Key takeaways: 

• Natural family planning is an approach to preventing pregnancy that does not use any pills, patches, injections, or any form of medication.
• Instead, cycle tracking is achieved using a variety of methods, such as fertility awareness and taking your temperature.
• These methods require consistency and often near-perfect use to be effective.

What you need to know about natural birth control and fertility 

What if birth control didn’t require any pills, patches, or injections? The fertility awareness method offers an alternative birth control option for those who want to go for an all-natural approach to pregnancy prevention. 

Also known as natural family planning, this birth control method requires most women to learn a bit more about their reproductive system in order to use it correctly. Find out more about fertility awareness to see if it might be a good birth control solution for you. 

What is natural family planning?

Natural family planning (also known as “the rhythm method” and “fertility awareness method”) involves tracking your ovulation in an effort to prevent or plan a pregnancy. 

Women are most likely to get pregnant on a select number of days near and during ovulation. Following natural family planning strategies, women can track which dates fall into that window, so they know to either abstain from sex or use a backup form of birth control (like condoms) to prevent pregnancy. Similarly, those trying to get pregnant can plan to have unprotected sex on those days to increase their chances of conceiving.

Ovulation tracking methods

How can you track your ovulation? There are actually a few different ways to do it:

Calendar method:

The calendar method involves tracking your menstrual cycle over several months to predict when you’re most likely to ovulate. You’ll record the first day of each period to determine the average length of your cycle. Ovulation typically happens about 14 days before your next period, so once you know the pattern of your cycle, you can estimate your fertile window.

Keep in mind that this method works best for people with very regular cycles. Even then, ovulation can shift due to stress, illness, or other factors, so the calendar method is often more effective when combined with other tracking techniques.

Cervical mucus method

Your cervical mucus naturally changes throughout your cycle, offering valuable clues about where you are in your fertile window. Right before ovulation, mucus usually becomes clear, stretchy, and slippery—similar to egg whites—which helps sperm move more easily toward the egg.

By checking and recording your mucus daily, you can identify the days you’re most fertile. This method requires body awareness and a bit of practice, but many people find it empowering to learn their body’s natural signals.

Temperature method

This method involves taking your basal body temperature (BBT) every morning before getting out of bed. Right after ovulation, your body temperature rises slightly—usually by about 0.5 to 1°F (or around 0.3 to 0.6°C)—and stays elevated until your next period.

Tracking these small shifts over time can help confirm when ovulation has already occurred. To get the most accurate readings, use a basal body thermometer and try to take your temperature at the same time each day.

Symptothermal method 

The symptothermal method combines multiple fertility signs—typically BBT, cervical mucus, and sometimes changes in cervical position—to give a more complete picture of your cycle. Some people also include mood, energy levels, or mild ovulation pain as part of their charting.

By layering several data points, this method can increase accuracy and confidence in identifying your fertile days. It requires commitment and attention to detail, but it’s often considered one of the more reliable fertility awareness-based methods when practiced consistently.

Wearable devices and fertility apps

For those who want extra support or more convenience, wearable devices and fertility apps can help track ovulation. Many smart thermometers, wristbands, or rings now collect temperature data while you sleep and sync with apps that analyze your cycle trends.

Apps that track your period, symptoms, or fertility signs can also help you spot patterns and predict ovulation. While tech tools can be helpful, they’re most effective when used alongside body awareness and consistent tracking.

Lactational amenorrhea method (LAM)

If you’ve recently had a baby and are exclusively breastfeeding, the lactational amenorrhea method can offer temporary pregnancy protection. It works because breastfeeding naturally suppresses ovulation, but only under specific conditions:

• Your baby is under 6 months old
• You’re breastfeeding exclusively (no formula or long gaps between feedings)
• You haven’t gotten your period yet

LAM is up to 98% effective when all criteria are met, but once your baby starts sleeping through the night or solids are introduced, its effectiveness drops.

Withdrawal method

The withdrawal method—sometimes called “pulling out”—involves removing the penis from the vagina before ejaculation to prevent sperm from entering the uterus. It doesn’t require any tools or medications, but it does require a high level of control and timing.

While this method can offer some protection, it’s less reliable than other options. Pre-ejaculate fluid can contain sperm, and any mistakes in timing can lead to pregnancy. Some couples use withdrawal as a backup in combination with other tracking methods or barrier protection.

Pros and cons of fertility awareness methods

Fertility awareness methods (FAMs), often referred to as natural family planning, involve tracking your cycle to identify fertile days and avoid pregnancy. Compared to methods like the pill, patch, ring, or IUD, FAMs offer lower protection but remain a meaningful choice for many people.

So, why do some choose fertility awareness despite the higher risk of pregnancy? The answer often lies in personal preferences and life circumstances.

Why some people prefer fertility awareness

• Hormone-free and side-effect-free: For those who’ve experienced unwanted side effects from hormonal contraception—like mood changes, acne, nausea, or low libido—fertility awareness offers a completely non-hormonal approach.
• Cost-effective: Once you learn how to track your cycle, this method doesn’t require a prescription, device, or medication, making it accessible for people with financial constraints.
• Values-based choice: Some individuals prefer fertility awareness methods for cultural or religious reasons, or simply because they want a natural alternative to conventional contraception.
• Body literacy: Learning the signals your body sends throughout your cycle—like temperature shifts or cervical mucus changes—can foster a stronger connection to your reproductive health and increase your sense of agency.

Challenges and considerations

Fertility awareness requires daily tracking, consistent routines, and a good understanding of your body’s patterns. It works best for those with regular cycles and a willingness to abstain from sex or use barrier protection during fertile days. The learning curve can be steep at first, and even small changes in sleep, stress, or illness can affect accuracy.

Additionally, some people turn to natural methods not out of choice, but due to limited access to other birth control options. If you live far from a clinic or struggle to get a prescription, it might feel like your options are limited. That’s where providers like Nurx can help—offering personalized care, expert guidance, and prescription birth control delivered right to your door, often at little or no cost with insurance.

Who shouldn’t use natural family planning?

Fertility awareness methods (FAMs) can be empowering for some, but they’re not ideal for everyone. These methods require close attention to your body’s signals and consistent daily tracking, so they work best when cycles are regular and predictable.

FAM may not be a good fit if:

• Your cycles are irregular. Tracking fertility becomes more difficult if your periods don’t follow a consistent pattern each month.
• You have PCOS or other hormone-related conditions. Health issues like polycystic ovary syndrome (PCOS) or thyroid imbalances can disrupt ovulation, making it harder to identify fertile days.
• You’re not able to track fertility signs daily. FAM requires checking cervical mucus, taking your temperature at the same time each morning, and recording cycle data regularly.
• You’re not comfortable avoiding sex or using protection during fertile days. FAM often involves abstaining or using a backup method like condoms during your most fertile window.
• You don’t have partner support. This method relies on communication and cooperation, especially when you need to use alternate protection during certain days.

If any of the above applies to you, a different birth control method might offer more peace of mind and ease. Still curious about your options? Nurx can help you find a method that matches your health, preferences, and lifestyle, with guidance from licensed providers, all from home.

How effective is natural family planning? 

Natural family planning, also known as fertility awareness, can be an effective method of birth control—but only when it’s used correctly and consistently. Fertility awareness methods are about 77% effective with typical use. That means approximately 1 in 4 people relying on these methods will become pregnant within the first year.

When used perfectly—meaning daily tracking of fertility signs, abstaining or using protection during fertile windows, and avoiding any missed steps—fertility awareness methods can be more effective.

But perfect use can be hard to maintain, especially with the demands of daily life, stress, illness, or irregular cycles. Effectiveness depends on several factors, including:

• Consistency: You’ll need to check and record your fertility signs—like cervical mucus, basal body temperature, and cycle length—every day.
• Cycle regularity: The method is most reliable for people with predictable, regular cycles.
• Accurate tracking and timing: Misinterpreting signs or miscalculating fertile days can increase the risk of pregnancy.
• Use of backup protection: Condoms or other barrier methods are often necessary during fertile days.

It’s also important to note that natural family planning does not protect against sexually transmitted infections (STIs). If STI protection is a priority, combining fertility awareness with condom use can provide more comprehensive protection.

How to get started with fertility awareness methods

If you’re considering natural family planning (NFP), the good news is that you don’t need a prescription or any special equipment to begin—just a little guidance, consistency, and the willingness to get to know your body’s rhythms. Here’s how to take the first steps:

1. Learn the basics

Start by familiarizing yourself with how your menstrual cycle works and what fertility signs to track. You’ll want to understand the different methods—like the calendar method, cervical mucus method, basal body temperature (BBT) method, or symptothermal method, which combines all three. Some people begin with one method and add more as they get comfortable.

2. Start tracking your cycle

Record the first day of your period every month to determine your cycle length. Over time, you’ll begin to see patterns that help identify your fertile window. Most people track for at least 3–6 months before relying on NFP for birth control, especially when using the calendar method.

3. Monitor fertility signals

Depending on which method you choose, you’ll start observing signs such as:

• Cervical mucus: Watch for clear, stretchy, egg white-like discharge—this usually signals that ovulation is near.
• Body temperature: Use a basal body thermometer to take your temperature first thing every morning. A slight rise typically indicates that ovulation has occurred.
• Other symptoms: Some people also track changes in cervical position, mild ovulation pain, or breast tenderness.

4. Use a chart or app

Many people find it helpful to use a fertility awareness app to keep track of symptoms and cycle data. Just be sure to choose one designed for NFP, not just period tracking. Alternatively, you can use a paper chart or spreadsheet if you prefer to stay analog.

5. Avoid or use protection during fertile days

Once you’ve identified your fertile window, you’ll need to either abstain from sex or use a backup method like condoms during those days. Consistency here is key to maximizing effectiveness.

6. Be patient with the learning curve

It takes time to learn how to interpret your body’s signals confidently. Consider working with a fertility awareness educator if you’re feeling unsure at the start.

Natural family planning can be a great fit for some, but it’s not for everyone, and that’s okay. If you’re finding it hard to track consistently, have irregular cycles, or simply want a more reliable option, Nurx makes it easy to explore other birth control options, including the pill, patch, or ring, with online consultations and home delivery.

You deserve a method that works for your body and your life.

Other non-hormonal birth control options

If natural family planning isn’t the right fit—or if you’d like additional protection—there are several non-hormonal birth control options to consider. These methods don’t alter your hormones and may be preferred by those with hormone sensitivities, medical restrictions, or simply a desire to avoid synthetic hormones.

Copper IUD

The copper IUD (like Paragard®) is a small, hormone-free device placed in the uterus by a healthcare provider. It works by creating an environment that’s toxic to sperm, preventing fertilization. It’s over 99% effective and provides long-term protection for up to 10 years—ideal if you want something low-maintenance but long-lasting.

Male and female condoms

Condoms act as a physical barrier that blocks sperm from entering the uterus. They’re also the only birth control method that helps protect against STIs. Male condoms are widely available and easy to use. Female condoms fit inside the vagina and offer similar protection, giving people more control.

Spermicide

This chemical agent kills sperm and is often used alongside other barrier methods. Available as gels, foams, or suppositories, spermicide can be inserted into the vagina before sex. On its own, it’s less effective—but when combined with methods like diaphragms or condoms, it offers additional peace of mind.

Diaphragm and cervical cap

Both of these flexible silicone devices are inserted into the vagina to cover the cervix and block sperm from reaching an egg. They must be used with spermicide for maximum effectiveness. These methods can be a good option if you prefer something hormone-free and reusable.

Choosing what feels best for your body

Finding the right birth control is a deeply personal decision—one that depends on your health, your lifestyle, your comfort level, and your long-term goals. Natural family planning may be a good fit if you’re looking for a hormone-free option and feel confident tracking your fertility consistently. But it’s not ideal for everyone, and that’s okay. 

Remember, your preferences might change over time, and your birth control should be flexible enough to change with you. Whether you’re exploring natural methods, curious about non-hormonal options, or looking for something more long-term, you deserve care that meets you where you are.

At Nurx, we’re here to make that easier. With expert providers, personalized recommendations, and discreet delivery straight to your door, Nurx takes the stress out of finding birth control that works for you. 

Explore your options today and take one more step toward care that fits your life, on your terms.

Frequently Asked Questions (FAQ): 

How can I prevent pregnancy naturally without pills?

You can use fertility awareness methods, like tracking ovulation and avoiding sex or using condoms during fertile days. It takes consistency and daily attention to be effective.

How can I take birth control naturally?

Natural birth control usually means tracking your cycle through body signs like temperature or cervical mucus. You’ll plan around your fertile window instead of taking medication.

How to avoid pregnancy naturally by food?

No food can reliably prevent pregnancy. A healthy diet supports overall wellness, but effective natural birth control requires tracking fertility or using barrier methods.

What is the success rate of natural birth control? 

With perfect use, FAM can be up to 98% effective. With typical use, effectiveness is closer to 76–88%, so consistency and correct tracking are key.

The information provided is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon this content for medical advice. If you have any questions or concerns, please talk to a medical professional.

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The information provided is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon this content for medical advice. If you have any questions or concerns, please talk to a medical professional.

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