A couple of months back I shared my fertility tracking charts on Instagram Stories, provoking a number of questions. What were they? How were they used? Was this the “calendar method”? I promised I’d do a post eventually, so this is my attempt to explain this really major lifestyle choice.
It’s helpful to do a little explanation of the various methods and exactly how babies are made.
The average woman has two ovaries full of eggs. Every month, a series of biochemical reactions (caused by hormones) induce an egg on one ovary (or both!) to ripen and be released. The egg travels through the fallopian tubes to the uterus. If fertilization doesn’t occur, the egg eventually dies and is expelled with the uterine lining during the monthly period. For fertilization to occur, healthy sperm cells need to find the egg in time. If it does, the egg is fertilized and implanted in the uterus. Note that the egg usually lives about 2 – 3 days. Sperm cells live for about 5 days. These are important facts to keep in mind.
Contraceptives work by inhibiting one of the above actions.
Hormonal contraceptives (the pill, the implant and the hormonal IUD) work by regulating the hormones such that either no egg is released, or by making it impossible for sperm cells to swim to the egg or by making the uterus non-conducive to a fertilized egg. If no egg is released, then the sperm cells can’t fertilize anything. If for some reason, an egg is released, then the pills work to make sure the uterus isn’t conducive to a fertilized egg, so that it won’t implant and can’t survive.
The copper IUD works by triggering the woman’s body to produce fluids that prevent sperm cells from reaching the egg. If the sperm cells die before they can reach the egg, there’s no fertilization..
See Also: Giving Birth The 2nd Time
Condoms and diaphragms work by preventing the sperm cells from reaching the egg. Ever. Some of them are coated with spermicide that kill the sperm cells.
All of these methods have ranges of success and failure but for the most part, they’re effective.
But not without side effects, though. And the side effects are one reason I choose not to use any of them. (The other reason is that the tiny risk that they might prevent implantation makes me feel queasy.)
The copper IUD is notorious for causing intense cramps and heavy bleeding. The hormonal IUD doesn’t have this particular side effect but it carries the side effects of the pill. Some women say their husbands can feel the IUDs during sex. Some say the devices get lost or come loose. Other side effects include nausea, pelvic infections and vaginal inflammation. In addition, IUDs carry a small risk of causing an ectopic pregnancy, which is usually fixed by taking out the affected fallopian tube.
The hormonal contraceptives are notorious for causing a combination of the any of the following: nausea, weight gain, mood changes, abdominal pain, chest pain, headaches, blurred vision or swelling of the legs and thighs.
See Also: 10 Things I Learnt About Post Partum Weight Loss
Some cause blood clots which can easily be fatal (a clot travelling to lungs or brain would be lethal in minutes). Because of their mode of operations, they might also cause an increase in yeast and/or vaginal infections. Most striking though, is that the use of hormonal contraceptives may increase the risk of breast and cervical cancer, while reducing the risk of ovarian and endometrial cancer. Considering that my experience with women getting breast cancer is higher than all the others, it’s almost a no-brainer.
Condoms and diaphragms are typically side effect free for most women. But some women complain of latex allergies and an increase in yeast infections. There’s also that it just doesn’t feel the same.
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So what do I use?
The umbrella term is “Fertility Awareness Method” but there are various techniques for carrying it out. The idea is simple. If the egg can only survive 2 days, and the sperm cells can only survive 5 days, then there is a maximum of 7/8 days during which a woman can get pregnant every cycle. If I abstain during that period, then I can’t get pregnant. That’s it in a nutshell. The question now is: how do I identify the days when eggs will be released so I can abstain in the days before and after that window? Most people know about the Calendar method, which involves counting the days between periods and identifying the “ovulation window” as the mid-point. This method is problematic because periods vary. A 25-day cycle can easily switch to a 31-day cycle with no explanation.
There’s the traditional FAM, that tracks 3 data points. Body temperature, cervical position (is your cervix soft or hard, open or closed, low or high) and cervical discharge. Because of the multiple biomarkers, this method is super rigorous and just as accurate in preventing pregnancy as any of the other artificial methods. I use a simplified version of FAM called Creighton. It only tracks cervical discharge (which you might’ve noticed yourself on some bathroom breaks). Some days, when you wipe front to back like we’re supposed to, it’s pretty dry. Some days, it feels (and looks!) like you just peed egg-white. Some days are in-between. Creighton has taught me to interpret those signs in determining if I’m fertile or not.
One downside about FAM (in my opinion) is that there’s no room for error. Your cycle is made up of either fertile days or non-fertile days. There’s no “maybe”. And so if you misread the signals and have sex on a fertile day, you will most likely get pregnant. Another thing I struggled with was the difficulty in finding a coach in Nigeria. FAM is not easy to learn on your own and for almost a year, I had to schedule periodic Skype calls with my coach in the US. Thankfully, I’ve learnt the system well enough that I no longer need frequent check-ins. And I’ve finally found someone who can teach it in Nigeria. So yay!
Whew. This has been a long post. I’d really like to hear your thoughts.Are you interested in learning FAM? We have a class coming up in March, you can book tickets here. What’s been your experience with contraceptives? Are you satisfied with your current method?
References:
https://www.zavamed.com/uk/intrauterine-contraception.html
https://www.cancer.gov/about-cancer/causes-prevention/risk/hormones/oral-contraceptives-fact-sheet
https://www.webmd.com/sex/birth-control/birth-control-pills#4
