We track ovulation using cervical discharge. Natural methods of birth control. Description of the cervical method of contraception

The cervical method, also known as the Billing method, is a NFP (natural family planning) method. It is used to determine the moment of ovulation as accurately as possible and thus choose the most favorable period for conception. The method received its name in honor of the Australian married couple Billing, who discovered that cervical mucus(a substance secreted by the mucous glands of the cervix) changes during the female cycle.

How does the cervical method work?

The Billing couple found that the production of mucus in the cervix is ​​directly related to hormonal changes during the cycle. The release of the sex hormones estrogen and progesterone has a direct effect on cervical mucus, which changes throughout the cycle not only in color and quantity, but above all in consistency. For the most accurate determination of the moment of ovulation with the cervical method, daily monitoring of the properties of mucus is necessary for several months. To do this, you should check the quality of mucus in the morning manually or using two layers toilet paper to identify signs of fertility. Features and changes in mucus are recorded in a special chart or history log, on the basis of which it will subsequently be possible to determine the date of ovulation.

Cervical method: there are 5 phases

The cervical method distinguishes 5 phases, within which two types of mucus are mainly distinguished.

• 1st phase: Immediately after menstruation, a woman's esrogen levels are still very low and mucus production is low. Cervical mucus continues to be produced, but forms a dense plug at the entrance to the uterus, preventing germs from entering. The vagina is drier at this point, which is why this phase is also called “dry days.”
• 2nd phase: Some time before ovulation, estrogen levels rise and the mucus plug changes its consistency. The vagina now also contains viscous, cloudy, yellow or white sticky mucus. Due to its relatively dense structure, this mucus still represents a natural barrier for sperm and limits or complicates their penetration into the uterus while the egg is not yet ready for fertilization.
• Phase 3: Just before and after ovulation, a woman's estrogen levels are highest. During this period, mucus production reaches its peak, which is commonly called “wet days.” The mucus becomes noticeably lighter, transparent and elastic. In its consistency, it resembles raw protein and can stretch between fingers or layers of toilet paper into a thread 6-15 cm long. This is the period of the so-called “crystallization of mucus” (stringency of mucus). It usually lasts about 2-3 days and clearly indicates ovulation. Since sperm penetrate well only through this “fertile” mucus, couples wishing to have a child are advised to have unprotected intercourse sexual intercourse since the appearance of such discharges. Thanks to mucus, sperm are also well protected from the hostile acidic environment of the vagina and can survive in a woman’s body for 3 to 5 days. The chances of getting pregnant thus increase significantly.
• 4th phase: A few days after ovulation, the female body begins to intensively produce progesterone instead of estrogen. Mucous discharge becomes more scanty, viscous, cloudy and lumpy. Conditions for penetrating sperm deteriorate, and the likelihood of fertilization inexorably decreases.
• Phase 5: During the premenstrual phase, mucus production continues to decrease and the body prepares for menstruation. Regular and continuous study of the structure of mucus is a fundamental point when using cervical method, this makes it possible to record even minor changes and evaluate your own body more objectively.

Is the cervical method reliable?

Mucus production female body depends on many different factors. Mental stress, bacterial infections However, medications (such as ointments or suppositories) used vaginally can affect the structure and amount of cervical mucus. In addition, its quality is affected by hormonal fluctuations, which complicate an objective analysis of symptoms. The production and quality of mucus can also be influenced by a woman’s diet. In addition, it is important to consider that the above-described signs in different women s can be expressed differently. It is for this reason that the cervical method requires constant monitoring of own body. The method is not suitable for everyone also because in some women, the cervical mucus undergoes such minor changes during the cycle that they cannot be detected with the naked eye. In addition to a method of determining the moment of ovulation for conception, the cervical method can also be used as a natural method of contraception. However, as independent method protection it is considered unreliable. Therefore, for both purposes it is recommended to combine the cervical method

The cervical mucus method, also called the Billing method, is a method of natural family planning.

The cervical mucus method relies on careful observation of mucus samples during menstrual cycle. Before ovulation, cervical secretions change - creating an environment that helps sperm pass through the cervix, uterus and fallopian tubes to the egg. By monitoring changes in cervical mucus characteristics, it is possible to predict ovulation, which can help you determine when you might become pregnant.

If you are planning a pregnancy, you can use the cervical method to determine better days for sexual intercourse. Likewise, if you're hoping to avoid pregnancy, it can help to know which days to avoid unprotected sex.

Using the cervical mucus method to prevent conception requires motivation and dedication. If you don't want to conceive, you and your partner should avoid sex or use a barrier method of contraception every month.

Advantages

The cervical method can be used as a way to determine fertile days or to avoid unprotected sex. Monitoring the condition of cervical mucus for conception and pregnancy protection is in an accessible way and doesn't have side effects. Some women choose to use the cervical mucus method for religious reasons.

This method natural family planning is sometimes combined with others, such as tracking or. It is sometimes called the symptomatic method.

Risks

Using the cervical mucus method to stimulate fertility and control conception does not pose any risks, but does not provide protection against sexually transmitted infections. In addition, the risk is slightly higher than with other methods of contraception.

It is estimated that 23 out of 100 women who use the cervical mucus method for contraception become pregnant in the first year of using this method. But at maximum correct use Pregnancy rates can be as high as 3 in 100 women per year using this method.

Formal training is required to become proficient in the cervical method. Constant and careful daily monitoring is also required. In addition, abstinence or use of contraception is required for 10-17 days of each cycle.

How to prepare?

To use the cervical mucus method, it is important to understand how discharge changes during the menstrual cycle. Typically you will have:

• No noticeable cervical discharge for 3-4 days after the end of menstruation
• Scanty, cloudy and sticky discharge within the next 3-5 days
• Copious, clear and moist discharge, resembling egg white, over the next 3-4 days - the period before and during ovulation
• No noticeable cervical discharge for 11-14 days before your next period

Although the exact length of these phases may vary, contact your gynecologist if the discharge does not correspond general scheme. You may have an infection that requires medical attention.

If you want to use the cervical method for contraception, contact your doctor first if:

• You recently had your first period, gave birth, or stopped taking hormonal contraceptives
• You have a breastfed baby
• You are approaching menopause
• You have a disease that affects regular ovulation, For example,

Your doctor may not recommend using the cervical mucus method if you have chronic infection reproductive organs.

How to check cervical mucus?

1. First, wash and dry your hands.
2. Find a comfortable position by sitting on the toilet, squatting, or standing with one foot on the edge of the bathtub or toilet.
3. Place one or two fingers inside your vagina. Index or middle, probably fits better Total. Be careful not to scratch yourself. Depending on how much cervical mucus you produce, you may not need to go deep, but getting a sample near the cervix is ​​still ideal.
4. Remove your finger from your vagina and examine the consistency of the mucus that remains on your finger. Do this by looking at the mucus and rubbing it between two fingers (usually your thumb and forefinger). Try squeezing your fingers and then slowly spreading them apart.

What do you need to know?

To use the cervical mucus method:

• Record your discharge data over several cycles. Starting on the day your menstrual bleeding stops, observe and mark your discharge on a chart. To avoid confusing cervical discharge with semen or normal sexual lubricant, avoid sex or use a barrier method of contraception during your first cycle. Also avoid douching, as this may cause you to miss the change in discharge.
• Check your discharge before and after urinating. Record the color (yellow, white, clear, or cloudy), consistency (thick, sticky, or rubbery), and feel (dry, wet, or slippery) of your discharge. Also pay attention to any dry or wet sensations in your vulva.
• Plan sex carefully during fertile days. These are the days when cervical discharge is abundant, transparent, elastic, wet and slippery - like raw egg white. If you're hoping to get pregnant, now is the time to have sex. Ovulation most likely occurs during or one day after last day This type of cervical secretion is also known as peak day.
• If you are hoping to avoid pregnancy, unprotected sex undesirable in the interval from the beginning of cervical discharge to the peak day and another 4 days after it (this is approximately 6-9 days in a row, starting from the 3rd or 4th day after menstruation with a 28-day cycle - editor's note). If you have unprotected sex before your discharge starts, you should avoid sex for the next 24 hours so as not to confuse semen and lubrication with cervical discharge.

Interpretation and mapping of cervical mucus can be challenging task. Most women need more than one instruction to recognize mucus patterns in a typical menstrual cycle. Consult your physician with any questions or concerns.

There are several various methods natural family planning.

Currently applied following methods fertility control (possibility of fertilization):

• calendar (or rhythmic);
• method basal temperature bodies;
• cervical mucus method;
• symptothermal.

Calendar method.

The calendar method is the oldest method of preventing pregnancy and is based on calculating fertile days. It is taken into account that ovulation begins 14 days before the start of menstruation (with a 28-day menstrual cycle), the viability of sperm in a woman’s body is approximately 8 days, and the viability of eggs after ovulation is 24 hours. Since the duration of the first phase of the menstrual cycle varies among different women, as well as in different menstrual cycles of the same woman, fertile days can be determined by subtracting 18 days from the shortest and 11 days from the longest menstrual cycle.

In order to calculate your fertile period, you need to track the duration of at least six menstrual cycles, during which you should either abstain from sexual activity or use another contraceptive method.

Fertile phase calculation:

For example:

Longest cycle: 30 – 11 = 19 days.

The shortest cycle: 26 – 18 = 8 days.

According to calculations, the fertile period is from the 8th to the 19th day of the cycle (12 days of abstinence are required to prevent pregnancy).

Basal body temperature method.

Based on changes in body temperature shortly after ovulation. An increase in basal body temperature indicates the development of ovulation, but does not predict its occurrence. Basal temperature sometimes decreases 12-24 hours before ovulation, after which it increases by an average of 0.2 - 0.5 ° C. Thus, the period from the beginning of the menstrual cycle until the basal temperature is elevated for three consecutive days is considered fertile. A true postovular rise in temperature lasts about 10 days. Since changes in basal temperature are affected by various factors(diseases, stress, sleep disturbances, etc.), interpretation of measurement results requires special attention.

Rectal temperature (basal body temperature) is taken at the same time each morning before getting out of bed and then recorded on the chart.

The infertile phase begins in the evening of the third day in a row when the temperature remains above the cover line.

If within three days the basal temperature drops to or below the covering line, this may mean that ovulation has not yet occurred. To avoid pregnancy, wait until three consecutive days with a temperature above the cover line before having sex.

Cervical mucus method (Billing method).

Based on the fact that the nature of cervical mucus changes during the menstrual cycle, and especially during ovulation. In the period before ovulation cervical mucus absent or observed with white or yellowish tint. As we get closer ovulatory period the mucus becomes lighter, more abundant and elastic, while the tension of the mucus (its stretching between the index and thumb) sometimes reaches 8-10 cm. Subsequent examination of a dried drop of cervical mucus under a microscope results in a pattern resembling fern leaves (“fern phenomenon”). The last day of high humidity is called the "peak day", which corresponds to the most high level estrogen in the body and the most fertile period. A day after the disappearance of abundant light mucus, ovulation is observed. Therefore, a woman using the cervical mucus method should assume that ovulation has begun two days before the appearance of “peak signs” of cervical mucus. After the “peak day,” the discharge changes dramatically under the influence of progesterone - it becomes thicker or stops.

The fertile period continues for another four days after the disappearance of abundant, light and elastic mucous discharge. The postovulatory, or late infertile phase of the cycle begins on the fourth day after maximum discharge and continues until the first day of the next menstruation.

A number of notations are used to keep records:

Symbol for designation menstrual bleeding.

Letter WITH to indicate dry days.

Letter M in a circle to represent moist, clear, fertile mucus (mucus).

Letter M to refer to sticky, white, cloudy, infertile mucus (mucus).

Symptothermal method.

Includes monitoring of basal body temperature, changes in cervical mucus, may include calendar method, as well as others physiological indicators ovulation: breast tenderness, bleeding from the vagina, a feeling of heaviness in the lower abdomen, etc. This method is combined and requires strict compliance with all the rules of the methods of which it consists.

Thus, the cervical mucus method is more indicative of determining the beginning of fertile days than the method of changing basal body temperature, since basal temperature rises only after ovulation.

You can determine your fertile days by monitoring your temperature and cervical mucus at the same time.

The fertile phase begins with the appearance of any mucus or sensation of moisture in the vagina. You should abstain from sexual activity during this phase until the rules of the “peak day” and temperature changes are applied.

You should apply the more conservative "rush day" rule and not have sexual intercourse until the 18th day.

Disadvantages of natural contraceptive methods

Natural Methods contraception has a number of disadvantages: their average effectiveness is up to 80%; Daily record keeping is required; vaginal infection may affect the consistency of mucus, etc.

Also when breastfeeding a child or when irregular menstruation women should choose other methods of modern contraception.

Lactational amenorrhea method

The lactational amenorrhea method refers to the use of breastfeeding as a method of birth control. It is based on physiological effect, which has the effect of a child sucking on the mother's breast, is the suppression of ovulation.

The duration of anovulation varies individually and can range from 2 to 24 months after birth, since physiological infertility develops during lactation.

Women who are not using contraceptive methods but who are fully or almost entirely breastfeeding and who are amenorrheic can be considered to have a very low risk (less than 2%) of becoming pregnant in the first six months after giving birth.

If at least one of these conditions ( breast-feeding, amenorrhea, no more than six months have passed since childbirth) is not fulfilled, it is necessary to use any other method of contraception. This also applies to women who have returned to menstruation and those who are not exclusively breastfeeding.

Coitus interruptus method

This traditional method Family planning involves the man removing his entire penis from the woman's vagina before he ejaculates. Since sperm does not enter the vagina in this way, fertilization does not occur.

The advantages of the method include:

• involving the partner in family planning issues;
• immediate effectiveness;
• does not affect breastfeeding;
• does not require cash costs;
• can be used at any time of the day.

The disadvantages include:

• low efficiency of the method (up to 80% protection);
• effectiveness may be reduced due to the presence of urethral canal penis remains of sperm from a previous ejaculation (about 24 hours ago);
• does not protect against sexually transmitted diseases;
• there may be a decrease in sexual sensations in both spouses and the development of sexual disharmony.

Fertility methods (i.e., the physiological ability of a woman or male body to participate in fertilization), also called “natural family planning methods” - a series of methods based on tracking changes in the body when it gives a signal of readiness for fertilization. A woman may only be fertile during one part of her menstrual cycle. By controlling certain changes in her body, a woman can more or less predict the time of the fertile phase and during this time, if she does not want to become pregnant, abstain from sexual intercourse. She can also use barrier methods if they are not prohibited by religious beliefs.

Temperature method

To determine the most likely time of ovulation and therefore the time of maximum possible conception, a woman must measure her basal body temperature, which rises and falls in accordance with hormonal fluctuations.

Every morning, before getting up, a woman must measure her temperature with a special basal thermometer and mark the result on a graph - a paper map. It is measured in the rectum at the same time every morning (for example, before getting out of bed). She should pay attention to the days of menstruation and sexual activity. The so-called “fertile windows” are 6 days. They begin 5 days before ovulation and end on the day of ovulation.

It is believed that days 10-17 in the menstrual cycle give a high chance of fertility (from the 1st day of the period, ovulation occurs approximately 2 weeks later).

However, not all women are able to conceive during this time period. Women who have longer or shorter menstrual cycles may have different periods fertility time.

Immediately after ovulation, in about 80% of cases, body temperature rises sharply. Some women can usually ovulate without this temperature regime. By studying temperature fields over several months, a couple can anticipate ovulation and plan their sexual activity accordingly. In order not to lose spontaneity, couples should try to avoid being fixated on a schedule when planning their sexual activity and use, for example, barrier methods of contraception.

Here are some tips for using the temperature method:

Measure your body temperature every morning without getting out of bed, preferably at the same time and on the same area of ​​the body.
- If possible, use a special thermometer to measure basal body temperature.
- After each measurement, record the temperature readings in a special chart.
- During ovulation, basal temperature rises by 0.2-0.5°C.
- Days most likely Conception, or fertile days, last as long as the basal temperature remains elevated for three consecutive days.
– Monitor your health closely to ensure that your fever is not caused by any other conditions or illnesses.

The cervical mucus method (or ovulation method) requires a woman to monitor the condition of her cervical mucus. She must write down the amount every day for at least a month, appearance, consistency and note others physical signs related to the reproductive system.

Cervical mucus changes in a predictable manner during each menstrual cycle:

Six days before ovulation, the mucus depends on estrogen and becomes clear and elastic. Ovulation may occur on the last day when the mucus has these properties;
- immediately after ovulation - mucus depends on progesterone, it is thick, sticky and opaque;
- separate models in the analysis of cervical mucus can provide high and accurate guidance to conception;

To monitor, use following rules:

Check the nature of your cervical mucus every day, three times a day after your period ends. To do this, wash your hands thoroughly with soap and take a sample of vaginal mucus. It is also possible to take a sample directly from the cervix with your finger.
- Look at the quality of the mucus (liquid, sticky, dry)
- Check if the mucus is sticky by simply spreading your fingers apart
- Check your underwear (if there are any stains)
- Try to make observations as often as possible (for example, when visiting the toilet)
- Determine the amount and color of mucus
- Try to identify cervical mucus (possibly the presence of male seminal fluid, lubricant. It could also be spermicides, if you use them)
- Record the results of the study daily and in detail. Note the consistency of the mucus (dry, sticky, creamy, egg white-like); its viscousness; presence of stains on linen; sensations in the vagina (dry, wet, slippery).

Calendar method

The calendar method (or rhythm method) is considered the least reliable fertility method. Women who have very irregular periods may have even less success with this method.

A woman first records her menstruation for 6-12 months, then subtracts 18 short-cycle days and 11 long-cycle days from the previous menstrual cycle. For example, if a woman's shortest cycle was 26 days and her longest cycle was 30 days, she should abstain from sexual intercourse from days 8 to 19 of each cycle;

Here are some tips to make this method easier:

Keep a menstrual calendar for 8 months, noting the length of each menstrual cycle starting with the first day of your period (the first day of your menstrual cycle) and ending the day before your next period (the last day of your menstrual cycle).
- Determine the longest and shortest menstrual cycles.
“Use the table to determine your likely fertile days.” The first day of fertility corresponds to the duration of your shortest menstrual cycle, and the last day corresponds to the duration of your longest menstrual cycle. Thus, the days with the maximum possible conception are in the interval from the first to the last - dangerous days.

Symptothermal method

This method combines the temperature method, the cervical mucus method and the calendar method. Therefore, it is considered the most effective method fertility. In addition, women monitor signs that can identify her fertile period. These symptoms include changes in the shape of the cervix, breast tenderness, pain and cramping.

Who is suitable for natural contraceptive methods?

Because of high risk During pregnancy, natural methods of contraception are recommended only to those couples whose religious beliefs prohibit standard, especially barrier, methods of contraception. Couples who want commandment-free sex life, use barrier contraception during the fertile phase and no contraception during the rest of the cycle.

However, they should understand that there will be a higher risk of pregnancy with this method. To be effective against pregnancy, a cycle based on the method requires attention, and on the part of the people involved, dedication, discipline, persistence and cooperation with a partner.

Advantages of the method

Natural methods are safe and do not cause any side effects
- Acceptable to all faiths and cultures
- Involving the partner in the family planning process, increasing feelings of intimacy and trust.

Method-based fertility cycles are not recommended for women unless they are in a committed, monogamous relationship and can count on their partner's willing participation. Awareness-based birth control methods do not protect against sexually transmitted diseases.

Some factors may interfere normal signs fertility, for example:

Recent discontinuation hormonal contraceptives
- recent miscarriage or abortion
- recent birth
- lactation
- regular travel in different time zones
- infection in the vagina, such as thrush or an STD

Other factors influencing the biological signs of ovulation:

Temperature measurement time
- alcohol consumption
- taking certain medications
- illness.

The effectiveness of natural contraceptive methods is about 60%, which means that up to 40 out of 100 women using this method become pregnant within a year.