DGRefHelp - NHS Dumfries & GallowayObservational methods measuring mucus and temperature have a failure rate of less than 1%
with perfect use and the rhythm method a failure rate of 9% with perfect use. Many drop to
25% failure when typical use is measured. However, efficacy is dependent on the woman’s
age, how often she has sex and her ability to adhere to the method. Efficacy is greater if more
than one of the above methods are used together
Fertility Awareness
Warning
What’s new:
There are no major changes since this guideline was last updated.
Introduction
Natural Family Planning (NFP) is a method of contraception based on a knowledge and interpretation of the menstrual cycle and an abstinence of penetrative sex during the most fertile period. There are three main methods used to determine the fertile period:
• Ovulation method observes cervical mucus changes
• Symptothermal method records body temperature daily
• Rhythm method makes calendar calculations of previous cycles
Clients should be given appropriate information about the methods and useful contacts for
instruction in their use.
FAM are more effective when women receive specialist training. Women interested in using
FAM for contraception purposes should be signposted to an organisation, service or local
recognised practitioner offering teaching. Information is available on the Fertility website
www.fertilitycare.org.uk
Advantages
- NFP gives fertility control to the couple and can have a positive effect on relationships.
- There are no physical side effects and it is universally acceptable to all faiths and cultures.
Disadvantages
- It can take 3 to 6 months to collect enough information to reliably use the method.
- NFP normally requires daily observation, which might be affected by life events.
- The period of abstinence can be long in some individuals.
- There is no protection from STIs.
- Clients with objections to artificial contraception, often for religious reasons.
- Clients wishing to avoid hormones or any invasive procedures.
- Can be purchased at most major chemists.
- Computerised devices which measure hormonal changes in the urine are also available and help predict the fertile period.
- Computerised thermometers help to predict the length of menstrual cycles.
LAM can be used effectively in the postnatal period provided clients fulfil three criteria:
- are amenorrhoeic (no bleeding after 56 days postnatal)
- are fully breast-feeding and not giving the baby any other liquid or solid food (except
infrequent water or vitamins ) with no more than 4 hours between feeds during the day and
6 hrs overnight - are less than 6 months postpartum.
LAM has a failure rate of 2%
The effect of expressing breast milk on the efficacy of LAM is not known but it may potentially be reduced.
This organisation will supply an information pack to interested individuals and arrange a tutor.
Telephone: 0141 352 7930
See website for centres and teachers.
- FSRH Clinical Effectiveness Unit. FSRH Clinical Guideline: Fertility Awareness Methods [Internet]. The Faculty of Sexual and Reproductive Healthcare; 2015 Jun [cited 2023 May]. Available from: https://www.fsrh.org/standards-and-guidance/documents/ceuguidancefertilityawarenessmethods/
- Sexwise [Internet]. The Family Planning Association (FPA); 2014 Jan. Fertility awareness methods; [updated 2018 Oct; cited 2023 May]. Available from: https://www.sexwise.org.uk/contraception/fertility-awareness-methods
- Fertility Care Scotland [Internet]. Fertility Care Scotland; 2022 [cited 2023 May]. Available from: https://fertilitycare.org.uk/