25th April, 20199 min read

Natural contraceptive methods: Are they a reliable option?

Last reviewed: 25/04/2019
Medically reviewed

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Natural contraceptive methods are ways of preventing pregnancy which do not involve the use of hormones or devices.

These natural methods of contraception include natural family planning (the fertility awareness method), which relies on observations about your body and menstrual cycle, the lactational amenorrhoea method, and the withdrawal method.

Natural family planning can be effective but you have to be motivated, and it’s generally only reliable if:

  • You are taught how to practice it properly
  • You can carefully follow instructions
  • You can keep a daily record of fertility signals (such as basal body temperature or cervical mucus patterns)
  • You account for things that can disrupt your menstrual cycle, such as illness or stress

The lactational amenorrhoea method is also effective as long as you meet the criteria to practice it safely and take care to follow it correctly.

The withdrawal method is significantly less effective, and is not recommended due to the number of unplanned pregnancies it can lead to.

If you are thinking about trying a natural contraceptive method, explore the pros and cons associated with each type of natural birth control. Consider your own mindset and mentality before you engage with a natural contraceptive method.

In this article you’ll learn about the three main types of natural contraception, how they work, and how effective they are.

Natural family planning

Natural family planning (sometimes called NFP or the fertility awareness method) is a natural method of contraception that requires careful measurement of fertility indicators so that you can abstain from unprotected sex on the days you are most likely to conceive.

How does natural family planning work?

You are only fertile for about 8-9 days of your menstrual cycle. During this fertile period, your body releases an egg (known as ovulation) and undergoes a series of changes.These changes include a slight increase in your basal body temperature, and a change in both the texture and appearance of your cervical mucus.

By carefully measuring these changes over a number of months, the NFP method helps you to identify your fertile days and plan accordingly.

One method involves taking your temperature every day and recording the results on a chart. You can also practice the natural family planning method by monitoring your cervical secretions for 3-6 menstrual cycles.

Tracking the length of your cycle can also help you to calculate when you're most likely to be fertile, but it is important to remember that the length of a menstrual cycle can vary over time. This means that you’ll need to track the length of your menstrual cycle for at least 12 months before it can be used as an accurate indicator, and you will always need to combine it with at
least one other signal.

It is best to record all three methods to give you a more accurate picture of your fertile window.

NFP is only an effective and reliable contraceptive method if it is taught by a specialised instructor who can coach you to understand your body’s fertility indicators.

How effective is natural family planning?

If practiced perfectly, natural family planning can be up to 99% effective. But in reality, mistakes can reduce the effectiveness of this method to around 76%. There are also several factors which can affect your fertility signs and make tracking your fertile period less reliable. These include illness, stress, travel, lifestyle, or the recent use of hormonal contraceptives.

Although most women can use natural family planning, there are certain circumstances where you might want to consider another method if:

  • There is a health risk to the baby if you became pregnant
  • You have recently stopped taking hormonal contraception
  • You have just had a baby and are currently breastfeeding
  • You have irregular periods
  • You have a short or long-term condition affecting your fertility signs, such as a sexually transmitted infection (STI) or pelvic inflammatory disease
  • You have recently experienced an abortion or miscarriage
  • You are taking medication which affects your cervical mucus production

NFP is also unsuitable if you:

  • Regularly travel through different time zones
  • Are unable to take your temperature in the recommended way
  • Are a heavy drinker

It’s a good idea to reflect on whether you can record information about your temperature or cervical mucus on a daily basis, or if you will be able to abstain from sex during your fertile days. Every contraceptive method will have its advantages and disadvantages, so weigh up what may be more suitable for you and your partner. Then visit your doctor or local family planning clinic to discuss your options.

What about fertility monitoring devices or apps?

Depending on where you live, you may be able to buy a device that’s designed to help you monitor and track your fertility. Some examples include:

  • Computerised thermometers, which combine information about the length of your menstrual cycle and your temperature to help you predict your fertile window
  • Luteinising hormone (LH) dipstick tests or ovulation predictor kits which are designed to help you identify how far through your menstrual cycle you currently are
  • Saliva testing devices

Saliva testing devices are not accurate and should not be used for avoiding pregnancy. Dipstick tests are also not effective as a method of natural family planning, while more research is needed to establish the effectiveness of computerised thermometers.

There are several phone apps that are designed to help you measure your menstrual cycle and predict your fertile days. According to the FPA, their reliability and effectiveness is unknown.

Lactational amenorrhoea method

The lactational amenorrhoea method (sometimes called LAM or the breastfeeding method) is a natural contraceptive method that involves breastfeeding after childbirth to avoid pregnancy.

How does the lactational amenorrhea method work?

Breastfeeding encourages the release of a hormone called prolactin, which blocks the release of hormones that cause ovulation. You are therefore less likely to fall pregnant while breastfeeding.

Women who are fully (or nearly fully) breastfeeding can use the LAM for the first six months after their baby is born, as long as:

  • You have complete amenorrhoea, which means that your periods haven’t returned
  • You are fully or nearly fully breastfeeding (this means that your baby is having breast milk only, and very little or no other liquids)
  • Your baby is less than six months old

If the frequency of your feeds drops too low, the levels of prolactin in your bloodstream will also start to drop, which can prompt the return of your menstrual cycle.

How effective is the lactational amenorrhea method?

If practiced correctly, less than two in 100 women who use LAM will get pregnant in the first six months. However, LAM is not for everyone as it can only be used by breastfeeding women.

The LAM method is only a temporary form of contraception. Once the conditions for using this method are no longer met, it becomes unreliable and it is advised that you use another form of contraception. It works while your baby is fully or nearly fully breastfeeding and under the age of six months, but it becomes considerably less effective once your baby is getting less than 85% of its feeds as breast milk.

This means that the risk of pregnancy increases once your baby moves onto solid foods, stops feeding at night, or starts to feed less regularly.

After having a baby, you can get pregnant before your periods resume, as you ovulate about two weeks prior to your period.

The Withdrawal Method

The withdrawal method is a natural contraceptive method that involves the male partner completely removing his penis from the vagina before ejaculation occurs. According to a study conducted in America, the withdrawal method may be one of the most popular forms of contraception among young adults and teenagers.

How does the withdrawal method work?

The goal of the withdrawal method is to prevent semen from entering the vagina and reaching an unfertilised egg.

How effective is the withdrawal method?

Unfortunately, the withdrawal method is one of the least reliable forms of contraception that you can use. Sperm may enter the vagina if withdrawal isn't precisely timed or if pre-ejaculation fluid contains sperm. It also requires a great deal of control from the male partner.

According to The Global Library of Women’s Medicine (GLOWM), the withdrawal method is only 78% effective. This means that if 100 women used the withdrawal method for one year, 22 of them would experience an unplanned pregnancy. As a result, the withdrawal method is not recommended as a form of contraception.


Choosing which type of contraception to use is a personal decision, and there are many things to take into account, including your age and medical history. Before you decide whether you want to explore a natural contraceptive method, take some time to think about how well it matches your mindset, lifestyle, and needs. If you think you may struggle to practice the method correctly - or you are worried it is not a good fit for you personally - it may be wise to consider other options.

Natural family planning is less effective if the instructions aren't carefully followed. There are also certain factors which can affect your fertility signs and situations where you may want to think about another contraceptive method. If you have a medical condition which means that pregnancy is something you just can’t risk, natural methods may not be appropriate because other methods are less likely to fail.

After looking into your options, consult your doctor or local family planning clinic to discuss further. Alternatively, you can use the Brook contraception tool to find out which types of contraception would suit your lifestyle. Brook is a leading sexual health charity which provides free sex and relationship information via an online portal.

And remember, natural contraception methods do not protect against STIs. A condom is needed for this. If you would like to read more about the different methods of contraception that are available to you - including hormonal medications, condoms, and implanted devices - check out our earlier blog on the different types of contraception.

If you are considering a natural form of contraception, you will find some useful information here.

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