Natural birth control acceptable to women, men

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NEW YORK (Reuters Health) - A "natural family planning method" in which women use a set of beads to keep track of their fertile days is effective and widely acceptable to women and their partners, according to a new study conducted at 14 sites in 6 countries.

By Anne Harding

NEW YORK (Reuters Health) - A "natural family planning method" in which women use a set of beads to keep track of their fertile days is effective and widely acceptable to women and their partners, according to a new study conducted at 14 sites in 6 countries.

"I'm really convinced that this is a method that needs to be part of an informed choice approach to family planning," Dr. Victoria Jennings, director of the Georgetown University Institute for Reproductive Health in Washington, DC, told Reuters Health. "Women have lots of options and they need to be aware of this one."

Jennings and her colleagues developed the Standard Days Method (SDM), in which women with menstrual cycles between 26 to 32 days long are instructed that they may become pregnant if they have sex on days 8 to 19 of their cycle. Women using the SDM can use a set of beads the Georgetown team designed, known as CycleBeads, to keep track of their fertile days, and may abstain from sex on those days if they don't want to get pregnant.

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In the current study, Rebecka I. Lundgren of Georgetown and colleagues from the Population Reference Bureau in Washington, DC, and the London School of Hygiene and Tropical Medicine conducted a "real world" test of the method.

Family planning groups, health ministries and community development organizations introduced SDM at 14 different sites in Latin America, Africa and Asia. A total of 1,646 women who chose to try the SDM were recruited into the study.

Age, education, and past use of modern contraceptives varied widely among the sites. The study participants typically abstained or used condoms during the fertile days of their cycle.

There were 14.1 pregnancies for every 100 women per year of use of the method, which was comparable to the 12 pregnancies per 100 woman years found in a 2002 clinical trial of the method. The main reason women got pregnant, the researchers found, was that couples "knowingly took the risk" of having unprotected sex on fertile days.

While people often associate natural family planning techniques like the "rhythm method" with religious beliefs, most women in the study who chose to use the SDM said they did so because it was side-effect free, didn't affect women's health and was inexpensive, the researchers note in the March issue of Contraception.

Jennings said that the degree of involvement with the method among women's partners in the study was surprising. "Men reported being very satisfied with the method, and a significant number of men reported being involved in some way in helping their partner to use this method," she noted, for example reminding a woman to move the marker on the beads or making sure to have condoms available on a woman's fertile days.

Ninety percent of both men and women in the study said they felt the SDM was easy to use, and that they would recommend it to others.

"Here in the US most of the women who choose to use it appear to be previous users of hormonal methods who have basically decided that they want to do something natural now," Jennings noted. When used properly, she added, the SDM is nearly as effective as the Pill and more effective than the diaphragm or condoms.

SOURCE: Contraception, March 2008.