NFP during Perimenopause
Question
We’ve used nfp (cervical mucus method) for a number of years and I’ve been very regular and had very definite fertile periods with which to work. We always thought it safest to avoid pregnancy by limiting ourselves to post peak sexual activity. Now I’m 49 and beginning periomenopause with strange mucus patterns that stop and start and seem to go through a fertile peak and then  start again with fertile mucus (long but not slippery or clear) up until the bleeding starts. Is there any reliable infertile times in sight for us before 12 months after my last period. If we are trying to be very careful to avoid pregnancy, is there much hope in any post peak time for sexual activity. It seems as if intercourse may be ruled out for years. What usually happens during periomenopause and how do older couples handle it????
Answer
Last Updated: June 17, 2013
It is not clear from your letter which cervical mucus method you are using, so I will address some basics to help you understand what’s going on and what you might expect. As you have expressed, your cycle patterns have become increasingly irregular. Since you have been using your method to avoid pregnancy, it has probably been a good idea to avoid pre-Peak intercourse, in light of the very real possibility of early ovulation (presence of mucus during your menstrual cycle, with the mucus continuing and ovulation occurring earlier in that cycle). This is a common pattern for premenopausal women, although it can happen to any woman.
As you have experienced, the post-Peak phase of your cycles has become increasingly irregular, with more confusing mucus patches and a return of Peak type mucus observed. That is normal at this time but you are concerned because you are unsure how to manage this new development confidently, especially to determine when you may have intercourse. Your most prudent use of your method is to make accurate observations, accurately chart what you observe and follow your method instructions for whatever you see. That might mean more abstinence than you might wish, but your strong desire to avoid pregnancy should motivate you at this time. I would also strongly suggest that you take a refresher course in your NFP method; perhaps your teacher, who will be looking at your charts, can give you some more concrete management of your cycles to help you pinpoint more times of infertility for intercourse and to thereby increase your confidence and satisfaction with your NFP method.
One important thing to be aware of at this time is the possible development of unusual bleeding, including intramenstrual bleeding, or any continuous discharges (especially if there is an odor). If you experience any of these, you should see your doctor for evaluation of the problem. Again, I commend you for the positive lifestyle you have chosen in practicing natural family planning and I hope my comments will help you weather this challenging time of your life.
Pamela Polis
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