Explaining How to Use Symptoms-Based Methods | Family Planning

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TwoDay Method

IMPORTANT: If a woman has a vaginal infection or another condition that changes cervical mucus, the TwoDay Method will be difficult to use.
Check for secretions	The woman checks for cervical secretions every afternoon and/or evening, on fingers, underwear, or tissue paper or by sensation in or around the vagina. As soon as she notices any secretions of any type, color, or consistency, she considers herself fertile that day and the following day.
Avoid sex or use another method on fertile days	The couple avoids vaginal sex or uses condoms or a diaphragm on each day with secretions and on each day following a day with secretions. They can also use withdrawal or spermicides, but these are less effective.
Resume unprotected sex after 2 dry days	The couple can have unprotected sex again after the woman has had 2 dry days (days without secretions of any type) in a row.

Basal Body Temperature (BBT) Method

IMPORTANT: If a woman has a fever or other changes in body temperature, the BBT method will be difficult to use.
Take body temperature daily	The woman takes her body temperature at the same time each morning before she gets out of bed and before she eats anything. She records her temperature on a special graph. She watches for her temperature to rise slightly—0.2° to 0.5°C (0.4° to 1.0°F)— just after ovulation (usually about midway through the menstrual cycle).
Avoid sex or use another method until 3 days after the temperature rise	The couple avoids vaginal sex, or uses condoms or a diaphragm from the first day of monthly bleeding until 3 days after the woman’s temperature has risen above her regular temperature. They can also use withdrawal or spermicides, but these are less effective.
Resume unprotected sex until next monthly bleeding begins	When the woman’s temperature has risen above her regular temperature and stayed higher for 3 full days, ovulation has occurred and the fertile period has passed. The couple can have unprotected sex on the 4th day and until her next monthly bleeding begins.

Ovulation Method

IMPORTANT: If a woman has a vaginal infection or another condition that changes cervical mucus, this method may be difficult to use.
Check cervical secretions daily	The woman checks every day for any cervical secretions on fingers, underwear, or tissue paper or by sensation in or around the vagina.
Avoid unprotected sex on days of heavy monthly bleeding	Ovulation might occur early in the cycle, during the last days of monthly bleeding. Heavy bleeding could make mucus difficult to observe.
Resume unprotected sex until secretions begin	Between the end of monthly bleeding and the start of secretions, the couple can have unprotected sex, but not on 2 days in a row. (Avoiding sex on the second day allows time for semen to disappear and for cervical mucus to be observed.) It is recommended that they have sex in the evenings, after the woman has been in an upright position for at least a few hours and has been able to check for cervical mucus.
Avoid unprotected sex when secretions begin and until 4 days after "peak day"	As soon as she notices any secretions, she considers herself fertile and avoids unprotected sex. She continues to check her cervical secretions each day. The secretions have a “peak day”—the last day that they are clear, slippery, stretchy, and wet. She will know this has passed when, on the next day, her secretions are sticky or dry, or she has no secretions at all. She continues to consider herself fertile for 3 days after that peak day and avoids unprotected sex.
Resume unprotected sex	The couple can have unprotected sex on the 4th day after her peak day and until her next monthly bleeding begins.

Symptothermal Method

Avoid unprotected sex on fertile days	Users identify fertile and nonfertile days by combining BBT and ovulation method instructions. Women may also identify the fertile time by other signs such as breast tenderness and ovulatory pain (lower abdominal pain or cramping around the time of ovulation). The couple avoids unprotected sex between the first day of monthly bleeding and either the fourth day after peak cervical secretions or the third full day after the rise in temperature (BBT), whichever happens later. Some women who use this method have unprotected sex between the end of monthly bleeding and the beginning of secretions, but not on 2 days in a row.