Advanced Cycle Tracking

If you're reading this post, then it's likely you have already heard of the symptothermal fertility awareness method (FAM) of cycle tracking and are interested in learning more. If you've never heard of FAM, then I suggest reading my post "Cycle Tracking 101" before you continue.

In this post, I've tried to compile a "how-to" guide for getting started with FAM. I know it can be overwhelming at first, so I've done my best to make this easy to follow and use. After reading, be sure to check out the end of this post, as I mention some important resources for you to utilize moving forward.

So, without further delay, let's get started!

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Step 1: Choose Your Medium

The first step in charting your cycle is to choose what medium you will use to track. The three main options are an app, a calendar, or a paper cycle chart. While there are pros and cons to each, it really just comes down to personal preference. The most important thing is that you pick a medium that you will consistently use.

If you choose to use a period tracking app:

• You will ideally want one that allows you to track when you period occurs, not just when the app predicts it will occur (in fact, I recommend turning off any cycle prediction feature entirely, if possible)

• Additionally, because advanced charting tracks more information than just your period, you will need to find an app that will allow you to document the more detailed components of FAM

  • E.g. cervical fluid, basal body temperature (with graph), and cervical position

• I recommend the app called Read Your Body, it allows you to keep track of a lot of detailed information

  • I would definitely recommend it if you want an easily accessible charting method that closely resembles a paper chart

  • This app does have a fee, but other apps like this are available for free (such as Flo), so if you find one you like better feel free to use that!

If you choose to use a calendar:

• I recommend using a planner over a regular wall calendar because you will need room to write down notes for each day

  • Consider having a planner that is solely dedicated to cycle tracking, this way you'll have plenty of room for notes and your charting will be easier to read

  • Additionally, you may wish to find one that includes graph paper, since you will need to graph your basal body temperatures (BBT) each day (alternatively, you can use a planner and pair it with a paper chart for the temperature graph portion)

If you choose to use a paper cycle chart:

• Make sure you are using a chart that allows you to track all the necessary components of your cycle

  • I recommend using the free one provided by Taking Charge of Your Fertility linked HERE

• Do note, a paper chart may look overwhelming at first, since it is designed to fit information on an entire cycle onto a single page

  • Be patient with yourself as you get familiar with this method of charting

NOTE: If you choose to use an app, you may want to consider combining it with a paper chart for the BBT graph portion. I have found that the app graphs can be difficult to interpret sometimes, especially if your temperatures jump up and down a lot. Additionally, using a calendar may make patterns more difficult to see. Therefore, I really recommend using a paper chart for this method, if you are willing to be patient and tackle the learning curve.

Step 2: Choose Your Data

Now that you've decided how you will chart, it's time to discuss what exactly you will be keeping track of. For the symptothermal method, you will be tracking your period, your basal body temperature (BBT), your cervical fluid, and your cervical position (optional). Additionally, you will also want to track your body's signals.

Your Period

Your period marks the beginning of each new menstrual cycle, and each one offers valuable health information. There are several things you will want to take notice of and chart during this phase.

1. When your period starts

• This is cycle day 1 and marks the beginning of your menstrual phase

2. What symptoms you experience each day

• Cramps, backache, bloating, nausea, vomiting, diarrhea, constipation, headaches, acne, mood swings, breast tenderness, etc.How heavy your flow is

• How often are you changing your pad/tampon/menstrual cup? How saturated/full are they?

• Are you passing clots? If so, how large are they?

• What color is your blood? (bright red, dark red, brown, purple-toned, etc.)

3. When your period ends

• This marks the end of the menstrual phase and the beginning of the follicular phase

4. How you felt about this period overall

• This can just be a brief note (E.g. lots of pain during this period, felt frustrated)

Your Basal Body Temperature (BBT)

Your basal body temperature is the lowest temperature obtained after a period of rest. Usually, BBT is measured first thing after waking up in the morning, before you even get out of bed. It's literally the FIRST thing you do after opening your eyes for the day.

Now, there are a few caveats to taking your BBT correctly, since inaccurate measurements can affect your chart. Let's take a look at them:

• You will need to use a BBT thermometer that measures to two decimal places

  • This is most accurate, since other thermometers will round the measurement

  • I've linked the one I recommend/used HERE, but other brands work as well

• Your temperature has to be taken at the same time every day...

  • This means that if you wake up at 6am for work, you'll have to wake up at the same time on your days off (sorry to say)

    • If you don't want to actually get up for the day at that time, you can wake up, take your temp, and go back to sleep if that works better for you :)

  • If you do not follow this step, you can still track you cycles, but the temps may not be fully accurate

    • This is more important if you are using this as a method of birth control

    • Be sure to mark temps as "questionable" for days where you slept more/less than normal

• You MUST take your temp as soon as you wake, before you get up out of bed or do anything else

  • This is very important, as excessive movement can affect the reading

• You need at least 3-5 hours of consecutive sleep in order for the temp to be accurate

  • Any disturbances in your sleep can affect your temperatures

    • So, if you had a restless night's sleep or got up to go to the bathroom, mark that temperature as questionable since it is potentially inaccurate

If you are a shift-worker, wake frequently at night, or absolutely do not want to wake up at the same time each day, then I recommend investing in a wearable BBT thermometer if you are willing/able. I use the Tempdrop, linked HERE (this was such a game changer for me, makes it so simple!)

Okay, so know that you know the "rules" of BBTs, let's discuss how you actually take them:

1. As soon as you wake up, place your thermometer under your tongue and leave it there for five minutes before even turning the thermometer on

• This allows the thermometer to adjust to the true temperature of your body and will help make your temp readings more consistent/accurate

2. After the five minutes have passed, turn the thermometer on so it starts recording

3. Once the thermometer beeps, look at the measurement and record it in your app or on your paper chart

• With the two-decimal thermometer, you will round down to the nearest tenth

  • E.g. your thermometer reads 98.26, so you round down to 98.2 and record this temp

4. Throughout your cycle, pay attention to the pattern of your temperatures

• Ovulation is confirmed by a visible increase in BBTs (called a "temp shift")

  • Typically, the rule is that is if you have 3 consecutive temperatures that are higher than the previous 6 days, you can assume that ovulation has occurred

NOTE: If you choose to use a wearable BBT (like the Tempdrop), the steps are much simpler. When you wake up for the day, simply sync the thermometer to your app, read the temp, and move on. Easy!

Your Cervical Fluid

Cervical fluid (also called "discharge" or "cervical mucus") is a secretion produced by the cells of your cervix. It has several purposes, with the main ones being to protect sperm and transport them from the vagina to the egg (if present).

Without cervical fluid, sperm cannot survive in the vaginal environment, it is too acidic. Cervical fluid acts as an alkalizer, allowing the sperm to live and fertilize an egg. Therefore, knowing how to interpret your cervical fluid is essential to using FAM for both birth control and pregnancy achievement.

Now, it's important to understand that cervical fluid exists on a spectrum, and the characteristics of the fluid change from day to day as a result of our changing hormones, namely estrogen. As your body approaches ovulation, your cervical fluid will become more "wet" in quality, ultimately peaking at ovulation. Cervical fluid development *typically* follows this pattern: menstruation - dry - sticky - creamy - eggwhite - dry or sticky - menstruation.

I want to emphasize that not all women will follow this exact pattern, and that's okay. What's important is learning to recognize and understand your personal pattern.

Now, let's explore the characteristics of each fluid type...

• Dry: typically occurs directly after menstruation ends, this is really the absence of cervical fluid

  • No cervical fluid can be seen or felt when wiping, in underwear, or while checking internally

• Sticky: typically occurs in the follicular phase as your body begins to prepare to ovulate

  • How does it feel, look, and stretch?

    • Feels pasty, tacky, gummy, crumbly, or flaky to the touch

    • Appears thick, white, off-white, or yellowish, typically opaque

    • May stretch some if it is gummy/rubbery, but typically does not

  • Main point is that this fluid is present, but is not really "wet"

• Creamy: typically occurs in the follicular phase, closer to ovulation than the "sticky" type fluid

  • How does it feel, look, and stretch?

    • Feels cool, creamy, milky, or lotion-like to the touch

    • Appears white and/or opaque

    • May stretch slightly (about 3/4 inch), but will break

  • The difference between sticky and creamy is the wetness (sticky is more dry)

• Eggwhite: typically seen in the final days before ovulation, considered the most fertile fluid type

  • How does it feel, look, and stretch?

    • May feel wet, lubricative, slippery, or watery

    • Appears clear, cloudy, or streaked

    • Stretches a LOT, at least 1 inch without breaking

  • Like the name implies, eggwhite mucus has the look and feel of raw eggwhites, so thinking of that can help you identify this fluid

• Uncertain: this is not really a type of cervical fluid...rather, it is what you should chart if you're cervical fluid is questionable in any way

  • Vaginal infections, personal lubricants, and semen can all interfere with the accuracy of your cervical fluid assessment

    • Chart your fluid as "uncertain/questionable" if any of these factors are present, since you will not be able to tell your true fluid type

In addition to the cervical fluid itself, you will also want to assess the sensation felt as you wipe across the vaginal opening. Vaginal sensation tends to directly correlate to the type of cervical fluid present. Dry fluid (A.K.A. no fluid) and sticky will typically feel dry or scratchy when wiping. Creamy fluid can feel smooth, moist, or wet. Eggwhite fluid will feel wet, slippery, and lubricative.

Okay, so now we know the different types of cervical fluid and vaginal sensation, so let's go over how to assess them:

1. Each time you go to the bathroom, take notice of your underwear

• Is there any cervical fluid present? True cervical fluid is usually clearly visible and doesn't usually absorb into the fabric (mostly sits on top of it)

2. When wiping with toilet paper (always wipe front to back) pay attention to two things: how it felt (sensation) and what's present on the paper afterwards (cervical fluid)

• If any cervical fluid is present, take note of the color and overall appearance before you touch it

• Some resources recommend wiping both before and after you use the bathroom to ensure no cervical fluid is missed

3. Don't let this part scare you...take the cervical fluid rub it between the pads of your thumb and finger

• This allows you to assess the true texture of the fluid, a necessary step

• Let go of the idea that your cervical fluid is gross or dirty, it's not. It's presence is a sign of health.

4. After you assess texture, assess stretch by stretching the fluid between your fingers

• Pay attention to how far the fluid stretches, if at all

5. Optional: You can also check your fluid internally, by running two fingers over your cervix and assessing the appearance, texture, and stretch once you remove your fingers from your vagina

• This can easily be done while checking cervical position, if you choose to do so

• I usually do this if I didn't have much cervical fluid present on paper/underwear and I want to know for sure if any is present at the cervical opening

Your Cervical Position (optional)

The cervix is the lower portion of the uterus that can be found at the top of the vaginal canal. It acts like a gate, allowing sperm to enter the uterus and potentially fertilize an egg near ovulation. It also allows the passage of menstrual blood. During birth, the cervix dilates and thins, allowing the baby to pass through and be born. Overall, the cervix is an amazing part of our anatomy!

Similar to cervical fluid, the actual position of your cervix will shift and change throughout your menstrual cycle. This can be felt by inserting a finger into your vagina to assess the height, texture, and openness of the cervix. Tracking your cervical position offers you an additional fertility biomarker. Although it is considered an "optional" fertility sign, I recommend including it if you are comfortable. If you choose to, it can very easily be done as part of your shower routine, as it only takes a few seconds.

Here's the characteristics you will want to assess when checking your cervical position:

• Height: refers to how far up in the vagina the cervix is sitting

  • Low - cervix can be felt close to the vaginal opening

  • Medium - cervix can be felt midway up the vagina

  • High - cervix can be felt far up in the vagina

• Texture: refers to how firm or soft the cervix feels to the touch

  • Firm - feels similar to touching the tip of your nose

  • Medium - feels softer than firm, but firmer than soft (if that makes sense)

  • Soft - feels similar to touching your lips if you pucker them

• Openness: refers to how open the opening of the cervix is (called the "cervical os")

  • Closed - feels tightly shut (may only be felt as a dent or dimple with your finger)

  • Medium - feels like it is in between closed and open (this takes practice to identify)

  • Open - feels open or "bigger" (may be able to rest your finger tip gently into the opening)

• Angle: refers to which direction the cervix is pointing in relation to your pelvis

  • Anterior -feels like it is pointing more forward (towards your belly-button)

  • Straight - feels like it is pointing straight down (towards the vaginal opening)

  • Posterior - feels like it is pointing more backward (towards your back)

Okay, now let's look at the characteristics of the cervix as they relate to your menstrual cycle...

• Menstrual Phase: cervix is usually low, firm, and slightly open to allow menstrual blood to flow/exit, angle of cervix may vary

  • Some women's cervix will naturally sit higher than others

  • Like all things related to FAM, it's important to learn your normal and compare from there

• Follicular Phase: cervix may begin as low, firm, and closed; may shift higher, softer, and more open as ovulation approaches, angle of cervix may vary

  • The timeline for this is different for everyone, some women may notice their cervix feels "fertile" for several days leading up to ovulation, and some may only notice it for one day

• Ovulatory Phase: cervix is usually high, soft, and open to allow sperm (if present) to pass through, cervix may be angled more straight

  • Many times, you will also feel wet eggwhite cervical fluid present at the cervix during this phase

• Luteal Phase: the cervix usually switches back to low, firm, and closed after ovulation has ended, angle of cervix may vary

  • As I mentioned earlier, some women may experience this change quickly after ovulation, while others may take a few days to notice the shift

So, now that we know what we're assessing, let's go over the steps to do it...

1. Choose a comfortable position (this may vary for each person depending on cervical height)

• I personally find it easy to do standing up with knees slightly bent

• Other options include squatting, sitting on the toilet, or putting one leg up on the edge of the bathtub

2. With clean hands, find your vaginal opening

• You can use a mirror if you like, or you can just feel around for it

• NOTE: if you've never looked at you vulva, definitely take a mirror and do so, your body is amazing!!

3. Gently insert one finger into your vagina

• If this is your first time doing this, take a moment to notice the texture (it feel a little spongy)

4. Now, try and locate your cervix

• Unless you happen to be ovulating (and therefore have a soft cervix) you should be able to differentiate the cervix from the vagina relatively easily

  • It will feel rounded, smooth, and much more firm compared to the walls of the vagina

5. Once you find your cervix, take note of how far you had to insert your finger to reach it

• This is how you will determine the height of your cervix

  • Was it relatively easy to reach? Or did you have to insert all the way up to your hand?

  • Again, very important to learn your normal here!!!

    • For example, my cervix tends to sit relatively low, so I can easily reach it during all phases of my cycle, even during ovulation. On the other hand, some women may have such a high cervix during ovulation that they cannot feel it. Everyone is different.

6. Next, notice the texture of your cervix

• Does it feel firm, soft, or in the middle?

7. Now, feel for the cervical os (opening) to determine the openness

• Can your finger tip rest inside the opening? Or does it feel tightly shut?

8. The last internal step is to try and notice the angle of the cervix

• When you feel the cervical os, which direction does it seem point?

  • Towards your bladder would be anterior, and towards your tailbone would be posterior

9. Finally, remove your finger from your vagina, taking note of any cervical fluid that may be present

• When you're done, chart your findings and see how it correlates with your cycle phase

NOTE: sexual arousal causes the cervix to rise higher in the vaginal canal, so always check beforehand or well afterwards, since the height will not be accurate otherwise

As I mentioned before, cervical position is considered an optional fertility sign. However, tracking it does offer several benefits, so I really recommend trying it out. In my own experience, checking cervical position has allowed me to better understand my charts, and it has helped me become more comfortable with my body. I encourage you to approach this practice with an open mind and let go of any belief that your body/vagina is "dirty" or "gross". Your cervix is amazing, and there is nothing wrong with learning your own anatomy.

If you choose to incorporate this this practice, please be patient with yourself. Learning to identify and differentiate the subtle changes of the cervix can take time, so my best advice is to just be consistent.

Your Body's Signals

The final aspect of advanced tracking is learning to identify and interpret your body's daily signals. The four main categories you will want to pay attention to are as follows: your mood, your energy levels, any negative symptoms you experience, and any notable events that occur. Think of these things as the final pieces of the cycle tracking puzzle. While tracking your fertility markers (BBT, cervical fluid, & cervical position) can give you a lot of insight into your menstrual health, tracking your body's signals helps give you the full picture.

By tracking your mood and energy levels in relation to your cycle, you will be able to better predict how you will feel during certain phases and plan your life accordingly. Tracking any negative symptoms you experience throughout your cycle can help you better identify the root cause of said symptoms and adjust your lifestyle to address them. In the case of existing gynecological conditions (such as endometriosis, adenomyosis, polycystic ovarian syndrome, fibroids, etc.) tracking your symptoms may help you receive a faster and more accurate diagnosis. Finally, by tracking any notable events, you are able to see what external factors may be affecting your period/cycle. This can help take a lot of the guesswork out when trying to identify irregularities and their causes.

So, here's a rough guide for what you will to pay attention to in this area...

• How is your mood each day?

  • Happy, sad, anxious, stressed, depressed, irritable, frustrated, angry, mood swings, etc.

• How are your energy levels each day?

  • Do you feel tired and fatigued (low), energetic and outgoing (high), or somewhere in between?

• Are you experiencing any negative symptoms each day?

  • If so, which ones specifically?

    • Pelvic - cramps, backaches, pelvic aching/pressure, heaviness in the pelvis, etc.

    • Abdominal - diarrhea, constipation, bloating, indigestion, heartburn, nausea, vomiting, etc.

    • Urinary - bladder pain, urinary frequency/urgency/pain, etc.

    • Sexual - pain with intercourse, cramping after orgasm, etc.

    • Other Symptoms - headaches, migraines, acne, breast tenderness, and any other symptom that you feel is important to include

  • When do these symptoms occur? Does there seem to be anything triggering them?

• Where there any notable events that occurred during this cycle?

  • Include both positive AND negative events (yes, even positive stress can affect your cycle)

    • Examples: travel, sickness, a stressful day at work/school, finishing a big project, having a busy day/social event, stress in a personal relationship, moving to a new area, etc.

• PLEASE feel free to also include anything else that you feel is relevant to your charting, even if it's not included on this list!

Step 3: Put It All Together

Okay, so you've chosen you medium and you know what to look for. But how do you actually begin tracking your cycle using symptothermal FAM? Not to worry! Here's a step-by-step breakdown of how to put it all into practice.

1. Everyday, first thing after waking up, place your BBT thermometer under your tongue and leave it in place for five minutes before pressing the button to begin measuring

• Once you get your reading, follow the rounding guideline (see "Your BBT" section) and chart your temperature on your chosen medium

• You will also want to record what time your temperature was taken as well and whether or not you feel it was reliable (did you get good sleep last night? were you more cold/hot than normal?)

2.a. If you are on your period, make note of all the points I detailed in the "period" section, as well as all the points in the "body signals" section (you can also track cervical position if you choose to)

• Reminder: the first day of your period should be marked as "day 1" of your cycle chart, with each subsequent day marked as cycle day 2, cycle day 3, etc.

2.b. If you are not on your period, track all the information for the "body signals" section, the "cervical fluid" section, and the (optional) "cervical position" section

• Follow the steps I outlined in these sections to correctly assess your cervical fluid/position

3. Every day, feel free to add any additional information that you feel may be important

• E.g. exercise, supplements, herbal teas, medications, etc.

4. When your next period begins, mark that as day 1 of a new cycle and REPEAT!!!

• You will also want to count the total number of days for your previous cycle and making note of it

After a few months, you should start to feel more comfortable with this method of cycle tracking, and you may begin to see patterns in your cycles. Additionally, there are more components to practicing FAM (such as confirming ovulation) than what I have covered in this post, but I'll be creating separate posts about that. For now, just try and get into the habit of daily charting using this method.

Good luck!

A Final Note

Although this post does cover a lot of information, it is not an exhaustive guide to the fertility awareness method. Additionally, I want to make it clear that I am not a certified FAM educator at this time, so I am only speaking from what I have learned and my own experience. The best way to learn how to practice FAM is to find and work with a certified FAM educator. However, I know this is not always feasible for everyone. This is why I HIGHLY recommend reading the book Taking Charge of Your Fertility by Toni Weschler if you plan on using this method, and I certainly would not recommend trying to use FAM for birth control purposes without doing so. I know that reading this book may seem like a bit much, but encourage you to view it as an investment into your long-term menstrual and reproductive health.

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What's Next?

Keep an eye out on the blog for most posts on FAM. We'll be discussing how to interpret your charts, identify menstrual issues, confirm/track ovulation, and more! Also, head over to my instagram for more info on how to track your cycle.

Disclaimer: The information provided on this site are for educational purposes only and is not medical advice. Always consult your healthcare provider before making any changes to your medications, diet, or exercise.