Natural Family Planning

1. Natural Family Planning

2. 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 woman’s cycle to avoid pregnancy.

3. 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?"

4. 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.

5. 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

6. Cyclic Fertility A woman’s 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)

7. 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 woman’s 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.

8. Short Cycle: ? In a short cycle, the early non-fertile phase is missing.

9. Medium: Fertile phase and ovulation preparation ovulation Menstruation Early non-fertile phase (pre-fertile phase) Late non-fertile phase (post-fertile phase)

10. 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.

11. Stress can delay ovulation • Positive Stress: • Christmas • Vacation • Birthday • Negative Stress: • Exam • Illness • Death in the family

12. If the oocyte (ovum) is not fertilized within 24 hours, it will disintegrate.

14. In the early non-fertile phase of a woman’s 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

15. 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.

16. 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

17. 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.

18. 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.

19. 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.

20. 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)

21. 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.

22. 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.

23. 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.

24. Ovulationphase Ovulation Fertile signs stop (see first baby) Feels = dry Sees = Nothing

25. Post-fertile phase or Late non-fertile phase Feels: Dry, or mucus is unchanging. Post-fertile phase

26. Long Fertile Cycle (35 days or longer) Longer pre-fertile phase Longer preparation stage of ovulation phase

27. Short Fertile Cycle (21 Days) ? Notice that there is no early non-fertile phase or pre-fertile phase.

28. 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.

29. Adolescent Cycles Fertile Cycle: Mid-Cycle Bleeding. . Caused by high levels of prolonged estrogen before ovulation *Untreated mid-cycle bleeding might lead to anemia

30. 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”.

31. 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.

32. Adolescent Cycles Anovular Cycle. No fertile signs

33. 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.

35. 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 CANCEROxford 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.”

36. 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;

37. 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).

38. 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.

39. Breast Cancer • For those women starting the pill before 20yrs 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

40. Death rate from breast cancer in: • Australia = 20.4/100,000USA = 20.7/100,000Japan = 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

41. 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 pill’s 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

42. 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.

43. 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

44. 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 Consumer’s Guide to the Pill" by John Wilks B Pharm MPS 2nd Ed 1997 • ALL Publications available from HLI Ireland £10.99 + £2.00 p+p

45. Sources and Links New evidence of a link between abortion, THE PILL, and breast cancer: http://us.catholic.net/rcc/Periodicals/Igpress/2000-12/inqury2.html Pill ‘could boost cervical cancer risk’: http://news.bbc.co.uk/1/hi/health/1894085.stm Clot 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/services02.html Sample NFP Charts: http://learnv.ycdsb.edu.on.ca/lt/FMMC/hpteacher.nsf/Files/mcmanad/$FILE/nfp_samplechart.xls

46. Created by Doug McManaman and Julita Koprianiuk of Father Michael McGivney Catholic Academy, April 2005.