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The symptothermal methods are fascinating but fairly complex ways of determining when a woman can become pregnant if she has intercourse and when sexual intercourse using no other contraceptives, is unlikely to lead to pregnancy.

            Below are a number of paragraphs about the ovulation and symptothermal fertility awareness methods:

OVULATION METHOD

            Cervical mucus changes signal the beginning and end of the fertile time, even among those who have irregular cycles.  Assistance of a trained instructor is necessary for correct use of the OM.  Observe your cervical secretions by ?the look, the touch, and the feel':

1.      Look at the secretions on your panties, fingers, or toilet paper to determine color and consistency.

2.      Touch the secretions to determine their stretch and slipperiness.

3.      Feel how wet the sensation is at your vulva.

When they first appear, the secretions may be scant but sticky and thick with a cloudy or whitish color.  Highly fertile secretions are abundant, clear, stretchy, wet, and slippery.  Ovulation most likely occurs within 1 day before, during or 1 day after the last day of abundant, clear, stretchy, slippery cervical secretions.  When you are observing your cervical secretions, do not douche, because it can wash out the secretions, making it very difficult to notice changes.

1.      Observe your cervical secretions every day, beginning the day after your menstrual bleeding has stopped, and record them daily on a special chart.  To help you avoid confusing cervical secretions with semen and normal sexual lubrication, some counselors advise complete sexual abstinence throughout the first cycle.  Alternatively, you can use a condom.

2.      Check secretions each time before and after you urinate by wiping (front to back) with tissue paper.  Note and record the color and appearance (yellow, white, clear, or cloudy) and consistency (thick, sticky, or stretchy) of the secretions, and how they feel (dry, wet, or slippery).  Record how much they stretch when pulled between your thumb and index finger.  Also, note the chart the sensations of dryness, moistness, or wetness at your vulva.  Always record the ?most fertile' observations you see during the day.

3.      For contraception.  Check for secretions as soon as your menses ends/  (Some counselors recommend avoiding intercourse or using a barrier method during menses because it is difficult to detect secretions when they are mixed with menstrual blood.) You can have sexual intercourse on preovulatory days if no secretions are present. (Some counselors recommend abstaining the next day and night following intercourse to allow time for bodily fluids to drain out of your body so you will not confuse semen and arousal fluids with cervical secretions.  The following day, check your cervical secretions.)  The fertile time begins when cervical secretions are first observed until 4 days past the peak day (the last day of clear, stretchy, slippery secretions).

4.      For conception. Have intercourse when cervical secretions are present.  The probability of conception is greater when the secretions are abundant, clear, stretchy, and slippery.

5.      Most women need help in the first few cycles to interpret their cervical secretion patterns and charts to determine the fertile time.

SYMPTOTHERMAL METHOD 

            Some couples prefer to observe more than one indicator of the woman's fertility.  Most couples who use a combined or symptothermal approach use cervical secretions and BBT to identify the fertile time.  The BBT, the temperature of the body at rest, is lower in the first part of the cycle, rises to a higher level beginning around the time of ovulation, and remains at the higher level for the rest of the cycle.  By taking her temperature on a chart each day of her menstrual cycle, a woman can retrospectively identify whether she has ovulated and, thus, calculate the end of her fertile time.

To use the STM, follow the steps for the OM and, in addition, take and record your BBT as follows to determine the postovulatory infertile time:

1.      Take your BBT every morning at the same time before getting out of bed (after at least 3 hours of sleep).  A special calibrated thermometer makes temperature reading easier.  Take the BBT orally, rectally, or vaginally, but take it at the same site each day so changes in BBT can be detected accurately.

2.      Record your BBT readings daily on a chart.  Connect the dots for each day so a line connects dots from day 2 to day 3, and so on.

3.      Your temperature will probably rise at least 0.4 degrees F ? around the time of ovulation and remain elevated until the next menses begins.  Your actual temperature and maximum temperature are not important, just the rise over the baseline (preovulatory) temperatures.

4.      If you have 3 days of continuous temperature rise following 6 lower temperatures, you have ovulated and your postovulatory infertile time has begun.  To see the baseline and rise clearly on the chart, draw a line just above (0.1 degree line) the lover (preovulatory) temperatures.  When you record 3 continuous temperatures above this line and the last temperature is 0.4 degrees higher than this line, your postovulatory infertile time has begun.

5.      If you cannot detect a sustained rise in BBT, you may not have ovulated in that cycle.  A true postovulatory BBT rise usually persists 10 days or longer.

6.      Some women notice a temperature drop about 12 to 24 hours before it begins to rise after ovulation, whereas others have no drop in temperature at all.  A drop in your BBT probably means ovulation will occur the next day.

7.      For contraception.  Rely on your cervical secretions to identify the beginning of your fertile time.  Your BBT can help you identify the end of your fertile time.  You should use a barrier method or not have intercourse during the fertile time if you do not want to become pregnant.

8.      For conception.  It is not possible to predict fertile days using BBT.  By the time the rise is detected, you are probably in the infertile phase of your menstrual cycle and have missed the opportunity to become pregnant.  To conceive, you should rely on your cervical secretions.

The paragraphs come from the 18^th edition of Contraceptive Technology.