12 February 2004

Natural contraceptives

These methods include natural family planning, coitus interruptus and breastfeeding.

These methods include natural family planning, coitus interruptus and breastfeeding.

Natural family planning (rhythm method)
This involves a woman keeping a menstrual calendar to enable her to accurately predict her fertile period. Most women ovulate about 14 days before the start of the next menstrual period which, in a 28 day cycle, is at the midpoint of the cycle. An unfertilised egg may live two days, while sperms were found to stay alive in the genital tract up to 10 days after intercourse although they may be able to cause fertilisation only for about four days. Thus, intercourse should be avoided during the phase when there is the greatest chance for sperms and eggs to meet.

  • Advantage: No hormones are taken, so there are no side-effects from these.
  • Disadvantage: It is not a very reliable method of contraception.
  • Effectiveness: If the fertile time is predicted correctly with the help of a menstrual calendar and additional use of basal body temperature, the effectiveness is around 80%.

Coitus interruptus (withdrawal)

  • Involves removing the penis from the vagina immediately before ejaculation.
  • By preventing sperms to enter the vagina, fertilisation does not occur.
  • Effectiveness depends on the male's ability to withdraw before ejaculation. Often, some sperms are deposited in the vagina before or during withdrawal, making this method not very reliable.
  • Disadvantage: Does not provide protection against sexually transmitted infections (STIs). STI-organisms can be transmitted by direct contact with surface lesions in both partners and from vaginal and pre-ejaculatory fluid.
  • Effectiveness: Pearl Index of 8-17.


  • In nursing mothers, ovulation is often suppressed which has the advantage that breastfeeding acts as a contraceptive measure. However, this is not a reliable method and breastfeeding women are often advised by their doctor to use the "mini-pill" to provide additional protection. The "mini-pill" contains only progestogens which has the advantage that it will not interfere with milk production. The importance with this pill is that it must be taken every day at the same time.
  • Once breastfeeding is stopped, a more effective contraceptive method should be used.

Read more:
Got pregnant on the pill?
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