Contraceptive Pearl: Natural Family Planning

Natural Family Planning (NFP) methods, also known as Fertility Awareness, help to predict fertile and non-fertile days. People with regular periods can predict ovulation by checking basal body temperature, cervical mucus, urine hormone tests, and/or calendar calculation. Smartphone apps are available for some NFP methods.

The fertile window begins 5 days before ovulation and ends 2 days afterward. Couples who avoid intercourse or use a barrier method during the fertile window can prevent unintended pregnancy. Success with NFP requires substantial effort from both sexual partners.

Studies of NFP methods show quite a wide range of efficacy, from 66% to 98%. These studies’ quality is limited by methodology, recruitment, and drop-out problems.

NFP demands dedication from its users. People with irregular periods cannot use NFP.  However, because NFP. However, because NFP requires no medication, costs little, aids in conceiving or avoiding pregnancy, and is accepted by religions that oppose contraception, it remains an important options for many couples.

Helpful Resources

Natural Family Planning Fact Sheet



Peragallo UR, Polis CB, Jensen ET, Greene ME, Kennedy E, Stanford JB. Effectiveness of Fertility Awareness-Based Methods for Pregnancy Prevention: A Systematic Review. Obstet Gynecol. 2018; 132(3):591-604. doi: 10.1097/AOG/0000000000002784.

Grimes DA, Gallo MG, Halpern V, Nanda K, Schulz KF, Lopez LM. Fertility Awareness-Based Methods for Contraception. Cochrane Systematic Review – Intervention. 2004; 4(CD004860). doi: 10.1002/14651858.CD004860.pub2. 

theBMJ. Fertility Awareness Based Methods for Pregnancy Prevention. BMJ. 2019; 366:14245. doi:


The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.

Contraceptive Pearls

This monthly clinical e-newsletter highlights evidence-based best practice for contraceptive care

Latest Blog Post

View More Posts on Topic