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Fertility Awareness Method and Natural Family Planning

August 2, 2021 by Eve Leave a Comment

Birth control pills historically revolutionized the rights and opportunities of women around the world. But for anyone who has taken hormonal contraceptive treatments, you understand that there can be annoying side effects.

Natural family planning, commonly known as fertility awareness or the calendar rhythm method, has been gaining popularity as an alternative method of family planning and is excellent for those trying for a baby. In this article, we discuss what’s involved in natural family planning to help you make a decision right for you.

Key Takeaways

Natural family planning (NFP) methods are a way to track signs of fertility throughout your menstrual cycle. You have sex at specific times to either avoid pregnancy or try to get pregnant.
When used correctly, natural family planning methods are an effective way of avoiding pregnancy, especially when used in conjunction with other birth control options such as condoms or caps.
It takes 3–6 months to learn this method.
Due to it being a hormone-free method, there are no physical adverse effects, and it is a good way to understand your level of fertility or reproductive cycle.
Always use condoms as well to avoid sexually transmitted infections (STIs).
Fertility awareness based methods are a good way to get in touch with your body’s natural functioning. They can help couples who are trying to conceive.

What Is the Fertility Awareness Method?

Also known as the symptothermal method, this method means tracking the signs that show what stage you are in your menstrual cycle to either avoid getting pregnant or to increase your chances of pregnancy.

How Does It Work?

You have to keep a daily record of your fertility signals, such as your temperature and the fluids coming from your cervix, or cervical mucus. There are a few different methods to ensure you are tracking your cycle effectively, detailed in the next few sections.

Methods of Natural Family Planning

The main ways to track your fertility are the:

Calendar method.
Cervical mucus method.
Standard cycle days method.
Basal body temperature method.

Natural family planning is typically most effective if you use all of these methods at the same time. It involves gathering your own personal data for a few months to figure out when you are at your most and least fertile.

Menstrual Cycle and Ovulation

During your menstrual cycle, there are fertile days and other times of your natural cycles when you are less likely to conceive. The average woman has a 28-day cycle, within a range of 24–32 days, although some have more irregular cycles. Cycle length is calculated from the first day of your period to the beginning of the next one.

During your period, or menstrual bleeding, you are the least likely to get pregnant, while during the window of ovulation, usually around days 11–14, you are at your most fertile time.

Ovulation is when the ovaries release an egg into the fallopian tube. The egg then lives in the fallopian tubes for 24 hours, and if it goes unfertilized, does not survive. Therefore the fertility window, in reality, is very small, but the trick is knowing exactly when ovulation will occur.

Monitoring Cervical Mucus

At different times in your cycle, the mucus from your cervix changes in color and consistency. At the beginning and end of your cycle, the cervical mucus is typically white and drier, whereas during the fertile days, many women have clear, slippery mucus. The cervical mucus method simply involves being aware of what your cervical mucus looks like throughout the month.

Many women may also experience spotting when they ovulate. This is when small spots of menstrual blood appear in the middle of the menstrual cycle, signaling their fertile days.

Calendar Method

Also known as the rhythm method and calendar rhythm method, this is a way for women to track ovulation times based on their own menstrual cycle and avoid unprotected sex when they ovulate.

If you track how many days your cycle is for a few months, based on when you start your period to the next one, you can figure out how long your average cycle is, and the most likely time you have ovulated. This method alone is not very effective at preventing pregnancy and is best used together with cervical mucus and the tracking basal body temperature method [1].

Standard Days Method

The Standard Days Method (SDM) recommends that there is a 12-day fertile window during which women with regular menstrual cycles (26–32 days long) should abstain from sexual intercourse or use a barrier method, such as condom or cap, to prevent pregnancy. It is simply calculated by mapping the 12 days in the middle of the cycle, between each period [2].

Temperature Method

The temperature method, known in women’s health literature as the basal body temperature (BBT) method, involves measuring your body temperature at the same time every morning when you are resting. It should be done before you get up and before you eat or drink anything.

It is used because there’s a slight rise in body temperature after ovulation. Therefore, when you chart your temperature, look out for a rise of 0.4°F, up from the week before. If you have detected a slight rise in your temperature, it is likely that your fertility window has finished for this cycle.

On which two days prior to basal body temperature rise is the chance of conceiving the highest?

8-7

2-1

3-2

5-4

Click on your answer to reveal what studies say

Show hint

basal body temperature

The third and second days before basal body temperature rise are when the chance of conceiving is the highest

Effectiveness of the Fertility Awareness Method

Done correctly, fertility awareness methods can be an effective way to prevent pregnancy. Failure rate is only 1–2%. If, during your fertile window, you abstain or avoid sex, it is unlikely that you will get pregnant. If you are trying for a baby, the fertility awareness method would be the first step to influencing when you conceive.

Preventing Pregnancy

When tracked correctly, natural family planning methods are highly effective for avoiding pregnancy: 98–99% of women did not conceive while using the natural family planning method, according to a comprehensive fertility study [3].

However, if fertility awareness methods are not followed accurately, they can lead to unplanned pregnancy. Remember, getting the methods right takes practice and commitment!

Which contraceptive method do you think is the most effective?

Fertility awareness methods

The pill

Copper IUD

Implant

Male condom

Choose an answer to reveal which method is most effective

Show hint

contraceptive method

An implant is the most effective way of preventing pregnancy

When you have figured out when your fertile times, remember to use condoms, the cap, or diaphragm when you have sex, or at least use the pull out method. Just in case, try to keep some emergency contraception at hand too.

Keep in mind that emergency birth control is a hormonal treatment and affects your cycle. If you take an emergency contraceptive pill, you have to use barrier contraception for two complete menstrual cycles before natural family planning is effective again.

Getting Pregnant

If you are trying to get pregnant, the natural family planning method is an excellent way to get in touch with your level of fertility and knowing when to time sex, increasing your chances of conception.

Is Natural Family Planning for Me?

Benefits

There are some key benefits of natural family planning:

There are no side effects or health risks as with medical contraceptives.
It is a hormone free method and no chemicals are used, as with birth control pills or hormonal contraceptives.
With correct information, practice, and advice, most women can track ovulation.
No follow up medical appointments are needed for the technique, once you have learned how it works.

The methods give you more control over your reproductive system and involve your partner in the process, which can have benefits to the relationship and your mental health.
Natural family planning is the only type of family planning that includes both preventing pregnancy and aiding conception.
Monitoring your vaginal discharge makes you more aware of your reproductive health and may help you recognize abnormalities, such as if you have a sexually transmitted infection.

Disadvantages

For 12–16 days in the month, you have to abstain from sex or use condoms, the cap, or pull out method, which some couples can struggle with.

Fertility awareness based methods do not protect against STIs.
There is a lot of room for mistakes, if you are not tracking correctly.
The method takes a few menstrual cycles to practice for you to control it effectively. Until then, you have to use condoms or caps.
Fertility signs have to be tracked consistently every day, which is not convenient for everyone.
Your cycle can become unpredictable if you are very stressed, there is a dip in your health, or you are lactating, in which case natural family planning methods should be reconsidered.

Lactational Amenorrhoea Method (LAM)

Lactation Amenorrhoea Method (LAM) refers to the time of infertility many women experience after having a baby and is a natural method of birth control. Intensive breastfeeding for the first six months after birth can stop ovulation, which some fertility research claims to be 98% effective in preventing pregnancy. However, it has received some criticism in other studies [4].

Is LAM Reliable?

Failure rate of LAM increases the closer the baby gets to six months old, so it is a good idea to start using other methods of contraception from five months after birth. Also, if you start weaning your baby early or feed them formula milk, your milk flow decreases and the LAM method becomes less of a guarantee to prevent pregnancy.

FAQ

Does the Fertility Awareness Method Work?

Yes; however, for it to be effective in stopping pregnancy, you have to keep track of all the fertility signs and use other contaceptives or abstain from sex during your fertility window.

How Is Fertility Awareness Based Method Used?

You track your body’s natural functioning and find signals that tell you when you are fertile, then avoid unprotected sex during the time that you are ovulating.

How Many Days Before and After Menstruation Is Safe?

It depends on your cycle. You technically cannot conceive during your first few menstrual bleeding days, but just at the end or after your period there is a chance you will, read more in can you get pregnant on your period.

Conclusion

It’s difficult to find a method of birth control that’s perfect. For a hormone-free method, natural family planning could certainly be an alternative to other forms of contraception.

However, do your best to use the birth control method correctly, by following all of the guidance, especially if you are trying to avoid pregnancy! If getting pregnant is something you want, this technique will definitely be of interest to you, but if it does not work and you are concerned about your reproductive health, always refer to a fertility specialist.

References:

[1] Johnson, Sarah, et al. “Can Apps and Calendar Methods Predict Ovulation with Accuracy?” Current Medical Research and Opinion, vol. 34, no. 9, 2018, pp. 1587–1594., doi:10.1080/03007995.2018.1475348.
[2] Weis, Julianne, and Mario Festin. “Implementation and Scale-Up of the Standard Days Method of Family Planning: A Landscape Analysis.” Global Health: Science and Practice, Global Health: Science and Practice, 30 Mar. 2020, www.ghspjournal.org/content/8/1/114.
[3] Frank-Herrmann P;Heil J;Gnoth C;Toledo E;Baur S;Pyper C;Jenetzky E;Strowitzki T;Freundl G; “The Effectiveness of a Fertility Awareness Based Method to Avoid Pregnancy in Relation to a Couple’s Sexual Behaviour during the Fertile Time: a Prospective Longitudinal Study.” Human Reproduction (Oxford, England), U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/17314078/.
[4] Van der Wijden, Carla, and Carol Manion. “Lactational Amenorrhoea Method for Family Planning.” The Cochrane Database of Systematic Reviews, John Wiley & Sons, Ltd, 12 Oct. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC6823189/.

How To Use the Female Condom: Step by Step Guide

August 2, 2021 by Eve Leave a Comment

Many women find unpleasant side effects with hormonal birth control, or feel a lack of autonomy when it comes to male condoms.

But what if there was a solution that could protect you from unwanted pregnancies and STDs? A comfortable, reliable method that didn’t interrupt you during sex? We’re showing you how to use the female condom so you can enjoy sex without the risk of pregnancy or STDs.

Key Takeaways

The single-use female condom can protect you against both pregnancy and sexually transmitted diseases (STDs) such as HIV and chlamydia.
There are now several brands available in a number of countries.
Internal condoms can increase sexual pleasure in some aspects.
Your male partner does not need an erect penis for insertion.
Female condoms have a low risk of breakage as they are more durable.

What Are Female Condoms?

Female condoms are transparent sheaths with two flexible rings at each end, one of which is open [1]. Also known as the single-use internal condom, they are worn inside the vagina or anus as a protective barrier against sperm and disease.

Why Use a Female Condom?

The internal condom is the only type of contraception controlled by women that protects your sexual health in two ways: against pregnancy and sexually transmitted infections or diseases (STIs, or STDs) [1].

How safe do you think the female condom would be when used with an HIV+ partner, twice a week?

90%

46%

30%

It won’t reduce the risk

Click on your answer to reveal what studies have found

Show hint

female condom

The female condom reduces the risk by up to 90% when used twice a week with an HIV-infected partner

You can enjoy a greater level of autonomy without the side effects of hormonal birth control while being protected against diseases that diaphragms or caps cannot shield you from.

Women interviewed in studies described more control over their sexual health, with their partner unable to refuse its use. They also expressed more pleasure during vaginal sex than with the male condom [1].

The female condom is also more durable than the latex male condom, so it is less likely to break. It is also only one size and does not need your male partner to have an erection. Other advantages are that you can use other oil-based lubricants if dimethicone isn’t enough, and it conducts heat better, so hot, humid days won’t affect it [2].

Types of Female Condoms

There are several brands of internal condoms, including the FC2, VA W.O.W. (or Reddy), Women’s Condom, and Cupid [3]. The FC2 is available online in the USA and clinics and distribution centers in over a dozen countries [4]. The VA W.O.W. is sold internationally [5] [6].

As of now, the FC2 is the only FDA-approved female condom on the market.

What Is the Internal Condom Made Of?

While the FC1 female condom was made of polyurethane, a type of plastic, the FC2 internal condom is made from synthetic latex. This is a little cheaper and does not make any noise during sex [1]. The VA W.O.W. is made from natural rubber latex, and so is the Cupid line [5] [6].

How To Use a Female Condom: Step by Step Guide

Before you have sex with an internal condom, it is ideal that you practice inserting one to get used to how it works and feels. As there is no research on how spermicides might affect its efficacy, we don’t recommend that you combine the two methods [7]. You don’t want to risk the condom’s integrity being damaged.

Here’s how to insert the female condom [8]:

Open the packet carefully and gently pull your condom out; do not use your teeth and be very careful with scissors. Ensure you do not have sharp fingernails either to prevent accidental tears.
Squeeze the small inner ring at the closed end of the condom. This goes inside the vagina first. You can raise one leg if it makes insertion easier or use what you find comfortable when inserting a tampon or menstrual cup.
Ensure the large ring, or outer ring, remains around the opening of the vagina. The inner ring should be up past your pubic bone; use your index or middle finger inside to check [7].
When you have sex, ensure that your partner’s penis stays inside the condom to prevent semen from entering your vagina [8].
Unlike the diaphragm, you must remove the female condom immediately after sex. To prevent semen inside from leaking out, you can twist the outer ring.
Dispose of the condom in a bin.

If the condom breaks, you should seek out emergency contraception, which can be effective for up to five days in preventing pregnancy. Always check the expiration date, as an old condom won’t be as effective. You must also avoid reusing any internal condom because there can be semen inside [8].

If you’re at a high risk of HIV exposure, you need a course of post-exposure prophylaxis (PEP) treatment to prevent the virus from gaining a foothold. Finally, if you practice anal sex, you can use the female condom for this purpose too, but you need more lube as the anus does not produce enough of its own fluid [8].

Effectiveness of Internal Condoms

When you choose a contraceptive method, your top priorities are how well it protects against pregnancy and STDs. But how effective are condoms?

Against Pregnancy

Research measuring typical use of the female condom has found a 15% failure rate over six months [9]. In comparison, tubal ligation has a 0.5% chance of failure over a year [7].

how to use the female condom The failure rate of female condoms compared to other birth control methods — The female condom has a failure rate of 21% over a year, compared to only 9% failure from the pill
Source: https://www.cdc.gov/reproductivehealth/unintendedpregnancy/pdf/contraceptive_methods_508.pdf

Perfect use, where you follow all instructions to the letter every time, has a 2.6% failure rate over six months. Comparative studies show that the female condom can prevent pregnancy at a similar rate to other barrier methods such as the diaphragm [9].

Against STDs

As a barrier method, the female condom does provide protection against some STDs. Researchers estimate that women reduce their risk of contracting HIV by over 90%, assuming they have sex twice a week with an HIV-positive man [9].

Female vs Male Condoms

The male condom is the only non-permanent form of male birth control, and is available in most grocery stores with a healthcare section. Like female condoms, they are effective against pregnancy and STDs, and are single-use only [10].

Male condoms do have disadvantages, however. They are tighter around the penis; heat and friction can easily damage them, you cannot use oil-based lubricants, and your partner must have an erect penis to put one on. It can be harder to enjoy sex when you must pause to use a condom. After sex, you have to hold onto the condom while pulling out too [10].

Male Vs Female condoms, which do you think is safer?

Male Condoms are safer

Female condoms are safer

All condoms are equally safe

Click to reveal what doctors and scientists have found.

Show hint

Male Vs Female condoms

Male condoms have been found to be more effective than female condoms, but not by too much.

Disadvantages of Female Condoms

The major disadvantage of female condoms is that they are less accessible. As of 2010, only 0.28% of condoms produced worldwide are female. One common myth that the US media have held is that women have a limited level of control over their bodies and would not use a female condom [1].

Many women also do not like the size and shape of internal condoms. Some describe them as “fiddly,” “odd,” or “looks like a large intestine,” others find the large size to be strange [2].

Sex education at school does not emphasize the female condom either, with women stating, “they showed it to us, but the method they emphasized the most was the male condom” [2].

How To Buy Female Condoms

How to get birth control that works for you? If you cannot find a physical store or clinic that sells the FC2, your best bet is to look online.

The Female Health Company website allows for direct purchase of the FC2 model in the United States, including bulk packages of 100 and 1,000 condoms. There are also options for uninsured and underinsured customers of 12 and 24-packs [11].

Many countries around the world, including Afghanistan, Nigeria, Peru, Tanzania, and the Netherlands, have distribution centers for the FC2 female condom. In addition, many health clinics, pharmacies and beauty salons stock them [4].

Only buy female condoms with the original branding. Avoid resold products as they may not have the same level of quality. In Europe and the UK, look for the BSI Kitemark or CE mark on the packaging, which indicates a high standard of safety testing [8].

As for the Cupid female condom, the brand website allows for online purchasing, with the business based in India [5].

The VA W.O.W. is available online at World Condoms; there is no purchase option on their website [6].

Costs of Internal Condoms

The cost of female condoms varies, but the FC2 is the cheapest. The Female Health Company’s Patient Assistance Program sells 12-packs at $28.95 each, and 24-packs at $47.95 each. This is an average of $2.41 for the 12-pack, and $2.00 for the 24-pack. Shipping is free throughout the country [11].

VA W.O.W. is the most expensive, at $9.95 for a pack of three [6].

FAQ

In a nutshell, what do we need to know about the female condom?

How Do Female Condoms Feel?

You may notice either increased or decreased sexual pleasure with a female condom. For example, the outer ring could stimulate your clitoris, but the external part may reduce stimulation to your labia. Pre-lubrication could enhance pleasure too [12].

Some couples report feeling more comfortable because of the stronger, more durable material, despite initial fears that the condom would slip or be pushed aside. Gentle insertion is key to a comfortable experience from start to finish, however, rapidly releasing the closed-end can feel like a rubber band [12].

What Is the Correct Way To Use a Condom?

For male condoms, your male partner must unroll it over his erect penis, starting from the tip and holding the end of the condom. After sex, he must hold onto the open end while pulling out [10].

A female condom can be inserted beforehand so you can enjoy sex uninterrupted. The smaller end, or inner ring, enters first to cover your cervix, while the external ring sits just in the vaginal opening [8].

Are Female Condoms Safer Than Male Condoms?

Internal condoms are at least as safe as male external condoms. A study on chlamydia, gonorrhea, syphilis and trichomoniasis rates found a non-significantly lower rate of STDs among women using female condoms [13]. A non-significant drop means that wearing a female condom was less likely to be the cause of their lower STD rates.

The improved disease control may be from the outer labia being protected by female condoms, unlike the male alternative. Women often report a better ability to negotiate and more confidence in asserting their need for safer sex, so with greater autonomy over your birth control, you may feel safer with a female condom.

Do Female Condoms Break Easily?

The risk of your condom breaking is low. Research comparing the FC2 with several new or tried female condoms found only a 0.82% chance of any breakage with the FC2. For clinical breakage, where the damage occurred during sex, the rate was only 0.25% [3].

The Women’s Condom, VA-wow and Cupid, all new condom brands under review at the time, had total breakage rates between 0.67% and 0.84% [3].

Conclusion

The female condom, or internal condom, is an effective way to protect you against infections during vaginal, anal and oral sex. Many women report greater comfort and sense of security, with the same ability to prevent pregnancy that male condoms offer.

References

authors, All, and Anny Peters. “The Female Condom: the International Denial of a Strong Potential.” Taylor & Francis, www.tandfonline.com/doi/full/10.1016/S0968-8080%2810%2935499-1.
Fernández, María Lameiras, et al. “A Qualitative Study of the Viability of Usage of the Female Condom among University Students.” Redalyc.org, Asociación Española De Psicología Conductual, 2006, www.redalyc.org/articulo.oa?id=33760111.
Beksinska, Mags E, et al. “Performance and Safety of the Second-Generation Female Condom (FC2) versus the Woman’s, the VA Worn-of-Women, and the Cupid Female Condoms: a Randomised Controlled Non-Inferiority Crossover Trial.” The Lancet Global Health, Elsevier, 23 Aug. 2013, www.sciencedirect.com/science/article/pii/S2214109X13700548.
“FC2 Availability.” FC2 Female Condom, 23 June 2021, fc2femalecondom.com/fc2-availability/.
“About.” Cupid Angel Female Condom – Best Female Condom in World, 15 Apr. 2021, www.cupidangel.in/about-cupid-angel-female-condom/.
“VA W.O.W Female Condoms Box 3.” WorldCondoms, worldcondoms.com/products/va-w-o-w-female-condom-box-3.
Food and Drug Administration. “Package Insert/Instructions Leaflet.” https://www.accessdata.fda.gov/cdrh_docs/pdf8/P080002c.pdf
NHS Choices, NHS, www.nhs.uk/conditions/contraception/female-condoms/.
R;, Trussell J;Sturgen K;Strickler J;Dominik. “Comparative Contraceptive Efficacy of the Female Condom and Other Barrier Methods.” Family Planning Perspectives, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/8033980/.
“How to Use a External Condom.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 2 June 2021, www.cdc.gov/condomeffectiveness/external-condom-use.html.
“FC2® Patient Assistance Program.” FC2 Female Condom, 6 Aug. 2020, fc2.us.com/product/fc2-patient-assistance-program/.
Jessamyn Bowling, Brian Dodge. “Female Condom Acceptability in Urban India: Examining the Role of Sexual Pleasure – Jessamyn Bowling, Brian Dodge, Nyamat Bindra, Bhaktiben Dave, Ritika Sharma, Vikram Sundarraman, Sivakumar Thirupathur Dharuman, Debby Herbenick, 2018.” SAGE Journals, journals.sagepub.com/doi/full/10.1177/1359105317745963.
This study was a collaborative endeavor by the *Philadelphia Department of Public Health and †Medical College of Pennsylvania. “Use-Effectiveness of the Female Versus Male Condom in… : Sexually Transmitted Diseases.” LWW, journals.lww.com/stdjournal/Fulltext/2003/05000/Male_Condom_and_Female_Condom_Use_Among_Women.10.aspx.

Can You Get Pregnant On Your Period?

July 28, 2021 by Eve Leave a Comment

Period sex is generally seen as safe between couples. It is a myth, however, that you cannot conceive during your period. The chances are low, but it depends on a couple of factors, especially the length of your cycle and whether you have sex at the beginning or the end of your period. Read on for more information about the chances of getting pregnant during your period.

Key Takeaways

It is rare that women get pregnant during their period; however, it is possible.
The chance increases slightly at the end of your period, especially if you have a naturally short cycle or ovulate early.
It is always a good idea to be aware of your cycle length. However, if you are trying to avoid pregnancy, talk to your doctor about the best contraceptive for you to be safe.

Can You Get Pregnant On Your Period?

The simple answer is yes. While women cannot actually get pregnant while they are bleeding, there is a fraction of women who might conceive at the very beginning or at the end of their periods.

During your period and when you are still bleeding, a woman’s fertility level is basically at zero. However, sperm can live inside the body for a number of days and you may be within your fertility window earlier than you think [1].

When do you think the probability of being in the fertile window is highest?

On the 7th day

On the 28th day

On the 1st day

On the 14th day

Click on the answer to reveal what studies found

Show hint

fertile window

The 14th day of the menstrual cycle is when the probability of being in the fertile window is highest

How Long Can Sperm Survive in Period Blood?

A man’s sperm can live inside the reproductive tract for up to seven days. Therefore if you have unprotected sex right after your period and then ovulate early, you can fall pregnant.

Is It Easier to Get Pregnant While On Your Period?

It is most likely that you will get pregnant if you have sex when you are at your most fertile, which is usually in the middle of your natural cycle, during ovulation. If you have sex right after your period, the risk of getting pregnant is still lower than at other times of your menstrual cycle, but there is a chance that you conceive during the week after.

Chances of Getting Pregnant On Your Period

During the time of menstruation or bleeding, it is not possible for women to conceive. However, there is around a 5% chance of conception at the end of your period, which for most women is after the first five days of her cycle, or five days after her period started [2].

Your Average Menstrual Cycle Length

Women’s menstrual cycles vary. The average length is 28 days; however they can range from 24–38 days, depending on if you have a longer or shorter cycle. Because of this, the time of peak fertility and most likely time for conception varies quite a lot. Menstrual cycles are measured from the first day of your last period to the first day of the next one.

You can learn to predict your ovulation cycle and periods to be aware of your most fertile days. If trying for a baby, most couples are advised to have more sex between days 11–14 for the best chances of conceiving. See our ovulation calculator for more on this.

The basics of menstrual cycles:

When periods finish, you are in the second phase of the cycle (days 6–14), when the uterus rebuilds its lining to prepare for a fertilized egg.
At around day 14, the ovary releases an egg, and it starts to move down the fallopian tube. This is called ovulation and is the most fertile window because there is a newly released egg. The egg lives for around 24 hours if it is not fertilized during intercourse [3].
The last part of the cycle, from day 25, is the luteal phase [4]. This is when the uterus prepares to shed its lining again for your next period. During the this phase, the chances of pregnancy are low; however, depending on the woman’s cycle, there is a small chance she can be fertile in the last five days before her period.

Some women track their cycles regularly, using the fertility awareness method to either avoid or increase their chances of pregnancy. If you do this, you will have a good idea of when your fertility window is.

Whether Or Not You Use Birth Control

If you’re using birth control, your chances of conceiving on your period are extremely low, depending on the contraceptive methods you use.

Verdict: Always Use Birth Control to Be Safe

Now that we know that it’s possible to get pregnant during periods, it is time to look into how to be fully safe. Are natural or medical methods the best way? Healthline media tends to promote medical options without considering the adverse effects on women.

There are side effects to birth control methods; however, to make natural fertility methods effective, you have to be fairly committed, with daily body temperature checks at consistent times, logging, observing cervical mucus, etc. There is always a small chance that you will ovulate earlier, particularly if you don’t have a very regular cycle.

Birth control pills may be more convenient than this, but most women know too well the adverse effects of hormonal treatments.

If you are looking to avoid awful acne and wild mood swings, there are a few non-hormonal birth control methods available, the most common being the copper IUD.

Condoms are often left aside by couples for period sex; however, they are a good option for all times of the month. You can read specific information about the effectiveness of condoms during period here. Remember that condoms are also the only effective method for protecting against STIs.

Which birth control method do you think is most likely to fail?

Fertility awareness-based methods

The pill

Implant

Male condom

Copper IUD

Click your answer to reveal the results

Show hint

birth control method

Fertility awareness-based methods have the highest failure rate

FAQ

How Likely Is It to Get Pregnant On Your Period?

You are not very likely to get pregnant on your period, but it is possible, especially if you have sex right at the end of your period.

Can You Get Pregnant On the First Day of Your Period?

The chances are extremely low, as you are in a different phase of your cycle and not close to your fertile window.

Can You Get Pregnant On the Last Day of Your Period?

Yes, possibly. Sperm can live inside your body for a week, which can take you into your fertile window, meaning ovulation might occur during this time.

Can Sperm Survive in Menstrual Blood?

Yes, sperm can live in the menstrual blood or inside the body for up to a week.

Are You Most Fertile During Your Period?

No, your most fertile time is during your fertility window, which is when you ovulate. For the average woman, this would be between days 11–14 of her monthly cycle.

Conclusion

The chances of you getting pregnant when you are on your period are slim; however, if you don’t want to get pregnant, it would be better not to count on this as a way to avoid pregnancy.

Getting to know your menstrual cycle can be a good way for women to connect with their bodies and their level of reproductive health. However, talking to a doctor for a reliable contraceptive is the best way to avoid pregnancy.

If you think that you could be pregnant, always use pregnancy tests to catch this early on. You may feel unsure about what birth control method is best for you and your health, or want to read more about the availability of each. You can also get more information on where to get birth control.

References

Sakkas, D., Ramalingam, M., Garrido, N., & Barratt, C. L. (2015). Sperm selection in natural conception: what can we learn from Mother Nature to improve assisted reproduction outcomes?. Human reproduction update, 21(6), 711–726. https://doi.org/10.1093/humupd/dmv042
Johnson, Sarah, et al. “Can Apps and Calendar Methods Predict Ovulation with Accuracy?” Current Medical Research and Opinion, vol. 34, no. 9, 2018, pp. 1587–1594., doi:10.1080/03007995.2018.1475348.
Oliver R, Basit H. Embryology, Fertilization. [Updated 2021 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542186/
Reed BG, Carr BR. The Normal Menstrual Cycle and the Control of Ovulation. [Updated 2018 Aug 5]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279054/

2021 Guide to Tubal Ligation: Side Effects and Reversal

July 27, 2021 by Eve Leave a Comment

Many women reach a point where they no longer wish to have children. Often this realization is liberating and can bring added benefits to their relationship and quality of life.

For women who seek a form of permanent birth control, getting their tubes tied may be one of their first treatment choices.

As a permanent sterilization technique, tubal ligation offers an excellent success rate at preventing pregnancy, with less than 1 in 1000 women becoming pregnant after undergoing the procedure.

This article discusses the main types of tubal ligation, possible side effects, and the procedure and risks involved in ligation reversal.

Key Takeaways

Tubal ligation is a form of permanent birth control for women who don’t want more children or women who don’t wish for children at all.
There are various techniques used for ligation, and most are non-invasive.
Ligation may result in post tubal ligation syndrome, although medical professionals highly debate the condition.
Tubal reversal is possible through minor surgery, after which you can get pregnant again.
Women who had their tubes tied may experience an ectopic pregnancy.
Alternatives to tubal reversal include IVF, surrogacy, and adoption.

What Are the Types of Tubal Ligation

Tubal ligation surgery does not always follow the same procedure, neither does it involve ‘tying’ your tubes. Instead, two main types of surgery provide a range of options for blocking or disrupting the path of an egg through your fallopian tubes.

Depending on your health, age, and medical history, a doctor may perform one of the following types of ligations [1]:

Laparoscopy

Laparoscopy is one of the most common types of ligation surgery. It involves the administration of general anesthesia and a minimally invasive sterilization procedure.

The fallopian tubes are blocked or disrupted by [1]:

Mechanical devices: Silicone bands and clips are the two most popular choices. If the tubal lumen is large or dilated, a mechanical device may not be effective. These devices are used to seal off a piece of the fallopian tubes, preventing an egg’s movement to the uterus.
Tubal excision: A doctor will remove a part, or all, of the fallopian tubes. It is the most effective form of tubal sterilization and offers a high success rate. In addition, a doctor may choose to perform a tubal excision if your fallopian tubes are abnormal.
Bipolar tubal coagulation: One of the most popular procedures for ligation involves using two rods placed on either side of the fallopian tube, through which an electrical current flows. This electricity cauterizes the tube and causes coagulation, effectively blocking an egg’s route to reach the uterus.

What do you think is the failure rate of laparoscopic tubal ligation?

58%

20%

39%

Click on any option to reveal what studies say

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laparoscopic tubal ligation

A laparoscopic tubal ligation has a failure rate of 39%

Laparotomy

A laparotomy is another simple procedure that can be done under general anesthesia. Often laparotomy techniques are used for ligations in postpartum women or those undergoing a c-section.

The most popular options for ligation during a laparotomy include the [1]:

Pomeroy technique: It is one of the most popular techniques and is the origin of the phrase ‘tying your tubes.’ The Pomeroy method involves folding a part of the fallopian tube and tying it up with a suture, then cutting off a piece of the tube at the top of the fold.
Parkland technique: Involves placing two sutures on different parts of the fallopian tubes and excising the tube in between them.

Although other methods like the Uchida or Irving technique may be used, they are by no means the most popular.

The average procedure time is around 30 minutes.

Tubal Ligation Side Effects: Potential Complications After Tubal Ligation Surgery

Most of the side effects you may experience after ligation surgery are related to the surgery and anesthetic themselves and not the procedure.

General Side Effects

Similar to the general vasectomy side effects and reversal symptoms, the effects of tubal sterilization are primarily due to the surgical procedure itself.

These possible side effects include:

Minor bleeding around the surgical incisions, especially if a laparotomy was performed.
Reactions to anesthesia, including delirium, drowsiness, confusion, and hypothermia [2]

Although the ligation procedure is simple, some patients may also experience mild abdominal pain due to the effects of the surgery.

Another common fear when opting for a tubal ligation procedure is that it may increase your risk of getting breast cancer. However, the surgery actually does the opposite [3].

Tubal Ligation Clips Side Effects

In the case that your fallopian tubes were clipped, there are various possible adverse effects, including [4]:

Tubal necrosis
Sterilization failure
Abdominal pain

Postpartum Tubal Ligation Side Effects

If your doctor performed a ligation during a cesarean section, you might experience the symptoms accompanying the c-section with greater intensity than those caused by the ligation.

These include [5, 6]:

Pelvic pain
Increased chance of developing asthma or allergies

Post Tubal Ligation Syndrome (PTLS)

Post tubal ligation syndrome involves a range of adverse symptoms affecting a woman after undergoing tubal sterilization.

The FDA does not recognize PTLS as a side effect of tubal ligation, and it is at the center of many debates within the medical community [7].

Symptoms of Post Tubal Ligation Syndrome

The symptoms of PTLS are believed to be caused by issues with blood circulation around the ovaries and fallopian tubes.

They include [8]:

Heavy bleeding
Pain during sex
Lower back pain
Missed periods
Fatigue
Mood swings
Hot flashes

Is Getting Your Tubes Tied Reversible?

If you find yourself having regrets after tubal sterilization, tubal reversal surgery could reverse the procedure and get you pregnant again.

During a tubal reversal, a doctor will either untie or reconnect your fallopian tubes, depending on the procedure used for the ligation.

If you’re thinking about getting tubal reversal surgery, talk to your health care provider about your options and whether a reversal is right for you.

Patient Age and Overall Health

If opting for reversal surgery, younger women usually have a far better chance of becoming pregnant than older women [9].

Your overall health may also impact your doctor’s recommendation, especially considering a body mass index of more than 25 decreases the chance of getting conceiving after reversal [10].

Type of Surgery Performed

A doctor’s recommendation for tubal reversal surgery will also depend on the sterilization procedure followed. For a successful reversal, your remaining fallopian tubes must be long enough to be reconnected.

The sterilization method won’t necessarily affect your success rate. It may simply impact the type or viability of the reversal surgery used [11].

Reproductive System Health

Another factor that may affect your doctor’s recommendation for tubal reversal surgery is your overall reproductive system health.

This will include checking that your uterus, ovaries, and other reproductive organs are healthy and functioning. Otherwise, reversal surgery may be unnecessary.

Your partner may also undergo a semen analysis to ensure no other conditions will keep you from getting pregnant after a reversal.

Tubal Ligation Reversal Surgery: What to Expect

Tubal ligation reversal, also known as tubal reanastomosis, is an outpatient procedure, so you don’t typically need to stay in hospital overnight.

If you decide you want to become pregnant after a ligation, a doctor will consider your medical history and recommend you for a reversal.

Procedure

Tubal ligation reversal surgery involves a non-invasive operation under anesthesia.

The most common method is through laparoscopic microsurgery, which first involves inserting a laparoscope that lets the surgeon see and decide whether your fallopian tubes are suited for a reversal.

The surgeon then makes a small incision just above your pubic hairline through which the laparoscope, accompanied by microscopic surgical instruments, is inserted.

These instruments are used to remove any clips, bands, or sutures constricting the fallopian tubes, and the tubal segments of the remaining fallopian tubes are stitched back together.

The entire surgery takes around three hours [12].

Complications and Risks

Tubal reversal surgery comes with its own set of risks, including:

Higher risk of ectopic pregnancy occurs when the fertilized egg grows and implants in the Fallopian tube instead of the uterus [13]. If the pregnancy is not terminated, it could become a life-threatening condition.
Infection or bleeding due to the surgery. This could be especially serious if the infection spreads to nearby organs.
Formation of scar tissue on the fallopian tubes.
Anesthesia side effects.

Recovery

Tubal reversal is an outpatient surgery that does not require an overnight hospital stay.

Your doctor can prescribe painkillers to deal with the after-effects of the surgery and may also arrange for a follow-up appointment to check on your recovery and healing.

Most patients only experience mild discomfort for several days after the surgery and can typically return to their jobs after around five days, depending on their recovery rate, and provided they do no heavy lifting.

In most cases, patients should be able to resume all their normal activities two weeks post-operation.

Since ligation is a form of non-hormonal birth control, you may be able to get pregnant immediately after the reversal procedure, although attempting to do so is not recommended.

Tubal Ligation Reversal Success Rate

Tubal reversal surgery success rates vary significantly from person to person. After undergoing tubal anastomosis, the average overall pregnancy rates range between 55% and 74% [14, 15].

Some women who achieve pregnancy after tubal anastomosis experience an ectopic pregnancy, which is a serious condition, and the resulting pregnancy is rarely carried to term.

As a result of the wide range in the tubal reversal success rate, some women choose to get pregnant or have children through alternative methods.

Tubal Ligation Reversal Cost

The average tubal reversal surgery cost is $6,800. This includes all pre- and post-operative consultations and care. Many insurance plans don’t cover tubal reversal after a fully informed and consensual tubal ligation was performed.

What’s Cheaper: IVF or Tubal Reversal?

On average, one IVF cycle costs $12,000, while additional medication may add an extra $3,000-$5,000 to the total. Many women don’t get pregnant on the first cycle and may need to undergo several more.

Compared to IVF, tubal reversal surgery is far more affordable and may be the better option for some, despite the variation in success rates.

Tubal Ligation Reversal Alternatives

If your doctor recommends against tubal reversal or doesn’t feel it is right for you, there are other alternatives for having children or getting pregnant.

Another option for permanent birth control is a male vasectomy, reviewed in our comprehensive article on vasectomy side effects and reversal.

IVF

In vitro fertilization involves fertilizing an egg by sperm outside the human body, usually in a test tube.

The fertilized egg is then transferred to your uterus through a thin tube. If the embryo implants, pregnancy occurs.

The average pregnancy rate through IVF is 30% for women under 36 and 15% for those 37 or older [16].

tubal ligation side effects and reversal The average pregnancy rate through IVF in women under and over the age of 36 — In women under 36 years, the average pregnancy rate is 30% whereas those over 37, it falls to 15%

Surrogacy

Another alternative to ligation reversal is surrogacy, during which another woman, or surrogate, carries and delivers the baby for you and your partner.

There are two types of surrogates:

Traditional: A traditional surrogate is artificially inseminated with your male partner’s sperm. The baby will share her DNA but will be yours to raise.
Gestational: Gestational surrogacy is the most popular option for women seeking an alternative to ligation reversal. It involves the in vitro fertilization of your egg by your partner’s sperm, after which the embryo is transferred to the surrogate’s uterus [17].

Pregnancy statistics for gestational surrogates average around 60% [17]

Adoption

Adoption is another excellent alternative for ligation reversal. It requires serious consideration, and not all couples may feel comfortable adopting a child instead of going through a pregnancy. However, for those who choose to adopt and do so with a positive outlook, the experience can be incredibly rewarding [18].

FAQ

Here are the answers to the most frequently asked questions about ligation and reversal.

Are Tubal Ligation Side Effects Common?

No, the side effects of ligation surgery are not common, and if they do occur, most are mild [19].

Can You Reverse Tubal Ligation Naturally?

Unfortunately, natural tubal reversal is not possible. Instead, a doctor must do it through minor surgery.

What Are the Symptoms of Tubes Coming Untied?

It is nearly impossible for ligation to fail and for you to become pregnant after the procedure. The slight possibility of this happening is likely due to technical mistakes occurring during surgery.

If a surgical mistake was made and your tubes grow back together, you may become pregnant and experience symptoms such as [20]:

Missed periods
Frequent urination
Fatigue
Insomnia
Lower back pain

If you’ve had ligation surgery and think you may be pregnant, visit your doctor immediately.

What Are Tubal Ligation Regret Statistics?

The category of women most likely to regret getting their tubes tied includes those without children, those under the age of 30, and getting the procedure done within 45 days after childbirth.

For women under the age of 30, the percentage who expressed regret averaged around 20%, while those over 30 had a 6% regret rate [21].

Conclusion

Regardless of your reasons for undergoing ligation, the side effects should be minor, and there are various options for tubal reversals.

Although ligation reversal does not have a 100% success rate, it is still more effective at producing a pregnancy than any alternative.

As long as you consider the risks and make an informed decision, both ligation and a tubal ligation reversal could help you take control of your reproductive cycle.

References:

Sung, Sharon. “Tubal Ligation.” StatPearls [Internet]., U.S. National Library of Medicine, 1 Mar. 2021, www.ncbi.nlm.nih.gov/books/NBK549873/.
Goldfuss, Sophia, et al. “Anaesthesia-Related Complications and Side-Effects in TAVI: a Retrospective Study in Germany.” BMJ Open, BMJ Publishing Group, 1 May 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6501997/.
Eliassen, A. Heather, et al. “Tubal Sterilization in Relation to Breast Cancer Risk.” Wiley Online Library, John Wiley & Sons, Ltd, 11 Nov. 2005, onlinelibrary.wiley.com/doi/full/10.1002/ijc.21582.
Konaté A;Rauzy V;Chalon S;Ceballos P;Rivière S;Ciurana AJ;Le Quellec A; “[Intraperitoneal Migration of Filshie Tubal Sterilization Clips: an Uncommon Cause of Chronic Abdominal Pain].” Gastroenterologie Clinique Et Biologique, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/12193864/.
Keag, Oonagh E, et al. “Long-Term Risks and Benefits Associated with Cesarean Delivery for Mother, Baby, and Subsequent Pregnancies: Systematic Review and Meta-Analysis.” PLoS Medicine, Public Library of Science, 23 Jan. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5779640/.
Sandall J;Tribe RM;Avery L;Mola G;Visser GH;Homer CS;Gibbons D;Kelly NM;Kennedy HP;Kidanto H;Taylor P;Temmerman M; “Short-Term and Long-Term Effects of Caesarean Section on the Health of Women and Children.” Lancet (London, England), U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/30322585/#:~:text=Short%2Dterm%20risks%20of%20CS,reduced%20intestinal%20gut%20microbiome%20diversity.
DW;, Gentile GP;Kaufman SC;Helbig. “Is There Any Evidence for a Post-Tubal Sterilization Syndrome?” Fertility and Sterility, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/9496325/.
H;, Satoh K;Osada. “[Post-Tubal Ligation Syndrome].” Ryoikibetsu Shokogun Shirizu, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/7757737/.
Godin, Pierre Arnaud, et al. “Laparoscopic Reversal of Tubal Sterilization; A Retrospective Study Over 135 Cases.” Frontiers in Surgery, Frontiers Media S.A., 9 Jan. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6333701/.
MM;, Hanafi. “Factors Affecting the Pregnancy Rate after Microsurgical Reversal of Tubal Ligation.” Fertility and Sterility, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/12909510/.
Kim SH;Shin CJ;Kim JG;Moon SY;Lee JY;Chang YS; “Microsurgical Reversal of Tubal Sterilization: a Report on 1,118 Cases.” Fertility and Sterility, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/9389817/.
K;, Dubuisson JB;Swolin. “Laparoscopic Tubal Anastomosis (the One Stitch Technique): Preliminary Results.” Human Reproduction (Oxford, England), U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/8567838/.
D;, Liu J;Fa Y;Lou. “[Relationship between Microsurgical Tubal Reversal and Ectopic Pregnancy].” Zhonghua Yi Xue Za Zhi, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/9772502/.
Karayalcin, Rana, et al. “Pregnancy Outcome of Laparoscopic Tubal Reanastomosis: Retrospective Results from a Single Clinical Centre.” The Journal of International Medical Research, SAGE Publications, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5536424/.
Schepens JJ;Mol BW;Wiegerinck MA;Houterman S;Koks CA; “Pregnancy Outcomes and Prognostic Factors from Tubal Sterilization Reversal by Sutureless Laparoscopical Re-Anastomosis: a Retrospective Cohort Study.” Human Reproduction (Oxford, England), U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/21115505/.
Dicker D;Goldman JA;Ashkenazi J;Feldberg D;Shelef M;Levy T; “Age and Pregnancy Rates in in Vitro Fertilization.” Journal of in Vitro Fertilization and Embryo Transfer : IVF, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/1919259/.
PR;, Brinsden. “Gestational Surrogacy.” Human Reproduction Update, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/14640380/.
Y;, Sánchez-Sandoval. “[Adoptive Parents’ Satisfaction with the Adoption Experience and with Its Impact on Family Life].” Psicothema, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/22047850/.
Marino, Sarah. “Tubal Sterilization.” StatPearls [Internet]., U.S. National Library of Medicine, 7 Sept. 2020, www.ncbi.nlm.nih.gov/books/NBK470377/.
Foxcroft, Katie F, et al. “Development and Validation of a Pregnancy Symptoms Inventory.” BMC Pregnancy and Childbirth, BioMed Central, 16 Jan. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3599678/.
HB;, Hillis SD;Marchbanks PA;Tylor LR;Peterson. “Poststerilization Regret: Findings from the United States Collaborative Review of Sterilization.” Obstetrics and Gynecology, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/10362150/.

Melatonin and Birth Control: Does It Affect the Pill and Is It Safe?

July 3, 2021 by Eve Leave a Comment

Melatonin is a supplement designed to improve the quality of your sleep, but many women fear it may interact or cancel out their birth control.

This article examines precisely what melatonin is, how it is used, whether it can affect your birth control pills, and possible natural alternatives.

Key Takeaways

Melatonin is a naturally produced hormone your body uses to regulate your sleeping patterns.
Melatonin supplements are usually recommended for people with sleeping difficulties.
Melatonin has other benefits like alleviating jet lag, aiding weight loss, and preventing seasonal depression.
Using the hormone with birth control pills could result in too much melatonin in your bloodstream.
High levels of melatonin could cause daytime drowsiness.
There is no evidence that melatonin cancels out birth control.

What Is Melatonin?

Melatonin is a naturally occurring hormone produced by the pineal gland. The pineal gland is located in your brain and functions mainly to detect and receive information about the light intensity of the environment [1]. It also regulates several hormones that affect female fertility and the menstrual cycle.

When it is dark, the pineal gland secretes melatonin into the bloodstream, which is essential in regulating your internal circadian rhythm. An increase in your melatonin levels leads to you feeling calm and drowsy.

When it is light, the production of melatonin slows or stops.

What Is Melatonin — Melatonin levels are low during late afternoon into the evening, where they begin to rise after 8 pm, peaking at 4 am

Will Melatonin Affect Birth Control?

Melatonin won’t cancel your birth control pills. That said, it’s documented to increase the likelihood that IVF will be successful. Though studies suggest it improves chances of conception, nothing suggests it is strong enough to cancel hormonal birth control.

That doesn’t make the use of the supplement advisable when you’re on birth control. Oral contraceptives have been shown to affect sleep patterns. The estrogen and progesterone in birth increase melatonin levels, increasing sleep time.

Simultaneously using a melatonin supplement could result in your body producing too much melatonin. This may raise your natural melatonin levels high enough to make you drowsy during the day too, which could interfere with your daily routine.

Melatonin has also been shown to have a positive effect on fertility. It has been used in women going through fertility treatment, which could counteract the effects of birth control pills, although this has not yet been scientifically confirmed [15].

Will Melatonin Affect Birth Control — Group 1 and 2 are experiencing unexplained infertility with tests showing significantly lower melatonin levels than group 3 and 4

If you are looking at taking melatonin but are worried about the interaction it may have with your oral contraceptives, consider using a form of non-hormonal birth control, like a birth control sponge, diaphragm, or male condoms.

Can You Take Melatonin on Birth Control?

Despite their possible interactions, no evidence suggests taking melatonin supplements cancels out or reduces the effectiveness of birth control pills. Taking a melatonin supplement for a few days to overcome jet lag or short-term sleeplessness should not cause your body to produce too much melatonin for an extensive period.

However, using melatonin with birth control could cause more severe side effects due to elevated melatonin levels, including:

Headaches
Diarrhea
Nausea
Anxiety
Effects on human reproduction [16]

If you are still unsure of the effects of adding external melatonin as a sleep aid while using birth control pills, and you do not want to use non-hormonal contraceptives, you may consider male birth control pills for your partner.

If you experience spotting or breakthrough bleeding while using melatonin and contraceptive drugs, there is a chance your birth control may not be working. You must use a backup birth control method until you can see your doctor.

Uses of Melatonin in the Body

Melatonin acts by binding to receptors in the brain and cells in the gonads, kidneys, cardiovascular system, and parts of your body’s immune system.

The hormone is vital for many bodily functions, including [2]:

Regulating circadian rhythms, also known as your internal 24-hour clock
Managing your sleep cycle according to the day-night environmental pattern
Modulating the onset of puberty, with high levels of melatonin shown to delay puberty in some cases
Exerting some control over your core body temperature, melatonin acts as a thermoregulator, lowering your internal temperature
Energy metabolism–managing the daily distribution of energy and your body’s metabolic functions
Exhibiting anti-aging and antioxidant properties
Regulation of blood pressure [3]
Possible anti-tumor properties and ability to slow down the progression of prostate and breast cancer [4]

Due to the extensive use of melatonin in your body, many people choose to take melatonin supplements for various benefits.

What Are the Benefits of Melatonin Supplements?

Exposure to light at night can interrupt melatonin production, giving you trouble falling asleep. Adding external melatonin supplements is mainly recommended to promote sleep in people suffering from sleep disorders.

Besides this, taking melatonin supplements can provide several therapeutic benefits, including:

Treatment of chronic insomnia: Melatonin helps to improve sleep quality and decrease the number of times you wake up during the night [5]
Treatment of sleep disturbances [6]
Alleviating jet lag
Possibly aiding weight loss [7]
May help ease the symptoms of seasonal depression [8]
Reduces the oxidative stress in your body as it acts as an antioxidant [9]

Are Melatonin Supplements Safe to Take?

In most cases, the short-term use of melatonin is safe even when taken in extremely high doses and should cause mild to no side effects [10]. The long-term (more than six months) use of melatonin and its interaction with other medication has not been thoroughly researched [11].

It is also essential to keep in mind that the FDA does not regulate melatonin dietary supplements or their recommended dosage.

How are Melatonin Supplements Taken?

Synthetic melatonin supplements come in various forms like:

Tablets
Capsules
Gummies
Liquid drops
Diffusers
Vape liquid

Typically a melatonin dietary supplement has a directed dosage between 1mg and 10mg, one to two hours before you go to bed. Dosage varies widely from person to person and should be discussed with your doctor.

Melatonin Side Effects

When used for less than six months, melatonin should not cause any significant side effects. Most people can safely use oral melatonin supplements with only mild side effects such as [12]:

Dizziness
Headache
Nausea
Sleepiness
Agitation
Mood swings
Irritated skin

Other Melatonin Interactions

Melatonin may interact with other medicines like:

Diabetes medications [13]
Blood thinners [14]

Melatonin supplements may interact negatively with some medications, although this has not been studied extensively enough.

One of the major concerns for women interested in melatonin supplementation is whether it will interact or block the work of oral contraceptives in the form of hormonal birth control.

FAQ

Below are the answers to some of the most commonly asked questions about melatonin and birth control.

Does Melatonin Cancel Out Nexplanon Birth Control?

There is no evidence that melatonin cancels or interacts with the action of Nexplanon.

Nexplanon is a hormonal birth control implant placed in your arm. It releases a hormone called progestin that prevents pregnancy by thickening the mucus in your cervix to prevent sperm from passing through, as well as stopping ovulation.

Does Melatonin Affect Birth Control Depo Shot?

There is no proof that melatonin negatively interacts with the birth control Depo shot.

The Depo-Provera injection also contains progestin and is administered once every three months. It can be a good alternative for women who are worried about taking melatonin while on the pill.

Does Melatonin Cancel Out Birth Control Pills?

No, there is no research or evidence that melatonin cancels out birth control pills. Interactions between the supplement and hormones in the pill may cause your body to produce too much melatonin and increase its effects.

Does Melatonin Cancel Out Mirena?

No interactions have been found between Mirena and taking melatonin.

Mirena is an IUD that releases the hormone levonorgestrel, which prevents pregnancy. Mirena effectively prevents pregnancy for up to six years.

Alternatives to Melatonin

If you choose not to use melatonin to improve your sleep, plenty of sleep aid alternatives are available.

Lifestyle Changes

Some lifestyle changes that can improve your sleep quality include:

Avoid drinking coffee or caffeinated drinks up to four hours before going to bed
Regular exercise [17]
Avoid using electronic devices like phones or TVs, which produce light that will disrupt your body’s natural melatonin production
Establish a regular sleep schedule
Avoid taking naps
Practice meditation, yoga, or other calming therapeutic activities to help reduce stress

Natural Remedies

Some herbs and plants have beneficial effects on sleep. The most well-known include:

Chamomile, which is primarily used in tea form [18]
Valerian root, taken as a pill, extract, or tea [19]
Lavender oil, used in a diffuser [20]
Magnolia bark, in capsule form [21]

Chamomile reduced the number of night awakenings in the subjects from 2.2 to 1.4

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy involves several exercises that manage your behavior before, during, and after going to bed. Unlike medications and supplements, the treatment provides long-lasting effects for sleep disorders like insomnia.

Cognitive-behavioral therapy is also suitable for people of all ages and has been proven especially effective in children and teens [22].

Conclusion

Despite many claims that melatonin supplements cancel birth control, there is no evidence of the interaction. Women taking birth control pills are advised only to temporarily use melatonin and always check with their doctor first.

Safely taking melatonin and birth control can significantly improve sleep quality, and help you get back your energy, whether you have insomnia, a sleep disorder, or even just jet lag.

References:

JH;, Korf HW;Schomerus C;Stehle. “The Pineal Organ, Its Hormone Melatonin, and the Photoneuroendocrine System.” Advances in Anatomy, Embryology, and Cell Biology, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/9670565/.
JH;, Korf HW;Schomerus C;Stehle. “The Pineal Organ, Its Hormone Melatonin, and the Photoneuroendocrine System.” Advances in Anatomy, Embryology, and Cell Biology, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/9670565/.
K;, Baker J;Kimpinski. “Role of Melatonin in Blood Pressure Regulation: An Adjunct Anti-Hypertensive Agent.” Clinical and Experimental Pharmacology & Physiology, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/29603319/.
Li Y;Li S;Zhou Y;Meng X;Zhang JJ;Xu DP;Li HB; “Melatonin for the Prevention and Treatment of Cancer.” Oncotarget, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/28415828/.
Aulinas, Anna. “Physiology of the Pineal Gland and Melatonin.” Endotext [Internet]., U.S. National Library of Medicine, 10 Dec. 2019, www.ncbi.nlm.nih.gov/books/NBK550972/#.
Xie Z;Chen F;Li WA;Geng X;Li C;Meng X;Feng Y;Liu W;Yu F; “A Review of Sleep Disorders and Melatonin.” Neurological Research, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/28460563/#:~:text=Melatonin%20has%20been%20shown%20to,sleep%20regulation%20and%20neuronal%20survival.
Amstrup AK;Sikjaer T;Pedersen SB;Heickendorff L;Mosekilde L;Rejnmark L; “Reduced Fat Mass and Increased Lean Mass in Response to 1 Year of Melatonin Treatment in Postmenopausal Women: A Randomized Placebo-Controlled Trial.” Clinical Endocrinology, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/26352863/.
VK;, Lewy AJ;Lefler BJ;Emens JS;Bauer. “The Circadian Basis of Winter Depression.” Proceedings of the National Academy of Sciences of the United States of America, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/16648247/.
E;, Reiter RJ;Tan DX;Osuna C;Gitto. “Actions of Melatonin in the Reduction of Oxidative Stress. A Review.” Journal of Biomedical Science, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/11060493/.
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2021 Guide to the Birth Control Sponge: Is It Effective?

June 24, 2021 by Eve Leave a Comment

Finding the right type of birth control is a lot like finding the right kind of shoe; you’re going to have to go through many until you find the one. Despite hormonal contraception being the most popular choice, there are many other options out there, one being the birth control sponge.

This article details how the sponge works, whether or not it’s effective, and if it could be the right choice for you.

Key Takeaways

The vaginal sponge is a non-hormonal method of contraception.
It prevents pregnancy 77-83% of the time.
The sponge is available over the counter from planned parenthood clinics, pharmacies, and drug stores.
You can use it to block sperm from the uterus for 24 hours without removing it.
It does not protect against STDs.

What Is the Birth Control Sponge?

The contraceptive sponge is a non-hormonal birth control method. It acts as a barrier in the form of a disk-shaped polyurethane foam sponge inserted into the vagina. The sponge works to prevent pregnancy by blocking the path of sperm to the uterus.

How Effective Is the Birth Control Sponge?

Physical barrier methods, like all contraceptive technology, are not 100% effective. Hormonal forms of contraception tend to prevent pregnancy more effectively [1].

Typically, the sponge is 77-83% effective, although this depends on whether or not a woman has gone through vaginal childbirth [2].

Giving birth to a child vaginally stretches the cervix and vagina, making the sponge far less effective [3].

A birth control sponge is more effective when used by a woman who hasn’t been pregnant before, though the contraceptive pill is still more successful

Vaginal Sponge and Spermicides

The contraceptive sponge contains a spermicide known as nonoxynol-9 that is gradually released over 24 hours and kills sperm before it reaches the egg [4].

Despite the spermicide inside, the sponge remains a relatively unreliable form of contraception and prevents pregnancy more effectively when combined with other birth control methods like the male condom.

Birth Control Sponge Advantages and Disadvantages

Below are the main pros and cons of the birth control sponge.

Advantages

Non-hormonal method of birth control: Avoids side effects of hormonal methods, such as weight gain, breakthrough bleeding, and nausea [5]
It does not require a doctor’s prescription
You only have to use it during sexual intercourse
Safe to use while breastfeeding
Won’t interfere with your menstrual cycle

Disadvantages

It does not protect against sexually transmitted diseases (STDs)
You cannot use it during your period
Not reusable

How Do I Use the Sponge?

You must insert the contraceptive sponge into the vagina prior to sex. The sponge covers your cervix and blocks the path into your uterus, held in place by your vaginal muscles. It is essential to insert the sponge according to instructions. If you use the sponge incorrectly, it will dramatically reduce its effectiveness.

How Do I Insert the Sponge?

Before inserting the sponge, remove it from its packaging and wet it with about two tablespoons of clean water to activate the spermicide.

To insert the sponge, position yourself with your legs slightly apart. Fold the sides of the sponge upward, and slide it folded side up, string side down, as far up into your vagina as it will go. Then, release it so that the edges unfold and cover your cervix.

When Can I Put the Sponge In?

It is essential to insert the contraceptive sponge before intercourse, even if it requires you to interrupt sex or foreplay to do so.

How Long Do I Leave the Sponge In?

To ensure maximum effectiveness, you must leave the sponge in for at least six hours after sex. However, you must remove it within 24-30 hours after insertion as leaving it in longer causes an increased risk of toxic shock syndrome.

How Do I Take the Sponge Out?

Most contraceptive sponges have a string attached to them to enable easy removal. Once you’re ready to remove the sponge, gently pull the string, or if you can’t find it, draw on the sponge itself.

Bear down and try gently removing the sponge. If it is still held in place by your vaginal muscles, wait a while to allow them to relax and try again.

Discard the used sponge after you’ve removed it.

Birth Control Sponge Side Effects

As with all contraceptive methods, there are possible side effects, including:

Allergic reaction: The spermicide released by the sponge can cause itching, sores, or a rash inside the vagina or on your partner’s penis [6].
Higher risk of toxic shock syndrome, causing fever, vomiting, diarrhea, and rashes, when misused [7]
Vaginal dryness or irritation [8]

FAQ

We’re answering the most frequently asked questions about the birth control sponge below.

Is the Sponge Birth Control Still Available?

Yes, the contraceptive sponge is still available. However, the only brand currently on the market is the Today sponge, which is available over the counter at pharmacies, drug stores, family planning clinics, and planned parenthood centers.

If you’re not sure how to get birth control, our article can help you find the best way for you.

Is the Birth Control Sponge Safe?

The contraceptive sponge is a safe barrier method when used according to its instructions. However, using it incorrectly could result in a greater chance of becoming pregnant or developing toxic shock syndrome.

Why Was the Birth Control Sponge Discontinued?

The vaginal sponge was mainly discontinued due to the development of the diaphragm, which was significantly more effective [9].

The Today contraceptive sponge was temporarily taken off the market in 1994 due to bacterial contamination in the factories where it was manufactured. At the time, the company found the upgrades necessary for it to meet FDA approval would not be financially viable.

The company was eventually taken over, and later the new, FDA-approved contraceptive sponge and spermicide barrier returned to the market and planned parenthood centers.

Can a Man Feel the Sponge?

No, you shouldn’t worry that your sex partner may feel the sponge. The material it is made of is soft and mimics the feel of the vaginal wall.

If you are unsure about using the sponge, there are various other methods of contraception, including birth control for men.

Conclusion

The birth control sponge is a non-hormonal form of contraception that you can use to prevent pregnancy for up to 24 hours. Despite it not being as effective as the diaphragm or cervical cap, using it combined with other forms of birth control prevents pregnancy up to 99% of the time.

If you’re looking for an easy-to-use, barrier contraception method, the vaginal sponge could be the right choice for you.

References:

K;, Mansour D;Inki P;Gemzell-Danielsson. “Efficacy of Contraceptive Methods: A Review of the Literature.” The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/20136566/.
Commissioner, Office of the. “Birth Control.” U.S. Food and Drug Administration, FDA, www.fda.gov/consumers/free-publications-women/birth-control#BarrierMethods.
B;, Trussell J;Strickler J;Vaughan. “Contraceptive Efficacy of the Diaphragm, the Sponge and the Cervical Cap.” Family Planning Perspectives, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/8354373/.
E;, Harrison C;Chantler. “The Effect of Nonoxynol-9 and Chlorhexidine on HIV and Sperm in Vitro.” International Journal of STD & AIDS, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/9506374/.
K;, Dawson. “Side Effects of Oral Contraceptives.” The Nurse Practitioner, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/503375/#:~:text=Some%20of%20the%20side%20effects,cancer%3B%20and%2C%20hepatic%20effects.
van Ulsen J;Stolz E;van Joost T;Geursen-Reitsma AM; “Allergy to Spermicidal Lubricant in a Contraceptive.” Contact Dermatitis, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/3652700/.
; “Toxic-Shock Syndrome and the Vaginal Contraceptive Sponge.” MMWR. Morbidity and Mortality Weekly Report, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/6318070/.
SM;, Beckman LJ;Murray J;Harvey. “The Contraceptive Sponge: Factors in Initiation and Discontinuation of Use.” Contraception, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/2582772/.
B;, Trussell J;Strickler J;Vaughan. “Contraceptive Efficacy of the Diaphragm, the Sponge and the Cervical Cap.” Family Planning Perspectives, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/8354373/.