Symptothermal contraception? That's the way it works
© Fuse / ThinkstockGranted, it's convenient: take the pill every day and the topic of contraception is off the table. According to the Federal Center for Health Education (BZgA), 37 percent of all adult couples in Germany rely solely on the pill. With a Pearl index of 0.1 to 0.9 when used correctly (meaning that out of every 100 women taking the pill per year, less than one pregnant), it is considered a safe method of contraception. But we are constantly taking hormones to our bodies - more than they can handle.
The decomposing substances of the hormones accumulate in our fat cells and leave the body only gradually. "That's why around a third of women still struggle with menstrual disorders a few months after stopping the pill," explains Drs. Ursula Sottong. The general practitioner leads the Malteser Working Group Natural Family Planning (NFP) in Cologne. Under the name "Sensiplan" she teaches the natural, symptothermal method of contraception.
How does the natural birth control method work?
Developed in the 1960s, the symptothermal method essentially relies on observing and evaluating morning body temperature and cervical mucus (formed in the cervix and seen and felt at the entrance to the vagina). Both changes in the course of the cycle. So the warm-up temperature from the beginning of the menstrual period to ovulation, ie in the first half of the cycle, by about two tenths of a degree Celsius lower than in the second half of the cycle. The cervical mucus is initially milky-cloudy and tough, but becomes clear in the days before ovulation, liquid and stringy. Based on these observations, a woman can determine her fertile days.
How long do I have to log my data?
NFP counselors recommend that women monitor their temperature after waking for three cycles daily, observe their cervical mucus, and note any further changes. The easiest and most reliable way to do this is with the pen and the cycle table, in which you also record your menstrual period. Because aids such as temperature or hormone computers need a relatively stable cycle length (20 to 35 days) for their calculation, which limits their reliability. On paper, on the other hand, with a little practice, you can work well with a 60-day cycle. After three cycles users know their fertile days and only have to enter the data sporadically.
What are the advantages of this method?
Through the symptothermal method, a woman learns how her body is ticking and gets a sense of her fertility. It will be more decisive because it can better weigh the advantages and disadvantages of different methods of contraception. "The awareness of your own body and the desire for a healthy alternative to hormones have become stronger," says Ursula Sottong. The claim to the partner to take responsibility has also increased.
Just a few years ago, only one percent of women of childbearing age (this is by definition the group of 19 to 45-year-olds) used natural contraceptive methods, be it three to four percent now. "Especially 20- to 30-year-olds switch to NFP," observes Sottong in their deliberations. There were also young men who want to convince their partner. Another plus point: "A woman who has understood how your body works also uses other methods of contraception, and understands why you can not just leave out a pill - it's a life-long learning experience," says Sottong.
And what are the disadvantages?
If you want to prevent of course, you need discipline in logging the data and the desire to deal with your own body. Only then is the method safe and has a Pearl index of 0.4. However, the safety of most contraception methods depends crucially on the right application. That's why method and application security often differ significantly. In the case of NFP, too, the Pearl Index is much higher when women have unprotected intercourse in the borderline areas of fertility. If you use a condom or a diaphragm, you only have the safety of the respective contraceptive. In addition, you must keep an eye on whether and to what extent your cycle changes when disruptive factors (such as time change during travel, shift work or stress) occur.
How long before and after ovulation do I have to prevent in addition?
From a biological point of view, the maximum period of fertility is six days: the sperm are viable for a maximum of five days, and the egg is fertile for 18 hours. But such a close temporal limitation is not possible by a self-observation. With the NFP method, you can narrow your fertile phase to nine to eleven days.
What typical mistakes happen when measuring body temperature?
Many women forget that they need to measure the temperature before getting up. Therefore, it is best to place the thermometer, pen and cycle sheet on the bedside table. In addition, always use the same thermometer in one cycle. Always measure in the same place - either in the mouth, in the vagina or in the anus. Note that you must knock down a thermometer after each measurement.
What do I do if I can not cope with observing the cervical mucus?
Sometimes the cervical mucus is not easy to examine - for example, on summer vacation, when you are in the water a lot. Or if you have irritation in the vaginal area through other contraceptive methods. Around 30 percent of NFP users therefore additionally feel their cervix (it connects the cervix with the vagina), because this also changes in the course of the cycle - in terms of strength and position.
To feel comfortable, place one leg on a stool or the edge of the bathtub and walk along the wall of the vagina with two fingers. The spherical or cone-like vault is the outer cervix. Immediately after menstruation, it is hard (like the tip of the nose) and protrudes deep into the vagina. It is sometimes harder to reach it when ovulating because it shifts higher into the vagina. It also softens (like the lips) and opens easily. After ovulation, it closes again, gets hard and gets deeper. The infertile days begin three days later.
What is there to pay attention to if I have previously avoided the pill?
Be sure to finish the pack and do not put it in the middle of the cycle. On the first day of your menstrual period you can start with the cycle table.
Does the symptothermal method help with the desire to have children?
Yes. Women benefit here too from their understanding of the cycle. After all, the probability of getting pregnant is less than 30 percent in each cycle. It helps to know that on a 60-day cycle, ovulation does not take place until around the 45th and not the 15th day. About 15 percent of women who use the NFP method have a desire to have children.
Who will help me if I have questions?
Malteser International has been providing consultants in natural family planning for 30 years. Currently, about 350 such NRP advisors are working nationwide - in medical practices, health centers, community colleges, Pro Familia or even independently. Depending on the provider, the costs for counseling in courses and / or telephone calls are between 60 and 220 euros, and in some cases they are also free. Some health insurance companies take over or contribute to the costs. Those who train themselves can do so with the help of the practice book "Natural & Safe". Thousands of women also meet in forums to exchange experiences.
