NATURAL METHODS

OBJECTIVES
• Definition of the natural method
• Classifications of the natural method
• Formulation
• Effectiveness
• Common side effects
• Eligibility criteria
• Guidance on correct usage
• Common misconceptions about the method
 NATURAL METHODS

• Natural methods refers to methods that do not use

artificial devices or hormones to prevent pregnancy.
• They rely on understanding and observing the
natural signs of fertility.
• These methods include; fertility awareness,
withdraw, and lactation amenorrhea.
 FERTILITY AWARENESS METHOD

• These are methods that help to track female’s

fertility cycle and predict when one is fertile.
• Sometimes called periodic abstinence or natural
family planning.
• A woman knowns how to tell when the fertile time
of her menstrual cycle start and ends.
 CLASSIFICATION OF FERTILITY AWARENESS
METHOD
1. CALENDAR-BASED METHOD
• This involves tracking of days of the menstrual cycle to
identify the start and end of fertile time.
• It is categorized into; standard days method and calendar
rhythm method
• On standard days method, a woman can use this method if
most of her menstrual cycles are 26 to 32 days long. Day 8
through 19 of every cycle are considered fertile days for all
users of this method so couples should avoid vaginal sex or
use condoms or diaphragms.
 STANDARD DAYS METHOD
Figure below shows standard days method;
 CLASSIFICATION CONTINUE

• On calendar rhythm method, a woman records the number of

days in each menstrual cycle for at least 6 months. The first
day of monthly bleeding is always counted as day 1. The
woman subtracts 18 days from the length of her shortest
menstrual cycle, this tells her the estimated first day of her
fertile time, then she subtracts 11 days from the length of her
longest menstrual cycle recorded. This tells her the estimated
last day of her fertile time.
• The couple avoids vaginal sex or uses condoms or a
diaphragm during the fertile time.
CALENDAR RHYTHM METHOD
 2. SYMPTOM BASED METHOD

• This method depend on observing signs of fertility.

• Cervical secretions; When a woman sees or feels cervical
secretions she may be fertile. She may feel just a little vaginal
wetness.
• Basal body temperature; A woman’s resting body temperature
goes up slightly after release of an egg ( ovulation ). She is
not likely to become pregnant from 3 days after this
temperature rise through the start of her next monthly
bleeding. Her temperature stays high until the beginning of
her next monthly bleeding.
 EFFECTIVENESS OF FERTILITY AWARENESS
METHOD

• Effectiveness depends on the user, the risk of pregnancy is

greatest when couples have sex on the fertile days without
using another method.
• 85% of the women using this method will not become
pregnant. Most of the couples in this study were using
calendar rhythm method
 SIDE EFFECTS

• There is no side effects, only health benefits is to protect

against risk of pregnancy.
 ELIGIBILITY CRETERIA

• Women willing to record and observe signs daily.

• Partner cooperation
• Committed to abstinence or alternative contraception during
fertile days
• Regular menstrual cycles
 GUIDANCE ON CORRECT USAGE

• Educate on correct observation and recordings on signs.

• Use charts or apps for tracking.
• Abstain or use barrier methods during fertile days.
• Consistency and regularity are key.
• Get proper instructions from a well trained fertility awareness
educator.
 COMMON MISCONCEPTIONS

• Fertility awareness are easy and require little effort.

• It provide protection against STIs
• It is only for women.
• It is unreliable
 WITHDRAW METHOD

• This the method where the male partner withdraws the penis
from the vagina before ejaculation to prevent sperms from
entering the female reproductive tract.
• It is also called coitus interruptus and pulling out.
• It works by keeping sperms out of the woman's body.
 EFFECTIVENESS

• It depends on the user: Risk of pregnancy is greatest when

the man does not withdraw his penis from the vagina before
he ejaculates with every act of sex.
• 80% of women whose partners use withdraw will not become
pregnant.
 SIDE EFFECTS

• It has no side effects, but health benefits and risks.

• Risk of pre-ejaculate fluid containing sperm leading to
pregnancy.
 ELIGIBILITY CRITERIA
• All men can use this method. No medical conditions prevent
its use.
• Male partner capable of controlling ejaculation.
• Willingness to practice withdrawal.
• This may be appropriate to couples who:
- are waiting to start another method
- have sex infrequently
- have no other method available at the time
 GUIDANCE ON CORRECT USAGE OF WITHDRAW

• When the man feels close to ejaculating, he should withdraw

his penis from the woman’s vagina and ejaculate outside.
• If the man has ejaculated recently, before sex he should
urinate and wipe the tip of his penis to remove any semen
remaining.
 COMMON MISCONCEPTIONS

• Withdraw is 100% effective

• It protects against STIs
• It is easy to use withdraw method
• Learning proper use of this method does not take time.
 LACTATION AMENORRHEA METHOD
• Refers to a temporary family planning method based on the
natural effect of breastfeeding on fertility. AMENORRHEA”
means not having monthly bleeding.
• This happens due to hormonal changes that occur when a
mother breastfeeds her baby.
• When the baby suckles, the levels of prolactin and oxytocin
secretion from pituitary gland increases, therefore suppresses
gonadotropin-releasing hormone (GnRH) a hormone that
stimulate pituitary gland to release luteinizing hormone and
follicle stimulating hormone, hence no ovulation.
 EFFECTIVENESS

• Effectiveness depends on the user, the risk of pregnant is greatest

when a woman cannot fully breastfeed her infant.
• It is 98%
 COMMON SIDE EFFECTS

• Lactation amenorrhea has no side effects

 ELIGIBILITY CRITERIA
• When woman is less than 6 months postpartum.
• Infant is exclusively breastfed ( 4-6 hours day and night ).
• All breastfeeding women can safely use this method but
those with the following conditions may want to use other
methods:
- Has HIV infections
- Is using certain medications during breastfeeding including
mood altering drugs or high dose of corticosteroids.
- If the new born has a condition that makes breastfeeding
difficulty for example premature babies.
 GUIDANCE ON CORRECT USAGE
• Start breastfeeding immediately (within one hour) or as soon
as possible after the baby is born.
• An ideal pattern is feeding on demand and at least 10 to 12
times a day in the first few weeks after childbirth, then 8 to
10 times a day thereafter including once at night in the first
month.
• Regularly monitor for return of menstruation.
• Ideally when the baby is 6 months old, the mother can start
giving her baby other foods besides breast milk.
 COMMON MISCONCEPTION

• Lactation amenorrhea is permanent method

• Women worries that they will run out of milk.
• It is effective to fat women only than thin women.
• It guarantees pregnancy prevention 100%.
 SUMMARY

• Natural family planning methods offer the hormone-free and

often cost-free options for family planning, but they demand
high user commitment and accuracy. While effective when
used correctly, they are generally less reliable than modern
contraceptives and provide no protection against sexually
transmitted infections.
REFERENCES

• World Health Organization.(2018 update), Family planning:

A global handbook for providers (3 rd edition). Baltimore and
Geneva.
• Centers for Diseases Control and Prevention. (2023).
Effectiveness of family planning methods.