basal body temperature as method of natural family planning

Last reviewed 01/2018

Basal Body Termperature

  • basal body temperature (BBT) elevation retrospectively identifies fertility
  • luteinizing hormone surge, which stimulates ovulation, is associated with a 0.5- to 1°F- (0.9- to 1.8°C) rise in BBT measured with highly standardized methods (1)
  • BBT can be taken orally, vaginally, or rectally with a sensitive thermometer
    • same site should be used daily
  • BBT
    • measured on awakening at approximately the same time every morning, before getting out of bed or doing any other activity
      • at least 6 hours of uninterrupted sleep the preceding night is necessary for accurate measurement
    • remains elevated throughout the luteal phase secondary to higher progesterone levels
    • woman assumed to have ovulated after observing 3 consecutive days of temperature elevation
    • pregnancy is avoided by abstaining from the beginning of menstruation until 3 to 4 days after the rise in BBT
      • all subsequent days until the beginning of her next menses are considered infertile
        • because sperm survive 5 days, BBT alone does not predict ovulation far enough in advance to identify all the potentially fertile days; it predicts only peak fertility, so thus the need to abstain from the beginning of menstruation (1)
    • many other factors also limit the use of BBT
      • some women ovulate without a clear rise in BBT
      • inaccurate basal temperature measurement can be caused by alcohol consumption, late nights or oversleeping, disrupted sleep, travel, time zone differences, holidays, shift work, stress, illness, gynecologic disorders and medications
      • biphasic shift of BBT has been found to vary up to 1 day before and 3 days after actual ovulation

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