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Fertility Awareness Methods, collection of techniques that help a woman determine which days of the month she is most

likely to get pregnant. A woman who does not want to become pregnant can then practice periodic abstinence from sex (known as natural family planning) or use a barrier method of birth control while having sex during this fertile period. About 0.2 percent of American women 15 to 44 years old who use contraceptives rely on fertility awareness methods. With typical use, fertility awareness methods are 80 percent effective in preventing pregnancy.

During each menstrual cycle, a womans fertile period begins around five days before ovulation (the release of an egg from one of the ovaries) and continues for about two days after ovulation. Using fertility awareness methods, a woman identifies her fertile period by at least one of three ways: measuring basal body temperature, monitoring cervical mucus, and calendar charting (also known as the rhythm method)

The basal body temperature method measures variations in body temperature to determine when ovulation has occurred. Normally, body temperature decreases slightly just before ovulation and begins to rise for several days afterward. The temperature remains slightly elevated until menstruation begins. With this method, a woman takes her temperature every morning before getting out of bed using a basal thermometer, which has an expanded scale to show slight changes in temperature between 36C (96F) and 38C (100F). While this method is effective in determining the time of ovulation, the beginning of a womans fertile period may occur two days before ovulation. Since sperm can live for up to 48 hours in a womans body, a woman who has unprotected sexual intercourse just before she ovulates may become pregnant if the sperm are still alive when the egg reaches the uterus. This method may be unreliable because lack of sleep and illness can change a womans body temperature.

The cervical mucus method requires a woman to examine the mucus from her cervix (opening of the uterus) to determine her fertile period. The consistency and amount of cervical mucus changes as hormone levels vary during the menstrual cycle. Just after the menstrual period, little or no mucus is discharged for three to four days. After that, discharged mucus may be thick, sticky, and yellow or white for two to three days. Over a period of eight to ten days, mucus becomes progressively clear, wet, slippery, and stretchy. Ovulation occurs sometime in the two days before or up to two days after the peak day of this clear, wet, stretchy mucus. The mucus then becomes thick and sticky again or disappears until after the menstrual period. The consistency of cervical mucus can be affected by medications such as antihistamines that change mucus production throughout the body, and by spermicides, sexual intercourse, vaginal infections, or the use of douches.

In the calendar charting method, a woman keeps a record of at least 8 to 12 menstrual cycles and uses the record to determine which days she is most likely to be fertile during an average menstrual cycle. One difficulty with this method is that fertile periods can vary from cycle to cycle.

Some women prefer periodic abstinence from sex during fertile periods as a method of birth control because it does not rely on devices or drugs to prevent pregnancy. In addition, some religions and cultures that do not approve of other methods of contraception permit the use of periodic abstinence.

If a woman chooses periodic abstinence or the use of a barrier method of birth control during her fertile period, she remains at risk for sexually transmitted infections (STIs) at other times of the month when she has unprotected sex. In addition, fertility awareness methods require a woman to keep careful records to determine her fertile periods. Also, if a woman has irregular periods, she may not be able to use fertility awareness methods to effectively prevent pregnancy. Many healthcare professionals recommend that a couple use more than one fertility awareness method to more reliably track fertility. Microsoft Encarta 2009. 1993-2008 Microsoft Corporation. All rights reserved.

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