Justisse Method

The
Justisse
for
Fertility Management
A User's Guide
by
Elaine Matus FMP &
Geraldine Matus FMP
Fertility Management Services
E
l
The
Justisse Method
for
A User's Guide
by
Elaine Matus FMP &
Geraldine Matus FMP
ACKNOWLEDGEMENTS:
Our appreciation goes out to all the women to whom we have taught
the Justisse Method, as each one has contributed to our greater
understanding of fertility. Appreciation also goes to our sisters, who
have encouraged us in every way to persevere in the development
of Fertility Management Services - the Justisse Method.
We would like to give special recognition to the work of: Dr.
Suzanne Parenteau-Carreau of Serena Canada, Drs. Lynn & John
Billings of The Billings Ovulation Method, and Dr.T.W.Hilgers of the
Ovulation Method - Creighton Model. Their works have been extensively modified to form the foundations of the Justisse Method.
%opyright 1988 by Elaine Matus & Geraldine Matus

Published by Fertility Management Services
Layout design: Katharina Dannenberg
Cover art: Thomas Dannenberg
Printed in Canada
As the content of the following pages will indicate, the Justisse Method involves careful observation and monitoring of certain complex bodily functions.
some of which may not be perfectly predictable in all circumstances. Accordingly, neither Fertility Management Services Ltd., nor the authors, nor their
respective employees, agents, licensees, heirs, executors, administrators, personal representatives, successors or assigns makes any express or implied
warranty about, or assumes responsibility for the accuracy, completeness or usefulnessof any information, methods or products disclosed in this manual.
and neither Fertility Management Services Ltd., nor the authors, nor their respective employees, agents, licensees, heirs, executors, administrators, personal representatives, successors or assigns shall in any way be held liable for any direct or consequential damage suffered by any person as a direct
or indirect result of any use of or reliance upon the contents of this manual. Any reliance placed on the accuracy, completeness or usefulnessof the contents of the manual or the methods described is at the user's own risk.
- TABLE OF CONTENTS
JUSTISSE METHOD USER GUIDE

CHAPTER 1
The Justisse Method
CHAPTER 5
Charting
fertility management
advantages of the Justisse Method
learning the Justisse Method

the basis of the Justisse Method
23
mucus definitions
23
the chart
24
sensation
25
X per day most fertile sign seen
25
miscellaneous symptoms
26
CHAPTER 2
Reproductive Anatomy and Physiology
stress and illness
26
cycle variations
charting example
26
ovarian cycle
basal body temperature
27
menstrual cycle
ovulation
cervical mucus
CHAPTER 6
Accomplishing Your Intentions with JM
29
nature's gate
fertilitv awareness
29
cervical changes
fertilitv manaaement
29
when theoretical effectiveness

to avoid pregnancy is reduced
29
defining days of fertility & infertility
30
basic charting considerations
31
basal body temperature shift (BBT)
10
fertilization
11
male reproductive system
12
res seminal fluidlcontact ~reanancv
CHAPTER 3
Checking for Mucus
*I"E *-*Mm%i*Y;iw:=
mUaAu-"IF
12
13
-<
observational check list
14
3 steps in checking for mucus " S O W
14
3 C'S of the mucus
14
CHAPTER 7
Other Chartina Considerations
continuous discharge
- yellow stamp management
36
coming off of the birth control pill
37
infertility
37
breastfeeding
37
post abortion or miscarriage
39
39
39
40
CHAPTER 4
Describing Sensations,
Mucus Observations, and Bleeding
15
- menopause
menarche - the first menstruation
the three sensations
15
arousal fluid
observational notations
15
semen elimination technique
photographs of mucus observations
19
sample charts
41
examination of the cervix
22
CHAPTER 8
Other Natural - zthods of Family Planning
49
calendar rhythn
49
basal body temperature
50
serena & couple-to-couple league
50
billings' ovulation method
50
ovulation method creighton model
51
bio-self
51
rabbit (aka Annel
51
References
52
Footnotes
53
climacteric
- SET
40
The Justisse Method
The Justisse Method
--
-_
The Justisse Method is a system for Fertility

Management. It is adapted from the Ovulation
(mucus) and Sympto-Thermal methods of Natural
Family Planning. It combines features from Billings Ovulation Method, Creighton Ovulation
Method, and Serena Symtpo-Thermal Method.
The Ovulation method was first described by Drs.
Billings in Melbourne, Australia. The SymptoThermal method was first described by Dr.
Roezter & Dr. Vollman.
The Ovulation method utilizes a symptom - the
discharge of cervical mucus - to determine times
of fertility and infertility in a woman's menstrual
cycle. The Sympto-Thermal method utilizes a
perceptable SHIFT in the basal body temperature
as well as cervical mucus symptoms. The Justisse
Method utilizes the knowledge from both of these
methods to approach fertility awareness or fertility
management in a manner that suits the individual
needs of the client.
An increasing number of women are searching
for ways to manage their fertility without drugs or
internal devices. The Justisse Method makes
available scientific information which can be applied to individual circumstances. Women of all
philosophical persuasions can use this information to regulate their fertility safely.
The purpose of this guide is to instruct in the
Justisse Method. The guide can be used alone
for self instruction, or used along with instruction
by a trained FERTILITY MANAGEMENT PRACTlTlONER (FMP) of the Justisse Method.
Fertility management requires understanding of
the reproductive system. It is necessary to have
a fundamental knowledge of reproductive
anatomy and physiology. This guide provides the
necessary information and also explains how to
chart a menstrual cycle. It opens the way to a new
awareness of how your body works in addition to
allowing management of reproduction.
Advantages of The Justisse Method

is easy to learn
is reliable
is helpful to achieve pregnancy
can help to identify infertility and other
reproductive problems
does not harm health
is inexpensive
can be used at any reproductive age
supports reproductive freedom
offers an opportunity for personal growth
by exploration of one's sexuality
is not influenced by marital status or
sexual behaviour
The Justisse Method
Learning the Justisse Method

The Justisse Method is designed for women to
gain confidence quickly. Instruction includes an
introductory session followed by a series of 6-9
follow-ups.
The introductory session includes: basic
reproductive anatomy and physiology, charting
basics, and discussion time. Each follow-up includes chart interpretation, review of method application, and individual management. Some
follow-ups include a quiz, use of pictures and sample charts from the guides, or other information
that may be necessary for a particular woman.
If you are using this guide for self instruction
and are having difficulty, contact a Fertility
Management Practitioner, for consultation and
clarification.
The Follow-up Schedule
1st follow-up takes place 2-3 weeks after the
introductory session.
2nd, 3rd, and 4th follow-ups are 2-3 weeks
apart.
5th follow-up is five weeks later.
6th, 7th, 8th, and 9th occur at three month
intervals.
After the 9th it is recommended to come in for
follow-up every 9-1 8 months.
If you change your intention in using the method
or reach a different reproductive stage, i.e.
menopause, breastfeeding, or post-abortion, it is
recommended you come in for a follow-up as soon
as possible. If you are using the Justisse Method
and decide to become sexually active for the first
time or after a period of abstinence, it is recommended that you come in for a follow-up.
Some women gain confidence quicker than
others. Some reproductive circumstances are
easier to interpret than others. The schedule,
therefore, is flexible. In the initial learning stages
(that is from introductory session to the third
follow-up) less time between follow-ups is recommended. As well, you may at anytime request a
consultation with your Practitioner.
Experience has shown that those who delay

early follow-ups have difficulty in their ability to
interpret their cycles and thus their confidence will
be lacking. Follow-ups are designed to discuss
observations, questions, and concerns in order
to affirm your interpretation of your chart and your
observational skills. In the early learning stages
if you wait too long between follow-ups many
questions, doubts, and concerns go unaddressed. You may feel discouraged. Successful and
confident use of the Justisse Method depends on
careful mucus observations, accurate and consistent charting of mucus symptoms and
temperature, if used. Be patient with yourself in
the early learning stages, and do not hesitate to
request assistance.
The Basis of the Justisse Method

In using the Justisse Method all women begin
by observing their cervical mucus symptoms.
Other symptoms are employed if needed in followup visits.
The diagram below illustrates the presence of
cervical mucus in the menstrual cycle.
The Justisse Method
The first day of the cycle is the first day of

menstruation. Menstrual flow lasts from three to
seven days. When the flow begins, it is heavy or
moderate and subsides to a light or very light flow.
After menstruation, you will usually notice a dry
sensation and usually no discharge at your vulva
for a few days (except in shorter cycles).
After those dry days, you may notice some
discharge at the vulva. You may notice it on your
undergarments or when you wipe yourself after
going to the bathroom. You may first notice a
sticky white mucus discharge. After a few days,
the discharge becomes clear and slippery. The
last day of mucus that is clear and slippery is called the peak day.
Following the peak day, there is a dramatic
change. The mucus changes back to a sticky
white discharge or disappears altogether. From
the fourth day after peak until the beginning of
the next menstrual flow, you will be dry.
Fertile days include the menstrual flow and the
first day mucus appears through the peak day and
for 3 days following. Infertile days include the dry
days after menstruation and from the fourth day
after the peak until the beginning of the next
menstruation.
In the diagram on page 2 you will notice that
the days between the peak day and the onset of
menstruation are numbered from 1 to 14. No
numbers appear between the start of menstruation and the peak day. This is because the phase
before peak varies greatly in length. The phase
after peak is stable in length. Fourteen (14) days
is the average length of this phase. Peak day correlates very closely with the time of ovulation.
Occasionally women experience a shorter
cycle than they normally have. When this happens, ovulation will occur earlier in the cycle. The
clue to an early ovulation is that there will be no
dry days following menstruation. Rather, mucus
will be present during the menstrual flow. Taking
this possibility into consideration, and being aware
that you can not predict when a cycle will be short,
the menstrual flow is considered fertile. However,
the light and very light days of the menstrual flow

can be observed for mucus as any other day. If
there is no mucus on the light and very light days
then these days are infertile.
The count of 3 after peak day is necessary
because ovulation can possibly occur on those
days. On average, ovulation occurs on peak day.
However, statistics have shown that ovulation can
occur on the first, second or third day after peak,
or the day before peak. Even though you are dry
on the days after peak your vaginal environment
is still alkaline enough to support sperm life. Thus
if ovulation were to occur on one of those dry days
within the count of 3 a pregnancy could occur.
That is why those days are considered fertile.
Reproductive Anatomy
and Physiology
In order to use and understand the Justisse
Method you need to have an awareness of how
your fertility works.
fertilization
fallo~iantube
cervix
vagina
Female Reproductive System; Fallopian Tubes,

Uterus, Ovaries.
The uterus is a pear shaped muscle. The
ovaries are almond shaped organs located on
either side of the uterus. Within the uterus is a
cavity. The cavity has a lining called the endometrium. The lower portion of the uterus, which
projects partially into the vagina is called the cervix. Lining the canal of the cervix are the cervical
crypts. It is within the cervical crypts that mucus
is produced. Mucus is produced only when you
are fertile. The rest of the time you will produce
no mucus, and have a sensation of dryness.
spine
Cycle Variations
Your cycle begins with the first day of menstrual
bleeding and ends the day before the next
menstruation. While it has been believed that the
normal menstrual cycle is about 28 days in length,
in fact only 30% of women experience such a
cycle regularly.
Cycle lengths vary within a range of 21-42 days.
A variation of 8 days between individual cycles
is considered regular.
The menstrual cycle is divided into two phases.
Ovulation is the dividing point. From menstruation to ovulation is the preovulatory phase. From
the day after ovulation until the day before the next
menstruation is the postovulatory phase.
The preovulatory phase of the cycle is variable.
You can not predict the exact time of ovulation.
In the preovulatory phase you will experience
menstruation for 3-7 days. The number of dry days
before ovulation will depend upon how early or
late ovulation will occur in that cycle. Several days
prior to ovulation a mucus discharge will be
noticed.
If you have a short cycle (21-26 days) you may
notice mucus on the light and very light days as
menstruation is ending. If you have moderate
length cycles (27-35 days) you may experience
a few dry days before mucus is noticed. If you
have a long cycle (36-60 days) you may experience many dry days or patches of mucus
before ovulation occurs.
menstruation
menstruation drv
mucus
mucus
,,
1
b
)ng cycle (36-60)
vagina
Side view of Female Reproductive System
moderate cycle (27-35)
Cycle length variations:
Whether you experience a 21, 35, or 60 day

cycle your postovulatory phase will be stable. For
example if your postovulatory phase were 13 days
in a 21 day cycle, it would still be 13 days in a
35 or 60 day cycle. The postovulatory phase, will
range from 9-17 days. The average is 14 days.
For any one woman her postovulatory phase will
remain stable from cycle to cycle.
Ovarian Cycle
As your cycle unfolds certain events occur in
the ovaries. This is called the ovarian cycle. The
ovarian cycle occurs simultaneously with the
menstrual cycle. Both cycles occur as a result of
the interaction of the hormones FSH (follicle
stimulating hormone), LH (luetinizing hormone),
estrogen, and progesterone.
The pituitary and hypothalamus glands regulate
the reproductive system. The hypothalmus
stimulates the pituitary to produce FSH, and LH.

FSH stimulates the development of the ovum. LH
stimulates the release of the ovum from the ovary.
The ovaries produce estrogen and progesterone
in response to stimulation from FSH and LH.
There are several hundred thousand primary
oocytes present in the fetus after 12 weeks gestation. These are inactive until puberty. They are
active from first menstruation until menopause.
Early in the ovarian cycle several primary
oocytes are stimulated by FSH to mature. A follicle develops around the maturing oocyte. After
a time one - and on occasion two - oocytes
reach full maturity. It is now called an ovum. Once
the ovum is mature LH causes the follicle to rupture and the ovum is released from the ovary. This
is called ovulation. The follicle remains behind in
the ovary where it becomes a temporary gland.
It lives as a temporary gland for approximately
14 days.
corpus luteum
produces progesterone
Mature (Graafian)
developing follicle
produces estrogen
The Ovarian Cycle: ovary cut away
As the follicle develops it produces a hormone

called estrogen. The more developed the follicle
is the more estrogen it produces. The highest level
(PEAK) of estrogen production is closely related
to ovulation. Estrogen is responsible for mucus
production and ovulation. After ovulation the remaining follicle is called the corpus luteum and
it produces a hormone called progesterone. Progesterone is the dominant hormone in the
postovulatory phase. Progesterone prevents further ovulation and stops mucus production.
During menstruation, the endometrium sheds

to its base cell layer. Following menstruation the
endometrium begins to grow again. Red blood
cells are rapidly produced creating a very dense,
hard surface. This is known as proliferation.
Estrogen simultaneously stimulates the development of the follicle and the growth of the
endometrium.
After ovulation the increasing levels of progesterone stimulate changes in the endometrium.
It becomes secretory. The cells of the endometrium begin to move apart from each other
and develop sugar and fat glands, capillaries, and
other cellular fluids. These changes make the environment suitable for implantation of a fertilized
ovum. If a pregnancy does not occur, progesterone levels fall. Without hormonal support
to the endometrium it will once again shed off as
menstrual flow.
If fertilization does occur, the corpus luteum will
continue to produce progesterone and support the
endometrium until the fetus' placenta is developed
enough to produce its own progesterone. This occurs at about 12 weeks gestation.
If there is insufficient hormonal support for the
development and maintenance of the endometrium the woman may experience infertility
or frequent spontaneous abortions.
Menstrual Cycle
The endometrium goes through changes during what is known as the menstrual cycle. The
event in the menstrual cycle familiar to all women
is the shedding off of the endometrium - known
as menstruation. The menstrual cycle and the
ovarian cycle occur simultaneously.
Biologically the menstrual cycle ends with the
shedding of the endometrium. The bleeding is
technically the end of the cycle. For the purposes
of fertility management, however, the first day of
bleeding is the recognized marker for the first day
of a new cycle.
menstrual
phase
, , proliferating
'
secretory phase
phase
estrogen
menstrual flow
follicular development
ovulation
luteal development
The Menstrual Cycle: Changes in the endometrium occur simultaneously with

events in the ovaries.
Ovulation
Cervical Mucus
Ovulation occurs on only one day in a cycle.

It can not occur again after progesterone levels
begin to climb. Progesterone prevents further
ovulation within 24 hours following ovulation.
Several ova can be released at ovulation as the
birth of non-identical twins and triplets prove.
However, when more than one ovum is released in one cycle, they must all be released within
the same 24 hour time period.
When the ovum is released from the ovaries
it is picked up by the fimbriated end of the fallopian tube. It travels about one third of the way
along the tube, where it awaits fertilization.
Once ovulation occurs, the ovum lives 12-24
hours. If it is not fertilized, it dies. Because this
time is so short very few women would become
pregnant if the life span of the ovum were all that
mattered. This is where the role of cervical mucus
becomes apparent.
It is still occasionally thought that ovulation can
occur when a woman is sexually stimulated. This
is not true!!
Cervical mucus appears prior to ovulation. Rising levels of estrogen stimulate the crypts lining
the cervical canal to produce mucus. Estrogen
reaches its peak production around ovulation
day. The estrogen peak corresponds with the
mucus peak. Cervical mucus prepares the way
for sperm, enabling them to live until ovulation
occurs.
Sperm require cervical mucus to survive.
Sperm, in the absence of cervical mucus, will die
within hours or even minutes when deposited in
the vagina. In the presence of cervical mucus
sperm may live from 3 to 5 days and wait for
ovulation to occur. Once ovulation has occurred
the rising levels of progesterone cause the cervical crypts to stop producing mucus, since
sperm survival is no longer necessary.
............
............
progesterone'.
menstruation dry
IUCUS
The appearance of cervical mucus with peaking estrogen.
Nature's Gate
The cervical mucus acts as a gate. The gate
is open when the mucus is flowing, and sperm
can enter the uterine cavity. The gate is closed
when mucus stops flowing and forms a mucus
plug. This blocks sperm entry to the cervix, and
thus the uterine cavity.
When estrogen levels are high the mucus that
is produced is called type E. Type E mucus arranges itself into strands called micelles. These
strands are the channels on which sperm flow
through the cervix. Type E mucus has an alkaline
Ph, which is ideal for sperm survival. Type E
mucus is produced in large amounts so that it
coats the surface of the normally acidic vagina.
In this manner sperm can survive their trip to the
cervix. It nourishes the sperm, and allows only
viable sperm to make the journey.
Of the 500,000,000 sperm present in a normal

ejaculate only 20,000 to 100,000 will actually ever
reach the ovum to attempt fertilization. They remain in the cervical crypts, or in crevices in the
uterine cavity to await ovulation.
Type G mucus and an acidic vaginal environment are hostile to sperm. Type G is thick and
gelatinous, acting as a physical barrier to sperm
trying to gain entry through the cervix. If any
sperm manage to make their way to the cervix
in the presence of Type G mucus they would find
Nature's gate closed.
When the gate is open conception is possible.
So therefore the woman's key to her fertility
is understanding when the gate is closed and
when it is open. This is why observing cervical
mucus is so critical for determining fertility.
type G mucus
DRY days
type E mucus
MUCUS days
Nature's Gate
Cervical Changes
By doing self examinations of the cervix a
woman may note changes that correspond to her
fertility.
During the infertile phases of the cycle, under
the influence of progesterone, the cervix is closed, firm and tilted toward the rectum. As estrogen
levels rise and mucus begins to be produced the
cervix opens slightly to allow mucus to flow
through.
As the cervix opens it becomes softer and its

position becomes straighter up and down until it
is very near vertical at ovulation. The softness may
be compared to the lips, and the firmness to the
tip of the nose.
These subtle changes observed over several
cycles become another reliable symptom for
determining fertility or infertility. This symptom is
usually employed in situations like breastfeeding,
and continuous mucus (see Chapter 7).
after menstruation
closed, firm, tilted toward rectum
as estrogen levels are rising

partially open, softer, straighter
around ovulation
very open, very soft, vertical
after ovulation until menstruation

closed, firm, tilted toward rectum
Changes in the Cervix
Basal Body Temperature Shift

Basal body temperature is the body's baseline
resting temperature. It is a measure of the heat
produced by body metabolism. Metabolism is
slower in the preovulatory phase of the cycle. Rising levels of estrogen slow metabolism keeping
the basal body temperature low. After ovulation
progesterone is produced. Progesterone speeds
up the body's metabolism in preparation for implantation of a fertilized ovum. Faster metabolism
causes the basal body temperature to rise and
remain high for the first three months of a
pregnancy or until menstruation occurs.
When basal body temperatures are plotted daily
the shift to a higher temperature after ovulation
is easily noticeable.
The Ovarian Cycle
menstrual
phase
, , proliferating
' ' phase
estrogen
Changes in the
Endometrium
Hormone Changes
I
Mucus Development
BBT SHIFT
The BBT SHIFT corresponds with other events

that mark ovulation.
is complete. The fertilized ovum now begins to

divide.
The fertilized ovum, known as a zygote, travels
through the fallopian tube as it divides and grows.
Within 3-4 days it reaches the junction of the fallopian tube and the uterine cavity. By then it will
consist of 16 cells, and is known as a morula. It
will then float freely in the uterine cavity for about
3-4 more days during which time it changes into
a blastocyst. Then it is ready to implant onto the
endometrium, where it will establish its life
support system from the woman. Implantation
takes place 6-8 days following fertilization.
If fertilization does not occur the ovum will
disintegrate and die within the fallopian tube.
Fertilization
Once ovulation occurs, if sperm are present,
they will migrate from the cervical crypts toward
the fallopian tubes. Fertilizationoccurs just above
the fimbriated end of the tube. The sperm meet
the ovum and attach themselves to the cell membrane. This membrane, called the zona pellicuda,
has a hard surface. The first sperm that burrows
its head through the membrane creates a reaction which seals off further penetration by other
sperm. The sperm leaves behind its tail, the
source of locomotion no longer needed.
Once the chromosomal material contained in
the body of the sperm unites with the
chromosomal material of the ovum, fertilization
enlarged sperm
Fertilization & Implantation
Male Reproductive System
\foreskin
in the
uncircumcised male
Male Reproductive System

A man's fertility unfolds in a similar manner as
a woman's. That is, the hypothalamus gland
stimulates the pituitary to produce FSH and LH
which initiate sperm production in the testicles.
From the testicles sperm travel to the
epididymis where maturation takes place. Once
mature they travel up the vas deferens to the ampulla to await ejaculation. Should ejaculation not
occur sperm is reabsorbed into the bloodstream.
On either side of the ampulla are the seminal
vesicles. These produce a fluid high in fructose
that keep sperm viable.
When the man is ready to ejaculate the sperm
travels through the prostate gland where it mixes
with seminal fluid produced by the prostate. It then
travels through the urethra and out of the penis.
Prior to ejaculation, the Cowper's gland, in front
of the prostate, releases pre-ejaculatory fluid. This
fluid cleanses and alkalinizes the urethra so that
sperm can survive its passage out of the penis.
Sperm are produced continuosly from puberty
until old age. As the man ages his fertility declines
- that is, the number and viability of his sperm
is reduced - though whatever the man's age he
is considered more or less fertile all the time. In
contrast, the woman is fertile for only a few days
each cycle, and her fertility lasts for only 25-40
years.
Preseminal FluidIContact Pregnancy

The man's pre-ejaculatory (preseminal) fluid is
the equivalent of arousal fluid. It is lubricative with
a cloudy or clear color. Its dual role is to act as
a lubricant to facilitate intercourse and as an agent
to alkalinize the normally acidic urethra so that
sperm can survive. Though the Cowper's gland
does not produce sperm the gland is located
along the route that sperm normally travel.
Therefore preseminal fluid may contain some
sperm.
During the woman's fertile times there is cervical mucus on the vulvar area. Contact with
preseminal fluid or ejaculatory fluid with the
woman's mucus may result in pregnancy even
without penetration or ejaculation. This is known
as a contact pregnancy (see Chapter 6 - "When
Theoretical Effectiveness is Reduced").
Checking for Mucus
Checking for Mucus

The technique described here for observing
mucus is the most effective for reliably defining
days of fertility and infertility.
You begin with a piece of toilet or kleenex tissue
folded flat. Wipe the vulvar area from front to back,
paying attention to the sensation you feel as the
tissue moves over the perineum towards the anus.
The perineum is the flat, smooth piece of skin between the vagina and anus.
Once you have determined the sensation,
observe the tissue for the presence or absence
of mucus. If mucus is present, finger test it for color, and consistency. Then make a mental note of
that observation. At the end.of the day chart the
most fertile observation you have seen during that
day. As well, note how many times you saw the
most fertile sign.
Check everytime you go to the bathroom.
Check before and after urination, before and
How To Wipe When Checking For Mucus1
after a bowel movement, last thing at night before

you go to bed, and before and after bathing. At
first you must remind yourself to do these observations, but quickly it becomes a habit. Once
learned, you know how hard it is to break a habit!!
The observation most commonly forgotten is
before urination. Many women find it helpful to
make that observation while still standing.
Check for mucus every day throughout your
cycle, except the days of heavy and moderate
menstrual flow. No checks are made on those
days because you would not be able to differentiate cervical mucus from endometrial fluids.
However, on the light and very light days of the
menstrual flow, observations can be made as
reliably as on any other day.
Accuracy and confidence in determining fertility
or infertility depends on making observations
100% of the time. It may be expected that poor
compliance to the routine of checking will undermine accuracy and confidence.
Checking for Mucus
Observational Check ~ i s t '

Check every time before and after you go to the bathroom
Check every time before and after bathing
Check before you go to bed and if you get up at night to urinate.
1
I
I
Use flat tissue

Wipe from front to back
Determine the sensation before looking at the tissue
Observe the tissue, and finger test for mucus
Make a mental note of what was observed, and/or felt
Make observations every day
Chart your most fertile observation daily
3 Steps in Checking Mucus
oft"'
S = Sensation: wipe the vulva from the urethra across the perineum to
the anus. Pay attention to the sensation this produces. The sensation will be DRY, or SMOOTH, or LUBRICATIVE. Decide on the sensation before looking at the tissue.
0 = Observation: observe the tissue for the PRESENCE or ABSENCE OF
MUCUS.
F = Finger Test: if mucus is present on tissue, finger test it between the
T
thumb and index finger for COLOR & CONSISTENCY.
Make a decision at each observation and mentally record it.
3 C's of the
Color
Consistency
Change
Sensation
MUCUS'
Observe mucus sample at eye level to decide color.

Sticky = V4"; Tacky = 1/2"-3/4"; Stretchy = 1" or more.
Make a mental note how the mucus or dry patterns CHANGE.
A LUBRICATIVE SENSATION with or without mucus that can
be finger tested indicates the presence of PEAK mucus. DRY
and SMOOTH are non-lubricative sensations.
Describing Sensations, Mucus Observations and Bleeding
Describing Sensations,
Mucus Observations
and Bleeding
The words and symbols used herein to describe
mucus are representative of the range of observations. The photographs of mucus on the following pages are a good representation of what you
may observe.
Of all the observations possible, you may experience only some. When you are charting at the
end of the day, pick the description that best
describes your most fertile observation. Use the
list of observational notations on the back of your
chart.
Though you may experience a similarity in your
mucus patterns from cycle to cycle, it is not uncommon for your mucus pattern to change due
to stress, illness, medication, or other variables.
It is best that the mucus pattern of each cycle be
charted and interpreted as seen, not as
anticipated.
The Three Sensations

DRY is an obvious sensation. You will feel a
halting and scratchy feeling, produced as the
tissue is wiped across the perineum. This is the
sensation most often felt in the cycle, as there are
more dry days than mucus days.
SMOOTH produces a creamy sensation as the
tissue is wiped across the perineum. There is a
feeling as if something is there because the tissue
now moves easier than with a dry sensation.
Smooth resembles the feeling of hand lotion.
Important: If you have a smooth sensation, yet

nothing can be finger tested off the tissue, it has
the same significance as a dry sensation.
LUBRICATION is an obvious sensation of slipperiness (gliding, mucousy) much like raw egg
white. When you wipe there is little resistence as
the tissue sails easily over the perineum.
The Three Sensations
I
DRY is associated with
I
I
NO MUCUS
SMOOTH can be associated with
VAGINAL CELL DISCHARGE
NON-PEAK MUCUS
PEAK MUCUS
LUBRICATIVE is associated with
PEAK MUCUS
Observational Notations
Observational Notations are a code system
designed to help you describe your observations.
Choose the notation that best fits your day's
observations.
Describing Menstrual Bleeding
Whenever bleeding occurs it is described as H heavy; M - moderate; L - light or VL - very light.
The flow pattern of menstrual bleeding will climb
a hill and come down. For example, flow patterns
may be as such:
The colors of menstrual flow range from a burgundy to a light red to pink or brown. On the light
and very light days of the flow, the woman makes
observations for mucus, notes sensation and
describes the color as brown, or redlpink.
Describing Unusual Bleeding
Breakthrough or withdrawal bleeding intramenstrually follows a different flow pattern than
menstrual bleeding. It would tend to be just
moderate, light or very light. Women experiencing this type of bleeding will easily identify it as
unusual. The color is usually brown, or pink. There
are special instructions for dealing with intramenstrual bleeding (see Chapter 6). It is very
important with observations of unusual bleeding
that mucus, sensation, and color be charted;
because intramenstrual bleeding may be
associated with ovulation.
lescribing Sensations, Mucus Observations and Bleeding
Observational ~otations'
On L & VL days of bleeding
mucus & sensation:
H - heavy flow
M - moderate flow
L - light flow
VL - very light flow
- mark in the presence or absence of
Categories of DRY:
0 - DRY
2 - damp without lubrication
2W - wet without lubrication
4 - shiny without lubrication
Categories of PEAK type mucus:
(Sensation of lubrication only nothing can be finger tested)
10DL - damp WlTH lubrication

10SL - shiny WlTH lubrication
10WL - wet WlTH lubrication
Descriptions for PEAK and NON-PEAK mucus that can be finger tested:
6 - sticky (114" or less)
B - brown
8 - tacky (112"-314")
C - cloudy (white)
10 - stretchy (1" or more)
CIK - cloudylclear
K - crystal clear
P - pasty
Y - yellow (even pale yellow)
G - gummy gluey
R - redlpink
Sensations:
D - dry
S - smooth
L - lubricative
Record the number of times that day you saw the most fertile sign:
X 1 - seen once
X 2 - seen twice
X 3 - seen thrice
AD - 4 times or more
Describing Categories of Dry:

0 = DRY
2 = damp without lubrication
2W = wet without lubrication
4 = shiny without lubrication
Describing Categories of Lubricative Sensation

Alone (Peak Mucus):
lODL = damp with lubrication
10SL = shiny with lubrication
10WL = wet with lubrication
All of these four dry descriptions have two

things in common. The sensation felt as you wipe
across the perineum is dry, and nothing can be
lifted off the tissue when finger tested. It is when
you observe the tissue that you will now differentiate which description to use.
All three of these descriptions have two things

in common, nothing can be lifted off the tissue
when finger tested, and the sensation is
lubricative. Whenever there is lubrication you
are of peak fertility.
DRY may have skid marks on the tissue, and

nothing else.
10DL = damp WlTH lubrication - there will be

a damp spot on the tissue. It feels
lubricative when the tissue is wiped
across the perineum. It feels lubricative
to the touch when finger tested, though
nothing can be picked up off the tissue.
damp WITHOUT lubrication - there will be

a damp spot on the tissue, and nothing can
be felt or seen on the tissue. Nothing can be
picked up off the tissue to finger test.
2W=wet WITHOUT lubrication - the tissue will
be wet looking, and nothing can be picked
up off the tissue when finger tested.
shiny WITHOUT lubrication - there will be
a shiny spot on the tissue though nothing can
be picked up off the tissue to finger test. The
shine will go away when rubbed if there is
no cervical mucus present. Shiny is commonly seen just prior to the change into a
mucus pattern, or away from a mucus pattern, as well as a day or two prior to
menstruation.
The damp, shiny, or wet appearance on the

tissue comes from vaginal cell sluff. This is not
cervical mucus. On occasion, there is enough
vaginal cell sluff present so that a woman will experience the sensation of smoothness as she
wipes across the perineum. But because she still
cannot finger test anything off the tissue, this has
the same significance as a dry sensation.
10SL = shiny WlTH lubrication - there will be

a shiny spot on the tissue. The shine
does not go away when rubbed with the
finger. It feels lubricative when the tissue
is wiped across the perineum. It feels
lubricative to the touch when finger
tested, though nothing can be picked up
off of the tissue.
10WL =wet WlTH lubrication - there will be a
wet spot on the tissue. It feels lubricative
when the tissue is wiped across the
perineum. It feels lubricative to the touch
when finger tested though nothing can
be lifted off.
In the above descriptions your fertility is

determined by the presence of a lubricative
sensation alone. If you have a lubricative sensation you are of peak fertility, regardless of
whether or not you can pick anything up off the
tissue.
Describing Mucus that can be lifted off the

tissue - Consistency and Color:
Consistency of mucus (texture, & threadiness)
6 = Sticky refers to mucus that when finger
tested between two fingers will lift up and

break apart at 114 inch or less.
8 = Tacky refers to mucus that forms a thread
of 112 to 314 of an inch when finger tested.
10 =Stretchy refers to mucus that forms a thread
of 1 inch or more when finger tested. Any
mucus that is stretchy is peak mucus.

P = Pasty refers to a texture noticed when
mucus is finger tested. It feels similar to hand
lotion. It tends to occur with sticky, cloudy
non-peak type mucus. Women who experience continual vaginal cell sluff tend to
experience pasty discharge frequently in
their cycle. In those cases their fertility can
be managed with a special Yellow Stamp
Management. For women with normal patterns of drynesslmucus this pasty discharge
signals the change into the mucus pattern.
G = Gummy or Gluey refers to the texture of
discharge that is present where there is an
inflammation of the cervix. The texture is like
half dried rubber cement, or bread dough.
It forms a thread which will be thick and
snappy, or gluey.
Color of Mucus:
B = Brown or R = RedIPink indicates the
presence of blood. These colors may be
seen close to ovulation day accompanying mucus, or a day or two before
menstruation begins or as it is ending. If
you see these colors on the tissue on a
L or VL day at the end of menstruation,
and there is no mucus present or lubrication you may consider it a dry day. If you
see these colors anywhere else in your
cycle you must consider yourself of peak
fertility and count 3 days after the last day
brown or pink was seen. This is unusual
bleeding. Consult your Practitioner
whenever there is unusual bleeding so its
significance can be discussed.
C = Cloudy mucus includes white, opaque, or
creamy colors.
CIK = CloudylClear is mucus that is partly
cloudy and partly crystal clear.
K = Clear is mucus that is crystal clear.
Y = Yellow (even pale yellow) tends to appear

if there is an infection or a very small
amount of blood. For some women it is
normal to have this color.
Sensation:
Mark down the most fertile sensation you had
that day in the space marked sensations.
D = dry
S = smooth
L = lubrication
Lubrication is the most fertile sensation. Smooth

may be associated with either the presence or
absence of mucus. If you feel a smooth sensation and there is no mucus present then it has the
same significance as a dry observation. If you feel
a smooth sensation and there is mucus present
then smooth is considered fertile.
---
Photographs of Mucus Observations
These photos are illustrative of the color and

consistency of mucus observations. Because sensation is something you feel, it can not be captured in a photograph. As you become familiar
with these photographs and compare them with
your observations, you will be able to appreciate
how the sensations of lubrication, smoothness,
or dryness are created.
Damp WITHOUT Lubrication = 2
Wet WITHOUT Lubrication = 2W
Shiny WITHOUT Lubrication = 4
Damp WITH Lubrication = 10DL
Wet WITH Lubrication = 1 G w ~
Shiny WITH Lubrication = 1 0 S ~
Sticky Cloudy Pasty = 6PC
Sticky Cloudy = 6C
Sticky Clear = 6K
.Stretchy Cloudy = 10C
Stretchy Clear = 10K
Tacky Clear = 8K
Stretchy Gummy Cloudy = 10GC
Tacky Cloudy Clear = 8CK
Sticky Gummy Yellow = 6GY
Discharge Seen on Undergarments

Observations of mucus seen on undergarments, though not generally reliable, may be
helpful. If you see anything that may be picked
up to finger test then make a note of it, especially if it is lubricative, tacky, or strechy. For some
women the beginning of their mucus pattern is
signalled by a wet or damp feeling on the
undergarmentsthroughout the day. If the wetness
or dampness is significantly different from other
days in the cycle, it is worth paying attention to.
A yellow crumbly discharge seen on
undergarments is vaginal cell sluff, which has
oxidized from being exposed to air. It has no
bearing on fertility.
Internal Examinations for Mucus
Internal examinations are not neccesary,
though in special circumstances they may be
recommended. If they have not been recommended to you it is because you have already
easily identified your mucus pattern and point of
change. Internal examinations may then lead to
confusion.
Examination of the Cervix

For most women, confident identification of the
mucus pattern is easily accomplished with observation of mucus alone. In special circumstances,
it may be recommended that a woman examine
her cervix to help identify her fertile phase.
The Technique for Self Examination of

the Cervix
When: Do the test in the evening, after the last
mucus observation of the day. Begin after
menstruation and check daily until the next
menstruation.
Precaution: Make sure your hands are clean.
Position: Use a sitting, standing, or squatting
postion - whichever is more comfortable for you
- but always use the same position.
How: Insert one or two fingers in the vagina.
Reach up and back until you touch the cervix. The
cervix feels like a small ball at .the top of the
vagina.
What To Feel For: Feel for a soft (like your lips)
or hard (like the tip of your nose) texture to the
cervix. Feel whether the os (opening) is open or
closed.
- Notations to Use for Cervical Changes

Soft = Sf
Hard = Hd
Open = Op
Closed = Cls
Notation of Cervical Changes: Mark your notations in the space reserved for miscellaneous
symptoms. The cervix is soft and open when you
are fertile. It is hard and closed when you are
infertile. These changes occur gradually over a
number of days, and can help confirm mucus
observations in situations where there is
confusion.
How To Examine The Cervix For Cervical

Changes
Charting
Charting
Every woman's fertility follows a predictable pattern based on human physiology. Within those
basic physiological parameters your cycle will unfold. Your charts will be a concrete record of your
body's unique expression of its fertility.
Whether you use the Justisse Method as a
health record, or as a means of avoiding or achieving pregnancy, careful and accurate charting are
important for confidence and success.
There are two kinds of mucus you may observe,
peak and non-peak. Both are fertile. It is important to understand their differences for charting
purposes. These definitions are located on the inside of your chart for easy reference. Peak mucus
is cervical mucus. Non-peak mucus is a combination of cervical mucus and vaginal cell sluff.
Mucus Definitions"
Peak Type Mucus is
any mucus discharge that is clear, stretchy
or lubricative.
Non-Peak Type Mucus is
any mucus discharge that is not clear,
stretchy or lubricative.
The Peak Day is
the last day of any mucus discharge that
is clear stretchy or lubricative.
The inside of your Justisse Method chart contains spaces for the date the cycle began, the appropriately colored stamp, sensation, descriptions
of the most fertile observation of the day, and
miscellaneous symptoms, stress, or illness. If you
are recording basal body temperature there is a
special Justisse Method chart that has a graph
for plotting temperatures, and a space to note how
and at what time of day the temperature was
taken.
Day of Cycle
Day 1 of the cycle is the first day of
menstruation.
Day of Month
Underneath Day 1 of the cycle mark the date
menstruation began.
Stamps
There is a place for a stamp on each day.
Choose the stamp that corresponds with your
observations for that day.
Red is for days of bleeding.
Green is for DRY category.
0 White Triangle on Green is for DRY

category within a count of 3.
Violet is for NON-PEAK mucus

White Triangle on Violet is for NON-PEAK
mucus within a count of 3.
Purple is for PEAK mucus.
There are also Yellow stamps used for management of continuous discharge. These are given
on special recommendation by your Practitioner.
Yellow represents an infertile mucus
observation based on identification of a
basic infertile pattern (BIP)
0 White Triangle on Yellow used as above

within a count of 3
Charting
Justisse Method chart for women charting mucus alone.
Justisse Method chart for women charting mucus and temperature.
Charting
Sensation
Mark down the most fertile sensation of the day
in the space marked sensations.
D = DRY
S = smooth
L = lubrication
Lubrication is the most fertile sensation. Smooth
may be associated with either the presence or
absence of mucus. If you feel a smooth sensation and there is no mucus present, it has the
same significance as a dry observation. If you feel
a smooth sensation and there is mucus present,
then smooth is considered fertile.
X Per Day - Most Fertile Sign Seen

Use the observational notations on the back of
your chart to best describe your most fertile sign
of the day. Mark in how many times it was noticed. If you make the same observation 4 times or
more use AD for all day. For example 0 AD;
6PC X I ; 1OWL AD; 8C X3; etc. Peak mucus is
always considered the most fertile.
X 1
- seen once that day
- seen twice that day

X 3 - seen three times that day
AD - seen 4 or more times that day
X2
--
Other Notations - Peak (PK),

Intercourse (Ili)
In addition to the notations on the back of your
chart you will use the following:
I= intercourse (penetration and ejaculation)
i = alternative sex
If barrier methods are used circle the I or i for
easy differentiation.
eg.
Ii
@@
Mark down all I and i under Miscellaneous

Symptoms.
PK = write PK on the purple stamp that is the

PEAK day. (The last day of PEAK mucus.)
The Count of 3
The stamps used within a count of 3 will be
a white triangle on green, or a white triangle on
violet. The color you use corresponds with that
day's observation. If the observation is dry
category use a white triangle on green. If the
observation is non-peak use a white triangle on
violet.
Ovulation does not always occur on peak day.
In 95% of women ovulation occurs within 2 days
before peak, on peak day, or within 2 days after
peak. In 5% ovulation can occur as late as the
3rd day after peak. For that reason you must count
3 after peak day.
The count of 3 after an unusual bleeding
episode is neccesary because unusual bleeding
commonly accompanies ovulation, or ovulation
may follow very quickly.
It takes three days for the vagina to return from
alkaline to acidic following a mucus pattern. It is
therefore important to count 3 after three days or
more of non-peak mucus. During those three days
there will be sufficient alkalinity for sperm survival.
It is also possible for 3 or more days of non-peak
mucus to accompany ovulation.
Write 1 2 3 on the three stamps with white

triangles following the last day of PEAK mucus
of a mucus pattern.
triangles following a single day of PEAK
mucus.
triangles following 3 or more days of NONPEAK mucus before PEAKIovulation.
triangles following an unusual bleeding
episode.
triangles following a PEAK mucus symptom on
L or VL days of the menstrual flow.
Charting
On occasion the count of 3 may be interrupted

as the mucus pattern begins to build up again (see
"Double Peak" in Chapter 6).
Miscellaneo.usSymptoms
There is space on your chart to record
miscellaneous symptoms commonly associated
with ovulation and/or menstruation.
Mark down any symptoms such as headache,
mood change, abdominal pain, breast tenderness,
libido change, etc. These symptoms can help in
the interpretation of your chart. You may or may
not experience them. If you find any symptom
recurs regularly at certain times in your cycle it
is worthwhile making a note of it.
After menstruation Sue felt a dry sensation for

five days and there was nothing on the tissue.
D
OAD
D
OAD
D
OAD
D
OAD
OAD
Stress and Illness
On the eleventh and twelfth day of her cycle Sue

felt a smooth sensation for two days and observed a sticky cloudy mucus on the tissue several
times. On the thirteenth, fourteenth, and fifteenth
days she felt lubrication and observed a tacky
clear mucus several times on two days, and all
day on the last day she noticed peak mucus.
In times of stress or illness you may expect your

cycle to be affected. Your cycle may be altered
by - overwork, moving, holidays, starting or
stopping a job, or emotional conflicts. Some ways
in which your cycle may be affected are: delayed
ovulation which makes the overall length of the
cycle longer; dry cycles in which there is no
mucus; limited mucus cycles in which the mucus
pattern is shorter than usual or there is little
or no mucus. This is the body's protective
mechanism against pregnancy in times of stress
or illness. If you are experiencing stress or illness
it is especially important to do your observations
regularly and accurately, chart carefully, and if in
doubt consider yourself of peak fertility.
The day following the above days of mucus, she

felt a smooth sensation, and observed a sticky,
pasty, cloudy mucus on the tissue. The last day
she noticed peak mucus was her peak day, and
she wrote a PK on that stamp. After peak she
counted 3. Day 1 in the count of 3 she observed
non-peak mucus so she used a violet stamp with
a white triangle. Day 2 and 3 of the count of 3
she was dry, and noticed no mucus so she used
a green stamp with a white triangle.
Charting Example
In one cycle Sue experienced the following observations. These are the correct stamps and
descriptions she used.
The first five days of her cycle she bled. The first
two days were heavy, the third was moderate, and
the fourth and fifth were very light. On the very
light days her sensation was dry and she saw only
a damp area on the tissue every time she
checked.
The following days she felt a dry sensation, and

observed a damp area on the tissue all day. On
the thirteenth day after peak she began her nc
menstruation. Her total cycle length was q7 An
Charting
Basal Body Temperature

If you are taking your basal body temperature
(BBT) plot the reading daily on the graph.
The temperature may be taken either vaginally or orally. Vaginal temperatures are preferred
as they tend to be more reliable. Oral
temperatures tend to vary more with illness or
disturbances, which may make interpreting the
temperature curve more difficult.
The BBT is taken first thing in the morning
before getting out of bed. If you work shift work
the temperature is taken after 'your" night of sleep.
A minimum of 5 hours rest is needed for an accurate reading. For an accurate picture of the
biphasic shift the temperature must be taken at
approximately the same time each morning, within
one hour. If you normally rise at 8:00 a.m., an accurate reading can still be made if you take it between 7:00 a.m. and 9:00 a.m. If the time varies
more than 1 hour, still take your temperature and
make a note of the time it was taken on your chart.
On the inside bottom of your chart there is a
space to mark how the temperature is taken and
the time it is usually taken.
I ovulation
TEMPERATURE
If vaginal temperatures are used, the thermometer must remain in place for 5 minutes. Oral
temperatures may be taken with a glass/mercury
basal body temperature thermometer or a BBT
digital readout thermometer. If the glass thermometer is used orally, it must be left in place
for 7 minutes. The digital thermometer takes approximately 2 minutes. The digital thermometer
will beep when the reading is complete. The digital
thermometer can be used vaginally, though it is
not designed for the vagina.
You take your first temperature of the cycle on
day 5 of your cycle and take it everyday thereafter
until menstruation begins. The day to day
temperature readings are not as important as the
overall picture of the cycle. You are waiting for
your temperature to shift from a low phase to a
high phase. The shift indicates ovulation has
occurred.
0 vaginal
0 oral
(5 minutes)
usual time taken
(7 minutes)
. . ...
Temperature notes from the chart
Basal body temperature shift (BBT)
BBT shift
The preovulatory temperatures are low, and remain more or less the same. When ovulation occurs the shift in temperature to the higher
postovulatory phase is obvious. When you have
counted three consecutive normal high
temperatures you have confirmation that ovulation has occurred. You are now infertile until
menstruation. Postovulatory temperatures remain
high until menstruation.
L'
BBT thermometer
Charting
The three high temperatures must be normal.

Disturbances such as illness, temperatures taken
late, not enough rest, or excessive alcohol consumption the evening before can give a false high
temperature. It is important when counting the
three high temperatures that any such disturbances are taken into consideration. If you doubt
that the temperature shift is normal - WAIT until the disturbance has passed before counting
three high temperatures. In the meantime, continue with careful mucus observations. Usually a
false high temperature due to a disturbance will
stay high for only one or two days. The exception to this is a flu or cold that lasts more than
one or two days.
If you have doubts about the temperature shift,
mucus will be your reliable guide until the disturbance has passed and the situation is clarified.
The temperature shift of three normal high
temperatures parallels your mucus pattern. Your
mucus pattern develops into a peak. The
temperature shift occurs either on peak or as the
mucus pattern is moving away from peak to dry
or non-peak mucus.
If you are taking your temperature it is important to understand the relationship between
temperature and mucus. Basal body temperature
shifts and mucus patterns are two symptoms of
the same hormonal events occurring throughout
the cycle. Of the two, mucus is the more reliable
for interpreting your fertility. Temperature is most
useful and reliable when used with a clear
understanding of mucus patterns.
Accomplishing Your lntentions With The Justisse Method
Accomplishing Your
lntentions with
The Justisse Method
Fertility Awareness
Fertility Awareness provides you with an

understanding of the reproductive system and
your own fertility patterns. It serves as a guide to
your health.
Whether you are using the Justisse Method as
a means to be in touch with your fertility or as a
health guide it is important to be accurate in identifying fertile and infertile days. Both fertile and
infertile times have parameters that are a reflection of normal reproductive health. By interpreting
accompanying hormonal, physical, and emotional
changes you maintain control of and value for your
fertility.
If you are using the Justisse Method to either
avoid or achieve a pregnancy then fertility
awareness facilitates fertility management. For
women of normal fertility it is a simple matter of
identifying times of fertility and infertility and using them according to their intention.
Charting is helpful if there is difficulty in achieving a pregnancy. Charting can reveal the reasonls
for subfertility or infertility. Whether the difficulty
is anovulation, limited mucus, tubal blockage,
suspected male infertility, or some other, the chart
is a non-invasive diagnostic tool. It forms a picture that helps to isolate the problem and thereby
give guidelines for regaining fertility. Subsequently
it is a guide to evaluate the effectiveness of any
given treatment.
Avoiding Pregnancy
In order to avoid pregnancy, use only infertile
days for intercourse or alternative sex. The
method is 99.6% effective to avoid pregnancy
when only infertile days are used for intercourse.
Achieving Pregnancy
If your intention is to become pregnant use days
of fertility for intercourse. If you and the man are
of normal fertility, and you use fertile days for intercourse there is a 75% chance of becoming
pregnant in the very first cycle used. There is a
100% chance of becoming pregnant by 6 cycles.
If you or the man are experiencing problems with
fertility, your success to achieve pregnancy varies
depending on the treatability and severity of the
problems.
When Theoretical Effectiveness

to Avoid Pregnancy is Reduced
Barrier Methods
If condoms, foam, diaphragms, jelly, cervical
caps, or other barrier methods are used during
the fertile time, the method's effectiveness is
reduced to the effectiveness of the barrier used.
(Some barriers can be displaced during active intercourse when the woman has abundant
lubricative mucus.)
Using days of fertility for intercourse with
barriers may not protect you from pregnancy.
The 99.6% effectiveness of the Justisse Method
is based on total abstinence from intercourse or
any alternative sex on fertile days. Use of barriers
would fall into the alternative sex category
because there is contact between the woman's
and the man's genitals.
Alternative Sex on Fertile Days

Alternative sex includes withdrawal, oral sex,
mutual masturbation, anal intercourse, and
penetration without ejaculation (coitus reservatus).
Some forms of alternative sex can result in
pregnancy if engaged in on a fertile day.
Remember, the purpose of cervical mucus is
to allow sperm to live and to transport it to the
ovum. When you are fertile, cervical mucus is
present in your vagina as well as on your vulvar
area.
plishing
?tentions With The Justisse Method
Pre-ejaculatory fluid occurs when the man is

aroused prior to ejaculation. This fluid may have
sperm in it. Whenever cervical mucus and
semen,and/or pre-ejaculatory fluid mix together
there is a possiblity of pregnancy. Alternative sex
on days of fertility carries with it the chance of
pregnancy. A pregnancy resulting from alternative
sex is known as a contact pregnancy.
Some women and men feel ambiguous as to
whether they want to achieve or avoid a pregnancy. "Taking a chance" seems okay for them.
If you are very determined to avoid a pregnancy
there should be no "taking chances". You will
know each and every day whether or not you are
fertile. Each and every day you choose your
intention.
If you have intercourse or alternative sex on
infertile days you will avoid pregnancy.
If you have intercourse or alternative sex on
fertile days you may be achieving pregnancy.
Defining Days
of Fertility and Infertility
The definitions for days of fertility and infertility
are outlined to help you accomplish your
intentions.
At the end of Chapter 7 you will find sample
charts entitled "Basic Charting". These charts are
illustrative of how fertile and infertile days are
defined, according to correct use of stamps and
notations.
For easy reference all basic charting considerations are outlined in point form first. A detailed
discussion for each point follows.
Accomplishing Your Intentions With The Justisse Method
Basic Charting Considerations

1.
Do your observations regularly and accurately.
2.
Chart daily at the end of your day, and note the most fertile sign of the day.
3.
When starting to chart avoid intercourse and alternative sex until you are
confident.
4.
Times of fertility
a. Moderate and Heavy days of the menstrual flow.
b. Non-Peak mucus days.
c. Peak mucus days.
d. Any days within a count of 3.
e. Any days of unusual bleeding plus count 3.
5.
Times of infertility
a. Light and Very Light days of the menstrual flow when no mucus is present.
b. All Dry days except those within a count of 3.
c. The days following your third normal high temperature until menstruation.
6. "Double Peak
a. When experiencing stress or illness be watchful for a "Double Peak".
b. If your temperature has not shifted after experiencing a Peak anticipate
a "Double Peak".
7.
When you doubt an observation or miss a day's charting consider yourself

of PEAK fertility plus count 3.
8.
Special infertility considerations

a. Men avoid ejaculation until the woman has mucus present.
b. Use mucus days of greatest quantity and quality and 2 days after for
intercourse
c. Record the length of thread the mucus makes.
d. Record abdominal or back pain.
9.
Breastfeeding
a. When TOTALLY breastfeeding, the first 56 days after the baby's birth are
infertile.
10. A BASELINE may be drawn after observing a temperature shift of 3 consecutive NORMAL high temperatures that are higher than the previous
6 low temperatures. The baseline is drawn one graph space above the
highest normal low temperature. All postovulatory temperatures should
be above the baseline.
31
1. Do your observations regularly
and accurately.
Your ability to identify the times of fertility and
infertility is directly dependant on regular and
accurate observations. Complacency about the
observational routine interferes with successful
use of the method, and lowers your confidence
and ability to interpret your chart.
A good routine for observations means checking for mucus 100% of the time before and after
urination, before and after bowel movements,
before and after bathing, before going to bed, and
checking if you get up at night to urinate. A good
observation is made by using flat layers of tissue,
wiping from front to back, deciding the sensation
before looking at the tissue, finger testing the
tissue for mucus, and mentally logging it for
reference when charting at the end of the day.
100% regular and accurate observations means
100% confidence.
2. Chart daily at the end of your day,
and differentiate the most fertile

sign of the day.
It is a good habit to chart at the end of every
day. Missing days of charting reduces your confidence, and your accuracy. Keep the chart by
your bed so it is accessible for charting at the end
of each day. Make sure to note the most fertile
sign of the day.
If you wish to note other observations for your
own purposes, do so. However, in that case
circle the most fertile sign to differentiate it from
the other observations, and mark them down
under miscellaneous symptoms, stress and
illness.
3. When first starting to chart, avoid
intercourse and alternative sex

until you are confident.
When first starting to chart avoid intercourse
or alternative sex until you have identified a
change into or out of a mucus pattern, or until
you are confident to identify a particular day as
fertile or infertile. For most women, the change
occurs within 2-3 weeks.
Women who have continuous vaginal cell

discharge, which sometimes happens in post pill
and breastfeeding situations, should avoid unprotected intercourse until their first follow-up,
or until their chart has been discussed with a
Fertility Management Practitioner.
Avoiding intercourse until you are confident
helps you observe your mucus pattern and dry
days without confusion from seminal fluid
discharge after intercourse. Once you have
observed dry days and a mucus pattern without
being confused, your confidence to use the
method according to your intention will come very
quickly. Confidence is achieved at different times
for different women.
4. Times of fertility
a. Moderate and heavy days of the
menstrual flow.
It is possible for cervical mucus to already be
present on the moderate and heavy days of
menstrual flow in short cycles. Short cycles do
occur. The endometrial fluid present in the heavy
and moderate menstrual flow looks very much like
cervical mucus, and has a lubricative sensation.
Therefore the endometrial fluid could be confused with cervical mucus if it is present. Because
an accurate observation can not be made, these
days are to be considered fertile in order to err
on the side of caution for those avoiding
pregnancy.
b. Non-Peak mucus days.
The change from dry into non-peak mucus
marks the beginning of fertility. Non-peak mucus
is fertile. Ovulation can be associated with a nonpeak mucus day.
When there are 3 or more days of non-peak
mucus, the acidic environment of the vagina
changes to alkaline, and remains so for three days
following. An alkaline environment enables sperm
survival and transport. Therefore, when the nonpeak mucus returns to dry you must count 3. You
do not have to count 3 after only one or two days
of non-peak mucus.
Accomplishin!
c. Peak Mucus days.

Sperm survival is optimum in peak mucus and
for 3 days after. Ovulation can occur with even
one day of peak mucus.
d. Any days within a count of 3.
The vaginal environment may still be favorable
to sperm survival during the count of 3. As well,
ovulation can occur on one of the days within a
count of 3.
e. Any days of unusual bleeding plus count 3.
Unusual bleeding, midcycle, is commonly
associated with ovulation. Because of this you
must consider yourself fertile on days of unusual
bleeding regardless of the presence or absence
of mucus. On those days make mucus observations as usual. The last day of the unusual bleed
is followed by a count of 3.
5. Times of Infertility
a. Light and Very Light flow days of the
menstrual flow when no mucus is present.
On the light and very light days the majority of
the endometrial tissue and fluid has been shed,
and now there are only traces left to be discharged. These traces will not produce a lubricative sensation unless cervical mucus is present.
If the sensation is lubricative or mucus is present
during the light and very light days of the
menstrual flow you are considered fertile. If you
are dry then you are considered infertile. Mucus
may be present on the light and very light days
of the menstrual flow in short cycles.
b. All dry days except those within
a count of 3.
lntercourse in the preovulatory phase of the
cycle should occur nights only, as you need the
whole day to determine whether or not you are
dry.
Intercourse every other night is a conservative

approach to take until you are confident in
eliminating seminal fluid from your observations.
Seminal fluid, which is present following intercourse, can be eliminated with the Semen
Elimination Technique (see Chapter 7). Once you
are successful at eliminating seminal fluid every
dry night preovulation can be used Cdr intercourse.
In the post-ovulatory phase of the cycle use
nights only for intercourse until you become confident in determining that ovulation has passed.
After that anytime of the day can be used.
c. The days following your third normal
high temperature until menstruation.
Ovulation has occurred when your temperature
shifts and remains high. You are considered infertile from the morning of the 3rd normal high
temperature until menstruation, providing you
have had no disturbances during the shift. If there
has been a disturbance rely on mucus observations until the disturbance has passed. Disturbances that can alter temperature are: sore throat,
vomiting, travelling, coldlflu, diarrhea, sleep
disturbances, fever, anxiety, alcohol consumption,
toothache, sunburn, electric blanket, some
medications, activity before taking your
temperature.
If your temperatures are confusing, mucus
observations will be your guide.
6. "Double Peak"
a. When experiencing stress or illness
be watchful for a "Double Peakn
It may happen that rising levels of estrogen are
inhibited by stress, or illness. When this happens
you may experience a mucus pattern that builds
up to a peak yet ovulation is delayed. Once the
stress or illness is relieved ovulation follows. If you
have not ovulated you will see mucus return. If
you have ovulated you will see menstruation
within 9-17 days, not another mucus pattern.
.ions With The
After experiencing a peak, before you consider

yourself in the postovulatory phase you must consider several things:
During the preovulatory phase
was there stress or illness in the cycle prior
to the peak?
was there anything unusual in the mucus
pattern build up?
did you start or stop medications (vitamins,
homeopaths, medical prescriptions and over
the counter drugs)?
has mucus returned?
Asking these 4 questions will help you determine with certainty that you have ovulated.
You may only experience a "Double Peak
cycle once or twice in 12 cycles. For some women
this is a normal pattern. Regardless of when it
happens it is always manageable, because the
presence or absence of mucus is your guide.
b. If your temperature has not shifted after
experiencing peak, then be watchful for a
"Double Peak".
Even though you may have experienced a
mucus pattern, until the BBT SHIFT has been
observed ovulation has not occurred. Consider
current stress and illness.
7. When you doubt an observation or

miss a day's charting, consider yourself of peak fertility plus count 3.
Doubt occurs most often when:
the observational routine has been
careless.
charting is not done daily.
observations are not accurately recorded.
questions are not clarified with a Fertility
Management Practitioner or by reviewing
the guide book.
there is stress or illness.
after an abortion, or pregnancy "scare".
you are coming off the Pill.
there is pressure to have intercourse.
some ambiguity exists as to whether or
not to avoid prennancy.
Good charting, good observational routine, and

follow-ups encourage you to trust your observations and charting ability.
8. Special infertility considerations

a. Men avoid ejaculation until the woman has
mucus present.
If there is concern about the man's sperm count

or the viability of his sperm, it is best that he conserve his semen until mucus is present.
Abstinence from ejaculation gives his body an opportunity to accumulate sperm. Mucus aids sperm
survival and transport to the fallopian tubes. Thus
every mucus day or day within a count of 3 is opportune for sperm survival. Intercourse is most
likely to result in pregnancy at this time.
b. Use mucus days of greatest quantity and
quality and 2 days after for intercourse.
This applies to women who have limited mucus
patterns. Limited mucus patterns can be: mucus
patterns with no peak characteristics, or mucus
patterns less than 3 days in length with peak
mucus. As well, the mucus that is observed is
usually limited in quantity. For example, a woman
with a limited mucus pattern may observe 8K only
one time in her entire cycle, whereas a normal
mucus pattern would include more frequent
observations of peak mucus. Limited mucus may
be a reflection of inadequate estrogen stimulation,
a damaged cervix, stress, or illness.
In the case of limited mucus a woman has to
identify what she understands to be greatest
quantity and quality. She observes for: her
threadiest mucus; her clearest or most
transparent mucus; her most abundant day of
mucus; and feels for her most lubricative sensation. Those days may not necessarily coincide
with the peak day. For intercourse use the mucus
days of greatest quantity and quality, and the two
days following. The alkalinity of the vagina at that
point is still favorable to sperm, and ovulation can
occur on these days.
c. Record abdominal or back pain.

Abdominal pain accompanies ovulation in
more than half of women. The pain may express itself as: a sharp short pain in the lower
right or left abdominal region (RAPILAP); a
dull ache or crampy sensation in the lower
abdominal region (AP); a lower back ache
(LBA). The pain may last for a few hours or
all day. If you experience this pain note it on
your chart.
9. Breastfeeding
a. When totally breastfeeding, the first 56
days after the baby's birth are infertile.
The earliest ovulation recorded in a total
breastfeeding situation has been at 73 days after
the baby's birth (10 weeks). Therefore considering the first 56 days (8 weeks) infertile takes into
consideration possible deviations. Total
breasffeeding is defined as: the baby's only
gratification is received from the mother's breast,
with the occasional sip of water.
10.A baseline may be drawn after

observing a temperature shift of 3
consecutive normal high temperatures that are higher than the
previous 6 low temperatures. The
baseline is drawn one graph space
above the highest normal low
temperature. All postovulatory
temperatures should be above the
baseline.
Your BBT baseline will remain relatively the
same from cycle to cycle within 1 graph space
(0.05 degrees Celsius). You will know the shift has
occurred when three consecutive normal
temperatures are 2-4 graph spaces (0.1 to 0.2
degrees Celsius) above the previous 6 low
temperatures. The graph on your chart is designed especially for plotting BBT. Even though
the shift is small in degrees, it shows up
dramatically on your graph.
The three high BBTs must be normal. Disturbances such as illness, taking your BBT too late,
not enough rest (5 hours minimum), or excessive
alcohol consumption the evening before, can give
a false high temperature. Temperature readings
during a disturbance are disregarded when drawing the baseline. It is important when counting
three high temperatures that disturbances are
taken into consideration. If there is doubt that the
temperature shift is normal, WAIT until the
disturbance has passed before counting three. In
the meantime continue with regular and accurate
mucus observations, as mucus will guide you
through these disturbances. Usually a false high
temperature due to a disturbance will stay high
for only one or two days. The exception to this
is a flu or cold that lasts more than one or two
days.
-er Charting
nsideration:
Other
Charting Considerations
Continuous Discharge
Yellow Stamp Management
Any woman experiencing a continuous
discharge will need special attention. Each
woman in this situation will be unique, therefore
management is based on individual mucus patterns. Experience has shown that by working with
a Fertility Management Practitioner a woman will
be able to confidently identify when her discharge
is fertile and when it is not.
Part of the management for continuous
discharge is the use of yellow stamps. Yellow
stamps are used to indicate discharge that has
been identified as infertile based on a BIP (basic
infertile pattern) within the mucus discharge.
Violet and purple stamps are used for identification of the "true" mucus pattern. The situations
when woman may experience continuous mucus
discharge are: cervicitis, breastfeeding, early
postpartum, and coming off the Birth Control Pill.
Cervicitis and Continuous Discharge
Cervicitis is an inflammation of the cervix. Either
the external area of the cervix or the inner canal
of the cervix may be affected. Most commonly cervicitis is caused by an infection. The infection may
be a sexually transmitted disease, or caused by
other bacteria or viruses. Cervicitis can be either
acute or chronic. Chronic cervicitis results in a
characteristic type of cervical discharge. This
discharge occurs throughout the course of the
menstrual cycle and is not related to fertility.
Sometimes the cervix undergoes other changes
known as ectropion and/or eversion. The tissue
lining the canal of the cervix protrudes into the
vaginal surface of the cervix. When this tissue
makes contact with the acidic fluids of the vagina
the cervix becomes inflamed. This is particularly
true during the infertile phases of the woman's
cycle. During fertile phases, the estrogenstimulated cervical mucus creates an alkaline environment in the vagina, which temporarily arrests
cervicitis. When the vagina becomes acidic again,
during the infertile phases, the inflammation
returns. With ectropions or eversions the cervix
will produce discharge in order to protect itself

from the acidic environment of the vagina during
the infertile phases. This is why the woman would
experience mucus continuously.
Cervical erosion is a condition in which the cervix is ulcerated, and inflamed. This also produces
continuous discharge. A cervical polyp; a tag of
tissue protruding from the cervix, can also become inflamed. A special set of criteria is used
to allow the woman to recognize the difference
between discharge due to cervicitis, ectropion or
eversion and normal cervical mucus patterns.
Essential sameness question - "Is today's
mucus essentially the same as yesterday's
mucus?"
Yes or No
The Essential Sameness Question (ESQ) is one

management technique for women with continuous mucus discharge. It helps them identify
their "true" mucus pattern. They will learn to
understand and interpret their Basic Infertile
Pattern. A "true" mucus pattern will be no longer
than 9 days. Any other days where mucus is experienced may be identified as a basic infertile
pattern. This must be clarified during follow-up
with your Fertility Management Practitioner. The
woman singles out the days of her "truen mucus
pattern by identifying the point in her cycle at
which there is a change from one type of mucus
to a different type of mucus. If sometime during
that day she has experienced mucus, the question she asks herself at the end of the day before
she charts, is: "has today's mucus been essentially the same as yesterday's mucusn? She may
have experienced mucus the day prior or maybe
two days ago. She must refer to the last day she
had mucus when asking the essential sameness
question. She answers the question Y-yes or
N-no, and notes it on her chart with the rest of
the day's observations. For this type of situation
it may also be helpful for the woman to note on
her chart both the most fertile sign of the day as
well as the sign she saw the most often that day.
This will help her and her Fertility Management
Practitioner at follow-ups to sort out a basic infertile pattern. Usually by the time a woman has
done 3 cycles of essential sameness question she
will be able to identify with confidence her "true"
mucus Dattern.
Other Charting Considerations
Breastfeeding 1 Postpartum and

Continuous Discharge
For two reasons a woman may experience continuous discharge during the breastfeeding or
postpartum period: her cervix may still be healing or there may be arousal fluid present. If a
woman's cervix has been damaged during the birthing process it may take several weeks or even
months to heal. Sometimes there is an ectropionleversion or cervicitis present. These conditions generally correct themselves as the cervix
heals. Until then a woman can use yellow stamp
management to interpret her mucus.
Part of the body's response to the suckling action of the baby at the breast is the production
of arousal fluid. Since a child may be nursed many
times a day in the early months it is possible to
mistake this arousal fluid for a mucus pattern.
With the help of her Fertility Management Practioner, she can learn to recognize the difference.
Coming Off The Birth Control Pill

It takes at least six months after coming off the
Birth Control Pill for a woman's body to heal. During this transitional time she may experience any
of the following:
anovulatory cycles (not ovulating)
continuous discharge
spotting
variable return of peak mucus
shortened pre and post-ovulatory phases
early ovulation
These situations are a result of fluctuating levels
of hormones during the recovery period. The
recovery period is variable, with an average length
of three to twelve months. As the woman's body
begins to exert itself hormonally, her cycles will
reflect more normal patterns.
Infertility
Generally infertility is defined as the inability to
achieve pregnancy within one year. Infertility is
a problem that is shared equally by women and
men. The Justisse Method helps to identify the
best times to achieve pregnancy. The accuracy

of certain infertility tests can be improved by charting. The chart helps to identify the best time to
perform the tests. Since the chart provides a
reliable picture of internal hormonal events,
sometimes less diagnostic testing is needed.
Once charting, a non-invasive diagnostic tool, has
reached its limits then surgery or ultrasound can
be used to diagnose physical defects.
In cases of infertility it is always best to test the
man's fertility first. The tests required for him are
less traumatic and invasive. A woman's fertility will
be reflected on her chart, whereas the man's remains in need of clarification. Your Practitioner
is trained to adopt a holistic approach in dealing
with problems of infertility.
These are some characteristicsof a menstrual
cycle which may indicate infertility.
Dry Cycles - there is no mucus pattern
observed, nor any sensation of lubrication felt
throughout the entire menstrual cycle.
Limited Mucus Cycles - the amount of
cervical mucus produced is minimal. Dry and
limited mucus cycles are related to inadequate ovarian function.
Normal Mucus Cycles - the amount of
cervical mucus produced is normal. If all
other aspects of the cycle are normal this
may lead to suspicion of physical defects.
Mono-phasic BBT curve - there is no shift
in the BBT curve. Mucus patterns may or
may not be normal. This is an indication of
anovulation. Anovulation is not always a
chronic condition.
Shortened postovulatory phase - the time
after ovulation is less than 9 days. This may
be an indication of hormonal disturbances.
A woman may experience problems sustaining a pregnancy, or the endometrium may
not develop sufficiently to allow ovum
implantation.
Long term stress, illness, or strenuous

athletic schedules - under stress a
woman's body reacts in a protective way by
not cooperating toward ovulation. She may
not ovulate or produce adequate mucu.s for
several months or years. When the conditions of stress are relieved, her body will
return to normal fertility.
There are too many possible circumstances that

would relate to infertility to discuss in this guide.
If you are unable to conceive your Fertility
Management Practitioner will review your situation. Infertility is a situation that may come and
go at various times in the woman's or man's life.
It has been known that some couples experience
infertility for years and then unexpectedly achieve
a pregnancy. Sterility is a permanent state of infertility, and a completely different diagnosis.
Breastfeeding
Prolactin is a hormone produced by both pregnant and breastfeeding women. Prolactin levels
increase throughout pregnancy reaching their
highest level just before birth. Every time the baby
is suckled at the breast prolactin is released. Prolactin supresses the production of estrogen,
thereby inhibitingovulation. Without suckling, prolactin levels fall abruptly. With suckling, prolactin levels are maintained. The chance of ovulation occurring is directly related to prolactin levels.
With high levels of prolactin, there is less chance
of ovulation. With low levels of prolactin, there is
a better chance of ovulation. Each woman's
response to varying levels of prolactin is unique,
as will be reflected in her charts. Ovulation may
or may not occur prior to the first bleeding episode
postpartum.
1. Total Breastfeeding
Total breastfeeding is defined thus: the baby's

only gratification is received from the mother's
breast, with the occasional sip of water. Charting
begins when the postpartum bleeding decreases,
usually in about three weeks. The first follow-up
with the Fertility Management Practitioner should
be two to three weeks after charting. As long as
total breastfeeding is maintained, the first 56 days
postpartlrm are considered infertile.
2. Partial Breastfeeding (Weaning)
Partial breastfeeding begins with supplemental feeding. When a baby gets nourishment (juice,
formula, solid food) or gratification (pacifier) from
a source other than the breast, even if only occasionally, weaning has begun. With partial
breastfeeding signs of fertility will return sooner
than in the total breastfeeding situation.
If partial breastfeeding is used immediately
postpartum the first 27 days are considered infertile. Charting should begin immediately if a
woman is not totally breastfeeding.
3. Fertility Returns
- Breastfeeding
The frequency and duration of suckling and skin

to skin contact with the baby plays an important
role in the delaying of ovulation. Fertility begins
to show signs of return as the physical connection between mother and child lessens. This
happens when:
the baby goes without nursing for intervals
greater than six hours
the baby begins to take nourishment from
sources other than the breast
the baby is held less as it becomes more
physically independent, e.g. crawling, walking
the mother is away from the child on a
regular basis, e.g. returns to work, takes
more time alone
These factors are important to consider when
you are observing for signs of returning fertility.
As fertility begins to return during breastfeeding
you will begin to notice mucus. This mucus will
come and go due to rising and falling levels of
estrogen, that are overcoming the effects of prolactin. When finally estrogen levels are high
enough, ovulation will occur.
Not Breastfeeding
If a woman is not breastfeeding the high levels

of prolactin which were present prior to delivery
fall abruptly. The woman in this situation can consider herself infertile for the first 27 days after birth.
Charting should begin immediately after birth.
Post Abortion or Miscarriage

Following an abortion or miscarriage, the hormone levels associated with pregnancy decline.
Within five days they reach normal levels. For this
reason, fertility can be noticed as early as two
weeks from the date of the abortion or miscarriage. Charting should begin immediately.
Climacteric
- menopause
The Climacteric is the normal physiological

process of decreasing reproductive functioning at
the end of a woman's reproductive years.
Menopause is marked by the actual cessation of
menstruation for 1 year. The climacteric begins
between the ages of 35 and 45 ending in
menopause between the ages of 37 and 56. The
climacteric is the winding down of the reproductive system. During this time a woman will notice
signs of decreasing fertility. Symptoms include:
menstrual cycles may become shorter and
more irregular
frequent anovulatory episodes
a variable return of non-peak and peak
mucus patterns
the post-ovulatory phase tends to be irregular
the pre-ovulatory phase tends to shorten
ovulation may occur earlier in the cycle
unusual bleeding episodes or a change in
the nature of her menstrual flow
Menarche - The First Menstruation

Fertility exhibits itself at puberty with the onset
of the first menstruation. Menarche will occur from
10-16 years of age. For several years after menarche there is a natural tendency for the menstrual
cycle to vary. A young girl may experience the
following:
the overall length of the cycle varies
mucus patterns that vary from cycle to cycle
a change in the nature of the menstrual flow
from cycle to cycle
These variations are due to a yet immature
hormone system. Young women can reliably use
charting to observe and understand their maturing reproductive system.
Arousal Fluid
In women arousal fluid is a discharge that
comes from the Bartholin's glands located just inside the vagina. It is produced in response to sexual stimulation. The fluid is designed to facilitate
intercourse and at this point in time has no known
relationship to fertility.
Arousal fluid is usually experienced as a
lubricative feeling with a cloudy or clear color. It
tends to dissipate quickly, lasting only 30 minutes
after sexual arousal ends. If you are confident that
you are noticing arousal fluid you may ignore it.
If in doubt, consider yourself of peak fertility and
count three.
Male arousal fluid is produced by the Cowper's
gland located just below the prostate gland. Male
arousal fluid is also known as preseminal or preejaculatory fluid. It is produced in response to sexual stimulation and is designed to facilitate intercourse and to alkalinize the urethra. Once the
urethra is alkalinized, a favorable environment is
made through which sperm can pass. A man's
arousal fluid is considered fertile, because it may
contain viable sperm.
Semen Elimination Technique

Following Intercourse (SET)
Seminal fluid will be discharged from the vagina
after intercourse. For some women, this may
create confusion. To prevent confusion, do the
Semen EliminationTechnique (SET). This technique is helpful to both charting and hygiene. Once
you have done SET, any discharge you see later
that day (if intercourse is in the morning) or the
next day must be charted as it is seen. This is
because seminal fluid can mock cervical mucus
symptoms. By doing SET the likeliness of seeing
seminal fluid and confusing it for cervical mucus
is, for the most part, eliminated.
Semen Elimination Technique
- SET
1. Urinate after intercourse within a comfortable time (approximately 1 hour).

2. As you urinate stop your flow several
times and wipe after each stop.
3. Any discharge seen later that day or the

next is charted as you see it.
Sample Charts
The charts on the following pages are samples
of different types of cycles. Each woman's fertility has a unique expression. The sample charts
are not intended to show what should happen, but
rather what is possible.
Misc.Symptoms;
Stress/lllness:
Stamps
'
'
'
'
'
'
'
'
'
'
'
'
Days from the onset of mucus plus count of 3 from PEAK are fertile.
,
:
,
!
,
:
,
!
,
!
. . . .
;aiaiai.iai.ieie:,eieieje:aja;a;@j@;~;~;~i~;a
;
n ~
Basic Charting
:;
:;
I;
Stamps
Stamps
- -
Basic Charting
Stamps
Marks "true" mucus pattern.
Breastfeeding or Post Pill Using Pre-Peak and Post-Peak Yellow Stamps

For Continuous Mucus
stamps
;@;@;@;@;@;@;@;@;.;@;@;@f@;@;@;e;@j@;@;@;@
..........................................................................................................................................................
,
,
8
Stamps
~@\@i~i~;@i@ie;@i@i~i@~~~;~i@i$i@i@i@i@;@;ei@
...........................................................................................................................................................
Sensat ion
: S : S : S : D : D : D : D : D : O : S : S :1
L 5 : s : D l O : D : D : D 1D : S : S : L : L : S : S : D : IDD : D 1 D : D : D : D : D: :
:6C: 6C18C '
:~ 8k
6 C ~wD~m4wl
~ ~ ~ ~ o ~ O A6 C~: fk:
O A8ICi
o lj O C i 6 p ~6i ~ ~ p j w D j o L D j o A D j ~
:x2ix2ixI P * ~ ~ O L D ~ ~ * D ~ W ~ D ~ 6c
Q I jxZjx,
~ 1 I0 k:X,
,
,---,---:---:---:---:----I---1---:---,---,---,---:---1---v---8---:---:---:---1---,---,---:---,---,---:---:---:---:---:---:---:---:---:---:
,
,
~3iXZiAX
o I~:AD:YI
--------------;---:---;---)---I---:---:---;---;---%-------;---:---a---a---;---;---;---;---:---;---;---;---;---;---;---:---;---;---;---;---:---:---;---;--,
0
Description
______-_---_--I--_
Breastfeeding or Post Pill
~OADA
.---;---:---;---*
.---:---:---;--;---:---:---:---;
:16':17 : I 8 :19 :20 :21 :22 :23 :24 :25 :26 :27 :28 :29 :30 :31 :32 133 :34 :35
.....................................................................................................
Day of Cycle : 1 : 2 1 3 : 4 1 5 : 6 : 7 : B 1 9 :10 :11 :12 113 114 :15
.........................................................................
--------------:---:---;---j---;--:---:---.---:---;---;---;---;--:---:---:---.
......................................................................................................
: 1 : 2 1 3 : 4 : 5 : 6 : 7 : 8 :
--------------:---:---'---:---;---:---:---;---.---;---.
Day of Cycle
___-__-_------(
:D:D:
Stamps
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Infertility
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For Continuous Mucus
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TEMPERATURE
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Basal Temperature and Mucus Chart

Anovulatory Cycle with Unusual Bleeding
Other Natural Methods of Family Planning
Other Natural Methods of

Family Planning
Calendar Rhythm Formula
Natural methods allow fertility to be managed

without the intervention of drugs, or internal
devices that harm the body. Artifical contraception treats the woman's body as if it were fertile
all the time. Thus artificial contraceptives are over
prescribed and fertility is regarded more as a
disease than a normal process. Natural methods
regard fertility as a natural function, and treat it
in a coopertative manner through knowledge. A
woman knows exactly when she is fertile or infertile. With that knowledge she can contracept
wisely when she is fertile, or choose to abstain
from intercourse.
Longest cycle minus 10 = last day of fertility.
The Justisse Method is just one of several

natural methods. Brief outlines of some other
methods are given here for your information.
Shortest cycle minus 20 = last day of infertility.
Example # I
Previous Cycle Lengths For 6 Cycles:
27,29,28,28,29,27
shortest cycle = 27
longest cycle = 29
27
29
- 20 = 7
- 10 = 19
last day of infertility = day 7

last day of fertility = day 19
Example #2
Previous Cycle Lengths For 6 Cycles:
37,28,35,26,31,43
shortest cycle = 28
longest cycle =43
28
43
20 = 8
10 = 33

Example #3
Previous Cycle Lengths for 6 Cycles
24,25,27,29,25,27
Calendar Rhythm
Calendar rhythm was the first natural birth
control method developed. The independant
works of Ogino and Knaus in 1929130 determined that the postovulatory phase is stable. They
realized that menstruation consistently followed
ovulation by approximately 14 days. Based on that
information they developed calculations to determine probable times of fertility.
The woman needs the length of 6-12 previous
cycles to begin using the method. The formula
to calculate probable times of fertility the calendar way is:
shortest cycle =24

longest cycle = 29
Other Natural Methods of Family Planning1
If a woman experiences a cycle shorter than

her previous shortest cycle, or longer than her
previous longest cycle, she must make adjustments accordingly.
Calendar rhythm calculations are based on old
teachings much of which have been disproven or
updated. Many women who use this method may
be overreading or underreading their fertility.
Women who are breastfeeding, in the
climacteric, in the early years following first
menstruation, or who are experiencing stress or
illness would find this method unreliable. About
50% of women have cycles that can fit this
formula.
Basal Body Temperature (BBT)

The basis of this method is the temperature
curve created by taking daily basal body
temperatures. Temperature is the only symptom
observed. See Chapter 5 for more detail on taking and interpreting basal body temperatures.
When purchased, most BBT thermometors include graphs and instructions for their use.
If the intention of the user is to avoid pregnancy,
then the only reliable time available for intercourse, is after the temperature shift. From that
time until menstruation the woman is infertile. The
days available for intercourse may be quite
restricted, especially in long or anovulatory cycles.
The temperature may rise falsely in times of
stress, illness, or if it is taken late. These factors
must be considered.
If the intention of the user is to achieve pregnancy, they may find temperature alone limiting,
as it identifies ovulation after the fact. Timing for
intercourse may be off. As cervical mucus appears prior to ovulation and is critical to sperm
transport and survival, it is recommended that the
woman understand their mucus symptoms. They
can then use the times when cervical mucus is
present to have intercourse, thereby increasing
chances of achieving pregnancy.
BBT is a helpful diagnostic tool for cases of
infertility, as it helps to identify whether or not
the woman is ovulating, and if her postovulatory
temperatures reflect a normal pattern.
Women with regular cycles, and no aversion to
longer times of abstinence may find this method
to their liking.
Serena & Couple-to-Couple League

Serena is a Canadian volunteer organization.
They utilize BBT graphs, mucus symptoms, cervical changes, and miscellaneous symptoms that
may accompany ovulation to identify times of fertility and infertility. Serena teachers are married
couples who prefer to counsel other married
couples. They will not teach single women. The
organization "values human life from conception"
and encourages this attitude in their users.
Couple-to-couple league is a U.S.A. volunteer
organization, that works in a manner similar to
Serena.
The above methods are both effective for
avoiding or achieving pregnancy, but there may
be some difficulty for clients to receive follow-up
consultations. This depends on the particular
volunteer teacher couple's commitment and
availability. Any woman seeking service from
these organizations must take it upon herself to
insist on follow-ups. The user pays for the cost
of materials, but the consultations are free.
Billings' Ovulation Method

The Billings method is based in Australia, but
has teachers world wide. They are a volunteer
organization - the user pays only for materials.
Their method is based solely on observations of
cervical mucus. It is reliable for both avoiding or
achieving pregnancy. The follow-up schedule may
be inadequate for some users, particularly those
with complex charting situations. In that case the
user must insist on follow-ups. Their teachers do
not neccesarily teach as a couple, however they
do prefer to teach married couples. They will teach
single women who are not sexually active. The
organization "values human life from conceptionn
and encourages that attitude in their users.
Other Natural Methods of Family Planning
Ovulation Method Creighton Model
Rabbit (aka Anne)
Ovulation Method Creighton Model is based in

the United States, and is a modification of Billings. As their Natural Family Planning Practitioners (NFPPs) are not volunteers, there is a fee
for consulations and materials.
Their practitioners may or may not be couples,
but once again they prefer to teach married
couples. Any practitioner may refuse to teach an
unmarried sexually active woman. They "value
human life from conception" and encourage that
attitude in their users.
Their educational program for training practitioners is comprehensive. They have a good
follow-up program for users. Practitioners are able
to handle many complex charting situations.
The Rabbit is a small hand held computer with

a BBT thermometer probe. The BBT temperature
curve of the current cycle is visible on the device
for the woman to interpret herself. As well it computes probable times of fertility before ovulation
based on 12 previous cycles. The device can
only store 12 cycles at any one time. There is no
way to keep a permanent record of all cycles.
Women using the Rabbit would find their accuracy
increased if they had an awareness of their cervical mucus. Rabbit can be purchased in the
U.S.A. and some places in Canada.
Bioself
Bioself is a small hand held instrument. It is a
combined computer and BBT thermometer, that
keeps track of a woman's cycle lengths and BBT
curves. Using this information it calculates
probable times of fertility and infertility. A small
light flashes red or green to let the w m a n know
what phase of her cycle she is in. The information can be printed out for a permanent record.
It is best used by women who have cycle lengths
that vary no more than eight days from cycle to
cycle, and women whose cycles range from 19
to 39 days in length. For these women, it can be
a reliable means of avoiding or achieving
pregnancy. Women who use Bioself are also encouraged by the dealers to be aware of cervical
mucus symptoms, though there is no Bioself
system for recording them. Bioself can be purchased world wide.
Other natural methods not specifically listed

here are derivatives of BBT, calendar calculations,
andlor mucus observations. References for these
other methods can be found in some bookstores
and libraries.
References
References
Adess Nancy et al: Fertility And Pregnancy
Guide For DES Daughters And Sons: DES Actionlcanada, 1983.
@
Nofziger Margaret: Co-operative Method Of

Natural Birth Control: The Book Publishing Co.,
1979.
Billings John J.,M.D.: The Ovulation Method: Advocate Press Pty.Ltd., 1980.
Nofziger Margaret: The Fertility Question: The

Book Publishing Co., 1982.
Davidson Farida and John: Natural Fertility

Awareness: The C.W. Daniel Co. Ltd., 1986.
Parenteau-Carreau Suzanne, M.D.: Love And

Life, Fertililty And Conception Prevention 3rd
ed.: Serena Canada, 1982.
Drake Katia & Jonathan: Natural Birth Control,

A Guide To Contraception Through Fertility
Awareness: Thornsons Publishers Ltd., 1984.
@
Hatcher Robert A., M.D. et al: Contraceptive

Technology: lrvington Publishers, 1988.
@
Hilgers Tom W., M.D.: The Ovulation Method of

Natural Family Planning 2nd ed.: Pope Paul VI
Institute, 1983.
Parenteau-Carreau Suzanne, M.D.: The

Menstrual Cycle, Knowledge And SelfObservation: Serena Canada, 1986.
@
Pfeiffer Regina Asaph & Whilock Katherine: Fertility Awareness, How To Become Pregnant
When You Want To And Avoid Pregnancy
When You Don't: Prentice-Hall Inc., 1984.
@
Hilgers Tom W., M.D.: Standardized Case

Management Approach To Teaching Natural
Family Planning: Creighton University NFP
Education And Research Centre, 1983.
@
Hilgers Tom W., M.D.: Reproductive Anatomy

And Physiology For The Natural Family Planning Practitioner: Creighton University NFP
Education And Research Centre, 1981.
Roland Maxwell, M.D. editor in chief: International Journal Of Fertility Vol 26:
No.3-lnternation Foundation For Studies In
Reproduction Inc., Scandinavian Association For
Studies In Fertility And International Federation
Of Fertility Societies, 1981.
@
Schwarz Edward F., Ph.D.: Endocrines, Organs

And Their Impact: Cornerstone Press, 1985.
@
Jensen Margaret Duncan, R.N., M.S. & Bobak

Irene M., R.N., M.S., editor David P. Carroll:
Maternity And Gynecologic Care, The Nurse
And The Family, 3rd ed: The C.V. Mosby Co.,
1985
Kippley John and Sheila: The Art Of Natural

Family Planning: Couple To Couple League,
1979.
Mishell Jr. Daniel R., M.D., Davajan Val, M.D.: Infertility, Contraception and Reproductive Endocrinology, Second Edition 1986.
@
Mucharski Jan: History Of The Biologic Control

Of Human Fertility: Married Life Information,
1982.
Stangel John J., M.D.: Fertility And Conception,

An Essential Guide For Childless Couples:
Plume, New American Library, 1979.
Stewart Felicia, M.D.: My Body, My Health, The
Concerned Womans Book Of Gynecology:
Bantam books, 1981.
@
Vollman Rudolf F., M.D.: The Menstrual Cycle-7

vols: W .B.Saunders Co., 1977.
@
Wilson Mercedes Arzu: The Ovulation Method

Of Birth Regulation, The Latest Advances Of
Achieving Or Postponing Pregnancy Naturally: Van Nostrand Reinhold Co., 1980.
@
Footnotes
Footnotes
1 The observational check list, how to wipe
the vulva, 3 steps in checking mucus "SOFT', and
the 3C's in checking for mucus are a modification of the Ovulation Method Creighton Model's,
observational routine, how to wipe the vulvar area,
3 steps in checking for mucus "SOFT', and 3C's
in checking for mucus. The Ovulation Method
of Natural Family Planning 2nd Ed., Tom W.
Hilgers, M.D.: Pope Paul VI Institute, 1983.
@
2 These observational notations are a

modification of the Ovulation Method Creighton
Model's vaginal discharge recording system. The
Ovulation Method of Natural Family Planning:
Tom W. Hilgers, M.D.: Pope Paul VI Institute,
1983.
@
3 These definitions are the same used by

Ovulation Method Creighton Model. The Ovulation Method of Natural Family Planning: Tom
W. Hilgers, M.D.: Pope Paul VI Institute, 1983.
@
Notes:
Other Instructions:
Notes:
Other Instructions:
Notes:
Other Instructions:
Notes:
Other Instructions:
Other Instructions:
Notes:
Other Instructions:

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The

Fertility Management Services

%opyright 1988 by Elaine Matus & Geraldine Matus

JUSTISSE METHOD USER GUIDE

advantages of the Justisse Method

learning the Justisse Method

X per day most fertile sign seen

stress and illness

basal body temperature

when theoretical effectiveness

defining days of fertility & infertility

basic charting considerations

basal body temperature shift (BBT)

male reproductive system

res seminal fluidlcontact ~reanancv

observational check list

3 steps in checking for mucus " S O W

3 C'S of the mucus

- yellow stamp management

coming off of the birth control pill

post abortion or miscarriage

the three sensations

semen elimination technique

photographs of mucus observations

examination of the cervix

basal body temperature

serena & couple-to-couple league

billings' ovulation method

ovulation method creighton model

rabbit (aka Annel

The Justisse Method

The Justisse Method

The Justisse Method is a system for Fertility

Advantages of The Justisse Method

The Justisse Method

Learning the Justisse Method

Experience has shown that those who delay

The Basis of the Justisse Method

The Justisse Method

The first day of the cycle is the first day of

the light and very light days of the menstrual flow

Reproductive Anatomy and Physiology

Female Reproductive System; Fallopian Tubes,

)ng cycle (36-60)

Side view of Female Reproductive System

moderate cycle (27-35)

Cycle length variations:

Reproductive Anatomy and Physiology

Whether you experience a 21, 35, or 60 day

stimulates the pituitary to produce FSH, and LH.

The Ovarian Cycle: ovary cut away

Reproductive Anatomy and Physiology

As the follicle develops it produces a hormone

During menstruation, the endometrium sheds

The Menstrual Cycle: Changes in the endometrium occur simultaneously with

Reproductive Anatomy and Physiology

Ovulation occurs on only one day in a cycle.

The appearance of cervical mucus with peaking estrogen.

Reproductive Anatomy and Physiology

Of the 500,000,000 sperm present in a normal

Reproductive Anatomy and Physiology

As the cervix opens it becomes softer and its

as estrogen levels are rising

after ovulation until menstruation