Photo by Reproductive Health Supplies Coalition on Unsplash Even the most skilled users of fertility awareness as contraception usually want to know about emergency contraception. Condoms and other precautions can fail, and we might not always track our temperature and other data as well as we could.  We also know women are only fertile for 9 days a cycle, so there's pretty big chunks of time when there's no need to go through the disruption and potential expense* of taking emergency contraception. (*You should be able to get free emergency co ..read more

If you want a baby (it’s not compulsory) you are probably  all too aware of your fertility, and how it declines with age. You might just want to sort a few things first. Like a suitable partner, a decent job, affordable housing, affordable childcare and while we're at it how about flexible working practices? Once you're ready, or reasonably ready, you have the small matter of getting pregnant to attend to.  Well-meaning, but oversimplified messages about the importance of contraception might mean you think you will get pregnant the moment you have unprotected sex ..read more

Photo by Hakan Nural on Unsplash ​My view is that you should get vaccinated. Any side effects are going to be better than getting Covid itself, even if you're pregnant, planning a pregnancy or breastfeeding. That said, you should also be prepared for a disrupted cycle if you're using fertility awareness as contraception. Delayed periods and heavier periods were experienced by over 4,000 women who had the Covid jab in this Sunday Times report. I've seen women's cycles affected by both Covid and the jab. It does what you’d expect from any kind of ill ..read more

Camden New Journal recently published an edition with a wraparound cover that imagined how things might look in 2030 if all the climate goals were reached. This is what I wrote for it: Camden wins NHS sustainability award for green contraception project NHS contraception used to mean medication or minor surgery. The NHS website listed fertility awareness (natural family planning) and said it was up to 99% effective but most GPs didn’t recommend it and women had to pay for support, or work things out for themselves. Today, thanks to an award-winning Camden project, women are routinely offered ..read more

Like millions of women I used to take the pill, and was lucky enough not to have any unpleasant side effects.  Then in 1995 thousands of women stopped taking it because of reports that it increased the risk of blood clots.  Despite that, I would have continued taking it if it wasn't for a friend who suggested using fertility awareness as contraception. I thought is sounded a bit fringe, not like a  serious way to avoid pregnancy. It also felt irresponsible. We were both working in the NHS, in public health, we knew how risk could be over-reported in the media.  St ..read more

Using fertility awareness as contraception can feel scary if you've ever heard it fails 1 in 4 women with typical use (25%). That figure is unhelpful as it lumps together all the different fertility awareness methods - some of them are better than others.    The new Guttmacher failure rate is more helpful because it gives a range of figures, depending on the method used. It ranges from 2% to 34% with typical use.  ​Guttmacher says the most effective fertility awareness method is Sensiplan, which is a more detailed version of the Fertility UK  ..read more

Using fertility awareness as contraception can feel scary, especially if you've ever heard it can fail 1 in 4 women.  Fortunately that statistic has now been updated, thanks to an evidence review from the US Guttmacher Institute. The new typical use failure rate ranges from 2 to 34 women in 100 (2% to 34%) depending on the method used. That's a big difference. The method you use matters. Guttmacher says the most effective method is Sensiplan, which I'm pleased about as Fertility UK (the method I teach) is broadly similar. It's also the approach which the NHS ..read more

True periods rather than the withdrawal bleeds you get on the pill can be a mixed blessing. If all goes well, they can be reassuring. A great indicator of overall health and fertility, and a handy way to confirm that we’re not pregnant.    However some women do have problems with their periods and with their cycle in general. Acne, breast pain, PCOS, painful periods, heavy periods, irregular bleeding, endometriosis, fibroids... It’s not exactly the stuff to fill anyone with joy about their natural hormones. The pill is often  presented as the solution but ..read more

Feeling prepared for the zombie apocalypse used to be one of the things I liked about using fertility awareness as contraception. And here we are – no zombies, but a pretty apocalyptic situation. Not a great time for popping to the GP or pharmacy for pill supplies, or getting a contraceptive injection or implant. So how is fertility awareness holding up? Well if you’re an established user you’re probably fine. You’ll know that stress can sometimes mess with your cycle, and how you can allow for that. You’ll have your thermometer, and your app or your paper charts and instructi ..read more

Do you need periods, or are they “God’s design flaw” as a senior health professional said in a recent Guardian article?  It depends on what you mean by a period. If you mean a pill withdrawal bleed, official FSRH guidance states there are "no health benefits." But what about true periods (the bleed you get after ovulation). That’s a trickier question. I’m not going to say you need periods. The pill is an important and hard-won contraceptive option. That said, those of us who want periods have some pretty good rea ..read more