There are many reasons a couple may be having trouble using NFP. They can include prolonged periods of abstinence while avoiding pregnancy, inability to get pregnant, confusing charts, and more. If you are having difficulty using a method of NFP and are looking for help, you've come to the right place. Below are some common issues that couples could face using NFP and some solutions. Ultimately; however, there are some NFP problems that are not DIY and it may be necessary to consult a professional. If you'd like to discuss your problem, please contact Jenny Ingles.
Before proceeding further, it's important to note that if you have learned a method of Natural Family Planning and currently have an NFP Teacher, then it is best to reach out to your teacher for help. Your teacher knows your chart and your personality best and is able to best assist you. If you have tried that and need assistance, then this page is here to assist you.
Also, if you have never formally learned a method of NFP and are self-taught, then many of your issues could be resolved by learning a method of NFP. Please visit our Method Overview Page to get started.
There are many different causes of confusing charts. Here are the most common causes:
Your method of NFP may show that you are fertile all (or most) of the time. This is impossible. If you have more than 11 continuous days of fertility (more than the 8 days leading up to and including peak plus 3 days following peak) then something isn't right. This could appear as continuous mucus and/or continuous "high fertility days" on the hormone monitor. No Basal Body Temperature (BBT) Shift and no appearance of LH Surge (hormone monitor) could also be present.
There are several factors that could cause these types of readings. The first is that you may be using the hormone monitor or BBT Thermometer incorrectly. Please consult your method teacher to ensure that you are using everything correctly. The second cause (mucus observation specific) could be a supplement or medication that you are taking. The use of Mucinex (or other expectorant medications) or large quantities of B6 vitamin can cause excess mucus secretions. Check your medications and supplements to see if this could be the cause. The third cause (mucus observation specific) could be a vaginal/yeast infection. For some women, the use of a high-quality probiotic can alleviate this. Talk to your doctor or pharmacist if you have questions about probiotics. The fourth cause for this could be a hormone dysfunction that is causing too much estrogen and not enough progesterone in your body. For this situation, it is recommended that you contact a NaPro or NFP-friendly Doctor for an evaluation. The fifth cause (mucus observation specific) is cervical inflammation which is not, in itself, dangerous but can cause chart confusion. This can be treated by a doctor or managed with specific method instructions (Creighton Model) that can walk you through how to determine which mucus observations are fertile and which are not. If this continues to be a problem, you may need to consider switching methods.
Difficulty Determining Peak Day
If you cannot pinpoint your Peak Day, then there are several things you can do. The first, and most important, is to contact your method teacher for instructions. If you are not seeing an LH surge on your monitor, then you may need to buy LH-only strips and test 3 times a day (AM, Midday and PM - around dinner time) to catch your LH surge. If you are still not seeing an LH surge, then you should be evaluated by a NaPro or NFP-friendly Doctor to determine why.
If you cannot determine your peak day because your mucus observations are confusing, then you should contact your method teacher for further instructions. You are typically looking for a drastic change in mucus from very fertile (or peak) type to less fertile (or non-peak) type. The most fertile day is your Peak Day. If you are having trouble because of continuous mucus observations, please see the information above.
Continuous infertility could indicate that you are not ovulating or that the hormones of Estrogen and/or LH are not sufficiently high enough to cause changes in your biomarkers. It could also be due to low or poor quality cervical mucus (see below) or possibly a hormone monitor error or usage issue. To rule out a hormone monitor error or usage issue, please contact your Marquette instructor for suggestions on how to check your monitor and also to ensure that you're testing properly. Some women may need to purchase additional LH-only strips and test multiple times per day to capture their LH surge.
Anovulation (not ovulating during a cycle) and low hormones can appear on charts as completely dry (no cervical mucus observations) or very few (4 or less) cervical mucus observations during a menstrual cycle. It can also appear on hormone monitors when there are no high and/or peak fertility days. Charts like this should be evaluated by a doctor to determine the exact cause of the infertile signs.
While NFP is extremely helpful in notifying women that they have an underlying medical condition, it is impossible to determine or diagnose these conditions without further consulting a professional. The Creighton Model FertilityCare System is the only method of NFP that can diagnose and treat medical conditions because it is directly linked to NaPRO TECHNOLOGY and has been studied for that specific purpose. However, the Sympto-Thermal and Marquette Methods are extremely helpful in certain situations at helping doctors tailor testing to determine what is causing underlying disorders. If you believe that you are experiencing any medical conditions that are affecting your fertility and ability to chart NFP, please contact an NFP-Friendly Medical Doctor for an evaluation.
Low/No or Poor Quality Cervical Mucus
Some women never or rarely see fertile (or Peak) type cervical mucus. This could be caused by many factors and it is important that, even if you are able to correct the issue with supplements/medications, you consult a doctor to determine the exact cause of this. Well-trained Creighton Practitioners are specifically taught to evaluate low and poor-quality cervical mucus and recommend protocols to help correct the issue. These protocols include supplements such as B6 and Over-the-Counter medications like Guaifenesin (Mucinex). The specific dosage would be determined by the quality and quantity of the mucus observations. These protocols are not recommended for everyone and would need to be discussed with your Practitioner, a pharmacist or a doctor before being started.
Polycystic Ovarian Disease (PCOS)
PCOS can present on charts in a variety of manners. Some charts may appear perfectly normal while others show cycles that last longer than 3 months with limited cervical mucus. This is due to the variations within the syndrome itself. There are different types of PCOS and great debate in the medical community regarding how many and how they present. There seems to be emerging agreement that there are at least two distinct types of PCOS. Women with the first type (Classic Type) often have more than 90 days in between periods and suffer from infertility and uncomfortable and embarrassing physical symptoms such as excess hair growth (particularly on the face), the inability to lose weight and cystic acne. The second type (Insulin-Resistance Type) typically appears with normal cycle lengths (both ovulatory and anovulatory), low progesterone biomarkers (see below), normal (or thin) body weight and infertility or chronic miscarriage. PCOS can only be diagnosed by a doctor and depending on the symptoms and severity of the syndrome have a variety of supplement and medication protocols. If you have been diagnosed with or suspect PCOS, please seek further assistance in managing your chart.
Low progesterone is a common problem in women of childbearing age and can be caused by a variety of things. It can cause very few symptoms, such as mild PMS, or very severe symptoms, such as severe PMS, Infertility and Chronic Miscarriage. Because progesterone is produced in the Luteal Phase (second half after ovulation) of the cycle, it is sometimes referred to as Luteal Phase Defect. The St. Paul VI Institute and NaPRO TECHNOLOGY have identified 5 distinct types of Luteal Phase Defect. These defects are usually identifiable when using NFP. If you are tracking your Basal Body Temperature, you may see no temperature shift at all, a slow to rise temperature shift, lower than normal luteal phase temperature or an abrupt drop-off in temperature that corresponds with a short luteal phase. If you are using a hormone monitor, then you may see continuous fertility or no fertility at all (depending on the defect type). Other common markers are premenstrual spotting of 3 or more days before the onset of menses and multiple days of brown spotting at the tail-end of menses. Luteal Phases of less than 10 days are also an indicator of low progesterone and can indicate an increased risk for miscarriage or pre-term labor. Low progesterone can be treated using bio-identical progesterone (oral, suppository or injectable) and is available by prescription only.
One cause of infertility and miscarriage is Thyroid Dysfunction. Hypothyroidism can be seen in Basal Body Temperature charts as lower than normal temperatures. Temperatures lower than 96.8 (some doctors would put the cutoff at 97.0) in the first half of the cycle and corresponding lower temperatures in the second half of the cycle can indicate hypothyroidism. When charting with ovulation-only methods (Creighton and Billings) it can appear similar to low progesterone.
NaPRO TECHNOLOGY and emerging research believe that Thyroid Stimulating Hormone (TSH) levels above 2.5 (2.0 in some research) are not optimal for fertility and recommend treatment. For women with hypothyroidism, their T3 and T4 will also be treated. Thyroid evaluation and treatment must be done by a doctor.
Difficulty with or Prolonged Abstinence
Abstinence issues tend to fall into one of two categories