Natural Methods of Birth Control (cont.)
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.
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.
In this Article
- Introduction to birth control
- "Natural" methods of contraception
- Calendar rhythm method
- Basal body temperature method
- Mucous inspection method
- Symptothermal method
- Ovulation indicator testing kits
- Withdrawal method
- Lactational infertility
- Douching and urination
- Find a local Obstetrician-Gynecologist in your town
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). 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.
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 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.
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 again start to use an appropriate method of contraception.
Douching and urination
Vaginal douching is the use of a liquid solution to wash out mucous 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.
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 infection (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.
Medically reviewed by Mikio A Nihira, MD; American Board of Obstetrics & Gynecology
Previous contributing authors: Barbara K. Hecht, Ph.D. and Carolyn Janet Crandall, MD, FACP
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