Natural Birth Control Options

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Natural birth control facts

  • Birth control is the use of practices, medications, or devices to prevent pregnancy.
  • Natural methods of birth control, or natural family planning, are a type of birth control that relies on observations about the woman's body and menstrual cycle.
  • Natural methods of birth control include fertility awareness methods.
  • Examples of natural methods of birth control include
    • calendar rhythm method,
    • basal body temperature method, and
    • cervical mucus examination.
  • Advantages of natural methods include
    • cost savings,
    • lack of prescriptions or health-care visits, and
    • avoidance of medications or procedures.
  • Disadvantages of natural methods are the fact that they can be difficult to use correctly and that sexual intercourse must be avoided at certain times of the month.

What are natural methods of contraception?

Natural methods of contraception are considered "natural" because they are not mechanical and not a result of hormone manipulation. Instead, these natural methods to prevent pregnancy require that a man and woman not have sexual intercourse during the time when an egg is available to be fertilized by a sperm.

The fertility awareness methods (FAMs) are based upon knowing when a woman ovulates each month. In order to use a FAM, it is necessary to watch for the signs and symptoms that indicate ovulation has occurred or is about to occur.

On the average, the egg is released about 14 (plus or minus 2) days before a woman's next menstrual period. But because the egg survives 3 to 4 days (6 to 24 hours after ovulation) and the sperm can live 48 to 72 hours (up to even 5 days in fertile mucos), the actual time during which a woman may become pregnant is measured not in hours, not in days, but in weeks.

FAMS can be up to 98% effective, but they require a continuous and conscious commitment with considerable monitoring and self-control. Although these methods were developed to prevent pregnancy, they can equally be well used by a couple to increase fertility and promote conception.

Quick GuideChoosing Your Birth Control Method

Choosing Your Birth Control Method

Birth Control Methods, Side Effects, and Effectiveness

There are a variety of birth control options, and it can be confusing when choosing the option that works best for you and your partner. Questions to ask yourself when considering birth control options are

  1. How important is STD (sexually transmitted diseases) protection?
  2. How effective is the birth control type or option?
  3. What are the side effects of the type of birth control?
  4. What are the advantages and disadvantages of the type of birth control?

What are the advantages and disadvantages of natural birth control?

Natural methods are typically very inexpensive compared to other methods of birth control unless a woman chooses to purchase ovulation test kits.

Advantages of natural birth control

  • A woman does not need to take medication or use hormonal manipulation.
  • No procedures or fittings by a physician are required.

Disadvantages of natural birth control include

  • It can be difficult to estimate or know precisely when a woman is fertile, allowing increased chances for unplanned conception.
  • Natural methods are not as effective as some forms of contraception.
  • Ovulation test kits are used by some couples using natural methods of contraception, and the cost of these kits is another potential disadvantage.
  • Being unable to have intercourse at certain times of the month is a disadvantage for some women.

Calendar rhythm method

The calendar rhythm method to avoid pregnancy relies upon calculating a woman's fertile period on the calendar. Based upon her 12 previous menstrual cycles, a woman subtracts l8 days from her shortest menstrual cycle to determine her first fertile day, and 11 days from her longest menstrual cycle to determine her last fertile day. She can then calculate the total number of days during which she may ovulate. If a woman's menstrual cycles are quite irregular from month to month, there will be a greater number of days during which she might become pregnant.

The calendar method is only about 80% effective in preventing pregnancy and when used alone, it is considered outdated and ineffective.

Basal body temperature method

The basal body temperature (BBT) method is based upon the fact that a woman's temperature drops 12 to 24 hours before an egg is released from her ovary and then increases again once the egg has been released. Unfortunately, this temperature difference is not very large. It is less than 1 degree F (about a half degree C) when the body is at rest.

The basal body temperature method requires that a woman take her temperature every morning before she gets out of bed. A special thermometer that is more accurate and sensitive than a typical oral thermometer must be used, and the daily temperature variations carefully noted. This must be done every month. Online calculators are available to help a woman chart her basal body temperature.

To use the basal body temperature as a birth control method, a woman should refrain from having sexual intercourse from the time her temperature drops until at least 48 to72 hours after her temperature increases again.

Mucus inspection method

The mucus inspection method depends on the presence or absence of a particular type of cervical mucus that a woman produces in response to estrogen. A woman will generate larger amounts of more watery mucus than usual (like raw egg white) just before release of an egg from her ovary. This so-called egg-white cervical mucus (EWCM) stretches for up to an inch when pulled apart. A woman can learn to recognize differences in the quantity and quality of her cervical mucus by examining its appearance on her underwear, pads, and toilet tissue; or she may gently remove a sample of mucus from the vaginal opening using two fingers.

She may choose to have intercourse between the time of her last menstrual period and the time of change in the cervical mucus. During this period, it is recommended that she have sexual intercourse only every other day because the presence of seminal fluid makes it more difficult to determine the nature of her cervical mucus. If the woman does not wish to become pregnant, she should not have sexual intercourse at all for 3 to 4 days after she notices the change in her cervical mucus.

Symptothermal method

The symptothermal method combines certain aspects of the calendar, the basal body temperature, and the mucus inspection methods. Not only are all these factors taken into consideration, but so are other symptoms such as slight cramping and breast tenderness. Some women experience lower abdominal discomfort (in the area of the ovaries) during release of an egg (ovulation).

Ovulation indicator testing kits

A woman can use an ovulation prediction kit to determine when she is most likely to ovulate. This is a special kit that measures the amount of luteinizing hormone (LH) in the urine. Because luteinizing hormone promotes the maturation of an egg in the ovary, the amount of LH usually increases 20 to 48 hours before ovulation. This increase is called the luteinizing hormone surge, which can then be detected in a woman's urine 8 to 12 hours later. The ovulation prediction kit is designed to measure the amount of luteinizing hormone in the urine.

There are a number of ovulation prediction kits sold at pharmacies which range from simple to complex. In the simplest, the woman urinates onto a test stick and the amount of luteinizing hormone is indicated by a color change. The intensity of the color is proportional to the amount of luteinizing hormone in her urine. A woman begins testing her urine 2 to 3 days before she expects to ovulate based upon the dates of her previous monthly cycles.

The optimum days for fertilization are the two days before ovulation, the day of ovulation, and the day after ovulation. The greatest chance of becoming pregnant is if intercourse occurs within 24 hours after the luteinizing hormone surge. Ovulation prediction kits are used primarily to increase the chance of a woman becoming pregnant, but they can also indicate to the woman that she is about to ovulate and should take appropriate contraceptive precautions.

Withdrawal method

Using the withdrawal method, the man withdraws his penis from a woman's vagina before he ejaculates so that the sperm released from his penis does not enter her vagina. Withdrawal is also called coitus interruptus.

There are problems with using withdrawal as a contraceptive method. First, a man may release small amounts of sperm before actual ejaculation. Secondly, a man needs self-control and a precise sense of timing to be able to withdraw his penis from the woman's vagina before he ejaculates. Because this can be difficult for the man to complete successfully, the withdrawal method is only about 75%-80% effective in preventing pregnancy.

Lactational infertility

Lactational infertility is based upon the idea that a woman cannot become pregnant as long as she is breastfeeding her baby. It is true that a woman may not ovulate quite as soon after giving birth as she would if she were not breastfeeding. Women who are breastfeeding usually start ovulating again between 10-12 weeks after delivery.

However, the method is not considered to be appropriate as a sole contraceptive measure. A nursing mother may start ovulating again and not realize she is fertile, as ovulation can occur prior to the return of her menstrual period. If this happens and the mother has unprotected sexual intercourse, she can become pregnant at the same time she is still breastfeeding her baby. If a nursing mother does not wish to become pregnant again, she must start to use an appropriate method of contraception.

Douching and urination

Vaginal douching is the use of a liquid solution to wash out mucus and other types of bodily debris from a woman's vagina. Many women choose to make regular douching a part of their routine for maintaining vaginal hygiene. Most doctors and the American College of Obstetricians and Gynecologists (ACOG) do not recommend the practice.

Regardless of whether a woman does it for hygienic reasons, vaginal douching does not work as a contraception method. During intercourse, active sperm can reach a woman's cervix and even the upper part of her uterus within five minutes of ejaculation. Douching after intercourse cannot be done soon enough to have any contraceptive benefits, and the douching could even force sperm higher up into the uterus. In addition, if a woman douches within a 6-8 hour period after using a spermicide, she may actually reduce the effectiveness of this contraceptive method.

Some women used to think that standing up and urinating immediately after sexual intercourse might reduce the chances of them becoming pregnant. They hoped that gravity might make it more difficult for sperm to swim "uphill" to the uterus and that the stream of urine running over their vaginal area would wash away sperm, similar to the process of douching. However, just like douching, urination after intercourse does not have any contraceptive value.

Quick GuideChoosing Your Birth Control Method

Choosing Your Birth Control Method

Abstinence

Abstinence from sexual activity means not having any sexual intercourse at all. No sexual intercourse with a member of the opposite sex means that there is no chance that a man's sperm can fertilize a woman's egg.

A man or a woman can practice abstinence from sexual activity for a specific period of time, or continuously throughout one's lifetime. Abstinence is essentially 100% effective in preventing pregnancy. Another significant benefit of abstinence is that it markedly reduces the likelihood of contracting a sexually transmitted disease (STD).

In this context, abstinence means refraining from all vaginal, anal, and oral sexual activity because sexually transmitted infections can be passed from one person to another in any and all of these ways. It should be noted that sexual activity such as mutual masturbation and touching of the other partner's genitals can, in some instances, transfer sperm during heavy mutual foreplay possibly leading to pregnancy.

REFERENCE:

Samra-Latif, O.M. et al. "Contraception." Medscape. May 02, 2014.

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Reviewed on 6/26/2015
References
REFERENCE:

Samra-Latif, O.M. et al. "Contraception." Medscape. May 02, 2014.

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