Natural family planning (NFP) or fertility awareness methods (FAMs) determine when a woman is fertile to avoid penetrative sex during that time.
Mostly, women who use NFP employ three markers: Methods include
- Cervical mucus
- Temperature
- and rhythm (calendar)
While several fertility markers are used in some techniques, others use one. The fertile period is set by when ovulation occurs. Even though the ovary can release the ovum up to 24 hours later, it is usually fertilized within the first 12 hours. Five days are the average sperm survival time in the upper reproductive canal. Still, most women have a viable period of 8–9 days or less because sperm can live up to 7 days.
Ovarian hormone production and the reproductive cycle are regulated by pituitary hormones FSH and LH. Fertility is predicted using FAMs by cyclical variations in progesterone and oestrogen levels.
The woman’s age, frequency of sex, and degree of compliance with the process all affect effectiveness. Up to 99% effectiveness can be achieved by FAMs combining fertility markers; the failure rate of the rhythm approach alone is about 20% (range 5-47%). Teaching FAM methods is most successfully done by qualified teachers.
Advantages
There are no side effects and FAMs are safe and appropriate for many religions and cultures. Women may decide against artificial contraceptives for ethical or health reasons.
Disadvantages
Learning how to track fertility signs and compile enough information to depend on the treatment could take three to six months. With changes in circumstances, such holidays or illness, keeping daily notes might be difficult. While some couples may go through protracted periods of infidelity, condoms or other barrier techniques can be utilized when suitable. Sexually transmitted infections are not protected against by this method.
Eligibility
The UK Medical Eligibility Criteria for Contraceptive Use rates the use of FAMs as ‘accept’, ‘caution’, or ‘delay’.
Fertility prediction
Accuracy of fertility prediction Finding the most fertile period and having sex during it can help FAMs get pregnant.
Method of rhythm
The low reliability of the calendar approach of fertility awareness makes it less common in the UK. At least six cycles of menstruation are recorded; twelve is ideal, and viable days are estimated using survival rates of sperm and ovum.
The longest and shortest menstrual cycles that have been recorded are used in the computations.
Long stretches of sexual abstinence can arise from this tactic alone, as Figure shows. Sometimes additional fertility awareness techniques are used with the information collected.
Temperature method
The main hormone of the post-ovulatory (luteal) phase of the menstrual cycle, progesterone, is thermogenic. Levels of progesterone rise and reach their maximum seven days after ovulation. 0.2–0.4°C is added to BBT by progesterone levels. Over the menstrual cycle, the BBT is tracked every day. Three high temperatures in a row that are more than 0.2°C higher than the preceding six signal the end of the fertile period. After at least three hours of sleep, or before getting out of bed in the morning, take your BBT, or awakening temperature, and before eating or drinking anything. 0.1°C markings on a mercury or digital fertility thermometer allow for oral, vaginal, or rectal temperature monitoring. If you are taking aspirin or paracetamol or have a temperature, this approach could be off.
Cervical mucus method
The Billings or ovulation approach is centered on identifying periodic variations in cervical secretions. Cervical mucus is examined and reported upon daily for colour, volume, and texture. There can be dry days after menstruation during which the vulva is not visible mucus. Mucus thickens and is clearer and slippier as oestrogen levels rise, like to raw egg white. ‘Peak mucus day’ is the last day of ‘fertile mucus’. Dry days are okay for having sex, which starts on the fourth day following peak mucous. This method works well with other FAMs or on its own. One self-examination technique for finding cyclical variations in the location and consistency of the cervix is cervical palpation. Location and consistency of the cervical.
Electronic monitoring
Computerized systems track changes in saliva, urine, and temperature. Not contraception but the fertile period for conception are determined by several of the current monitors. Fertile periods are determined by use of LH and oestrogen levels in electronic urine testing instruments. For the user, these gadgets might be costly. The physiological fertility techniques are combined with a fertility monitor in the Marquette method.
Lactation amenorrhoea method (LAM)
Ovulation is reduced by breastfeeding because it changes the frequency and intensity of gonadotrophin pulses. Ovulation and ovarian activity resume when nursing frequency and duration decline or when extra feeds are added. LAM is 98% successful as birth control. If a woman takes LAM and her nursing frequency drops, her menstruation resumes, or she is more than six months postpartum, her chance of becoming pregnant goes up.
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