Natural Family Planning

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Natural Family Planning
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Natural Family Planning
Natural family planning (NFP) describes various
modern methods of achieving or avoiding pregnancy
based on knowledge of the signs and symptoms of
human fertility. It requires abstinence from
genital contact during the ovulatory (fertile)
phase of a womans cycle to avoid pregnancy.
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Natural Family Planning
The idea behind natural family planning is very
simple. A woman is fertile for only about 100 to
120 hours during a month. Let's call this time
period the "window of fertility." By avoiding
sexual intimacy during the window of fertility,
pregnancy can be avoided. This method can also
help achieve pregnancy by understanding the
fertility cycle better and learning when the
probability of conceiving is highest. The
question that various natural family planning
methods are trying to answer is "How do I
determine exactly when the window of fertility
starts and ends?"
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Fertility The ability to become a parent
Cycle A period of time from one menstruation to
another. It varies from 1 every 20 days to 1
menstruation a year, or twice a year, etc.
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The Four Seasons of the Fertility Cycle
Late Summer Early infertility
Fall Ovulation time
Early Summer Menstruation
Spring Late infertility
Winter Preparation time for ovulation
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Cyclic Fertility
A womans fertility is cyclic. She is not always
fertile, but only periodically. Her fertility
cycle begins at puberty (11-15 years).
menstruation
Ovulation or fertile phase
Early non-fertile phase (pre-fertile phase)
Late non-fertile phase (post-fertile phase)
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Not all cycles are the same. A woman may have
what is called a long cycle, or a short
cycle, or a medium cycle. Moreover, a womans
cycle is not always regular. Some months she may
be medium, others she may be long, etc.
Long Cycle
During a long cycle, the early non-fertile phase
is long.
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Short Cycle
?
In a short cycle, the early non-fertile phase is
missing.
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Medium
Fertile phase and ovulation
preparation
ovulation
Menstruation
Early non-fertile phase (pre-fertile phase)
Late non-fertile phase (post-fertile phase)
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The pituitary gland is the master hormonal gland
of the human body, located at the base of the
brain. It sends signals to the thyroid gland,
adrenal glands, ovaries and testes, directing
them produce thyroid hormone, cortisol, estrogen,
testosterone, and many more.
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Stress can delay ovulation

• Positive Stress
• Christmas
• Vacation
• Birthday

• Negative Stress
• Exam
• Illness
• Death in the family

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If the oocyte (ovum) is not fertilized within 24
hours, it will disintegrate.
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In the early non-fertile phase of a womans
cycle, the passageway from the vagina to the
uterus is closed by thick mucus. Sperm are
unable to pass through the cervix.
Sperm appear much larger than they would be in
reality
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The cervix is completely open during the
preparation stage of the fertile phase
In the fertile phase, the passageway from the
vagina to the uterus is open. A slippery-type
mucus assists the movement of sperm through the
cervix and nourishes the sperm.
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Once the oocyte is released, the cervix begins to
close.
After the fertile phase ends, the cervix is again
closed off by a thick-mucus plug, blocking the
cervical canal. Sperm are unable to pass through
the cervix. This late infertile phase is
followed by the menstrual phase.
It takes three days for the cervix to close
completely
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Role of Cervical Mucus

• Nourish sperm, that is, keep it alive. Sperm can
  live up to 3-5 days in this environment. When
  there is no mucus, the sperm will die quickly
  for they can live up to an hour without mucus.
• Eliminate weaker sperm or damaged sperm. Only
  the best quality sperm will reach the oocyte.

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Role of Cervical Mucus

• Provide transportation so they can move towards
  the fallopian tubes.
• Finally, to let the woman know when her fertile
  time starts and ends.

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Days of Bleeding
Fertile signs
Dry sensation. No mucus or unchanging mucus
Days 1 2 allow for the possibility of
ovulation. Day 3 allows for the life span of the
oocyte.
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Medium Fertile Cycle (27 days)
Fertile phase and ovulation
preparation
Menstruation
Early non-fertile phase (pre-fertile phase)
Late non-fertile phase (post-fertile phase)
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Menstruation
Sees blood Feels wet
Endometrium
menstruation
Length of menstruation depends on the thickness
of the lining of the uterus (endometrium).
Usually 5 to 7 days.
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Pre-fertile phase
Pre-fertile phase or Early non-fertile phase
Sees Nothing Feels Dry or nothing Or, there
is a cervical discharge that is the same every
day. It does not vary. It will be sticky and
opaque.
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Preparation stage of the fertile phase
Preparation
Feels wet and slippery. Mucus might be
sticky at first, but it changes, becomes more
stretchy and transparent. Everyday the mucus is
different, becoming more and more oily and
slippery.
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Ovulation phase
Ovulation
Fertile signs stop (see first baby)
Feels dry Sees Nothing
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Post-fertile phase or Late non-fertile phase
Feels Dry, or mucus is unchanging.
Post-fertile phase
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Long Fertile Cycle (35 days or longer)
Longer pre-fertile phase
Longer preparation stage of ovulation phase
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Short Fertile Cycle (21 Days)
?
Notice that there is no early non-fertile phase
or pre-fertile phase.
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Days of Bleeding
Fertile signs
Dry sensation. No mucus or unchanging mucus
Days 1 2 allow for the possibility of
ovulation. Day 3 allows for the life span of the
oocyte.
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Adolescent Cycles
Fertile Cycle Mid-Cycle Bleeding. . Caused by
high levels of prolonged estrogen before ovulation
Untreated mid-cycle bleeding might lead to anemia
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Adolescent Cycles
Fertile Cycle Delayed Ovulation Several
patches of fertile signs finally ending in
ovulation. Ovulation is confirmed by the number
of days from the last patch of signs until the
end of the cycle (11-16 days). Ovulation is also
confirmed by the changing mucus pattern which
ends in slipperiness.
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Adolescent Cycles
Anovular Cycle Several patches of fertile signs
but no ovulation. The count between the last
patch and the end of the cycle will be less than
10 days or more than 16 days.
The cycle is quite challenging because ovulation
might actually take place. However, the lutheal
phase is too short and pregnancy cannot be
sustained.
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Adolescent Cycles
Anovular Cycle. No fertile signs
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The following slide shows a sample chart that
includes the recording of both the fertile signs
(ovulation method) and the basal body temperature
(symptothermal method). It might look
complicated at first, but it is very simple and
easy to get used to.
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Threats to fertility
STDs (I.e., chlamydia) One attack of chlamydia
can leave you with a 35 chance of infertility,
two attacks will raise that number to around 50.
A third attack of chlamydia will very likely
render a woman infertile. Abortion The pill (at
least for some adolescents) CONTRACEPTIVE PILL
LINKED TO CERVICAL CANCER Oxford University study
finds substantial increased risk British study
links cervical cancer to long-term use of the
contraceptive pill. Researchers from Cancer
Research UK's epidemiology unit in Oxford
reviewed 28 studies covering 12,500 women. They
found the longer a woman took the pill, the
greater her risk of developing cervical cancer --
with a 10 increased risk of if they took the
pill for 5 years or less, 60 for 5 to 9 years'
use, and 100 greater risk (i.e. double the risk
of a non-pill-using woman) if they had taken it
for at least 10 years.
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• The Benefits of Natural Family Planning
• is based on sound scientific knowledge
• helps the couple understand their mutual
  fertility
• enables couples to achieve or avoid a pregnancy
  
• promotes the mutual love of the couple
• is morally acceptable
• does not require regularity of the menstrual
  cycles
• can be successfully applied during
  breastfeeding, premenopause and discontinued use
  of the birth control pill
• is invaluable for infertile couples, both for
  achieving pregnancy, and as a tool in the
  diagnosis and treatment of reproductive
  disorders

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• is simple to learn.
• Divorce rate for those using NFP 0.043
• Does not cost anything.
• There are no adverse medical side effects, like
  Deep Vein Thrombosis, pulmonary embolisms, heart
  attack, strokes, cervical cancer, and breast
  cancer.
• NFP does not treat your fertility as if it is a
  disease.
• NFP has psychological benefits that strengthen
  the marriage relationship (see article The
  Psychology of the Misuse and Rejection of
  Contraception).

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Problems with the Pill The Pill has been proven
to produce blood clotting defects. These have
resulted in thrombophlebitis, pulmonary embolisms
(blood clots which lodge in the lung and may be
fatal), strokes, heart attacks and blindness. A
more complete listing in the FDA patient warning
brochure lists 18 other diseases or health
problems that have been associated with the Pill,
including cancer. The mortality risks for women
taking the Pill are higher than those for
pregnancy.
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• Breast Cancer
• For those women starting the pill before 20 yrs
  old, the risk of developing breast cancer was
  820 higher than for healthy non-users of the
  same age.
• For women starting pill between 20-25 years,
  relative risk was 180 higher than healthy
  non-users.
• Other researchers cite the risk of breast cancer
  for young women (less than 20 yrs old) is
  200-480 higher than for non-pill users.
• In one study of 918 Dutch women diagnosed with
  invasive breast cancer, 85 had used the pill at
  some time.
• Even 3 months use of the pill has been reported
  to be associated with 100 increase in breast
  cancer.
• For more than ten years use, breast cancer risk
  increased by 310.
• women with breast cancer, who at an early age
  have used oral contraceptives, have larger breast
  tumours and a worst prognosis compared with later
  (pill users) and never users.
• Source Contraceptive Pill Side Effects.
  http//www.iol.ie/7Ehlii/pill_side_effects.html

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Death rate from breast cancer in Australia
20.4/100,000 USA 20.7/100,000 Japan
7.1/100,000

• ie a x3 fold reduction in Japan. Australia/USA
  have a pill history of 30 years with identical
  breast cancer statistics. Industrialised Japan,
  has no pill use, reports one third the rate.
• (Note With use of Depo-Provera (DMPA) "Use for
  two years or longer before age 25 was associated
  with a significantly increased risk of breast
  cancer" (ie 360 increase)
• Source Contraceptive Pill Side Effects.
  http//www.iol.ie/7Ehlii/pill_side_effects.html

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• Cervical Cancer
• Pill use in women less than 20years old means
  280 higher risk of cervical cancer
• In women 20-24 years, its 70 higher.
• In women 25-29 years its 40 higher.
• Another study cites increased risk of 250 for
  cervical cancer amongst pill users.
• Longer term users(6-12 years) 100-340 increased
  risk of non-users cervical cancer.
• However, one of these studies showed women who
  used the pill for only 1-6 months had a 190
  increase in cervical cancer than non-users.
• Clinical evidence cites the pills role in
  activation of and enhancing HPV (Human Papilloma
  Virus) in initiation of cervical cancer.
• Source Contraceptive Pill Side Effects.
  http//www.iol.ie/7Ehlii/pill_side_effects.html

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• Deep Vein Thrombosis (DVT)
• Risk of DVT increased by 600-900 (ie 5-8 fold)
  compared to non-users in users of 3rd generation
  progestagen pills (eg containing gestodene eg
  Femodene, Minulet, Tri-minulet, or containing
  desogestrel eg Marvelon).
• Across all age groups, use of the 3rd generation
  pill brands had a 770 greater DVT risk than
  non-pill users.

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• Second generation progestagens such as
  levonorgestrel and norethisterone have 120-280
  increase risk of DVT.
• For teenagers aged 15-19yrs risk of DVT " for
  the desogestrel-containing oral contraceptive was
  7-fold higher than that of the levo-norgestrel
  containing products among women aged 20-24 the
  risk was 4-fold higher.
• IMPORTANT! Note that this x7 increase was
  relative to 2nd generation users not non-users!!
  Therefore, by computation, risk for 15-19yr olds
  compared to non-users is (120-280) x 7 x
  15-26 fold risk!!
• A x50 fold increase risk of DVT for users
  carrying a blood clotting factor V Leiden
  mutation.This occurs in 5-15 of European women.
  Note mechanism gestodene causes decreased
  oestrogen metabolism in liver leading to
  accumulation in body leading to increased DVT
  risk.
• Source Contraceptive Pill Side Effects.
  http//www.iol.ie/7Ehlii/pill_side_effects.html

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Infertility after pill-use Women may not
conceive for up to 48 months or longer depending
on age This is due to atrophy of the mucus
secreting glands thus preventing sperm
transport. Note Fertility drugs cause
hyperstimulation of the ovaries, leading to
increased ovarian cancer of the ovary due to
increased minor trauma of the covering
epilthelium. The pill, and pregnancy, and breast
feeding cause a rest in ovulation, thus
associated with a decreased incidence of ovarian
cancer. Some family planning advocates defend or
advocate pill use because of the associated
decrease in ovarian cancer rates (0.2 risk). To
do so in light of the appalling side-effects of
the pill documented is a woeful ignorance of the
facts or a deliberate and cynical act of
injustice to women. Source Contraceptive Pill
Side Effects. http//www.iol.ie/7Ehlii/pill_side
_effects.html References "A Consumers Guide
to the Pill" by John Wilks B Pharm MPS 2nd Ed
1997 ALL Publications available from HLI Ireland
10.99 2.00 pp
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Sources and Links
New evidence of a link between abortion, THE
PILL, and breast cancer http//us.catholic.net/rc
c/Periodicals/Igpress/2000-12/inqury2.html Pill
could boost cervical cancer risk
http//news.bbc.co.uk/1/hi/health/1894085.stm Clo
t risks of newer pills confirmed http//news.bbc.
co.uk/1/hi/health/1447377.stm Philosophy,
Assumptions and Benefits of Natural Family
Planning http//www.marquette.edu/nursing/nfp/ser
vices02.html Sample NFP Charts
http//learnv.ycdsb.edu.on.ca/lt/FMMC/hpteacher.n
sf/Files/mcmanad/FILE/nfp_samplechart.xls
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Created by Doug McManaman and Julita Koprianiuk
of Father Michael McGivney Catholic Academy,
April 2005.