Fertility Awareness Methods and Your Sex Life (Episode 555)

Full Transcript: Episode 555

Lisa Hendrickson-Jack:

This is the Fertility Friday Podcast, episode number 555. Happy New Year. I thought a great way to ring in the new year would be to dive into a brand new FAMM Research Series episode. And in today’s episode, we are looking at an interesting question, which is: does fertility awareness impact your sex life, your relationship? And I found a really interesting study that looked at this. They had a really good sample size of fertility awareness users. They surveyed both male and female members of the couples. And so we’re going to dive in and find out what they found out.

So when it comes to fertility awareness methods, it’s certainly not something that every single person is going to gravitate to. This is something that I’ve talked about over the years — fertility awareness, I think users of fertility awareness, people who are interested in it, people who are drawn to it, people who are excited about it and love charting their cycles — it’s not for everybody. I think that fertility awareness methods are methods for which we self-select. Nobody is pushing you to chart your cycles. There’s not a lot of even support in our conventional healthcare system to do this, to chart your cycles and to use alternative or natural methods to avoid pregnancy. I think there’s potentially more support to use it for conception. But even then, I hear many women saying that their provider talked negatively about it because they felt that it would cause too much stress.

So interestingly, with fertility awareness methods, often we’re going against the grain because we don’t necessarily have all of the support and all of the understanding of our healthcare providers and even friends and family to do it. So I always say users of fertility awareness methods self-select. And so definitely there are people for whom this would not be their ideal scenario. And when we think about some of the potential objections or complaints that people might have to use fertility awareness methods — there’s a lot — I’ve heard a lot of different things over the years. And I think one of the things that people will sometimes say is that, you know, if we use this method, then it’s going to kill the spontaneity. Because then it’s not like being on the pill or having an IUD inserted when, you know, we can just have sex at any time without having to think about it. The protection is kind of sorted out. We don’t have to go through that thought process. And so, you know, that’s certainly an objection that I’ve heard over the years, which is that it would ruin that spontaneity. It might have a negative impact on your sex life, because of course there is a window — a fertile window, a period of time — where you wouldn’t be able to have unprotected sex, and you have to account for that and plan for that and have a discussion with your partner about how you’re going to manage that time.

And so theoretically, from that perspective, it could have a negative impact because it would kind of kill some of that spontaneity that you might have if you were using one of the hormonal methods, for example. And then from that perspective, maybe it could have a negative impact on your relationship — in that maybe you would have a negative impact of not having that spontaneity. And so I suppose in today’s episode we’re going to be looking at that question, because this is what the researchers were looking at. They surveyed over 2,500 participants — I should say, because each individual participant submitted a study — but either way, they had a really good sample size of users of natural family planning or symptothermal method users. And so they were able to kind of gather this data from what the actual users are seeing.

Now, before I jump into the data, I do think that there’s two different perspectives on this, which we’ll be getting into. There’s the perspective of kind of that spontaneity thing that I mentioned, and it’s going to kind of change how we’re engaging with each other and this could be negative. But there’s also a camp that says, well, wait a minute, this has actually had a positive impact on my relationship. So a lot of fertility awareness users — because you’re not just available all the time for unprotected sex and because there has to be communication about it and there has to be a strategy — many couples find that using fertility awareness actually increases their communication and potentially improves their sex life in different ways.

Now, one thing that of course I’m going to mention is that when you’re using hormonal methods, one of the most common types of side effects that people experience are sexual side effects. And that ranges from low libido, even decreased sensation. And there’s the concerning data around vulvar changes. And if you are not familiar with all of that research, feel free to grab a copy of The Fifth Vital Sign. In chapter 7, I delve into these topics in detail and of course provide a ton of sources and references if you’re wanting to dive even deeper into the research itself.

So interestingly, a counter to that argument is that many women find that when they come off of hormonal birth control, their libido eventually is restored and they want sex more. They actually find that they feel more like themselves and they discover that actually they have more of a libido. And even though they’re having to make arrangements around that fertile window now and engage potentially a bit differently with their partners than they were engaging before, a lot of women find that this is actually positive because they’re wanting to have sex more. And there is that old kind of joke that, well, one of the reasons the birth control pill works is because you don’t want to have sex anymore.

Now, that is not everybody’s experience. There are many women who find that when they’re on birth control, their sex drive and libido is different and not exactly as robust as it used to be. And of course a concern of mine is that many young women are going on birth control before they necessarily know themselves, before they necessarily know what their kind of baseline libido is like. So there are other women who’ve been on the birth control pill for so long that they just don’t think they have much of a libido, only to find when they actually come off birth control that there it is.

So lots of different aspects of this conversation that I wanted to kind of throw out there, just right from the top, so that we can be thinking about different perspectives from different people. Of course, different people have different experiences with all methods. So there’s no one method that’s going to work for everybody. But it is useful to think about why some individuals may find the method to be not as good as others, and then it allows you to think, okay, well, where do I sit in this? How do I find this information? Because maybe you don’t fall into the camp that you previously thought.

So let’s talk a little bit about the study. One of the motivations for these researchers was actually to gather more information specifically about users of symptothermal fertility awareness-based methods. So one of the things that they do toward the beginning of the study is they define the difference between natural family planning, NFP, and the symptothermal method. So if you’re not familiar, natural family planning is very similar to fertility awareness. They’re basically the same thing, except that when someone is practicing natural family planning methods, specifically, these methods tend to heavily discourage the use of barrier methods or other types of options for unprotected sex in the window. So typically, natural family planning is teaching an abstinence model, where you’re expected to just avoid unprotected sex altogether during that window. So you’re having a period of time when you’re not having sex that coincides with that fertile window, assuming that you’re using the method for birth control. And then outside of that fertile window, or when pregnancy is impossible, then you can have unprotected sex. And so it’s essentially a no-barriers option where abstinence is the key way to avoid pregnancy.

And of course, all the different criticisms and potential pushback that I shared about fertility awareness could be even more so with natural family planning, because then in this situation, on the one hand, you have couples who could say, “Well, now there’s a whole period of time where we can’t have sex.” And sometimes that coincides with when the female participant at least wants it more, because there’s certainly a lot of anecdotal and some research data that would indicate that many women experience a rise in their libido around ovulation. And this would be the time when you would be abstaining from unprotected sex. Now, there’s another camp that would say, well, having that period of time that we aren’t having sex actually increases our desire, and when we are able to have sex, it makes it more exciting and fun. So there’s always two sides to the coin.

So from that perspective, they kind of know the data around natural family planning. And so they were wanting specifically to learn a little bit more about the users of the symptothermal method. And of course, with the symptothermal method, the main difference is that abstinence is not the primary strategy for avoiding pregnancy. Of course, it can be part of what couples are doing, but typically with the symptothermal method, barriers are encouraged. And so a couple has the ability to decide how they’re going to manage that fertile window — whether they’re going to use alternative sex practices, so having sex outside of penis-vagina intercourse, doing other activities, whether they’re going to use barrier methods that are non-hormonal. And so they have this option of how to manage that window.

And within this study, about 80% of the users specifically indicated that they were using the symptothermal method, and then there were some natural family planning members. The majority of the participants of the study were women — unsurprisingly, about 77% — and 23% were men. And the total number was just over about 2,200 participants. And most of the participants were within reproductive age.

One of the things that the researchers noted — I think when research is done, there are some aspects of it that are of convenience. They’re often done out of university school settings and things like that. So there is a high percentage of participants who are university-educated, and a high percentage were married. And so they did kind of point out that this wouldn’t necessarily be applicable to a general population, but it is giving us an insight into these natural family planning and symptothermal method users.

The majority of the study participants were specifically using fertility awareness to avoid pregnancy — about 80%. And interestingly, when they separated out those who were trying to conceive, most of them had been trying to conceive for less than a year. And when they asked questions about previous pregnancies and things like that, they did find that more than half of the female respondents reported that they had conceived when they were trying to in six months or less. And they hypothesized that that kind of short time to pregnancy could be at least somewhat related to their increased knowledge of their fertile window.

And just a couple pieces of data that were interesting to point out: about 41% of the users reported that they were using barrier methods. A significant percent of the female users had previously used hormonal contraceptives — about 44% — and then those who had never used contraceptives made up 56%. So I thought that that stat was in line with what I would think of for this population. When you get a population specifically of individuals who are current users of alternative methods, who are using fertility awareness-based methods, I do think that you’re going to have a higher percentage than the general population who’ve never used hormonal contraceptives. Because again, if you’re aware of fertility awareness-based methods and using them, you know that there’s an alternative.

What I find is that there are so many different reasons why a person would choose fertility awareness-based methods, but there is a percentage of women who are choosing these methods because specifically either they didn’t do well on hormones, or maybe they had family members, or maybe their mother was kind of outspoken about hormonal contraceptives and aware of these methods. So within these populations specifically, I do think that you have sometimes a higher percentage of women who haven’t used hormones. I think in the general population, it’s a little bit more rare to find women who have never used hormonal birth control. So I would imagine that when you look at the stats in general, they say about 80% of women have used hormonal contraceptives at one time or another. So interestingly, in this study, there was quite a lower number overall who had ever used contraceptives.

So let’s talk about what the researchers found related to the use of fertility awareness methods and how it impacted their relationship and their family life and things like that. About 95% of women and 55% of men said that using fertility awareness-based methods helped them to know their body better. This stat is not a surprising stat to me. I think that it is in line with what my experience has been. And it also highlights the different reasons potentially that women were using the method. But almost all of the women who use the method reported that it helped them to learn more about their body. So this is not surprising. We’re not taught anything about our body. So for many of us, when we dive into the fertility awareness world and we learn about how the cycle works and the fertile window and all of this information surrounding that, it really does give us these insights that we would not potentially have learned otherwise.

I always think to myself, well, if I hadn’t learned this through fertility awareness-based methods, where would I have learned it? I don’t think I would have learned it outside of this context, not to this degree. And then 55% of men — I think that that’s interesting as well, because of course with fertility awareness-based methods, a lot of the knowledge and education is around the female body. There is education around the male body in order for us to understand the interplay, but the majority of that education is around the female body. So I feel like those stats make perfect sense.

And when it comes to relationship satisfaction, 74% of men and 65% of women said that fertility awareness-based methods had helped to improve their relationship. I think that that is interesting as well. Now, interesting that there was a higher percentage of men, lower percentage of women, but overall, the majority of participants did report that their relationship improved based on using fertility awareness methods. So from that perspective, I think again it’s in line with a lot of the things that I’ve heard around how it forces you to have these conversations with your partner. It opens up these conversations and you end up having a closer relationship because you are ending up talking about things that you otherwise wouldn’t necessarily have discussed. And so that is something interesting that the study picked up.

Now, when they directly asked them if using fertility awareness-based methods had harmed their relationship — to kind of put it in the reverse — less than 10% said that it did. So overall, the results were positive.

So one of the questions that they asked was around whether or not they felt that their partner needed to be involved. Both the male and female participants recognized that the involvement and commitment of their partner is important for use — 94% of women and 96% of men. So this is one of the key pieces of using fertility awareness-based methods, which is that you do need your partner’s participation. It will not work if your partner is not willing or able to participate. And by participate, I mean abstain from unprotected sex — not necessarily abstain from all sex, but abstain from unprotected sex during that fertile window. There has to be an alternative option for how to manage that fertility in that fertile window. And your partner has to be on board with that, otherwise the method can’t work. If we’re not modifying behavior during the fertile window, if we’re not avoiding unprotected sex by doing something else, then it isn’t going to work.

And so this can be portrayed then as a negative. For some couples, it’s not going to be appropriate. If your partner is not going to participate, then it’s not going to work. And so I think that shows some of those mixed numbers, where every single person who uses the method may not have a partner who is totally willing to modify their behavior during that time. You might have a partner who really isn’t willing to modify their behavior. They might not be open to whether it’s using a condom or whether it’s opting for an alternative type of sex that doesn’t involve penetration. It might just be that this isn’t going to work.

And certainly there are couples out there — I know I’ve worked with some clients who said similar things — who might have been trying to conceive and kind of found that once things get started, one thing will lead to another. And so basically during certain times they find a way to avoid it altogether. I’ve certainly heard a variety of different examples of that.

And then one of the things that I’ve experienced as well as a teacher is that some couples, their partners are heavily involved — whether it’s actually putting the thermometer in and recording the temperature on their paper chart. That level of involvement, versus not even wanting to talk about it. Now, I would say the majority of women that I’ve worked with, their partners are at least supportive. They may not be as heavily involved as to actually be inputting data for them, but certainly supportive of it and finding ways to help and at least cooperate and participate and modify their behavior so that the method could work. But I’ve certainly seen the full range.

So I feel like these study results do accurately reflect just the mixed experiences of people with this method. They asked a question about if using the method had helped them to speak more about sexuality with their partner — kind of getting at: has this improved your communication around this issue? And so most women and men — 69% of women, 72% of men — felt that fertility awareness methods had helped them to just speak more freely about sexuality with their partner. And less than 8% overall did not feel that way.

And when they asked the “did it help your sex life” question, about 62% of women and 63% of men said that fertility awareness methods had actually helped to improve their sex life, while 37% of women and 25% of men felt that it was the same as it was before — like it hadn’t necessarily increased it or decreased it. Their sex life was the same, but it certainly hadn’t made it worse. And then approximately 1% of women and 11% of men felt that fertility awareness methods had harmed their sex life.

So when they asked the question in reverse, the overwhelming majority reported that it had either helped or it was neutral. And only a small percentage — interesting that a larger percentage of men, but only a small percentage overall — felt that it actually had a negative impact on their sex life.

And something that I thought was really interesting that I hadn’t anticipated the researchers would ask about was if they felt that using fertility awareness methods had helped them to better explain sexuality to their children. This was not a question that I was expecting, but among the participants who answered the question, 85% of women and 82% of men indicated that the knowledge that they learned through using fertility awareness-based methods had helped them to better explain sexuality to their children. I didn’t necessarily anticipate that question.

And one other piece of data that I wanted to share is that when they asked about their frequency of having sex and if they’re happy with that, 75% of women and 73% of men said that they were either satisfied or very satisfied with their frequency of sexual intercourse. Slightly over 20% were unsatisfied, and less than 5% were very unsatisfied.

So again, when we’re looking at the overall response, the vast majority of these couples who participated and who were fertility awareness method users were generally satisfied with their sex life. They were generally satisfied with the frequency of sex that they were having. They were generally satisfied with the method itself and the impact that it had on their relationship. And there was a far smaller percentage of participants who had found that it had a negative impact.

To summarize the results: in this study, the vast majority of men and women did feel that using fertility awareness methods helped them to better understand their bodies, improved their relationship overall, and helped to improve their communication around topics of sexuality with both their partners and children. And the results of this study are consistent with other research in the area.

There’s a couple of points to consider, of course, when we think about, well, why is that? One of them is that these couples who are using fertility awareness methods are typically self-selecting. And one of the stats that the researchers shared in the study was the average duration of use. The participants of the study had used fertility awareness methods for an average of eight and a half years. And there was a range — from brand new, so under a year, all the way up to 35 years that the users had been using it. So when you think about that, if someone is using fertility awareness methods for an average of eight years, some of them using it for 10, 15, 20 or more, then you are going to have people that are seeing the benefit and choosing to continue to use it. The majority of people who are going to choose to do something for like 10 or more years — they’re not doing it because they hate it, right? They’re doing it because they see some benefit of it.

So it does make sense. And again, this research and the results of this study don’t prove that fertility awareness is going to work for everybody. But it certainly shows that the users who do choose to use it, who are inspired to use it for one reason or another, and who feel compelled to continue using it — they clearly are seeing a benefit from it. So contrary to popular thought, there are plenty of fertility awareness users who are happy with it, who don’t find that it has a negative impact on their sex life or their relationship. On the contrary, there are plenty of users who find that it has a positive impact, who are happy to use it.

And so it does give us that kind of full conversation around it. When you are speaking to whether it’s healthcare professionals, or friends, or family, or acquaintances around this topic, and you’re hearing some of that pushback — oh, well, you know, I wouldn’t want to do that because then I wouldn’t be able to have sex whenever I want, it would have a negative impact on my relationship — when we talk to the people who actually use it, the vast majority find that it actually has a positive impact. And they find that it improves their communication and all of those things, and they see the benefit of it. So that’s certainly something to consider.

The results of the study are not necessarily surprising to me. They are in line with my experience of working with users and getting that perspective from people who are in the thick of it, who are using the method and whose partners are supportive of it — because it’s not going to work if your partner isn’t supportive of it.

But it does leave us with that question of: it would be really interesting to do a deeper survey of the people who didn’t find it to be beneficial, didn’t find it to help their relationship, didn’t find that it improved their sex life. I would be interested to basically do a survey of the detractors to find out what was it about the method that really didn’t work for them? Or what was the reason why they felt — there was a small percentage of respondents who felt that it had harmed their sexual relationship, or that it had not improved their communication, potentially made it worse? So what was the experience of those couples? I think that would help us to better understand the question of what are the characteristics of people who do find it to be useful, and what are the characteristics of people who don’t, so that we can better understand where they’re coming from.

Because again, each person has a different and unique experience with these methods.

So I’m going to go ahead and wrap there. I hope today’s episode has given you some deeper insights as to how fertility awareness methods can impact relationships and what basically the users of these methods are saying — not necessarily in their own words, because it wasn’t a qualitative study, but essentially what their experiences have been.

And certainly I hope that if you tuned into this episode out of curiosity, maybe you’re not yet that familiar with fertility awareness methods, hopefully it has given you some food for thought. And also, going back to the average user being at eight and a half years — showing you that for a lot of people out there, this is the way that they’re living their lives. This is just normal. This is what they’re doing. They’ve been doing it for a long time. It’s been working for them. They successfully use it to prevent pregnancy. They’re happy with it. And it’s just as normal as anything else.

And I think it is useful to get that insight, because of course when you’re out in the world and having these conversations, the average person has probably either never heard of fertility awareness-based methods or really had a limited exposure to them, doesn’t really know a lot about them. So as a newer user, if you yourself are a newer user of these methods, it can certainly feel like you’re kind of out there doing this thing that no one knows about. And you can kind of feel like you’re off by yourself. So I think it is helpful also to see that there are a lot of people out there who do use these methods and use them consistently. And it’s just a normal way of life for them.

And when you have an opportunity to learn from these populations, like we did in this research study, or even connect with populations like this — I know in my programs, it’s a rare opportunity to connect with like-minded women who are also extremely passionate about this topic. It is nice to know that there are more of us out there for whom this is just a normal part of our lives.

So with that said, I hope that you have a wonderful weekend. Whenever you’re tuning into the show, if you can think of somebody who would benefit from hearing today’s episode, the share link is fertilityfriday.com/555.

And we are celebrating 10 years of Fertility Friday. This new year, 2025 — we have been podcasting for 10 years. The 10-year anniversary was in November of 2024. And so the reason that this podcast has kept going for a whole decade, the reason that it continues, the reason why I’m able to continue putting out episodes is because of your support — whether that is simply by sharing the show with friends, talking about it, whether it’s by sharing my books: The Fifth Vital Sign and Real Food for Fertility and the Fertility Awareness Mastery Charting Workbook. However you are spreading the word about this work is what allows me to continue to put out this highly detailed free content for you every single week. So I just want to thank you all for your support.

If you have enjoyed the show, if it has benefited you in any way, I would really appreciate it if you would leave a rating and review on Apple Podcasts. Again, that helps people to find the show, and it shows that newer listener what we’re talking about here, what your experience has been. So if the show has touched you in any way, if you’ve benefited from it, I would highly encourage you and invite you to leave a review and a rating on Apple Podcasts. I do try to look at all of them and I really appreciate all of you who have taken the time to do that. So again, thank you for listening. I hope you have a wonderful weekend, whenever you’re tuning into the show. And of course, as always, until next time — be well and happy charting.