NFP- sharing experiences?

[RedRoses]

Hi there!
I'm just wondering: are there people around here that use Natural Family Planning aka symptho-thermal method?

I've been an active user for about 2 years by now. Since I don't know anyone else who uses this method, it gets kinda lonely I'd like to exchange views and experiences. Questions such as:
-how do you feel about using this method?
-what are your reasons to choose this method?
-to what degree is your partner involved (or do you feel comfortable with)?
-how does it affect your relationship (both pos and neg)?
-what sources did you use to learn this method?
-do you combine with other methods of contraception during your fertile periods or not?
-etcetera

For those who do not know what this is, I wouldn't want to make this an ununderstandable thread
NFP is a method in which a woman observes her body daily, records findings and analyzes them, to determine when she is fertile. It can be used as contraception as well as pro-conception. There are a lot of 'natural' unreliable methods that gives this one a 'bad' name. However; the method as described is based on scientific research (mostly in Germany) and is sometimes referred to as NFP-DAG. It has a pearl-index for 'practical use' of 2 (which equals 2 women in 100 becoming pregnant after regular sex over a year). This is about the same as the pill (see Brandye's topic: Birth Control Failure Rates and for information about the Pearl-index: Birth control)

So ladies, please hit the reply-button
O, and men who use the method in their relationship are most welcome as well!

[Brandye]

I do hope that you get a good discussion going on this topic, Roses. There are many articles in most languages that are available so non-German speakers are not left out. In fact, "sympto thermic" as a search term will score in most European languages. I have never practiced this approach myself but would like to clarify for those who lack your experience.

There roughly three approaches to "natural" contraception. The first is simply watching the calendar and avoiding several days around ovulation time - "normally" the fifteenth day of the menstrual cycle, counting the first day of the period as Day 1. This approach leads to many pregnancies. Few women, and fewer younger women, are so regular in either their periods or ovulation. Further, allowing for sperm living within our reproductive tract for several days, this can block out nearly half the month. Those dating, rather than living together, could find the extensive "blackout dates" difficult.

A slightly better techniques is the basal temperature method. First thing each morning, the woman takes her temperature - before getting out of bed - and keeps track. Our temperatures rise half a degree or so at ovulation. The records are important to identify when to anticipate ovulation because sex the night before can result in pregnancy. Or, resuming sex after the temperature rise runs the risk of the egg lingering in a fallopian tube and becoming fertilized even after the temperature rise. Again, we are dealing with blackout dates that can be quite lengthy. Vaginal intercourse is limited to just after the period for several days and the days after the temperature rise.

The best natural approach is what you are advocating. It requires the basal temperature each morning and uses other indicators. The other indicators must be determined by the individual woman (except for one). Some women experience breast tenderness at ovulation; some have a sharp pain (mittelschmerz) from the ovary releasing the egg; some, increased sexual desire and either spotting or leaking excess vaginal juices. The one that we all have is a change in the mucosa of the cervical os. This requires training, both for us and for our partners, who are better able to make the observation. The cervix is blocked by a mucuous plug except during our periods (so we can drain) and right after ovulation (to allow sperm entry).

I have read the studies on the effectiveness of this technique and they have the same reminders and control of subject behaviour that all the tests of contraception use. Usually those women who report some laxness in their discipline with whatever system or technique are not included in the final count of pregnancies. For those not familiar with the Pearl Index, it divides the number of pregnancies in a study by the number of menstrual cycles the women report and this is then standardized to pregnancies per 100 women per year. There is also an issue in the length of the study conducted changes the denominator, but that is splitting hairs (no pun intended). The "studies" I have seen reporting a Pearl number of 2 are from non-medical, non-scientific studies. Those few scientific studies including real life experience fall far short of this number.

This approach is fine for a stable relationship in which alternative ways to gain satisfaction are used. It is not an acceptable technique for younger women who have sex on weekends, or some such, and who lack the discipline to rigourously follow the protocol. As evidence, see the number of posts here by women who "forget" to take a pill. If you cannot discipline yourself to take a pill, do not try rather sophisticated techniques of self-diagnosis to protect yourself.

[RedRoses]

Thank you for the added explanation, dear Brandye! And yes, I do hope will get a good discussion and dialogue As I'm very curious!

[RedRoses]

Comon don't be shy! Is there honestly no-one here who hasn't at least tried? Has a partner that does? As mentionned: you may use the method for pro-conception as well... So perhaps you could share experiences

[big916]

So this isn't an either or method? Women can still use bpc while checking these signs?

[RedRoses]

Big: No, it isn't. When on birth control pills you technically don't have a cycle. There is a steady flow of hormones administered, which you interrupt to cause a bleed. There is no ovulation. The body is fooled to be pregnant. The NFP-method is about observing your natural cycle. That is your method of contraception.

The natural cycle
The average cycle is between 23-35 days. Many women experience a slight change in the number of days each cycle (for example: 24-26 days). The cycle is basically a game of estrogen en progesterone:

Before ovulation: A cycle starts every first day of a menstruation. At the first stage of the cycle the level of FSH rises. This means that the vesicles holding the eggcells in her ovaries are being stimulated to grow. The more they grow, the more the level of the hormone estrogen rises. This hormone is causing the lining of the womb to rebuild. Basically; the body is getting ready for ovulation. The more oestrogen, the more the cervical mucus increases in quantity. This mucus can be felt by women at the entrance of their vagina. As Brandye explained: the cervix is blocked by a mucuous plug except during our periods (so we can drain) and right after ovulation (to allow sperm entry).

Around ovulation: As the level of LH rises, this stimulates the growing vesicles that hold the eggcells to produce progesterone. The lining of the womb is getting ready for a fertilized egg to implant itself in. Eventually one eggcell lets go of the ovary and "jumps" into the oviduct. Which is known as: ovulation. In rare cases; there are two eggcells. As the estrogen levels are still fairly high and progesterone is building, the quality of the cervical mucus changes into very fluid. The body is making the cervix into a more happy place for sperm. And the bodytemperature rises a little.

After ovulation; the vesicle where the eggcell came from shrinks into a little yellow gland. It continues to produce progesterone. The levels peak. And the cervical mucus becomes more tough again. If not fertilized, the eggcell dies about 12-24 hours after ovulation. If the eggcell wasn't fertilized, the yellow gland disappears 14-16 days after ovulation. The drop of progesterone makes the lining of the womb more lose. Menstruation occurs, a new cycle has begun.

Using Natural Family Planning
As you can see, these hormones influence certain symptoms. What a woman observes in NFP, is basically:

1. basal temperature, each morning, before getting up, preferably at the same time, you note this directly.

Once the temperature is higher than the highest prior 6 measures within this cycle, this could be a sign ovulation is occuring. It needs to stay higher the second day. If the third day the measurement is a least 0.2 degrees Celsius higher than the highest of the prior 6, then this is the first indication ovulation has occurred.

2. the cervical mucus, each day you observe how the mucus feels and looks at each toilet visit and you remain conscious of what you experience during the day. You note the best quality at the end of the day.

The cervical mucus changes in quality and quantity. What the highest quality is, may differ each woman. But generally; it will be dry or a bit moist at the beginning of the cycle. Then mucus becomes visible. The mucus will increase in quantity, be a bit yellow/white colored and clotty. Closer to ovulation it feels very wet and looks watery and/or you can make long elastic-like thin threads out of it when you hold it between thumb and index fingers. Than it returns to a lesser quality.

Basically: when the highest quality is observed, you wait until a lesser quality occurs. When there is no higher quality during the next 3 days, then this is the second indication ovulation has occurred.

3. the positioning of the cervix each day at the same time you check to positioning and note how

The position of the cervix also changes during the cycle. It gets higher and you can feel how the cervix becomes soft and opens a little. Around ovulation it feels as soft as an earlobe, while before and after; more like the tip of your nose. When the cervix is closed again and doesn't change within 3 days, this is the third indication ovulation has occurred.

4. anything particular that can be associated with ovulation Note this if it occurs.

This differs each woman, could be: enhanced libido, a certain smell, tender breasts, ovulation pain (aka mittelschmertz)

5. anything that could have disturbed your findings. Note this if it occurs. This is highly important!

Alcohol, sleeping late, emotional outbursts, sports, measuring your temperature late, medication, illness, etc. Over time you know which ones influence your cycle most. If you see findings out of the ordinary, such as a sudden rise in temperature, and you know you had a fight the evening prior, the elevated temperature could be influenced by this. If you're not sure; best to skip a certain finding out of your calculation

Adding calculations together:
You skip the disturbed findings. You always use 2 indicators for ovulation: temperature+cervical mucus OR temperature+ cervix position. I personally use all 3, the cervical positioning as my back-up data.

And whatever comes last; determines whether ovulation has occurred. So if you haven't determined your elevated temperature, but have had 3 days after the highest mucus quality, you will wait till you can interpret the temperature. Or vice versa. You can then have unprotected sex till the first day of the next cycle. You'll have about 10-14 days on the average.

Some extend this period, until the first few days of the next cycle. This could be done, depending on how long the cycle is. A woman with an average 35 day cycle will generally be more "safe" to practice this, than a woman with an average 24 day cycle. A sperm cell will survive 3-4 days inside a woman, some even 7 days. So if ovulation occurs early, you could still become pregnant!

NFP & your (sex)life
Advantages of this method is that there are no side-effects. You don't use anything "foreign" in your body; you're allowed to respect it's natural state. Which can be very freeing to many women. You don't need any preparation for intercourse. It's cheap. It is highly reliable, when used in the correct way. Anyone wanting to learn should seek an NFP-counselor.

It encourages to respect your body and be conscious about your lifestyle. It is beneficial for your relationship. Women generally feel much respected by their men. It encourages a couple to talk about sex and pregnancy in a conscious way. And it encourages you to be creative with sex in the days penetrative sex is off the menu.

You'll have about 10-14 days at the second stage of each cycle to have unprotected penetrative sex. But; strictly NFP-users statistically have just as much sex as others do. They just have it at different times. To add extra time; you could use condoms in the more fertile periods. But mind you that a condom could fail! Other types of contraceptives are not possible to combine with NFP, as it influences your findings.

When you do decide it's time for children; couples using NFP become pregnant quicker than others. Because the method can be used for conceiving as well. Recent German research has found that couples who were trying to conceive between 1-3 years, half of them had become pregnant within 8 months using the method. There are couples that learn the method explicitly to conceive.

WARNING
I have explained some basics here. Mind you: the above is not a complete overview! And: it takes a woman about 3 cycles to get to know her own cycle and learn how to use it. It is strongly recommendable to ask for a NFP-counselor to guide you through this. Also: NFP does not protect you from HIV/STD's!

I am currently taking classes to become a NFP-counselor. And I've used the method myself for nearly 4 years now. I've made this summary based on Dutch and German information. If some words seem oddly translated, please ask. Or correct me if you think something is wrong. Esp Brandye, you're most welcome!

Any questions? I'd be happy to answer!

[RedRoses]

After all the theory, on a little personal note:

To me using natural family planning has encouraged me to listen to my body and to get to know it. To establish a profound bond and connection with it. Your body is your temple. Your home that will cradle, support and protect you till the day you die. And yet; I didn't know it for so many years. In fact; I silenced and repressed it. NFP has greatly improved my understanding of my body and myself. It has learned me to trust, love and accept on levels that reach far beyond fertility.

This passion and fascination has stimulated me to pick up an education to help women discover the wonders of their bodies. If all goes well, in about a year I will have obtained all the certificates and be a female fertility-, pregnancy- and birth-counselor. I'm so much looking forward to this career change!

[big916]

oh ok i misread your question is your op that says "do you combine with other methods of contraception during your fertile periods or not?" sounds great for the right women who would be diligent on documenting these signs everyday. i'm curious though how a woman checks her cervix position when she can't see it since it is inside her?

[RedRoses]

Originally Posted by big916

oh ok i misread your question is your op that says "do you combine with other methods of contraception during your fertile periods or not?".

Yes, I did ask that question. We have at times used condoms during the more fertile periods. And I have been looking into a cervical cap (as posted here: spermicides/diaphragm & NFP?) I've checked my books and asked my counselor; my initial thought appears to be right. You can't combine NFP with a cervical cap and spermicides, cause it could disturb the cervical mucus and/or make it impossible to observe for at least a day or 2. This is not much preferable. What you could do; use the cervical cap during one cycle, get back to NFP on the next cycle, since the disturbance isn't long term. Or it could be proper to use a cap in cycles that you find it hard to determine ovulation (when you had a fever in the first stage prior to ovulation, it can become impossible to calculate).

Originally Posted by big916

i'm curious though how a woman checks her cervix position when she can't see it since it is inside her?

Checking your cervix is quite a discovery and adventure in itself! Or at least: to me it was
What you do (and I'm describing this from the woman's point of view) is:

Get on your knees or sit in a squat.
Insert your middle finger in your vagina (palm facing towards you, it will most likely push against your labia).
As you slowly insert upward, you point your finger slightly backwards (towards the rectum).
The tip of your finger remains pointed upward (since you don't want to scratch the cervix).
At a certain point you will either feel the kind of nosetip or earlobe. In the middle there is a little "dip", this can be slightly open or firmly closed.
Et voila; there is your cervix!
Gently feel the area by circling your finger across it. Don't poke or push it!

Discover which position feels best to you. When you start recording findings, always feel your cervix in the same position. If you're comfortable with it; you could also feel with two fingers by adding the index finger. Depending on how short your fingers are (like I have ), you could use little tricks.
- If you bear down a little the cervix will come towards your finger.
- you could use the other hand to apply very light pressure on you lower abdomen.
- you could push with the other hand on the hand inserted, to get your finger a bit deeper.

My bf was much surprised when I told him about my victory of locating my cervix. And he was really thrilled the first time I allowed him to feel it. Though he has had many lovers before me, he never got to feel inside a woman so consciously. If she's willing to let you, the instructions are basically the same when feeling it inside her as a male. Be very gentle and go very slow! Few women actually have their partners feel it for them daily, because they find it hard to reach themselves. It contributes to the "together-feeling" of using this method.

Originally Posted by big916

sounds great for the right women who would be diligent on documenting these signs everyday

That's what it takes. I wouldn't recommend to switch to this method for those who, for example, tend to forget their BC-pills
When we chose this method together, it was on 1 condition; I would quit if I'd start to feel distant from my body, as if I'd be making myself into a science-project. That never happened. As described; I actually feel more in touch with my body than I ever did before.

[epicsexy]

This is somewhat an off topic question. Right before my period or during, sex would hurt like he was hitting something, would that be my cervix? It doesn't happen now that I'm on bcp. If so wouldn't it make more sense to hurt when the cervix is closed?


Also I really enjoyed this post, I have learned a lot about myself I didn't know, somethings all women should know. I would love to try this method, as for now my life is constantly busy and changing, maybe sometime in the future, like when I start college.