Natural methods have two things in common: on the one hand, they are completely harmless to health (although sometimes psychologically stressful), on the other hand, they are accompanied by restrictions on sexual intercourse. Most of them are less safe than the other contraceptive methods. Therefore, they should be used only if you accept a possible pregnancy.
Coitus interruptus
Known since ancient times and the most unsafe method is coitus interruptus, in which the man pulls the penis out of the vagina just before ejaculation (Pearl index: 4-18).
Calendar method
The calendar method according to Knaus and Ogino is based on the calculation of ovulation and thus narrowing down the average 8-9 fertile days around it (12-16 days before the onset of menstruation). During this time, sexual intercourse is avoided. The Pearl index is 9.
Hormone and temperature measurement
Hormone and temperature measurement using a microcomputer (for example, Persona) involves determining the hormone concentration in the urine or the temperature in the morning (basal body temperature) and calculating the fertile days from this. As with the calendar method, sex is then abstained from during this period.
With the hormone measurement method the Pearl index is 6, with the temperature method 0.6-3.5. These methods are not suitable for women with irregular menstrual cycles and irregular daily routine.
Fertile days can also be inferred from the appearance and consistency of cervical mucus (Billings ovulation method), but this requires some practice. Currently being tested is a device that measures carbon dioxide levels in the air we breathe as an indicator of readiness to conceive.
Contraception with the help of an app
Support in calculating fertile days can also provide a cycle app. The range of such apps is large – but when choosing, women should look carefully, because the contraception apps use different methods.
Apps based on the symptothermal method (NFP method, natural family planning) use the measured data from the current cycle for calculation. For this purpose, women have to enter information on body temperature and consistency of the cervical mucus or width of the cervix on a daily basis.
Apps that only document the cycle history of the previous months and use these statistics as the basis for calculating the next cycle are completely unsuitable for contraception.
Which method comes into question when?
The individually optimal contraceptive method is best found with the help of a gynecologist. Young girls will often choose a low-dose pill with a combination of estrogen and progestin. Good alternatives are the vaginal ring and the contraceptive patch.
In older women, the risk of estrogen-related complications such as heart attack, stroke, or pulmonary embolism increases. Therefore, switching to a progestin-only preparation or to non-hormonal contraceptive methods such as the copper IUD or the pessary may be appropriate.
During breastfeeding, methods that do not affect breast milk are suitable. In addition to condoms, these are primarily barrier methods such as pessaries, cervical caps or Lea contraceptives. Progestin-only preparations also do not appear to affect milk quality or infant growth.
