The Rhythm Method gets an update

Medical researchers have developed a new approach to natural birth control that, if used correctly, could be as effective as many other popular contraceptives on the market.

Like most forms of birth control, it is far from ideal. It’s basically a new way of counting a woman’s potentially fertile days. But it is increasingly being used by family-planning clinics such as Planned Parenthood who are recommending it to some patients and a growing number of local pharmacies also offer it.

The interest reflects an increasing desire for new methods of contraceptives that are safer, cheaper and easier to use than current options. Recent headlines about the health risks associated with hormone replacement therapy after menopause have made some women wary of contraceptives that involve ingesting hormones for years on end. Yet, the period of time women use contraceptives during their lifetimes has increased significantly in recent decades as more people become sexually active at earlier ages, delay childbearing or choose to have smaller families.

The new natural approach, known as the Standard Days Method, was developed by the Institute for Reproductive Health at Georgetown University using a computer model based on records of over 7,500 menstrual cycles compiled by the World Health Organisation. Like all natural methods, it aims to prevent pregnancy by accurately predicting a woman’s fertile days – but it seeks to avoid the cumbersome calculations that have long lead to high failure rates.

It succeeds by widening the window of potential fertility. But the result – a 12-day stretch requiring either abstinence or some other form of contraception – is likely to discourage many women from trying the approach. “It’s an impediment to the method,” says Victoria Jennings, director of Georgetown’s reproductive health institute, who helped develop it. But, she adds that calculating a fail-safe time when you can have sex without fear of pregnancy will allow some people to “reduce their reliance on condoms” or other unappealing contraceptives.

There are only a few days each menstrual cycle when it is possible for a woman to get pregnant, but they vary by person. Under the new method, a woman considers herself potentially fertile on Days 8 through 19 of her menstrual cycle and must avoid unprotected intercourse during that time. To determine when that is, she makes a one-time purchase of a colour-coded string of beads called CycleBeads. Each bead represents one day of the menstrual cycle. She moves a rubber ring over one bead every day. When the rubber ring is on a glow-in-the-dark white bead, she is fertile and must avoid unprotected intercourse. When the rubber ring is on a brown bead, she is not fertile.

If used correctly, the standard days method has a first-year pregnancy rate of less than five per cent, according to a study of 478 women who used the method for up to 13 cycles. That is comparable to spermicides, the condom and the diaphragm. The birth-control pill is far more effective, with only a 0.3% failure rate if used correctly. But the problem for both is that few people use them perfectly. Just as women forget to take their daily pill (making the actual failure for the pill eight per cent), they could easily forget to move the rubber ring over the beads and, as a result, lose track of the days. (The method’s developers recommend keeping track of your cycle using a calendar as well as the beads.)

But the advantage of the standard days method is that unlike other natural birth-control options it is simple to learn and easy to use, say health-care providers who have started teaching patients how to use the beads in recent months. It doesn’t require a woman to take her temperature every morning before she gets out of bed. She does not have to observe changes in the mucus inside her vagina or to use calculations like counting backward from the first day of her period to locate the day on which she ovulated the previous month.

“A lot of women get pregnant mistakenly because they misread their cycles,” says Virginia Reath, one provider of the pill in New York. “This is visual and simple.”

The beads first came on the market last year. Approximately 100,000 women world-wide now use them, including 20,000 in the US Most women here buy them over the Internet (www.cyclebeads.com), although Planned Parenthood, other family health clinics, some local pharmacies, and health-food chains such as Whole Foods and Earth Fare now offer them as well. Still, sales of CycleBeads are minuscule compared to the US$2.5 billion oral contraceptives market.

The method is suitable only for women who have regular menstrual cycles between 26 and 32 days. For those with shorter cycles, the institute has come up with an approach called the TwoDay Algorithm, for which an efficacy study was just completed. Under this method, a woman monitors herself for the presence of cervical secretions. Unlike other natural methods, she doesn’t have to differentiate between the types of secretions. Instead, if she notes secretions of any kind, and she noticed them the day before as well, she should consider herself fertile.

Reath, the New York family planning adviser, says that for young women not in a stable relationship, she still recommends condoms, either alone or in conjunction with another birth-control method, in order to prevent sexually transmitted diseases. “Younger people are more likely to make erotic and spontaneous decisions,” she says. “This method is for sexually responsible people.”

Taken from the Internet