FAM is a tool for identifying the fertile and infertile days of the menstrual cycle. While FAM reduces dependence on other contraceptive methods, it does not eliminate or exclude the use of additional methods if and when a couple wants to have sex during the fertile and pre-fertile days of the cycle.
While FAM has the potential to reach a nearly 100% effectiveness rate (post-ovulation), actual user effectiveness is not a guaranteed statistic; it is determined by the user’s understanding of how the method works, the quality of her fertility charts, and the degree to which the client implements the method rules correctly and consistently (see article about effectiveness).
Some research studies show that user effectiveness of Sympto-Thermal Methods (STMs), like FAM, can reach 98%, but these studies assume that a couple is choosing to abstain from intercourse until the post-ovulation time is confirmed. In other words, there is no calculated risk-taking for nearly half-to-two-thirds of the cycle. This means that while user effectiveness is high, so is the price of limited freedom to engage in intercourse during a significant number of days of the cycle.
Many FAM instructors, though not all, believe that each couple has the freedom to make an informed choice about what they want to do during the pre-fertile and fertile days of the cycle. For couples who choose more leniency, they will learn about the different options for maximizing contraceptive safety, adopt the goal of preventing/postponing pregnancy with the utmost responsibility, and find the method “mix” that works best for them. Safe sex during pre-fertile and fertile days means that a couple knows how to use other methods correctly, including two simultaneous methods during the fertile days. It also means that when using these other methods, the statistical effectiveness of 98% no longer applies, rather the statistical efficacy of these other methods.
User effectiveness will also be influenced by the type and number of back-up methods that a couple uses during the fertile and pre-fertile days.
No method of contraception is 100% (except for abstinence) and FAM is not a “stand-alone” method. This means that couples who want to maximize their days of “sexual freedom” during the cycle, understand that:
- The use of two, simultaneous methods is necessary during the fertile days (e.g. diaphragm and gel, condom and spermicide, withdrawal and spermicide).
- During the learning period (4-6 months or cycles of charting), the use of one method is necessary during the pre-fertile days of the cycle.
- Couples who choose to rely solely on a condom during fertile days are at risk for an unplanned pregnancy. If a condom breaks or “malfunctions,” this risk approaches 100%!
Contraceptive methods to use with FAM
The methods linked below can be used during the fertile and pre-fertile days. They can be effective when used correctly and consistently, as prescribed. It is worth noting that actual user effectiveness for these methods varies between 75-95%. This leaves a hefty, 20% margin of difference, so it is important to understand the following:
- There is no absolute number/statistic which protects an individual user from experiencing an unplanned pregnancy.
- What determines personal statistical effectiveness is not something inherent in the method itself but rather the actual characteristics of the person/couple using the method, i.e.
- How motivated are you to prevent or delay pregnancy?
- Have you received proper instruction on how to use the method?
- Do you know how the method works?
- Have you practiced using the method once or twice to get experience and skill?
- How confident and safe do you feel with the method?
- Does your partner support the method?
- Are you satisfied with the method?
- Using a method, whether it be a condom or a spermicide, for the first time will most likely confer a lower effectiveness rate than using a method for the third or fourth time. In other words, the onus of responsibility, of reaching the highest efficacy, depends on the user characteristics rather than on the method itself.
- It is critically important that after choosing one or more spermicidal, barrier or male methods, the person/couple practice using that method at least once or twice before relying on it in “real time.” This means inserting an ovule, a film strip, gel or sponge into the vagina, and sleeping through the night with the product in place. This is necessary for testing the product inside the body as a small percentage of users may experience burning or itching. It is best to know in advance whether or not a person has a sensitivity to the ingredients. Practicing the method before using it with a partner is also a good way to ensure that insertion is done correctly. This is also true for male condoms.
- All single-use methods require initial learning, skill, experience, and familiarity before use in “real-time.” Using 2 simultaneous methods during the fertile days is the best way to reach 100% effectiveness.
Single-use spermicide methods
There are six types of Spermicides. These products can be found in most pharmacies and pharma chains
In the U.S. and elsewhere-
- VCF Film
- VCF pre-filled applicators/non-toxic gel (non-spermicidal gel with natural acids that lower pH in the vagina)
- Phexxi Gel (new, non-spermicidal gel which lowers vaginal pH)
Diaphragms (cervical barriers)
Diaphragms are multi-use devices that can last for many years and they are used together with either a chemical spermicide-gel or a non-chemical gel made of natural acids (so it is not technically a “spermicide”). There are currently three kinds of diaphragms on the market. The following links to articles, videos, and other resources provide practical information about diaphragms and other barrier methods. See if the Diaphragm is right for you.
Although the CAYA can be purchased without a prescription, it is recommended that one get fitted by a trained practitioner or nurse who will also provide instructions for proper use. Most physicians and gynecologists have not been trained to fit diaphragms, so it is best to verify before making an appointment. Here is a list of diaphragm fitters in Israel.
These links come from the Israeli importer:
SINGA (new diaphragm)
Femcap (cervical cap)
The male condom comes in a variety of types, colors, sizes and flavors, with or without spermicide. Condoms are made of latex, polyurethane, and lambskin. Condoms are the only method of contraception that can prevent sexually transmitted infections.
General information (Wikipedia)