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  • Title: [Natural methods of contraception].
    Author: Philippe HJ, Jamin O, Martin MT.
    Journal: Rev Infirm; 1992 May; 42(9):58-60. PubMed ID: 1514009.
    Abstract:
    The use of natural contraceptive methods, which require avoidance of sexual relations during the fertile period, declined with development of effective modern methods. At present, their practice is most appropriate for women with vascular, metabolic, or other pathology contraindicating use of modern methods and for couples in which the male partner is fully involved in contraception. Contraceptive methods should be simple, effective, reversible, and safe. The 2 principle methods in France are hormonal contraceptives, used by 50% of couples, and IUDs, used by 30%. Hormonal contraceptives, primarily oral contraceptives (OCs), have a Pearl index of .16% and satisfactory reversibility, but their metabolic and vascular effects make them inappropriate for some women. The Pearl index for IUDs is 1-2%. IUD users have a higher risk for tubal infertility, and some other possible complications are very serious. Neither OCs nor IUDs are indicated for young girls, perimenopausal women, or postpartum women. The main shortcoming of the natural methods is their failure rate, which is probably related to insufficient instruction in their techniques or to forgetting that they require cooperation of both spouses. The Ogino-Knaus or calendar rhythm method involves calculating the fertile period taking into account the life expectancy of the gametes. Calculation is based on the study of the duration of the menstrual cycle in the preceding year. The Pearl index has been estimated at 1-47%, depending on the regularity of the cycle. The temperature method is based on modifications of body temperature due to hormonal variations. The fertile period is considered to begin with the 1st day of menstruation and to last for 3 days following the thermal shift. The Pearl index is 12.2%. Disadvantages of the method are problems of interpretation related to physical exertion or stress and the need for a long period of abstinence. The method of palpation of the cervix is based on detecting the cervical modifications caused by hormonal variations. Estrogens cause softening, opening, and ascension of the cervix, while progesterone causes descent and hardening. Palpation of the cervix allows identification of the fertile period. No Pearl index has been published. The main problems are difficulty in nulliparas and the risk of infection. The Billings method is based on modifications of the cervical mucus during the cycle. The Pearl index is 3%. The principal disadvantages are the difficulty of interpretation and the time required for learning the method. The symptothermal method combines analysis of the periovulatory signs with the taking of the body temperature. The Pearl .8%. The main shortcoming is the possibility of contradictory signs.
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