Contraceptive Pearl: An Overview of Fertility Awareness-Based Methods
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The Creighton Method and the Symptothermal Method appear to be the most effective of the FABMs, with typical-use efficacy rates of approximately 95% and 92%, respectively.2 The Creighton Method involves monitoring the characteristics of cervical mucous and bleeding days, while the Symptothermal Method uses calendar calculations, body temperature monitoring, and cervical mucous characteristics to help predict fertile days.2 It is important to note that these methods may take some time to properly understand and report symptoms. Such methods may be appropriate contraception for people who are committed, organized, and meticulous. The Calendar-based method involves either avoiding or planning for intercourse on days 8-19 of a person’s menstrual cycle; this method has an efficacy of less than 90% with typical use.3
There are two FDA-approved apps that help identify fertile days. Natural Cycles tracks body temperature via a wearable device and is approximately 93% effective with typical use.3 Clue Birth Control is an app that uses input from the user’s menstrual cycle and is FDA-approved for those ages 18-45 with predictable cycles who have not recently been pregnant or on hormonal birth control. It is approximately 95% effective with typical use.3,4 Some of these apps may have data privacy issues that patients should be aware of. Encourage patients to read the terms of use before signing up. The Digital Defense Fund has resources on how to protect yourself online.
There are many different methods for family planning, and clinicians should be prepared to have discussions with patients about the full range of contraceptive methods, including FABMs. As access to reproductive health care and the uncertainty around digital privacy in cellphone applications increase, clinicians must be prepared to provide counseling in a patient-centered, non-judgmental approach to help patients choose the method that best aligns with their health and family planning goals and privacy concerns.
RHAP Resources:
Your Birth Control Choices Fact Sheet
Fertility Awareness Methods (Natural Family Planning)
Download and print our resources for free from our website or visit our store to buy physical copies!
Partner Resources:
Reproductive Health Hotline (ReproHH): A free, confidential phone service (1-844-737-7644) offering evidence-based clinical information for healthcare providers across the US who have questions related to sexual and reproductive health.
Sources:
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