Frequently Asked Questions

The educational tool sympto® is not a contraception app! There are no (fake) predictions like fixing ovulation day, the start of next menstruation or the fertile days, based on statistics to propose (fake natural) contraception but: 

sympto® is a tool that helps women to learn and to manage Symptothermia (the modern symptothermal method), the best alternative to chemical/artificial contraception, so that you can correctly identify the individual signs of your fertility (biomarkers). Compared to the classic Symptothermia charted on paper, sympto® has several advantages:

- You can't forget the rules you have to use and the signs you have to chart: sympto® reminds you of them. 

- The peak day is not triggered when you forget to put the black-dash while observing nothing or when you don't indicate the occurrence of postovulatory cervical fluid sign (icon of the yellow cloud).

- A new cycle is not triggered with the icon of the 3 red drops if before that day you could not identify an ovulatory and luteal phase by double checking: temperature/cervical fluid. The true menstruation is always following ovulation in the luteal phase. Without this, you have an intermenstrual bleeding which cannot start a new cycle.

- Educational messages which will guide you throughout the whole cycle to help you make correct observations.

- No paper charts that may get lost or are messy: everything you enter is registered on a specially safe server. Your cycle charts are always clean and clear and can be printed out and be shown at your gynaecologist meeting etc. 

- Increased visibility of your cycles, statistical data for proposing the supposed beginning of the next fertile phase, also with double check

- The birth of your child is calculated from your last temperature rise

- breastfeeding and perimenopause mode if needed 

- the management is facilitated and encourages you to keep Sympothermia as your companion

sympto can only indicate your infertile phase if it detects an ovulation. HBC, such as the pill, suppresses ovulation most of the time. Additionally, sympto cannot be made responsible for an unwanted pregnancy while on HBC such as due to having forgotten to take the pill. Our question for you is: What is the benefit of observing a cycle that has been mutilated by synthetic hormones? (Certainly, from a scientific point of view, it could be interesting to find out how many ovulations still occur under synthetic hormones.) With sympto, you observe your own natural cycle. As soon as you find confidence in your body and in your partner you can stop taking damaging synthetic hormones.

The symptothermal method helps you to identify your fertile days by observing two symptoms: your waking temperatures and the quality of daily elixir (cervical fluid) classifications. The educational sympto program interprets the quality your own observations and calculates your infertile days before ovulation, the fertile and highly fertile days around ovulation and the infertile days after ovulation. sympto monitors your observations in order to define your fertile window as narrowly as possible.

Ovulation cannot be predicted. This is due to the very subtle interactions of various hormones such as estrogens, progesterone, LH, FSH etc. It is further made impossible because of external factors such as stress, illnesses, jet lag, etc. that can impact your cycle on an endocrine level. However, by observing your fertile signs will be able to pinpoint your most fertile days. Ovulation happens on one of these days.

Your ovulation day can only be detected by ultrasound that can make visible follicle maturation and the release of the ovum. Since it is not possible to undergo daily ultrasound sessions, sympto employs a safety margin to ensure ovulation is contained within the span of your fertile window.

Furthermore, a distinction must be made between biphasic cycles and ovulatory cycles: most biphasic cycles are ovulatory. But the following exceptions explain possible, temporary infertility: the ovum gets stuck in the opening follicle, the follicle remains closed and cannot release the ovum or there was no ovum inside the follicle that turned into the corpus luteum. In all these scenarios there will still be a biphasic chart, meaning a low temperature level followed by a higher one.

Click here to read the clinical studies.

sympto® has integrated the biological laws of the female cycle. These were first fully described by the Austrian MD J. Rötzer. Later, the nfp-sensiplan, Germany, adopted and modified them slightly.

When you start charting, sympto® will only indicate 5 infertile days preovulatorily at the beginning of your cycle. This is a symptothermal standard that sympto® integrates. After 12 completed cycles, sympto® will free up either more or fewer infertile days preovulatorily, according to your cycle profile. This precautionary measure protects you from taking risks in your preovulatory phase while you are still learning. Later on, it will help define your fertile window more narrowly. After ovulation, sympto® will free up 7 to 16 days of absolute infertility. Your fertile window is established by cross-checking two symptoms: temperature and life elixir (cervical fluid), the core of the STM. We encourage you to read in detail about this in "The Complete Symptothermal Guide" available for free download.

The blue fertile phase continues if sympto® couldn't identify an ovulation before the bleeding. Confirmed ovulation is always followed by an infertile yellow phase. A bleeding episode without preceding ovulation is intermenstrual and you are potentially fertile: your cycle just goes on! Or, you haven't entered enough key information in sympto®. Please study the "How does it work" page on sympto.org in order to understand this point thoroughly. In this case, as a safety measure, sympto® will not start a new cycle. Contact your personal counselor to discuss the matter. Chats in forums are inadequate.

Cycle phases without ovulation frequently occur in teenagers, in women during pre-menopause, but also in women in the best of health when subjected to a serious stress factor, physically or emotionally. As long as your temperatures have not risen, there has been no ovulation: sympto® must display fertile (blue) until ovulation has been confirmed by temperatures risen and Peak day validated by elixir shift. The reoccurrence of another patch of elixir reveals that your cycle is going through a second ovulation attempt which, if successful, will immediately be followed by the typical temperature rise.

For the sake of clarity on sympto®, a new cycle is always triggered with the 3-drops icon. The one-drop icon expresses spotting only. If you observe these 3 drops (bright red flow) only on the second day of your menstruation, It will simply extend your infertile rose phase by 1 day and respectively also the infertile yellow phase. 

If you are unsure about which constitutes the first day of your menses you can check it by taking your temperatures starting a few days before your first of flow. The day of blood flow and sudden temperature drop is physiologically cycle day 1 of a new cycle and you want to enter the 3-drops icon. The 2-drops icon expresses medium flow and does not trigger a new cycle.

You can start today by indicating your most recent menses and continue tomorrow by taking your first waking temperature. You can also start anytime in the past by introducing your menses retrospectively by the 3 red drops. Once you have entered your menstruation, sympto® will launch your first cycle. Starting in your second cycle, you can reduce the number of temperature entries to a certain minimum. An accurate and fast thermometer designed for measuring your waking temperature can be bought from our shop. Not every thermometer on the market satisfies the STM requirements. It must have an accuracy of 0.05°C/0.1 Fahrenheit and be marked as basal.

You start your observations by opening a new cycle chart in sympto. Your cycle always starts with your menstruation: cycle day 1 is your first day of bright, red flow. This is expressed on sympto by entering the 3-drops icon.

In your first cycle on sympto you will not see any infertile days until an ovulation has been confirmed by temperature rise and sympto has validated it on your chart with 3 solid stars. This absence of any preovulatory, infertile days in your very first cycle is a precaution since sympto has no record of your most recent ovulation. Starting in your second cycle, however, sympto® will free up the first five cycle days as infertile.

You may occasionally have an anovulatory cycle. This will be made evident by sympto displaying blue (probably fertile) all the way through your chart even if you enter the 3-drops icon to express a bleeding. This is because ovulation may happen during or immediately following your bleeding episode. In reality, a bleeding that has not been preceded by a confirmed ovulation is not a menstruation but an intermenstrual bleeding. In order to confirm ovulation in these situations you must continue recording temperatures even during the bleeding episode. Eventually, you will catch a temperature rise confirming ovulation. But you must be patient as you cannot predict when you will ovulate.

You want your waking (also known as basal) temperatures. Use a thermometer that has two digits to the right of the decimal point and is rated for basal or charting use. Don't use a fever thermometer. You can buy the Cyclotest Lady thermometer from the symptoShop. Record your temperature before getting up at the same time each day and after a solid sleep of at least five hours. You can take your temperature orally, vaginally or rectally, but whichever method you choose, stick with it for the duration of an entire cycle, never switch mid-cycle. sympto® requires you to enter temperatures only throughout the fertile (blue) phase until you have received three full stars marking a completed temperature rise (closure of your fertile window). You may miss a temperature recording occasionally or have a 'disturbed' temperature due to alcohol consumption or insomnia etc. Don't worry: there is a strategy to manage those days in your chart. This is explained in detail in the temperature recording guidelines in "The Complete Symptothermal Guide" that you can download free of charge and that serves as your exhaustive symptothermal charting reference.

After ovulation the contraceptive effectiveness is 100% (Pearl index 0.0). Thus, postovulatorily, it outperforms any hormonal birth control (HBC). During the first 5 cycle days, the Pearl index is 0.2. During the infertile days after day 5 and before ovulation (some 2 to 5 days), the Pearl index is 0.8. Even in this phase, the STM is as effective as HBC. It is therefore up to you and your partner to achieve contraceptive effectiveness, depending on how you manage your fertile days: you can remain abstinent during this time or use a condom (which will decrease contraceptive effectiveness). Check the clinical studies on sympto.org. For conception achievement, the couple will pin point the most fertile days!

sympto® operates within the framework of the classic STM but it takes advantage of modern digital tools. It thereby simplifies and enhances the method resulting in greater motivation in the user. You don't have to fill in your charts by hand every single day. sympto keeps a simplified chart for you in your phone that stays tidy no matter how many times you modify an entry. You can see your full chart only on your sympto.org web account. Your cycle data in the app on your cell phone is regularly synced with your web account where you can print it out. Your web account keeps your cycle chart safe in case your cell phone is lost.

The user has to learn the method in order to be able to introduce appropriate observations. sympto® is an educational tool.

sympto is the first web program and app integrating all relevant fertility signs to satisfy the symptothermal standard (elixir, temperature, Döring/Rötzer day, cervix exam). Fertility gadgets and apps that take one fertility sign into consideration or several separately do not execute the symptothermal cross-check and fall short in terms of effectiveness. In theory, these may perform for women with extremely regular cycles who never experience anovulatory phases. In reality, women's cycles are dynamic and can go through irregularities at any time. sympto® adapts readily to irregular cycles and is designed for all women for the entirety of their fertile life, from menarche to menopause.

In order to maximize your chances of conception, you must determine your most fertile days. You will need to learn how to classify your elixir and watch for  strechy elixir  on sympto® and your elixir shift (point of change in elixir quality) to identify your Peak Day. This day will be identified as very fertile. If you only observe creamy elixir  before your shift, then this will be identified as your most fertile. In addition to this and independently of it, the sympto® engine projects 5 highly fertile days into your current cycle by reporting the most fertile days of the previous cycle. These special cycle days are the first and second day of temperature rise and the three preceding days preceding.

The STM is an ideal observation tool for a girl to track the maturation process of her cycle. It's the only way for her to know if she's ovulating regularly.

sympto® does not replace a barrier method of contraception and does not prevent sexually transmitted diseases.

The use of the STM allows women to be protected from the side effects of HBC. There is a worldwide consensus about synthetic hormones being a risk factor for cancer (more on www.komen.org), especially for women who smoke. Certain breast and uterine cancers can thus be prevented. This fact must be reiterated to medical doctors many of whom still don't know the basics of the STM. They should not prescribe HBC to smokers because this practice compounds several risk factors. Regrettably, the STM is not appealing to most physicians because women become independent and gain more confidence in their own bodies. We are still actively in search of medical doctors and natural therapists who recommend the STM. Our Foundation's ultimate goal is to help women feel confident in their bodies and to empower them. Below, under F.A.Q. #14, we quote some excerpts from the open letter that Professor Rötzer addresses to his colleagues in his bestseller, "A Complete Guide to the SympoThermal Method".

Prof. Josef Rötzer, MD, was the pioneer of the true symptothermal method. Here below an excerpt from his book “Natural Conception Regulation” (Herder 1996). Print this open letter to share with your MD. (The term ‘natural conception regulation” has been replaced by ‘the symptothermal method’.)

My dear colleague,

Around the world there is an evident and increasing interest in the symptothermal method (STM). The World Health Organization in Geneva, for instance, has its own collaborative dealing with methods for the determination of a woman’s fertile period. The STM is fundamentally different from the obsolete and unreliable calendar rhythm methods of Knaus and Ogino, and goes far beyond the old basal body temperature methods. Under certain circumstances it is even possible to do without temperatures.. The most effective method is the STM.

There are NFP education centres in over 70 countries across the globe.

When a couple practices the STM as a joint endeavour instead of relegating it to the wife as her responsibility alone, and if the couple has adequate information available, the effectiveness of the STM rivals that of the 'Pill'. With competent instruction, every couple can learn to time intercourse to avoid pregnancy effectively.

As a general practitioner or gynaecologist, you undoubtedly already have a heavy schedule of professional responsibilities. It is not at all the intent of this letter to suggest you instruct your patients in the STM. The woman presenting this letter to you is already learning the STM and can obtain additional information whenever she needs it. My only request to you is this: Please take a genuine and sincere interest in the new form of the STM selected by your patient. You can obtain further information in the book from which this letter was copied.

I would be very thankful to you if you could make the STM more known among those women who are looking for an alternative to hormonal contraception.

Cordially yours,

Josef Rötzer, M.D.

Unfortunately, this appeal even though written some thirty years ago has not been noticed by the medical community. Still, do not give up, but rather copy it together with the clinical studies from our menu page and give or send them to your MD or gynaecologist.

The best way to receive competent advice about charting your cycles is to be matched with a sympto® counselor. If you are new to the method we recommend you purchase 6 months of counseling as this is typically the duration of your learning phase. Our counselors are certified symptothermal specialists of different languages who can view your charts and will communicate with you confidentially whenever you have a question.

Do I ovulate several times during the cycle? - A second ovulation may occur within hours of the first ovulation, but never days later, during the yellow infertile phase.

Why does the WHO have bad ratings for the natural methods? - The WHO supported the symptothermal method until the nineties. Since the year 2000 the WHO only teaches the calendar and similar methods that mislead women...

These and other lies are discussed in the Manual The Complete Symptothermal Method.

You can print out your first chart from your account even if you decide not to purchase any further premium access. If you would like to continue charting by hand on your own, make sure you understand the symptothermal laws and know how to interpret your observations correctly. Use our free Guide for your reference. You can find blank charts in the symptoShop for free download.

You leave all the symptothermal, manual bookkeeping behind and let sympto® do the calculating and cross-checking for you while keeping your charts tidy and stored in a safe place. A WEB Access account lets you access all features such as printing and sharing of your charts and viewing your cycle charts in full screen. sympto® is not a medical device but a charting assistant, an educational device, and a platform for presenting your own observations. We do not discount the classic approach of manual charting your symptothermal observations. Our goal is to make charting more appealing.

On cycle day 6 in your chart you will notice a very important day: the Döring/Rötzer day (marked as D in your chart) that opens your fertile window even without elixir observation.

This Döring/Rötzer value is named after two medical researchers who brought us the symptothermal standard of 'earliest-temperature-rise-minus-seven'. Döring discovered that ovulation is preceded by six fertile days of follicle maturation and Rötzer added an additional day as a safety margin. This value can only be calculated in retrospect for each cycle and is determined for you after 12 cycles of charting by subtracting 7 from the cycle day of your earliest temperature rise out of those 12 cycles. Sympto will calculate this for you. For the first 12 months, the Döring/Rötzer day is conservatively set on cycle day 6, unless you have previous charts allowing you to custom-set it for you right from the start. The Döring/Rötzer day or elixir observed opens your fertile window, whatever comes first. You will notice that sympto assigns you a second d-day, marked with a small d; this refers to the Dörinf/Rötzer day for one particular cycle and thus varies from cycle to cycle. This is why sympto calculates your big D day by locking in after 12 months on your earliest one. This is to protect you from taking risks in your preovulatory phase because you can never predict ovulation. It is possible to have your D day lock in after 12 months at an earlier day than cycle day six but this is the exception seen generally in women with very short cycles or women over the age of 35.

If you maintain your sympto® account throughout pregnancy and breastfeeding, you will support an important women's cause that enhances health and general well-being . You can also benefit from sympto®'s special features during this time. More about in Disclaimer and general conditions as well as on the products page.

See disclaimer and general conditions, and our free Manual "The Complete Symptothermal Guide" that you can find in the menu.

Your thermometer must be precise and specifically designed for charting. We recommend the Cyclotest Lady thermometer, a German product. If you cannot find it in your drugstore you can order one from the symptoShop. You can also chart with a simple gallium thermometer by Geratherm, again a German quality product. But it takes 3-5 minutes for measurement, while Cyclotest Lady displays a precise result after only 30 seconds and records it reliably. We warn you against all fever thermometers that are explicitly not recommended for charting your waking or basal temperature.

The symptom cross-check is the hallmark of the STM. It enables the accurate demarcation of your fertile window. This cross-check correlates temperatures with cervical fluid (elixir) observations and is indispensable for contraceptive effectiveness, for keeping your fertility window as short as possible, for identifying your most fertile days and for managing irregular cycles. This is where sympto® is superior to manual charting: it executes the cross-check for you and prompts you to avoid incoherent or illogical entries.

If you are competent and your situation demands it, you may choose to chart temperatures only, or you may switch to elixir-only (Billings mode). For instance, you are traveling and forgot your thermometer. Set your parameters for this cycle to Billings mode and select also the cervix exam feature. However, without the symptothermal cross-check in either of these two charting options, you will lose some infertile days. Learn more about the intricacies of each option by studying our free manual "The Complete Symptothermal Guide".

The temperature rise confirms ovulation. This rise is proof that ovulation has taken place and will not happen again in this cycle. Without elixir observation, more days must be considered as fertile as a precaution. Temperature-only charts require a 4th and 5th temperature recording above coverline, sometimes even a 6th value, before displaying postovulatory infertility. Furthermore, this option does not exempt you from your elixir observations, as your elixir flow may begin very early, i.e. before the Döring/Rötzer day, and you are considered fertile from that moment on. On the upside, the temperature-only option also works for irregular cycles.

You can activate your Billings mode in your Personal Parameters. This mode is also recommended for pregnancy achievement or for women who are very sure about their Peak day. It will display the infertile yellow phase (after ovulation) 4 days after the Peak day, granted that your Peak day identification is correct, and some rose infertile days at the start of the new cycle. The breastfeeding program is inspired by the Billings mode.

When you are at the entrance page of your account, you will always see the Peak Day icon, followed by the 3 stars. It is the keystone the STM with its cross-check of elixir and temperature that opens and closes the fertile window.

The STM is based on daily observations of your fertile signs the woman observes on a daily base. The rhythm method, a.k.a. Knaus-Ogino Method, on the other hand, calculates your fertile window by assuming a pattern from past cycles. The rhythm method is therefore unreliable, even for women with regular cycles. The STM is also often confused with the temperature method which was developed in the fifties by Döring, Marshall, Vollmer and others. The STM, however, does integrate some important elements from the temperature method, as described in question 23.

Whenever your Peak day identification is unclear, the cervix exam can help you decipher the situation. It gives you access to elixir internally so that you can identify one of the four Peak day possibilities described in our Manual on page 26. If you cannot find any elixir you can generate your Peak day by cervix exam alone. In this case, once you determine your cervix to be high and soft, you trigger Peak day by entering the black-dash or yellow cloud icon on the elixir level the next day. See p. 87 in the Manual.

The Symptotherm Foundation is a humanitarian, non-religious NGO exempted from Federal income taxation. For a number of years, the Foundation tried to improve the application of the STM by optimizing instructional literature accompanying the Bioself fertility indicator. Faced with the necessity of developing a new generation of Bioself (a multimillion Euro project), the Foundation opted for a much more comprehensive and more powerful concept: sympto.org. sympto® is a symptothermal trainer.

When you open an account on sympto.org and purchase a subscription or make a donation, you help us promote the Symptothermal Method by supporting an important women's and couples' cause that fosters health-preventive measures. You also help us finance translation into other languages and improve the sympto software.