Chart your cycle

Manage your fertility

The effectiveness of fertility awareness to help couples avoid or achieve pregnancy or monitor gynecological and reproductive health, relies on the fact that all females can be taught to observe, chart and interpret the three primary signs of fertility: cervical mucus secretions, basal body temperature and cervical position. Fertility signs are influenced by the primary hormones of the menstrual cycle: estradiol and progesterone. Our practitioners are deeply knowledgeable about the hormones and their fluctuations in the menstrual cycle, and will teach you how to build a savvy, intimate relationship with your body.

The benefits of menstrual cycle charting

The health of your menstrual cycle is a reflection of your whole body health, and an important diagnostic tool according to the American College of Obstetrics and Gynaecology, who stated in their committee opinion “Menstruation in Girls and Adolescents: Using the Menstrual Cycle as a Vital Sign” (ACOG, 2015) that the menstrual cycle constitutes the 5th vital sign – along with heartbeat, breathing rate, temperature, and blood pressure. Regular, healthy ovulation during our reproductive years is vital to our long term health, regardless of whether or not we choose to have children. A robust menstrual cycle provides the hormones that ensure strong bones, healthy breasts, healthy heart, sharp mind, healthy sex drive, and vitality well into older age.

Troubling menstrual cycle symptoms such as heavy bleeding, severe cramps, irregular periods, acne, cysts, fibroids and other menstrual cycle difficulties may indicate a number of health concerns requiring skilled attention. Lifestyle factors such as sleep patterns, nutritional deficiencies, various drugs, allergies, alcohol, thyroid issues, autoimmunity, leaky gut, SIBO, environmental toxins and more can play a part in menstrual cycle symptoms, affecting your reproductive and overall health. Consultations with a Justisse Holistic Reproductive Health Practitioner (HRHP) can help you to monitor and address your menstrual cycle concerns and understand which root cause they point to, letting your menstrual cycle serve as a mirror for your general health. Your HRHP can assist you in gathering the information and support to make lifestyle and health care choices that support your menstrual cycle health, or refer you to the appropriate caregiver.

Regardless of your goals for charting your cycle, be it avoiding or achieving pregnancy, mapping your perimenopausal symptoms or using your own hormones to excel in sports, having fertility awareness is key to optimizing your hormonal health and general wellbeing. Having Body Literacy also facilitates reproductive freedom and informed choice. Above everything else, gaining fertility awareness fosters a relationship with your body that few women are taught in neither schools nor the healthcare system.

Resources

  • If you’re wondering what cervical mucus is, please see our mucus gallery!

  • If you’re a medical professional wanting to know more about the value of fertility awareness, please visit the FACTS website.

  • If you want to chart with the Justisse method and need materials, please visit our Shop!

  • If you would like to chart on your phone: Read Your Body is the non-profit menstrual cycle charting app for iPhone and Android. It has a dedicated settings template for the Justisse method and allows you to chart your unique cycles in real-time. It’s highly customisable and inclusive, with total data privacy.

  • If you’re wondering what cervical mucus is, please see our mucus gallery!

  • If you’re a medical professional wanting to know more about the value of fertility awareness, please visit the FACTS website.

  • If you would like to chart on your phone: Read Your Body is the non-profit menstrual cycle charting app for iPhone and Android. It has a dedicated settings template for the Justisse method and allows you to chart your unique cycles in real-time. It’s highly customisable and inclusive, with total data privacy.

References:


Menstruation in girls and adolescents: using the menstrual cycle as a vital sign. Committee Opinion No. 651. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;126:e143–6.

Prior, C Jerilynn (2020) Women’s reproductive system as balanced estradiol and progesterone actions—A revolutionary, paradigm-shifting concept in women’s health. Drug Discovery Today: Disease Models, Volume 32, Part B, p. 31-40. https://doi.org/10.1016/j.ddmod.2020.11.005.

Rubinstein, E., Kissling, E., Hillard, P., Harlow, S.a., Warren, M., Prior, J. C., et al. (2004, September 21). 1. Vaginal bleeding what’s normal what’s not? 2. What does the menstrual cycle tell us? 3. The power of the period: What the case studies tell us. Paper presented at the Menstrual cycle is a vital sign, New York at the New York Academy of Sciences.

Vigil P, Blackwell LF, Cortés ME. The Importance of Fertility Awareness in the Assessment of a Woman’s Health: A Review. Linacre Q. 2012 Nov;79(4):426-450. doi: 10.1179/002436312804827109. Epub 2012 Nov 1. PMID: 30082987; PMCID: PMC6027096.

Scientific basis and efficacy

Fertility awareness based methods (FABMs) involve charting the menstrual cycle by tracking physical signs or biomarkers that provide information about the fertile and infertile phases of the cycle. This information allows the users of FABMs to alter their sexual behavior to avoid or achieve pregnancy. Correct and consistent use of a fertility awareness based method can be as effective in preventing pregnancy as other modern methods of contraception. Solid science, professional instruction and personal commitment provides a highly effective form of contraception in those for whom the method is a good fit.

The Justisse Method is a symptothermal FABM combining cervical mucus and basal body temperature charting. Cervical changes can be charted as an optional third biomarker. The Justisse Method also has guidelines for mucus-only charting which means that it can be used as a mucus-only method as well. The Justisse methodology strives to increase Body Literacy and users are encouraged to observe other signs such as ovulatory pain, breast tenderness, fluid retention, changes in appetite, and emotional sensitivity to monitor hormonal processes and well-being. Body literacy supports making informed decisions with respect to health and judging the likelihood of conception from having intercourse, day by day.

FABMs can be highly effective methods with perfect-use rates comparable to other modern methods of contraception such as hormonal contraceptives. However, motivation, consistency, partner support, behavior during the fertile phase, and access to professional instruction may significantly affect the effectiveness an individual can reasonably expect. (Holland et al., 2022).

All methods of contraception have a spectrum of efficacy that spans between perfect and typical use. Perfect use refers to an efficacy rate based on the method being used exactly as it is designed. Typical use refers to an effectiveness rate under typical, real life conditions.

A systematic review from 2018 (Peragallo Urrutia et al.) indicated a lack of high-quality studies on the effectiveness of FABMs. Likely reasons for this include:

  • General lack of funding for these methods

  • A low number of users

  • The challenge of studying FABMs in a comparable way to other methods

Although studies indicate perfect-use efficacy rates between 95.2 and 99.6 % for modern FABMs (Peragallo-Urrutia et al., 2018), these methods are highly user-dependent and typical-use rates are harder to define. Typical use effectiveness rates have ranged between 77.2 and 98.2 % depending on the method and study population (Trussel et al., 2018; Peragallo-Urrutia et al., 2018) but because of the marginal nature of these methods, population level typical-use rates comparable to those obtained for more widely used methods are not available for individual FABMs. The only population level rate available indicated a typical-use rate of 76 % for users of any method based on identification of fertile time with the majority using a calendar based method or merely attempting to time intercourse based on their own (correct or incorrect) understanding of their fertile period (Jennings & Polis, 2018; Turner, 2022 ).

Historically, FABMs have been ignored in medical care settings that focus on pregnancy prevention because there is more room for user error and thus a potential wide gap between perfect and typical use rates. Despite the vast differences in efficacy from one method to another, FABMs are often lumped together and the only population level typical-use rate is cited for all methods. Most studies on modern FABMs have indicated a typical use effectiveness rate of over 85 % among study populations who learned the method with an instructor (Duane et al., 2022).

There are yet no independent studies on the effectiveness of the Justisse Method in particular. Most recent studies on symptothermal methods have indicated perfect-use rates between 97.6 and 99.6 % and typical-use rates between 86.8 and 98.2 % (Peragallo Urrutia et al., 2018, Duane et al., 2022). Most recent studies on mucus-only methods have reported perfect-use efficacy rates between 96.6 and 98.9 % and typical use rates between 77.2 and 96 % (Peragallo Urrutia et al., 2018, Duane et al., 2022). The effectiveness of the Justisse method is expected to fall within these ranges. Symptothermal charters can expect a somewhat higher efficacy than mucus-only charters, and those learning the method with an instructor and highly motivated to use the method correctly and consistently can expect higher effectiveness than those with a more relaxed approach to possible pregnancy. The Justisse Method has been used successfully for pregnancy prevention by thousands of women since its development in the 1980s and updates to the methodology have been made to further improve effectiveness as new research in the field has been published. If you are already a Justisse method user or a practicing HRHP, please view the User Guide Addendum.

The Justisse Method is designed to be learned with the support of a Justisse Holistic Reproductive Health Practitioner (HRHP). To achieve the highest effectiveness, adhering to the recommended follow-up schedule is advised. What ensures the efficacy of the Justisse Method is proper instruction, correct and consistent use, adherence to the guidelines designed to avoid pregnancy, and asking for support when menstrual cycle parameters or intentions with the method change. Moreover, before relying on the Justisse Method as the sole method of birth control, it is recommended that the learning guidelines are first strictly adhered to for at least 3 complete menstrual cycles. Experience shows that the more consistently users follow the method as instructed, the sooner they develop confidence in the method, and the more effectively they achieve their intentions.

References:

Duane, M., Stanford, J. B., Porucznik, C. A., & Vigil, P. (2022). Fertility Awareness-Based Methods for Women’s Health and Family Planning. Frontiers in medicine, 9, 858977. https://doi.org/10.3389/fmed.2022.858977

Holland, Colleen and Schonbrun, Michal. Brief Statement of STM Efficacy. Association of Fertility Awareness Professionals, 2022.

Jennings, V. H. & Polis, C. B. (2018). Fertility Awareness-Based Methods. In Hatcher, R.A., Nelson, A.L., Trussell, J., Cwiak, C., Cason, P., Policar, M.S., Edelman. A., Aiken. A.R.A., Marrazzo. J., Kowal. D., (Eds.), Contraceptive technology. 21st ed. Ayer Company Publishers, Inc.

Peragallo Urrutia, R., Polis, C. B., Jensen, E. T., Greene, M. E., Kennedy, E., & Stanford, J. B. (2018). Effectiveness of Fertility Awareness-Based Methods for Pregnancy Prevention: A Systematic Review. Obstetrics and gynecology, 132(3), 591–604. https://doi.org/10.1097/AOG.0000000000002784.

Trussell, J., Aiken. A.R.A., Micks, E., Guthrie, K.A. (2018). Efficacy, safety, and personal considerations. In Hatcher, R.A., Nelson, A.L., Trussell, J., Cwiak, C., Cason, P., Policar, M.S., Edelman. A., Aiken. A.R.A., Marrazzo. J., Kowal. D., (Eds.), Contraceptive technology. 21st ed. Ayer Company Publishers, Inc.

Turner, J,. (2020). Misrepresentation of contraceptive effectiveness rates for fertility awareness methods of family planning. Journal of Obstetrics and Gynaecology Research, 47(7), pp.1-7. doi: 10.1111/jog.14593

Learn how to chart

Today, social media as well as the tech market is overflowing with information on fertility and charting your cycle, but true fertility awareness is unfortunately hard to gain from an instagram reel. At Justisse, we are overjoyed at the spread of fertility awareness, yet at the same time concerned about the often poor quality and misleading nature of the information available on this topic. Your cycle and your situation is unique, something most blog posts do not consider. An algorithm can never replace awareness, just as an app can’t substitute an experienced teacher who will listen to you.

Whether you’re looking to chart your cycle for natural birth control, conception support, insemination timing, or health monitoring, our practitioners are trained to teach you how to chart, and interpret your data according to your intentions. Working with a Justisse practitioner improves your success with the Justisse Method, which is especially important if you are charting for purposes of avoiding or spacing pregnancies. Your HRHP will guide you through an introductory session followed by follow-up sessions, and check your progress and confidence along the way.

Our Justisse Holistic Reproductive Health Practitioners (HRHPs) can be found all around the world, and most work online as well. Costs may vary between practitioners, as they all have specialized skills and backgrounds. You can locate an HRHP by visiting our directory.

We strongly recommend you contact your HRHP when you:

  • Change how you want to use the Justisse Method. For example, from achieving pregnancy to avoiding pregnancy.

  • Enter a different reproductive situation. For example, peri-menopause, breast feeding/postpartum, post-abortion, or coming off of hormonal contraceptives..

  • Decide to become sexually active after a long period of abstinence or for the first time.

  • Experience a change in your reproductive health, or other health status.

  • Engage with a new sexual partner.

  • Are having difficulty conceiving, wish to conceive through insemination or want to understand your fertility status prior to IVF.

  • Observe changes in your menstrual cycle that are confusing.

  • Change how you want to use the Justisse Method. For example, from achieving pregnancy to avoiding pregnancy.

  • Enter a different reproductive situation. For example, peri-menopause, breast feeding/postpartum, post-abortion, or coming off of hormonal contraceptives..

  • Decide to become sexually active after a long period of abstinence or for the first time.

  • Experience a change in your reproductive health, or other health status.

  • Engage with a new sexual partner.

  • Are having difficulty conceiving, wish to conceive through insemination or want to understand your fertility status prior to IVF.

  • Observe changes in your menstrual cycle that are confusing.

Find an instructor

Justisse Practitioners are comprehensively trained in areas of human sexuality, client care, all methods of birth control, and menstrual cycle chart interpretation. They are committed to giving you reproductive health education and Body Literacy. They are trained to help people make fully informed reproductive health choices and to share, without prejudice, all information necessary to exercise full reproductive freedom, which includes but is not exclusive to respecting ethnic and cultural diversity and ideological and religious beliefs.

A Holistic Reproductive Health Practitioner does not conduct manual examinations, prescribe medication or give medical advice, unless they have other licenses and designations (e.g. doctors, midwives) that permits them to do so.

Justisse Practitioners conduct practices in Canada, United States, Sweden, Norway, Finland, South Africa, Kenya, Brazil, Norway, Finland, Ecuador, Mexico, and all offer virtual consultations. You may locate them in the Justisse HRHP directory.

Please note that:

  • HRHP Trainees are in the theoretical part of their training and are not yet prepared to take clients.

  • HRHP Interns are in the practicum phase of their training and are able to take clients at a reduced price, under supervision of their Justisse Faculty trainer.

  • All our HRHP’s have different backgrounds and competencies, in addition to the knowledge that they’ve acquired in the program. In our directory you can read more about their individual professional approach and specialties, and what languages they speak.

All graduates and interns of Justisse College International are required to be licensed by Justisse College International, as well as be members in good standing with JuPA (the Justisse Practitioners Association), which requires them to be committed to ethical practice, professional conduct, and continuing education. All graduates are also accredited by the Association for Fertility Awareness Professionals (AFAP). In Canada a Justisse HRHP is designated as a health professional in accord with the Canadian Health Professions Act.

We look forward to helping you achieve your goals!