Advantages and disadvantages of calendar contraception. "Safe Days": Should I trust calendar contraception Prevention of pregnancy by cycle

A woman is able to conceive only 1-4 days a month. The life span of an egg, like that of a butterfly, is short, and in order for conception to occur, spermatozoa must have time to meet it alive. Therefore, if you correctly determine the period of ovulation (it usually falls somewhere in the middle of the menstrual cycle), the risk of unwanted pregnancy can be minimized by being careful on the "fertile" days and enjoying unrestricted sex on all other days.

Not just mechanical counting

“We know, we know,” some will chuckle, “we tried to calculate all these days according to the calendar, and nothing good came of it.” And they will be right. The so-called calendar method, which even previous generations tried to resort to, cannot be relied upon. If only because there are many women with an irregular menstrual cycle, and its fluctuations due to certain circumstances can occur in everyone. We will talk about a method based on the signs of fertility. Often it is also called symptothermal, because it includes observing some external symptoms and measuring temperature. At the same time, it is not necessary to refuse the calendar method, just its role will be rather auxiliary.

How to apply?

The task of the method is to determine the beginning and end of the fetal period in a woman. For this you need:

Excretion monitoring. Shortly after the end of menstruation, women develop mucous discharge. Their traces can be seen on underwear or on a paper napkin while visiting the toilet. If a woman feels moisture at the entrance to the vagina, it's time to take precautions - although ovulation has not yet begun, the vaginal environment is already suitable for the survival of spermatozoa (and they can live 3-5, or even 7 days under suitable conditions). The closer to ovulation, the brighter the character of cervical mucus appears: at the most fertile time, it is plentiful, transparent and extensible (similar to raw egg white). Flexibility can be tested by taking a little mucus between the thumb and forefinger. Conception is possible until 4 days have passed after the peak of these signs. Then the discharge becomes dryish or stops altogether, which means absolute safety.

Monitoring the condition of the cervix. This is easy to learn, especially for those women who are used to using sanitary tampons. The condition of the neck is best checked with the middle finger (it is the longest). On fertile days, the cervix is ​​high, soft to the touch, like lips, and wet. On the day of ovulation, these signs reach their peak. After ovulation, the cervix drops down and becomes firm. 3 days later, we can assume that the fetal period is over.

Measurement of basal body temperature. Every morning, before getting out of bed, a woman should measure her basal body temperature during the cycle in the same way (in the rectum or in the vagina) and with the same thermometer. During ovulation, a woman's body temperature rises by 0.2-0.5 degrees. If the temperature has stayed at an elevated level for 3 days, you can afford to relax.

Additional signs of ovulation. Specific sensations in the abdomen, engorgement and soreness of the mammary glands, a sharp change in mood.

How to behave in a "dangerous" time?

What to do when “you can” does not need to be explained, because everything is possible. When “you can’t”, you will have to change your sexual behavior. Each couple does this according to their preferences. Strict adherents of naturalness can:

• refrain from vaginal intercourse, switching to other forms of sexual intercourse for a while;
• resort to the technique of interrupting sexual intercourse;
• take a break from your sex life.

The rest can use condoms, diaphragms and/or spermicides.

Errors are possible

According to the American Johns Hopkins University, the probability of error with this method of protection varies greatly: from 20 to 99%, depending on the correct application. Unfortunately, mistakes are possible here due to inattention, especially in the first year of using the method, when the woman has not yet learned to observe herself.

pros

• No side effects.
• Inexpensive or completely free.
• The method has no medical contraindications.
• Sometimes this is the only possible method of family planning for those who, for religious reasons, do not allow other methods of contraception.
• Instant restoration of fertility.
• The method can be used not only to prevent, but also to plan conception.
• The couple gets an idea about the structure of the female reproductive system.
• Men are involved in the family planning process.

Minuses

• The effectiveness of the method directly depends on the correct definition of the phase of the cycle.
• It will take 2 or 3 menstrual cycles to master, and at this time, other means must be used for safety net.
• Interferences such as high fever, vaginal infection, recovery from childbirth, breastfeeding, and other conditions that affect discharge and body temperature can complicate the determination of fertility signs, making the method unreliable or difficult to perform.
• Does not protect against sexually transmitted infections.

Practice

Get into math. The calendar (or rhythmic) method is a mathematical calculation of the fertile phase.

Write down the number of days of each menstrual cycle for at least six months. The first day is always considered the day of the beginning of menstruation.

Of all recorded cycles, choose the shortest and longest. Subtract 18 from the number of the shortest cycle. The resulting number is the first day of the fertile phase. Subtract 11 from the longest number. The resulting number is the day it ends.

That is, if the shortest cycle is, for example, 26 days, and the longest is 32, it will look like this: 26-18=8; 32-11=21. This means that unprotected sex is safe until the 8th and after the 21st day of the cycle.

Despite the fact that the calculations are made "with a margin", the calendar method helps more to determine the beginning, rather than the end of the fetal period.

Important

Are you afraid to take risks? Some consider menstruation to be a natural contraceptive. In fact, it does not always serve as an obstacle to conception. Although unprotected sex is considered safe in the first 5-6 days of the cycle, sometimes the fetal period begins earlier. During menstruation, the appearance of cervical mucus is difficult to notice, and therefore, if you do not want to take risks, start using protection from the first day.

Many women choose to use so-called natural methods of family planning, which are based on observations of the physiological signs and symptoms of the fertile (when a woman is fertile) and infertile (when a woman is not fertile) phases of the menstrual cycle.

The purpose of this method is to determine the "dangerous" period, when the ability to fertilize is highest. The idea of ​​the calendar (or rhythmic) method is simple: avoid sexual intercourse during a period when there is a chance of becoming pregnant. The rest of the time, you can not think about methods of contraception and not use any of them.

The successful use of these methods requires self-discipline and careful record keeping, in addition, this is not a method of contraception, but a method that allows you to determine the fertile period, abstaining from sexual intercourse during this time helps to prevent pregnancy.

Natural family planning methods

Can be applied:

• women who cannot use other methods;
• women with regular menstrual cycles;
• couples who do not use other methods for religious or philosophical reasons;
• couples willing to avoid intercourse for more than a week during each cycle;
• couples in conditions where modern contraceptive methods are not available.

This method is far from ideal - for every 100 women who use natural contraception, there are 10-15 unwanted pregnancies per year. In addition, the calendar method of protection cannot be used with an irregular menstrual cycle. Yes, and abstinence from sexual contact, of course, can complicate a woman's life.

How it works

Determining the time of onset and the duration of the period of possible conception is carried out based on the duration of the menstrual cycle over the past 8-12 months (no less!). The beginning of the dangerous period is calculated by subtracting the number 18 from the duration of the shortest cycle (for example, in 12 months, the shortest cycle was 26 days long, so the beginning of the fertile period falls on the 8th day of the cycle).

The end of the dangerous period is calculated by subtracting the number 11 from the length of the longest cycle (for example, in 12 months, the longest cycle was 30 days, so the end of the fertile period occurs on the 19th day of the cycle). Thus, the period of possible conception begins on the 8th day of the cycle, and ends on the 19th (in the above example, the menstrual cycle cannot be called absolutely regular, therefore the duration of the fertile period was 11 days). With such a period, sexual intercourse without the risk of conception is possible until the 8th day of the cycle (its beginning falls on the 1st day of menstruation) and after the 19th.

It is necessary to avoid sexual intercourse during the “dangerous period”, or use additional methods of contraception (condom, spermicides), in extreme cases, resort to emergency postcoital contraception.

For the calculation, you can use the table:

Table usage example

The menstrual cycle is from 27 to 33 days. In the table, you need to find the shortest cycle - 27 days and determine the first "dangerous" day (in this case, 9 days after the start of menstruation). Next, you need to find the longest cycle - 33 days and determine the last "dangerous" day (in our example, 22 days after the start of menstruation). Thus, the "dangerous period" will be from the 9th to the 22nd day of the menstrual cycle (counting from the 1st day of the last menstruation).

The reliability of the method is less, the greater the difference between the longest and shortest menstrual cycles over the past 8-12 months. For women with irregular cycles, this method is generally unacceptable.

Despite the variety and availability of modern barrier and hormonal contraceptives, natural methods of contraception continue to be very popular. According to the observations of gynecologists, more than half of the women surveyed use them to prevent unwanted pregnancies. Although such methods differ in their physiological nature, their effectiveness is extremely low.

Typical representatives of this group include two options - the calendar method and interrupted sexual intercourse. But we are only talking about the first one - if used correctly, it can be really effective. The whole problem is that women, using it, are guided by dubious sources - the advice of relatives or girlfriends. Therefore, obtaining reliable information will allow you to protect yourself “wisely”.

Since it is simply impossible to eliminate the calendar method of contraception, it is therefore important to modify it as much as possible, making it possible to use it. Therefore, an important direction is the maximum obtaining of information about it. Knowing the advantages and disadvantages will allow a woman to reconsider her views on contraception or make an effective addition to it.

concept

The calendar method can be called not only physiological, but also completely natural - its implementation does not require additional means or devices. Its whole essence lies only in the commission of sexual intercourse on certain days of the menstrual cycle:

1. Despite its historical nature, the method was recorded in the literature only at the beginning of the 20th century. Moreover, his study had a completely opposite interest - finding out the fertile interval (days with the maximum probability of becoming pregnant).
2. Accordingly, observations have given another fact - in the menstrual cycle of a woman there is a period characterized by a minimum possibility of conception.
3. The starting point for the assessment was the determination of the moment of ovulation - the release of a mature egg from the ovary. Therefore, a period consisting of several days before and after this event has a high probability of pregnancy.
4. But closer to the next menstruation, cyclic hormonal changes reduce the likelihood of fertilization. Therefore, sexual intercourse during this period will not lead to conception - there are no conditions for its commission.
5. If we take approximate numbers, then safe days take a gap of about two weeks (with a menstrual cycle consisting of 28 days). At the same time, it is almost divided in half by the first day of the onset of the next menstruation.

The calendar method requires a high responsibility from a woman - she should not know the approximate duration of the cycle, but strictly maintain a monthly calendar, be sure to determine the day of ovulation.

Advantages

It was the absence of any extraneous manipulations that determined the high popularity of the method - a woman just needs to know when she has safe days. The advantages of this method of contraception are best considered in comparison with other possible options:

• Unlike hormonal contraceptive pills, it has no systemic effect on the body. Therefore, the method is characterized by the complete absence of contraindications and side effects. Therefore, along with interrupted sexual intercourse, this method of protection is the most physiological and safe.
• There are also a number of advantages over barrier methods, and the main one is the lack of connection with sexual intercourse. Immediately before sex or after it is not required to carry out any activities that have a distracting effect. And the most important factor - the calendar method does not affect the sensations, which change significantly when using condoms or spermicides.
• The generalized point for both options is the material side of the issue. Not every family or couple is able to allocate a stable amount of money for effective protection. Therefore, such contraception is the most budget option for such people.

But all the pluses are almost completely covered by the minuses - it is not for nothing that natural methods are considered the most ineffective in gynecological practice.

Flaws

But the calendar method already has its own negative points, and it makes no sense to list them in comparison. Each of them should lead the woman to the idea that it is better to choose a different method of protection:

• Immediately it is worth mentioning the Pearl index - it was specially designed to evaluate the effectiveness of contraception. Its value shows how many women out of 100 became pregnant, being protected by this method. For the calendar method, it ranges from 9 to 40 (slightly lower than that of coitus interruptus).
• It is only suitable for women with regular and steady menstrual cycles. To correctly determine the safe interval, it is required that its duration be approximately the same at least 12 months.
• Spermatozoa in the vaginal cavity die quickly, but in the cervical mucus they can persist for up to 6 days. Therefore, with a short menstrual cycle, the probability of fertilization remains throughout its duration.
• The method does not protect a woman from possible infection with sexually transmitted diseases, as well as other sexually transmitted diseases. A person who is protected in this way should always be aware of the possible risk. Therefore, it is by no means suitable for casual sex.

At present, the calendar method has not lost its relevance, but it should only be used in combination with other options - barrier or hormonal contraception.

Application

To correctly determine safe days, two prerequisites are required - keeping a diary of menstrual cycles, as well as using special formulas. Such a competent approach will minimize the likelihood of pregnancy:

1. A diary should be kept even before the use of such contraception - to assess the regularity of menstruation. With it, a woman determines the main parameter - the total duration of the cycle. Currently, it is possible to purchase simplified versions - ready-made calendars in which you only need to mark the necessary days.
2. Then, using the first formula, the beginning of the fertile period is determined. To do this, 18 days are subtracted from the duration of the shortest cycle.
3. The second formula allows you to calculate the end of the days during which the maximum probability of conception remains. It is necessary to choose the longest cycle, and subtract 11 days from this figure.
4. The resulting gap is considered safe - during it, sexual intercourse is least likely to end with fertilization. For convenience, its duration is also better noted in the diary of cycles.

The moment of border safe days is important (three days at the beginning and end of the period) - it is believed that during them it is better to use barrier contraception.

Necklace

Recently, the Austrian gynecologist Maria Hengstberger has developed a special pocket device for daily monitoring of the course of the menstrual cycle. Outwardly, it looks like a necklace consisting of multi-colored beads:

• The ratio of the balls roughly corresponds to the division of the cycle into several parts.
• A few red ones (from 3 to 5) represent periods, blue beads characterize the fertile period, and yellow beads indicate the safe period.
• The number of balls in the necklace is 28, which is typical for the average duration of the menstrual cycle.
• It also has a special device - a rubber ring that can move through the beads. A woman must move it forward daily, independently determining the onset of a safe period.
• The first red ball is taken as the starting point - it corresponds to the beginning of menstruation.

A special necklace is an alternative to a calendar only if the length of the cycle matches the number of beads in it.

Combined variant

Since the calendar method itself is limited in time, its combination with barrier methods of contraception is optimal. Their combined use will allow you to have an active sex life during the fertile period:

• After determining the safe interval, it is important to immediately subtract three days from it at the beginning and end. They are considered borderline - when the probability of getting pregnant remains high.
• As a result, about 7 days remain, during which the probability of conception becomes extremely low. In this interval, you can not use additional means used for protection.
• But in the borderline and fertile period, determined using the calendar, it is better to use barrier methods of contraception. Their choice is now diverse - these are condoms, as well as spermicides in the form of vaginal tablets, suppositories, gels or foams.

Contrary to misconceptions, douching now does not belong to any group of contraceptives. Therefore, its implementation should not be made an alternative to the listed barrier methods.

Physiological or biological methods of contraception are among the natural methods of family planning. Consist in refraining from sexual intercourse during the fertile phase of the menstrual cycle (the period during which a woman can become pregnant). During the menstrual cycle, a woman's body prepares for conception and pregnancy. If a conception does not occur, this process is repeated again. The duration of the menstrual cycle is determined from the first day of menstruation (the beginning of bleeding) to the first day of the next and is 21-36 days, more often 28 days.

Phases of the menstrual cycle

In the first phase of the menstrual cycle (in the first 14 days of a 28-day cycle) in ovaries there is a growth and maturation of the follicle (vesicle with an egg inside). The growing vesicle secretes estrogens (female sex hormones). Under the influence of estrogens, the mucous membrane grows uterus- endometrium. On the 14-16th day of the cycle, the follicle bursts, and a mature egg, capable of fertilization, comes out of its cavity, that is, ovulation . Ovulation occurs under the influence of pituitary hormones and estrogens. During each cycle, several follicles begin to develop, but only one of them reaches ovulation. Thus, in each menstrual cycle, as a rule, only one egg is available for fertilization. But sometimes (on average in one of 200 cycles) two follicles mature at the same time, so that two eggs can be fertilized, which will lead to the development of fraternal twins. The egg from the ovary enters the abdominal cavity, is captured by fimbriae (fimbriae) fallopian tube and goes into her lumen. Due to the contraction of the fallopian tube, the egg moves into the uterine cavity. If there are spermatozoa in the lumen of the fallopian tube, the egg is fertilized. Meanwhile, the bursting follicle collapses, leaving a small blood clot in its void. Further, from the cells of the follicle, which are yellow, a temporary endocrine gland develops - corpus luteum , which begins to produce a hormone - progesterone . Distinguish between the yellow body of menstruation and in the case of fertilization of the egg - the corpus luteum of pregnancy. The corpus luteum of menstruation usually functions throughout the second half of the menstrual cycle (14 days). The corpus luteum of pregnancy begins to function when the egg is fertilized and continues throughout pregnancy. If fertilization does not take place, the corpus luteum is in the stage of reverse development, the maturation of a new follicle begins, and endometrial rejection occurs in the uterus, which is manifested by bleeding (menstruation). Probability conception maximum on the day of ovulation and is estimated at about 33%. A high probability is also noted on the day before ovulation - 31%, as well as two days before it - 27%. Five days before ovulation, the probability conception according to experts, it is 10%, in four days - 14% and in three days - 16%. Six days before ovulation and the day after it, the probability conception very small. Considering that the average "life expectancy" of spermatozoa after ejaculation is 2-3 days (in rare cases, it reaches 5-7 days). The female egg remains viable after ovulation for about 12-24 hours. The maximum duration of the "dangerous" period during which pregnancy can occur is 6-9 days. Ovulation divides the menstrual cycle into two phases: the maturation phase of the follicle, which, with an average cycle duration, is 10-16 days, and the corpus luteum phase, which is stable, independent of the duration of the menstrual cycle, and is 12-16 days. The phase of the corpus luteum refers to the so-called period of absolute sterility (pregnancy is impossible under any circumstances), it begins 1-2 days after ovulation and ends with the onset of a new menstruation.

Addiction conception from cycle phases

Bearing in mind the possibility of fertilization, three phases can be distinguished in the menstrual cycle (relative sterility, fertility and absolute sterility). Relative sterility (phase 1) lasts from the first day of the menstrual cycle (the beginning of bleeding) until ovulation. The duration of this phase of the menstrual cycle depends on the speed of the “response” of the follicle to the action of pituitary hormones, which, in turn, may depend on the emotional background, environmental, climatic conditions, etc. That is, ovulation can occur a little earlier or a little later, depending on certain environmental factors. During this period, difficulties sometimes arise with contraception, since the duration of the phase of relative sterility can vary from cycle to cycle within a few days, even with a stable duration of the menstrual cycle as a whole. This fact should be taken into account if you want to get pregnant in this cycle, that is, you should not count on conception after one intercourse on the day of the expected ovulation. The result will be guaranteed if there is sexual intimacy 1 time in 2-3 days during the "dangerous period". Fertility phase (phase 2) starts from the moment of ovulation and ends 48 hours after ovulation. These 48 hours include the time during which a mature egg is capable of fertilization (24 hours); the next 24 hours are allotted for inaccuracy in determining the time of ovulation. Absolute sterility (phase 3) begins 48 hours after ovulation and continues until the end of the menstrual cycle. The duration of this phase is quite constant and is 10-16 days. If we are talking about contraception, then it is rational to consider the last 10 days of the cycle as the phase of absolute sterility. Knowing the physiology of the reproductive system and the fertility periods of her menstrual cycle, a woman can use natural methods of family planning:

• with the aim of conception - planning sexual intercourse in the middle of the cycle (10-15th day), when fertilization is most likely;
• for the purpose of contraception - abstaining from sexual intercourse during that phase of the menstrual cycle during which the probability conception the largest.

Advantages of EMPS:

• no health risk
• no side effects
• free
• involving men in family planning
• use for pregnancy planning
• deepening knowledge about the reproductive system
• closer marital relationship possible

Disadvantages of EMPS:

• low efficacy (9-25 pregnancies per 100 women within 1 year of use)
• maintaining daily records
• the need for a thermometer (for the temperature method)
• the need to abstain from sexual activity during the fertile phase of the menstrual cycle
• only effective for women with regular menstrual cycles
• do not protect against sexually transmitted diseases

Natural family planning methods can use:

• women of reproductive age who have a regular menstrual cycle
• couples who are religious, ethical and other beliefs do not allow the use of other methods of contraception;
• women who, for health reasons, etc., cannot use other methods;
• couples who are willing to abstain from sexual activity for more than one week in each cycle.

Should not use these methods:

• women whose age, number of births or health conditions make pregnancy dangerous for them;
• women with an irregular menstrual cycle (breastfeeding, immediately after an abortion);
• women with irregular menstrual cycles;
• women who do not want to abstain from sexual activity on certain days of the menstrual cycle.

Types of physiological methods

Biological (physiological) or natural family planning methods (EMPS) include: calendar (or rhythmic), temperature, cervical mucus method, symptothermal (a combination of the two methods listed above), coitus interruptus, lactational amenorrhea method (physiological suppression is observed during lactation ovulation due to the baby sucking on the breast), abstinence (abstinence from sexual intercourse). Calendar (rhythmic) method To determine the fertile phase, it is necessary to analyze at least 6-12 menstrual cycles. During this period, abstinence from sexual activity or protection by barrier methods of contraception is necessary. When analyzing the menstrual calendar for 6-12 months, the shortest and longest cycles are distinguished. The number 18 is subtracted from the number of days of the shortest and the day of the beginning of the "dangerous" period is obtained, and the number 11 is subtracted from the number of the longest menstrual cycle and the last day of the "dangerous" period is found out. Let's give an example of calculating the "dangerous" period with a constant menstrual cycle of 28 days. The beginning of the "dangerous" period: 28 - 18 = 10th day of the cycle. End of the "dangerous" period: 28 - 11 = 17th day of the cycle inclusive. The duration of the "dangerous" period is 8 days. It starts on the 10th day of the menstrual cycle and ends on the 17th day. Attention! This method can be used only with strict accounting of all menstrual cycles in the calendar and with a small spread of the menstrual cycle during the year. If you have not marked the duration of the menstrual cycle on the calendar for 6-12 months and cannot say with accuracy about the stability of the cycle, then this method is not suitable for contraception, as well as for calculating the most favorable for conception days. temperature method is based on determining the time of temperature rise in the rectum (basal temperature). It is known that at the time of ovulation, the temperature in the rectum decreases, and the next day it rises. By measuring basal temperature daily for several (at least three) months and abstaining from sexual intercourse in the first phase of the menstrual cycle, including the first three days of a rise in temperature after ovulation, a woman will be able to determine when she is ovulating. The effectiveness of the method depends on the accuracy of determining the timing of ovulation. Therefore, it is necessary to measure the temperature, observing the following rules: always in the morning, within 10 minutes, immediately after waking up, without getting out of bed, using the same thermometer and with your eyes closed, since bright light can provoke the release of certain hormones and contribute to a change basal temperature. The thermometer is inserted into the rectum to a depth of 4-6 cm. The temperature value is noted on the graph. basal body temperature chart(see graph 1): normal from the very beginning of the menstrual cycle (its duration is calculated from the first day of the previous menstruation to the first day of the next) and before the onset of ovulation, the basal temperature is below 37 degrees C and can vary within a small range, for example, from 36 .6 degrees C to 36.8 degrees C. At the time of ovulation, the temperature drops slightly (for example, to 36.4 degrees C), the next day the basal temperature rises above 37 degrees C (37.2-37.4). At this level, she keeps until the next menstruation. The decrease in temperature and the subsequent jump beyond the line of 37 degrees C allows you to determine the time of ovulation. In a 28-day cycle, a healthy woman usually ovulates on days 13-14 of the cycle. It should be noted that due to an increase in body temperature in various diseases, the figures for basal temperature also become high. But can only these two days be considered "dangerous"? Far from it. Even having clearly defined your individual ovulation period, you cannot protect yourself from accidents. If you are nervous, overworked, the climate has changed dramatically, and sometimes for no apparent reason, ovulation can occur 1-2 days earlier or later than usual. In addition, it is necessary to take into account the duration of the viability of the egg and sperm. If, on the eve of the expected menstruation, and especially during the expected, but delayed menstruation, a slightly elevated temperature in the rectum persists, then this allows one to suspect a pregnancy that has already occurred. The temperature method for determining the period of increased fertility implies sufficient discipline of the woman and the exclusion of haste in the morning. The inconvenience of the method is associated with the need for daily temperature measurement, and a rather long abstinence. However, when used correctly, the effectiveness is quite high. In women suffering from diseases of the genital organs, the schedule of basal temperature may change. In this case, the question of the advisability of using this method should be discussed with the doctor. Cervical (cervical) mucus method. In different phases of the menstrual cycle, cervical mucus is produced in the cervix, different in quantity and consistency. Its quantity and consistency is influenced by female sex hormones (estrogen and progesterone). At the beginning of the cycle, immediately after menstruation, when the level of estrogen is low, there is little mucus, it is thick and sticky. This thick and sticky mucus forms a fibrous network that "plugs" the cervix and creates a barrier to sperm entry. In addition, the acidic environment of the vagina quickly destroys sperm. Rising levels of estrogen gradually change the cervical mucus, which becomes clearer and thinner. Nutrients appear in the composition of the mucus to maintain the vital activity of spermatozoa, and its reaction becomes alkaline. This mucus, getting into the vagina, neutralizes its acidity and creates an environment favorable for spermatozoa. Such mucus is called fertile, its amount increases 24 hours before ovulation. The last day of slippery and wet slime is called afternoon rush. This means that ovulation is close or has just occurred. After ovulation, under the influence of the hormone progesterone, cervical mucus forms a dense and sticky plug, which prevents the advancement of spermatozoa. The vaginal environment becomes acidic again, where the spermatozoa lose their mobility and are destroyed. 3 days after the appearance of sticky, viscous mucus, a phase of absolute sterility begins, during which, until the start of the next menstruation, pregnancy will be impossible. Using the cervical mucus method for contraception involves keeping records. In this case, a number of codes can be used (see graph 1). It is believed that the first day of menstruation is the first day of the cycle, subsequent days are numbered. Phase of relative infertility: red squares with an asterisk indicate days of menstrual bleeding; green squares indicate a period characterized by dryness in the vagina, the so-called "dry days". The fertility phase (yellow squares with the letter M, day 11 of the menstrual cycle) begins with the appearance of mucus in the vagina. Ovulation has not yet occurred, but the sperm that has entered the woman's genital tract at this time can remain viable and "wait" for the egg. As ovulation approaches, cervical mucus becomes more abundant and elastic. In this case, the tension of the mucus (when it is stretched between the thumb and forefinger) can reach 8-10 centimeters. Next comes rush day(M). This means that ovulation is close or has just occurred. The fertility phase continues for another 3 days and its total duration in our case is 7 days (from 11 to 17 days of the menstrual cycle). The phase of absolute sterility begins on the fourth day after the maximum discharge (on our chart from day 18) and continues until the first day of the next menstruation.

• Since mucus can change its consistency throughout the day, watch it several times a day. To do this, the thumb and forefinger are inserted into the vagina and the existing secretions are taken. Further, the mucus is evaluated for consistency and ability to stretch between the fingers. There are no discharges on dry days. Each night before bed, determine your fertility level (see legend) and put the corresponding symbol on the map.
• Abstain from sexual activity for at least one cycle to determine the days with mucus.
• After the end of menstruation during "dry days" you can safely have sex every second night ( dry day rule). This will prevent mucus from being confused with semen.
• When any mucus or a feeling of moisture in the vagina, sexual intercourse should be avoided or barrier contraceptives should be used at this time.
• Mark the last day of clear, slippery, gooey mucus with an X. This is rush day- the most fertile period.
• After rush day avoid sexual intercourse for the next 3 "dry days" and nights. These days are not safe (the egg is still viable).
• Starting from the morning of the 4th "dry day" and before the onset of menstruation, you can have sexual intercourse without fear of becoming pregnant.

The effectiveness of this method is low: 9-25 pregnancies per 100 women within 1 year of use. Coitus interruption method consists in removing the penis from the vagina before ejaculation (ejaculation) begins, so that sperm does not enter the vagina and cervix. Its advantage is that it does not require any training or special devices, can be applied at any time and does not require monetary costs. The method requires considerable attention on the part of the man, since some men have spermatozoa in the secret that stands out even before orgasm. In addition, sperm, getting on the skin of the genital organs, retains fertilizing properties for some time. There is a widespread opinion regarding the violation of the sexual function of partners using coitus interruptus. Harmless application of this method is possible with a high sexual culture of partners, with sufficient motivation for choice. It is not recommended for young, inexperienced men and those who have difficulty with erection, potency and premature ejaculation.

Instructions for partners:

• In order to improve the coordination of their actions and to avoid mutual misunderstanding, the partners should discuss their intention to use the interruption method. before intercourse.
• Before sexual intercourse, a man should empty his bladder and wipe the glans penis to remove semen that may have been left over from a previous (less than 24 hours ago) ejaculation.
• When a man feels that ejaculation is about to happen, he must remove the penis from the woman's vagina so that the sperm does not get on her vulva. A woman can help him by moving back a little at this time.

Lactational amenorrhea method (LAM) - use of breastfeeding as a contraception. It is based on the physiological effect that the child has on the suppression of ovulation by the suckling of the mother's breast (physiological infertility develops during lactation).

Who can use MLA

• Exclusively breastfeeding women who are less than 6 months postpartum and have not yet started menstruating.

Who Shouldn't Use MLA

• Women who have resumed menstruation.
• Women who are not exclusively (or almost exclusively) breastfeeding.
• Women who have a baby already 6 months old.

It's important to know

• Feed your baby from both breasts on demand (about 6-10 times a day).
• Feed the baby at least once at night (the interval between feedings should not exceed 6 hours). Note: The child may not want to eat 6-10 times a day or may prefer to sleep through the night. This is normal, but if any of them occur, the effectiveness of breastfeeding as a contraceptive method is reduced.
• As soon as you start replacing breast milk with other foods or liquids, the baby will suckle less and breastfeeding will no longer be an effective method of contraception.
• The resumption of periods means that your fertility has returned and you should immediately start using other methods of contraception.

Abstinence - abstinence from sexual intercourse. This method of contraception does not affect breastfeeding. With abstinence, the effectiveness of protection against pregnancy is 100%. But for some couples, long periods of postpartum withdrawal are difficult to bear. Therefore, abstinence is convenient to use as an intermediate method.

The method of regulation of childbearing is much more precise than the rhythmic method, which is considered obsolete today. It defines a method of regulating fertility or assessing fertility as “the use of physiological signs and symptoms of the menstrual cycle to determine its phases when fertilization can and cannot occur. This information can be used for natural family planning or for the diagnosis and treatment of infertility.” Natural family planning helps you know when a woman is ovulating. This can be done in many ways: by examining cervical mucus, observing vaginal secretions of cervical mucus, measuring core body temperature.

Observation of cervical mucus, combined with measurement of core body temperature and other symptoms that accompany ovulation, is called symptothermal family planning. Commercially available ovulation indicators that test urine before and after ovulation can be purchased from pharmacies, but it's much easier and cheaper to learn how to tell your own ovulation time from changes in cervical mucus. Studies have shown that the symptoms of ovulation in some women, such as breast tenderness, ovulation-related mid-cycle pain, changes in the position of the cervix, are not always accurate signs of ovulation.

In a comparative study of fifteen different methods, including variations on the most common ovulation methods, it was found that observing vaginal secretions alone, known as the ovulation method, was the most accurate and practical for determining the best time to conceive. The addition of core body temperature does not increase the accuracy of the vaginal discharge alone.

The advantage of knowing your cycles of possible conception simply by changes in vaginal discharge during the month is that you will know in advance when conception will be possible. During ovulation, intercourse can alternatively be practiced without intercourse, or barrier methods can be used during this period, however, some experts note that depending on which barrier you use, it may be difficult to determine the state of cervical mucus. Very friendly couples decide this issue together. When a couple uses this method, they often develop a deep respect for each other for fertility and sexuality. It enhances every aspect of their relationship. The soul is involved here.

Method of birth control, with or without the use of barrier methods of contraception during ovulation, can be a very effective contraceptive. To this should be added a system of forbidden points. The most intensively studied method of ovulation according to the Creighton model. Three extensive studies have shown that the method effectively prevents pregnancy in 99.1-99.9% of cases, while in practice the level of effectiveness is 94.8-97.3%. These differences have been attributed to differences in methods of teaching use and errors in application.

If you know when you ovulate, it greatly increases your chances of conception.

It is generally believed that the probability of conception during one cycle in a couple with normal childbearing function ranges from 22 to 30%. But if sexual intercourse is performed for conception, the probability increases significantly. In one study of couples who were about to conceive, 71.4% of the subjects who already had children became pregnant during the first cycle. For subjects who had not previously had pregnancies, this figure was 80.9%. During the fourth cycle, conception occurred in 100% of those who had not previously had pregnancies.

For couples who are having difficulty conceiving, using the ovulation method without other additional testing can significantly increase the chances of conception. The ovulation method also works well for women with irregular periods, breastfeeding mothers, and pre-menopausal women.

Most birth control method experts always recommend that patients consult a specially trained natural family planning consultant because, although the method is simple, it requires support and training, especially in the beginning. The reason is partly that - one of the couple may initially experience unpleasant feelings and grief. Of course, for many it will seem completely new to introduce conscious control of the childbearing function into all areas of sexual relations and take care of it daily. Proper individual counseling by experienced professionals is critical to the success of natural family planning in general; and the application of the ovulation method in particular. It is difficult for him to learn from books, most likely due to the emotional and psychological aspects. What experience a woman (and a married couple) gains from using this method often depends on the quality of the training at the beginning and on instructions during the application of the method.

Couples who use birth control during their reproductive years experience no side effects and often see an increase in the intimacy of their relationship, which includes shared responsibility for their shared fertility.

Although we try to associate interest in natural family planning with some religions, many women resort to this method because it is clearly a holistic approach to childbearing. In a telephone survey of randomly selected women in Germany (1267 in total), 47% of respondents wanted or really wanted to learn about natural family planning, 20% said they were very likely to use it in the future. Religious motives as a motivating reason were absent. I suspect that if practitioners knew this method better and promoted it more, it would be used more widely. Whether you are using a birth control method to prevent pregnancy or to conceive, knowing your ovulation cycle gives you additional options. Here is a brief overview of the most common methods.

Determining the phase favorable for conception

The egg lives from 6 to 22 hours after ovulation. The viability of sperm depends on the composition of the mucus. In fertile mucus, sperm can live up to five days. Without fertile mucus, sperm cells die after a few hours. Thus, during each cycle there are seven days during which pregnancy can theoretically occur. One study found that among healthy women who are trying to conceive, about all conceptions occur during sexual intercourse during the six-day period ending on the day of ovulation. Although no conception in this study occurred after the day of ovulation, the authors of the study estimate that there is a 12% chance of conception on the day after ovulation as well as seven days before ovulation. The study also concluded that for couples who want to conceive, intercourse every other day will be just as effective as intercourse every day. In practice, if you want to get pregnant, you have to have intercourse four times during your most likely fertilization period, which lasts a week. This is usually more effective and less difficult than trying to have intercourse every other day.

Mucus examination (ovulation method)

Research has shown that virtually all women can easily learn to check for the presence or absence of type E (estrogen-stimulated) fertilizing mucus by simply observing vaginal discharge in the vulva.

When menstruation stops, mucus from the cervix is ​​present in a minimal amount. You feel dry. There is no mucus in the vaginal opening, there is no discharge on the linen. Such a lack of mucus indicates the absence of the possibility of fertilization. On these dry days, you can have sex without contraception. The cervix begins to secrete type E mucus about six days before ovulation, so you will know in advance approximately when you will ovulate. When you find mucus on your underwear and you can wipe it off your crotch with toilet paper, you will know that the period of possible fertilization has come. Type E mucus under a microscope contains channels that help sperm enter the uterus. When dried, the mucus forms a characteristic pattern, similar to a fern leaf. This mucus is similar in appearance and consistency to raw egg white. Some women note that this mucus makes laundry wet. You can conceive from when the fertilizing mucus first appears until the fourth day after the peak of its discharge. The last day when any mucus appears, clear, which stretches (stretches more than 2.5 cm between the thumb and forefinger), viscous, is called the peak day of mucus production. This day of peak mucus is closely related and correlated with ovulation, which occurs within plus or minus two days of peak day in 95% of cases.

G-type mucus (stimulated by progesterone) appears immediately after ovulation. This type of mucus is not elastic. Such mucus is opalescent, slightly sticky to the touch. Under a microscope, it does not show channels that facilitate the movement of spermatozoa. This type of mucus, on the contrary, blocks the passage of sperm. After the release of ovulation mucus, the mucus from the cervix may stop secreting (you may become dry) or become denser and thicker (L-type mucus begins to be secreted). In any case, the changes are distinct and easy to see. Your menstrual cycle will begin 12-15 days after the peak of mucus secretion.

Another fluid in your body cycles with your hormonal cycle: saliva. With the change in hormone levels during the cycle, saliva, when dried, begins to form a certain pattern of a microscopic fern leaf, similar to the pattern formed when the mucus from the cervix dries out. You can buy a special small microscope, they are widespread in Europe and Japan. This is another way for a woman to determine her fertilization cycle and manage it in the best possible way, whether for conception or contraception.

Keep records of core body temperature for three months to see if you are ovulating

Although cervical mucus is more accurate, measuring core body temperature and recording for several months is an interesting way to learn about your body and its internal rhythms. It can also help you correlate changes in mucus with ovulation.

The rise in temperature during ovulation occurs under the action of progesterone. If you become pregnant during the period when you measure your core temperature, you will notice that it has risen and does not fall. This rise in core temperature is a very early sign of pregnancy. When a woman becomes pregnant, her progesterone levels rise in her blood, and her temperature becomes higher than outside of pregnancy.

On the first day of your menstrual period, the first thing you should do in the morning is to take your core temperature. This day is considered the first of your cycle. Do this for three cycles, keeping separate notes for each cycle. Build charts. You can then use temperature charts to record changes in mucus.

Ovulation is accompanied by an increase in internal temperature of about 0.6-0.8 ° C, it occurs approximately between the time when the temperature begins to rise and when it reaches its highest point. The time of the most probable fertilization occurs at the end of the third day of elevated temperature.

If you have a very regular cycle, you can get an idea of ​​how long you are likely to conceive and how long you are less likely to conceive with the following entries: Record your cycle length for at least six months to determine the earliest possible day you might ovulate. The follicular phase of the cycle - from the first day of the period to ovulation - can have a different duration. The luteal phase - the phase of the ovarian corpus luteum hormone - is the time from ovulation to the first day of the period, usually lasting 14 days. To determine the first day of your cycle when you might ovulate, subtract 14 from the length of the shortest cycle you've had.

Thus, if your cycle lasts from 26 to 31 days, the earliest day you can ovulate is day 12 (26-14 = 12). Depending on the condition of your cervical mucus, you are likely to have intercourse before the eighth or ninth day of your cycle, when you/can avoid pregnancy. By doing these calculations, you can easily see why the records of the state of the mucus usually give more accurate results than the calendar method.

The condition of the cervix also changes during the monthly cycle. During ovulation, it is much softer and wider than in other periods. You can easily feel it with your finger in the vagina. This can easily be done in the bath. Some women note that the position of the cervix also changes during this period.

In summary, there is no right or wrong way to deal with your fertility. Each of us must realize how heavily programmed we are that we cannot trust our body without external manipulation of hormones. When you understand this, you can make an informed choice. Women who are in love relationships with men who support them do not use contraceptives at all. They just enjoy sex when they feel like it, knowing that if they get pregnant, it will be wonderful.