As many of you know, I’ve had six children in nine years. I’m certainly open to having more children in the future, but I feel like my body would benefit from a break from pregnancy/nursing, especially as I am working to overcome my autoimmune disease and heal my thyroid.
Why Not Hormones?
I’ve written before about why I choose not to use hormonal or artificial contraceptives and what I use instead. I explained in that post:
Hormonal contraceptives are made from artificial hormone-like substances that attempt to mimic the effects of naturally occurring hormones in the body. Hormonal contraceptives work by:
- suppressing the release of hormones that trigger ovulation;
- stimulating production of thick cervical mucus, which prevents sperm survival and ability to travel to a ripe egg in the fallopian tube in the event that ovulation does occur;
- disrupting the ability of the cilia (whip-like cells that line the fallopian tube) to move a fertilized egg toward the uterus in the event that conception does occur;
- preventing buildup of the uterine lining, and thereby inhibiting implantation of a fertilized egg in the event that one arrives in the uterus.
Personally, the mere possibility that conception could occur and then the fertilized egg could be prevented form implanting is enough to keep me from ever wanting to use hormonal contraceptives.
Problems With the Pill
Artificial hormones like those found in hormonal contraceptives aren’t good for Mom either (or the water supply for that matter).
Sam Epstein, MD and author of The Breast Cancer Prevention Program, explains:
More than 20 well-controlled studies have demonstrated the clear risk of pre-menopausal breast cancer with the use of oral contraceptives. These estimates indicate that a young woman who uses oral contraceptives has up to ten times the risk for developing breast cancer as does a non-user, particularly if she uses the Pill during her teens or early twenties; if she uses the Pill for two years or more; if she uses the Pill before her first full-term pregnancy; if she has a family history of breast cancer.” (emphasis added)
Doing the math, this means a woman who takes the Pill for even just two years before the age of 25 and before she’s had a pregnancy to term increases her risk of breast cancer tenfold.
As I’m not personally a fan of increased cancer risk, and I’m also not a fan of altering my hormones with artificial means. For these reasons I’ve used alternative methods to track my fertility.
How to Test for Fertility
A woman is only cyclically fertile, and within a normal cycle will go from infertile to fertile (for a short window) and back to infertile. Couples who have tried to conceive a child know all too well that there are infertile periods of the month.
Natural methods of achieving or delaying pregnancy depend on knowledge of a woman’s cycle and body to be able to pinpoint the fertile window and use that time accordingly. There are ovulation calculators (and see the other suggestions below) that make this easier to calculate and track based on your specific cycle.
I often hear it said in the health sphere that every body is different and the path to health depends on being able to tune into one’s individual needs. I think this holds especially true when it comes to fertility. So how to listen and know what is going on with your fertility?
Natural Family Planning Made Easier
Natural Family Planning or NFP as it is called requires observations of indicators like Basal Body Temperature (BBT), mucus production, cervical position, and other symptoms to predict ovulation. This often means charting these observations to interpret an overall picture of fertility.
You can find a class to teach you how to practice these methods, or there are several apps (this is one of them) that make charting easier. Better yet, there are even computerized devices that connect to these apps and make this process of tracking fertility more accurate and easier to do.
Most fertility monitors are recommended for achieving pregnancy but aren’t labeled for use in avoiding pregnancy or recommended while breastfeeding. I tried to find information on using fertility monitors for these purposes, but there was limited information available.
My Experience Using Fertility Monitors
When given the chance by Fairhaven Health, I decided to test four of these fertility monitors side by side for six months and compare the results to see:
- which were the most accurate;
- if they could be used during breastfeeding or to delay pregnancy.
The four methods I compared side by side were:
I also charted my fertility using the Sympto-Thermal method of Natural Family Planning. This is what I found:
What It Is: The OvaCue was easy to learn how to use and provided two different types of data: oral and vaginal readings. The OvaCue works by measuring electrolyte levels in saliva and cervical mucus and pinpointing ovulation up to 7 days in advance.
According to this website:
The OvaCue Fertility Monitor consists of a hand-held monitor with a colored screen, an oral sensor, and a vaginal sensor – the ideal combination for pinpointing your most fertile days in your cycle and for confirming when ovulation occurred. The monitor has been demonstrated to be over 98% accurate in predicting ovulation in studies funded by the National Institute of Health.
How I Used It: The OvaCue doesn’t require any charting or additional data. All I had to do was take an oral reading each morning and a vaginal reading each afternoon/evening. It charted my cycle based on the readings and gave a very clear indication of when ovulation would occur and when the infertile window began.
Like all fertility monitors the OvaCue is most accurate for women who have a somewhat regular cycle but it works for those with irregular cycles as well. While breastfeeding and before I had a cycle, I simply reset the monitor every month if I didn’t see ovulation to create another window for it to measure. This would be similar to what might happen for a woman with anovulatory cycles or other hormone imbalances.
The OvaCue is 98% accurate in testing. Here’s an overview:
I used the OvaCue to track my hormone levels while breastfeeding and for several months had only minor fluctuations in electrolyte levels, indicating no fertility. Once fertility returned, it predicted ovulation 7 days in advance and gave me an accurate measure of when the fertile window ended.
Overall, I preferred the OvaCue and it is the method that I will be using from now on. It is more pricey than the other fertility monitors I tested (though less than the popular LadyComp), but I felt it gave the most accurate data. The OvaCue also matched my charting exactly for my fertile window and showed fertility ending when basal temperature confirmed that this was the case.
2. Fertile Focus
What It Is: The Fertile Focus uses a microscope to track the changes in the saliva that correspond with changes in fertility. The website explains the FertileFocus microscope:
“Designed by leading fertility expert, Dr. Amos Grunebaum, ObGyn, Fertile-Focus is the affordable high-quality saliva-based fertility test (or personal ovulation microscope) that predicts ovulation with 98% accuracy – up to 72 hours in advance.
Fertile-Focus allows women to identify their most fertile days by testing and viewing the visual changes that take place in saliva throughout the monthly cycle. Just prior to ovulation, women experience an “estrogen surge,” and a distinct fern-like pattern becomes visible in saliva due to the hormonal changes. Fertile-Focus provides the highest quality, powerful 50x magnification lens for easily identifying these crystal “ferning” patterns.”
How I Used It: The Fertile Focus predicts ovulation several days in advance based on the patterns in the saliva. Since I was using the OvaCue while nursing a baby and creating “cycles” for it to track, I used the Fertile Focus as a backup method to show ovulation if the OvaCue missed it. All that is required is to place a small amount of saliva on the fertile focus each morning (before eating or drinking), let it dry and then look at it with the microscope.
The Fertile Focus showed the ferning pattern in my saliva at the same time that my charting showed a rise in fertility and the same time that the OvaCue predicted ovulation. It only gave me about 3 days advance notice, compared to the 7 day notice with OvaCue but it was fascinating to see the change in my saliva.
I liked how portable and easy to use the Fertile Focus was, but prefer the extra data with the OvaCue. The Fertile Focus is also the least expensive of the methods I tried. Though it didn’t provide as much advance notice of ovulation, it did predict it accurately.
3. iBasal Thermometer
What It Is: The iBasal Thermometer is a device that relies on the Basal Body Temperature (BBT) method for tracking fertility and pinpointing ovulation. The iBasal has a built in alarm clock to remind you to take your temperature each morning and it measures temperature to 1/100th of a degree. I’ve charted with the BBT method before but the iBasal charts for you to make the process easier.
The website explains:
Basal body temperature (BBT) charting is a tried and true method for determining precisely when during your menstrual cycle you ovulate. Your basal body temperature is the temperature at which your body rests, which tends to be a bit lower than your “normal” temperature, usually 97 point something degrees F versus 98.6 degrees F. By measuring your BBT each morning (after a full night’s sleep) throughout your cycle you can detect the natural and subtle rise in your basal body temperature that occurs just after ovulation. This post-ovulatory shift in BBT is caused by increased production of the hormone progesterone, sometimes referred to as the “warming hormone.”
How I Used It: I kept the iBasal by my bed and took my temperature with it each morning. While I was nursing and didn’t have a cycle, it showed slight variations in my temperature, but not enough to indicate a shift in fertility. Also, since I was working on improving my thyroid hormone levels during this time, it registered a few false ovulations, though most women (even while nursing) wouldn’t have this variable to deal with.
It did confirm that ovulation had happened after (which corresponded with the other methods I was using) but it didn’t give advance notice.
4. Ovulation Sticks
What It Is: Ovulation sticks use urine to identify a rise in LH (Leutenizing Hormone) that occurs 12-48 hours before ovulation. They are very accurate, but don’t give much advance notice of ovulation.
How I Used Them: I use these mainly to confirm what the fertility monitors were saying and confirm that ovulation did occur. They can be pricey and must be bought each month, so they aren’t the best option but they do give an extra way to confirm that ovulation has occurred and that LH levels have dropped. I won’t use these long term but they were useful as an extra way to verify the data from the other machines.
What I Use Now
After comparing all four methods side by side for six months, I’ll be sticking with the OvaCue and using the Fertile Focus as a back-up to verify. There is also a great community at Fairhaven Health of women using these different methods and they have forums where you can ask questions and get advice.
As I’m trying to temporarily avoid pregnancy, I’m using these methods to pinpoint my fertile window so I can avoid getting pregnant, but the same technology is excellent at helping pinpoint ovulation to achieve pregnancy.
With this existing technology and as more research and innovation happens, fertility monitors provide an alternative to hormonal contraceptives and also allow women to know and understand their bodies and possibly identify hormonal problems.
Full list of my resources at the bottom of this post
Full list of resources supporting the electrolyte method used by OvaCue at this link
This article was medically reviewed by Dr. Anna Cabeca, a gynecologist and obstetrician and a menopause and sexual health expert. As always, this is not personal medical advice and we recommend that you talk with your doctor.
Have you ever used a fertility monitor or natural family planning method? Please share what worked for you below!
Discussion (231 Comments)
Thank you for doing this research. I do not like taking birth control pills as I am always afraid of missing them and I have a high aversion to “popping pills”. My question is would the OvaCue work on someone who is irregular? My fertility window is different every month.
Katie - Wellness Mama
It has for me as I’ve been irregular while getting my cycle back after nursing.
Thank you for this information! Have you ever used Clearblue fertility monitor? I was researching it when I found your review here. I have heard of people using it during breastfeeding but was wondering how it works. Couldn’t find any info. I am imagining that you reset it each month you did with the ovacue?
I’ve been reading about Daysy and its not on your list do you have any input on it by chance or any possibility of you doing a test and review on it as well?
Thank you so much for posting this. I’m currently pregnant and I’ve been looking in to alternatives to birth control pills since I went off them to try to get pregnant. I’ve always been afraid to try anything else for fear of it not being accurate enough to prevent pregnancy. I’ve read about both the LadyComp and OvaCue and I’ve been wondering which is more accurate. It makes me nervous to use these methods while nursing because ovulation is so uncertain. It’s great to read a review from someone who used it while nursing.
Just ordered my OvaCue. Thanks you, Katie!
Katie - Wellness Mama
Mommypotamus, how is the OvaCue working out for you? I am nursing and haven’t gotten my cycle back yet and am trying to decide between clear blue fertility monitor and ovucue.
Thanks in advance for any information you can share!
Did you ever get any information in reply to this? I am breastfeeding and would like to purchase Ovacue IF it will work.
Katie I am very worried now, I’m only 21 and I have been taking oral contraceptives for about 2 years, and never been pregnant. I know now that I should never have started but every girl I knew was taking them and it seemed like the only option. (and I never would have started if I knew it the fertilized egg could be prevented form implanting)
I don’t know what to do, my husband and I have been relying on BC because we can’t afford to have kids right now but we do want to have kids in a few years. Is there anything I can do to decrease the risk of cancer?
Katie - Wellness Mama
Focus on balancing your hormones and reducing any inflammation 🙂
I am 46 and very healthy, with mostly regular, fertile cycles. I have 4 healthy children (17, 14, 8, 4) and my generation was told oral contraceptives were basically miracle pills–alleged cures for acne, cramps, heavy bleeding, protection from uterine cancer, etc. We were NOT told they are abortifacients. I was on them for probably 4 years then off then on again another 1-2, stopping 6 months before I knew we wanted to ttc. I have been off them since 1/1996). I am careful about diet and exercise. You will be fine! :-). I had no problems conceiving at 40 1/2, 6 months after my husband had had a vas. reversal after 2 years. and was finally convinced we were being called to have another child. What a blessing for you to know so much (and to care!) as a young adult.
I am a hige fan of your blog and your work and have been for awhile.
I want to start planning my 2nd child this year.
I’ve been paleo for 4 years and have given birth and am nursing an 18 month old and I fear I may Have messed up somewhere along this past year.
I am feeling awful.
My lean muscle has disappeared, my sprinting and fitness over all has reduced, my metabolism is sluggish, my migraines are back and I have gained so much weight that I look like my pre primal self.
I was doing fabulous till about 6 months ago (one year postpartum).
My toddler started drinking less breast milk and my menstruation returned after a 15 month break.
So either it’s my nutritional profile or hormonal profile that has gone totally out of gear with these changes. Honestly yes I have slacked off a little over the past year or so but nothing that warrants this huge a backlash.
I’ve been reading about estrogen dominance of low progesterone with extended breastfeeding. There seems to be a link there.
I don’t understand though, how something so natural as breastfeeding a toddler could make me such a mess? It doesn’t add up.
Are these changes temporary? Is this a modern lifestyle thing? Have i really slacked off that much? Should I begin supplementing big time (calcium/ folate/ magnesium?)
I wonder if you’ve had any experience with this since you have nursed and been pregnant for a long time these past few years.
Did you face hormonal upheaval or is it my nutritional profile. Can’t figure it out. Also I always practiced natural contraception and listened to my body knew when I was ovulating etc, now I just can’t tell!
Katie - Wellness Mama
Are you consuming any carbs? Being too low carb and nursing can sometimes do that. Sometimes, a natural progesterone cream can also help…
Hi Aloka! I’m in a similar situation to you! My daughter is nearly 2.5 and we are still breastfeeding and eat a paleo diet. My period returned when she was around a year and I had a feeling that something was not quite right. It took quite awhile for me to finally get to a naturopath, but she tested my progesterone levels, thyroid, vitamin d and vitamin b. The thyroid was OK but my progestorone was extremely low. Same for the B and D. She wrote a prescription for bioidentical progesterone and I’ve been taking it for a few months now and periodically checking in with her. I also take Vitex, magnesium, cod liver oil, B vitamins and evening primrose oil. I highly recommend finding a naturopath or an open-minded doctor to test your hormone levels and thyroid so that you can go from there rather than guess. It may be preferable to address what may be going in in your body before going for the pregnancy ride. I also totally agree with Katie about carbs – I went too low carb with paleo in the beginning (sort of by accident) and do better eating plenty of sweet and regular potatoes, fruits, etc. There’s tons of great info on this site. Katie does a service to us all to share her wisdom!
Hi lily. Thanks for sharing your story. I also suspect its progesterone but i went to a couple of doctors to ask tog et my hormones checked but they just said check your thyroid and looked blank when i spoke about progesterone – estrogen imbalance.
I don’t think i am too low carb I eat plenty of fruits and vegetables.
thanks though I will make sure i get all the tests done and seems like progesterone cream will help.
thanks Katie and Lily
we are in the boat!
I was wondering if you got the progesterone cream-and how you feel. I just ordered it myself
Does it say anything about using the vaginal testing after intercourse? I’m wondering if the change in chemicals that naturally happen would mess with the accuracy.
Also is this something you order on line or do they carry it at a medical supply? Insurance may pay for it if it’s at a med supply… Just a thought
Katie - Wellness Mama
Yes, you can’t test for 8 hours after intercourse. I don’t think that a medical supply would carry this but it might be worth checking for sure
Hey did you ever figure out if this is available via med supply? I looked on a few websites that carry them but was unable to find any fertility monitors to be covered. If you did find it could you send me the website link? Thanks!
In my early 20’s I found the book ‘Taking Charge of Your Fertility,’ and it literally changed my life. I finally learned exactly what my body was doing and how to ‘read’ it. Conception control without a prescription was empowering and liberating! My hubby and I not only managed to avoid pregnancy for, TEN years, but concieved on our first attempt, then avoided pregnancy for another nearly 4 years, and once again: conceived on our first try. In fact, I suspected I was pregnant before the tests could tell, based on what my body was doing. AMAZING. I don’t chart or take temps, but keep track of physical signs (mostly ‘egg white’). I charted for about 6 months at the begninning, but once I figured it out, it was simple. A barrier method used a few days a month, and no Rx needed.
Yes, Fertility Awareness worked wonders for me too! I was on the Pill for years for endometriosis but got to the point where I just couldn’t stand being so out of touch with my body any more. When I met my husband I was motivated to find a decent solution….
I charted faithfully for a year and was very confident that I knew what my body’s patterns were.
After that, I went ‘solo’ and simply monitored mucus and cervical behaviour.
We were successfully unpregnant for several years. Then on our first try, we were pregnant at age 39, and now have a beautiful healthy 4 year old. Then again, we were successfully unpregnant for 3 years before deciding to go for it again. We conceived immediately, but that pregnancy did not stick. We waited a few months and tried again — again, immediate pregnancy. However, that one didn’t work either and I ended up having to have a D&E. Incredibly, we conceived again during the glory days of late summer and are expecting another lovely little fella soon. I am almost 44. My OB just shakes his head and says he can’t believe it…. 🙂
Your story is inspirational. Thanks for sharing.
That is amazing! Thank you for sharing your story 😀
24 years ago my mother became pregnant with me at the age of 42 after having 2 kids 22 years earlier and 1 other 2 years earlier. I am part of her story now and am so grateful for my life and for my mother. Blessings to you and your family!
In Australia we call TCOYF the ‘Billings Ovulation Method’ named after the doctors that developed it. I learnt it from their book 23 years ago and also have 100% successfully conceived 3 children and prevented pregnancy …I’m now 48 and in a new relationship and am out of touch with my fertility since the past few years as I didn’t need to track when my past relationship broke up. Things have changed. I don’t seem to be having fertile mucous anymore although I’m still having menstrual cycles. The last thing I want to do is take contraceptives or have my tubes tied. I’m not really gunning for a pregnancy either! Probably time to read the book again! I’m curious to try one of the methods in this blog post as well to see if I’m actually ovulating.
I bought the FertileFocus. I had just stopped my birth control, and started using it about 4-5 days after my last menstrual cycle. Every other day it seemed to “ferning.” I then bought some ovulation strips. They arrived the date I should have been ovulating and sure enough I was! Because I was using these as a birth control, I spent the next two weeks waiting and worrying. I am not sure if the issue with the FertileFocus was that my estrogen levels, which is tests, were unstable due to the stop of the BC, but my body seemed to still be exactly on cycle. I am giving it the benefit of the doubt that possibly my estrogen was off, but I still wouldn’t recommend it for anyone using it as BC or planning to conceive as it does not seem to be as effective as using an urine ovulation predictor.
Katie - Wellness Mama
It can take several months after going off hormonal contraceptives to have normal levels.
This is useful i wish i have read it before . I’m 23 and went,on,the pill for ~3 years due to extremely painful periods. Out of the blue I stopped taking them because I just thought they couldn’t be good for me. My,period has stabalized and,now i juice everyday and try to be healthier. Your site gives me great tips
Have you heard of the LadyComp? It would be worth looking into and adding to your list.
Katie - Wellness Mama
I have and a lot of people do really well with it, but it is more expensive and with thyroid problems, temperature isn’t an accurate method for me 🙁
Hi. I just had a miscarriage so haven’t had a period yet. Does the ova cue work if you don’t have a period? I have conceived 3 of my 6 kids before my period had returned. Love all the info, you’re my go to site I tell everyone about.
I was just going to say, I love the lady comp. It’s pricey but the easiest and reliable.