’t rely on medication or devices. Instead, you monitor your body’s natural fertility signals to identify the days you are most likely to get pregnant. By identifying your fertile window, you can avoid unprotected sex during that time (1).
To make this work, you need to track three primary signals:
- Ovulation timing: You determine this by tracking the length and regularity of your menstrual cycle.
- Basal body temperature: You must track slight temperature fluctuations every single morning.
- Cervical secretions: You will assess changes in cervical mucus consistency regularly.
Tracking and recording these signs forms the basis of NFP. While you can use single methods, they are significantly more effective when combined. We will explain how to track these signals and weigh the pros and cons below.
Benefits and Disadvantages
Before ditching your current birth control, you need to understand the trade-offs. NFP requires more effort than taking a pill, but the health benefits are worth it for many.
Benefits of Natural Family Planning
- No Side Effects: Most contraceptives come with a laundry list of physical side effects. NFP has zero. You aren’t using chemicals, synthetic hormones, or implanted devices to alter your natural processes.
- Instantly Reversible: When you decide you want a baby, you simply use the data you’ve been collecting to time intercourse. There is no waiting period for hormones to leave your system.
- Religious Acceptance: For those with religious restrictions regarding birth control, NFP is usually an acceptable option.
- Body Empowerment: Monitoring your fertility signals helps you understand your reproductive health deeply. You become the expert on your body. This knowledge can also help you spot potential infections or hormonal imbalances much sooner than you would otherwise.
- Budget Friendly: Aside from a thermometer and a tracking app or journal, this method is free (2).
- Partner Connection: NFP requires communication. Your partner learns about your cycle, and you share the responsibility of abstaining during fertile windows, which can strengthen your bond.
Disadvantages of Natural Family Planning
- No STI Protection: Fertility awareness does not protect against sexually transmitted infections. If you are not in a monogamous relationship, you are at risk for diseases like chlamydia or HIV.
- Requires Cooperation: You cannot do this alone. Your partner must be willing to abstain or use barrier methods (like condoms) during fertile days. If they aren’t on board, the method will fail.
- Steep Learning Curve: Following and tracking multiple fertility signs is harder than popping a pill. You need to commit to learning the system and keeping accurate records daily. It may take several months of observation before you can confidently rely on your data.
- External Factors: Stress, illness, travel, and alcohol can throw off your basal temperature or cycle length. If your data is skewed, you might miscalculate your fertile window (source).
- Variability: Every woman is different. Some women have subtle fertility signs that are difficult to track, making the method frustrating or unreliable for them.
Be Careful
Who Shouldn’t Use Natural Family Planning
NFP is not a one-size-fits-all solution. Factors related to your lifestyle, medical history, or current health status can render the method ineffective.
If any of the following apply to you, NFP might be risky:
- Your periods are consistently irregular.
- You are currently breastfeeding (after 6 months) or are newly postpartum.
- You recently experienced a miscarriage or an abortion.
- You have conditions affecting fertility, such as pelvic inflammatory disease (PID) or active vaginal infections.
- You have high-risk health issues like cardiac disease where pregnancy could be dangerous.
Some restrictions are temporary. For example, you can begin NFP once a vaginal infection clears or after your cycles return to normal postpartum.
However, certain medications can disrupt fertility signals like temperature or mucus production. Be cautious if:
- You take medication known to cause birth defects, making pregnancy prevention critical (4).
- You take antihistamines or other drugs that dry up or alter cervical mucus.
- You recently stopped hormonal birth control and your cycle hasn’t regulated yet.
Lifestyle factors also play a huge role. You should consider other options if you:
- Travel frequently across time zones (this disrupts temperature readings).
- Have disrupted sleep patterns (new moms or shift workers).
- Have multiple sexual partners.
- Drink alcohol frequently, as it spikes body temperature (5).
If you are determined to use NFP despite these challenges, speak with a specialist. They can help you navigate the nuances or suggest a specific method, like the Sympto-Thermal method, which may offer more safeguards.
Natural Family Planning Methods
Before diving into the methods, you need a quick refresh on the menstrual cycle. It helps to know exactly what biological gears are turning.
Understanding the Menstrual Cycle
The menstrual cycle is your body’s way of prepping for a potential baby. It runs from the first day of bleeding to the day before your next period starts.
A “textbook” cycle is 28 days, though many women vary. Here is the play-by-play:
Day 1
Your period begins. The uterus sheds its lining because no egg was fertilized. Estrogen and progesterone are low, which often causes irritability or fatigue.
Days 2-5
While you are bleeding, your ovaries are already working. Follicles (fluid-filled sacs containing eggs) begin to mature (6). Cramps are common, but they usually subside after a few days.
Days 6-8
Bleeding typically stops. One dominant follicle continues growing while the others fade away. Estrogen levels rise, which usually boosts your mood and energy.
Day 8
Your uterine lining begins to thicken again, building a “nest” for a potential embryo. Estrogen continues to climb.
Days 9-13
Estrogen peaks. This triggers a surge in Luteinizing Hormone (LH), which tells the ovaries it is time to release the egg. You might notice more clear, slippery discharge during this time.
Day 14
Ovulation occurs. The follicle bursts and releases the egg into the fallopian tube. The egg lives for only 12 to 24 hours. If it isn’t fertilized in that window, it dissolves. Many women feel their sex drive peak right now; nature is trying to help you conceive.
Days 15-24
The egg travels down the fallopian tube. The empty follicle transforms into the corpus luteum and pumps out progesterone to keep the uterine lining thick for implantation.
Days 24-28
If you aren’t pregnant, hormone levels drop sharply. This crash causes PMS symptoms like bloating and anxiety. The uterine lining breaks down, and you restart at Day 1.
Calendar Method
The calendar method, or rhythm method, relies on math. It assumes your past cycles predict your future ones. You need to track your period for at least 6 to 12 months before relying on this (7).
Here is the catch: While an egg lives for 24 hours, sperm can survive inside you for up to five days (8). This means your “fertile window” is roughly six days long.
The Calculation:
Let’s say your shortest cycle was 25 days and your longest was 31 days.
- Find the start of the window: Take your shortest cycle (25) and subtract 18. Result: 7. You are potentially fertile starting Day 7.
- Find the end of the window: Take your longest cycle (31) and subtract 11. Result: 20. You are potentially fertile until Day 20.
- The Verdict: You must abstain from sex (or use condoms) from Day 7 through Day 20.
This leaves a large window where sex is off-limits. If your cycles are irregular, the window gets even bigger, or the method simply fails.
The calendar method is risky on its own because stress or illness can delay ovulation, making your math wrong. Typical use failure rates are around 24 percent (9).
While 24 percent is an impressive number, typical use of male condoms has a 13 percent fail rate, respectively. (source) It’s all about what risks you are willing to take. If you go without contraception, there is an 85 percent chance that you WILL become pregnant!
Women, who have migraines with vision changes, cannot be on hormonal birth control due to their risk of stroke. However, pregnancy can be an equally dangerous condition for some. The risk is relative to your medical history and comfort level.
For some women, natural family planning is the right choice. In my case, I am a personal fan of fertilityfriend.com!
Editor's Note:
Caitlin Goodwin, MSN, RN, CNMUse this method only if you have very regular cycles, and ideally combine it with other signs like temperature or mucus.
Basal Temperature
This method involves tracking your Basal Body Temperature (BBT) to confirm ovulation. You need a specific basal thermometer that measures to the 1/100th of a degree (e.g., 97.56°F). Regular fever thermometers aren’t precise enough (10).
How it works:
After ovulation, progesterone raises your body temperature slightly (about 0.4°F to 1.0°F). By charting this shift, you can identify when ovulation has passed.
The Rules:
- Take your temp every morning immediately upon waking.
- Do it before sitting up, drinking water, or speaking.
- Take it at the same time every day.
This method confirms ovulation after it happens. It doesn’t predict it in advance. Therefore, it is best for identifying the safe window in the second half of your cycle.
Factors like alcohol, fever, or sleeping in a cold room can mess up your chart.
Cervical Mucus
Your cervix produces mucus that changes texture throughout your cycle to either block sperm or help it swim. Checking this mucus daily gives you a real-time fertility status.
How to check:
- Wash your hands.
- Insert a clean finger into your vagina to find the cervix (it feels like the tip of a nose).
- Collect a sample and observe the texture between your thumb and finger.
What to look for:
- Post-Period (Dry): You may feel dry or sticky. Probability of pregnancy: Low.
- Pre-Ovulation (Creamy): Mucus becomes cloudy, creamy, or lotion-like. Probability of pregnancy: Rising.
- Ovulation (Egg White): This is peak fertility. Mucus is clear, slippery, and stretchy (like raw egg whites). It helps sperm survive. Avoid unprotected sex.
- Post-Ovulation (Dry): Mucus dries up again or becomes thick and sticky.
Stay hydrated for accurate results. Note that douching or spermicides wash away mucus and should be avoided.
Lactational Amenorrhea Method (LAM)
Breastfeeding can be a natural contraceptive, but only if you follow strict rules. Lactational Amenorrhea (LAM) works because frequent nursing suppresses the hormones that trigger ovulation (11).
The 3 Criteria for Success:
- Your baby is under six months old.
- You have not had a period since giving birth.
- You are exclusively breastfeeding on demand (day and night), with no long gaps between feeds.
If you supplement with formula, pump instead of nurse, or if your baby sleeps through the night (going more than 4-6 hours without nursing), your fertility may return unexpectedly.
Once your baby starts solids or you get your period, this method is no longer effective (12).
Warning
Withdrawal Method
The withdrawal method (“pulling out”) involves the male removing his penis before ejaculation. It’s free and requires no equipment, but it is risky.
It requires perfect self-control and timing. Furthermore, pre-ejaculate fluid can sometimes contain sperm, meaning pregnancy is possible even if he pulls out in time.
Roughly 22 to 28 out of 100 women get pregnant using this method annually (13). It is better than nothing, but we don’t recommend relying on it as your primary birth control.
Sympto-Thermal Method
This is the “gold standard” of NFP. It combines the calendar, basal temperature, and cervical mucus methods into one comprehensive chart.
By cross-referencing signs, you get a double-check system. For example, your calendar might say you are safe, but your mucus says you are fertile. In the Sympto-Thermal method, you would trust the mucus sign and abstain.
When used perfectly, this method is up to 99 percent effective. However, typical use (where people get lazy with charting or take risks) drops that effectiveness. It requires the most discipline but offers the highest reliability (14).
Technology: Using Apps
Tracking charts on paper is old school. Modern apps use algorithms to interpret your data for you.
Popular options include:
- Kindara: Pairs with a specific thermometer (Wink) to sync temperature data automatically. Great for charting nerds.
- Clue: A user-friendly period tracker that uses past data to predict future windows.
- Natural Cycles: This is the first app to be FDA-cleared specifically as a contraceptive method. It requires you to take your temperature daily and tells you “Green Day” (safe) or “Red Day” (use protection).
Apps are great tools, but they are only as good as the data you feed them. If you enter junk data (or skip days), the algorithm will fail you.
How Effective Is Natural Family Planning?
Effectiveness depends entirely on two things: accuracy of tracking and self-control.
“Perfect use” means you follow the rules 100% of the time. “Typical use” accounts for real life, forgetting to chart, misreading a thermometer, or risking sex on a fertile day.
Here is how NFP failure rates (typical use) compare to medical methods (15):
Medical Methods (Pregnancies per 100 women/year):
- IUD / Sterilization: Less than 1.
- The Pill: 7.
- Condoms: 13.
Natural Methods (Pregnancies per 100 women/year):
- Sympto-thermal method: 0.4 to 5 (when taught by a pro and followed strictly).
- Lactational Amenorrhea (LAM): 2 (only in the first 6 months postpartum).
- Calendar / Rhythm Method: 13 to 24.
- Withdrawal: 22 to 28.
- Natural Cycles App: Approximately 7 (typical use) (16).
As you can see, guessing (Calendar/Withdrawal) is risky. rigorous tracking (Sympto-thermal) rivals the pill in effectiveness, but only if you stick to it.
Natural Family Planning FAQs
What Religion Is Natural Family Planning?
Natural Family Planning is not specific to any one religion, but it is heavily promoted by the Catholic Church. It is the only form of birth control officially sanctioned by the Church because it remains open to life and respects natural cycles. However, many non-religious people use it simply to avoid synthetic hormones.
Is Natural Family Planning Hormonal?
No. NFP is 100% non-hormonal. It works by observing the hormones your body already produces, rather than introducing synthetic estrogen or progesterone to suppress them. This makes it an ideal choice for women who experience migraines, mood swings, or blood pressure issues on the pill.
Is Natural Family Planning FDA Approved?
Generally, NFP is a practice, not a product, so the “method” itself isn’t regulated. However, the app Natural Cycles has received FDA clearance to be marketed as a digital contraceptive. It is currently the only app with this specific designation in the US.
What Is the Main Disadvantage of Natural Family Planning?
The biggest downside is the lack of spontaneity and the effort required. You must track your signs daily and abstain from sex (or use condoms) for about 7 to 10 days every month. It puts the responsibility heavily on the user; if you slack off on tracking, your risk of pregnancy shoots up immediately.
What Is the Most Reliable Natural Family Planning Method?
The Sympto-Thermal method is the most reliable. Because it combines temperature (BBT), cervical mucus, and calendar calculations, it provides a “double-check” system. If one sign is unclear, the other protects you. When used perfectly, it has a 99% effectiveness rate.
Does Natural Family Planning Cost Money?
NFP is essentially free. You do not need prescriptions, pharmacy visits, or insurance. Your only costs are a good basal thermometer (usually $15, $40) and potentially a subscription to a premium tracking app, though paper charts or free apps work fine too.
