The cervical method, also known as the Billing method, is the ENP (Natural Family Planning) method. It is used to determine the most accurate moment of ovulation and thus choose the most favorable period for conception. The method got its name in honor of the Australian Billing couple, who discovered that cervical mucus (a substance secreted in the mucous glands of the cervix) changes during the female cycle.
How does the cervical method work?
Spouses Billing found that the production of mucus in the cervix is \u200b\u200bdirectly related to hormonal changes during the cycle. The release of sex hormones estrogen and progesterone has a direct effect on cervical mucus, which changes throughout the cycle not only in color and quantity, but primarily in consistency. To maximize the exact determination of the moment of ovulation with the cervical method, daily monitoring of the properties of the mucus is required for several months. To do this, you should check the quality of mucus in the morning manually or using two layers of toilet paper to detect signs of fertility. Features and changes of mucus are recorded in a special schedule or history journal, based on which later it will be possible to determine the date of ovulation.
Cervical method: 5 phases are distinguished
The cervical method distinguishes 5 phases, within which 2 types of mucus are mainly distinguished.
- 1 phase: Immediately after menstruation, the woman’s esrogen level is still very low and mucus production is low. Cervical mucus continues to be produced, but forms a tight plug at the entrance to the uterus, which prevents the penetration of microbes. The vagina is drier at this point, so this phase is also called “dry days”.
- 2 phase: some time before ovulation, the level of estrogen rises and the mucous plug changes its consistency. Viscous, cloudy, yellow, or white, sticky mucus is also present in the vagina. Due to the relatively dense structure, this mucus still represents a natural barrier to sperm and limits or complicates their penetration into the uterus, while the egg is not yet ready for fertilization.
- 3 phase: immediately before and after ovulation, a woman’s estrogen level is highest. During this period, the production of mucus reaches its peak, which is called “wet days”. The mucus becomes noticeably lighter, transparent and elastic. In its consistency, it resembles raw protein and can stretch between fingers or layers of toilet paper into a string 6–15 cm long. This is the period of the so-called “crystallization of mucus” (mucus ductility). Usually it lasts about 2-3 days and clearly indicates ovulation. Since sperm penetrate well only through this “fertile” mucus, couples wishing to have a baby are advised to engage in unprotected sexual intercourse from the moment such secretions appear. Thanks to the mucus, the sperm are also well protected from the hostile acidic environment of the vagina and can survive in the woman’s body for 3 to 5 days. The chances of getting pregnant are thus greatly increased.
- 4 phase: a few days after ovulation, the female body begins to intensively produce progesterone instead of estrogen. Mucous secretions become more scarce, viscous, cloudy and lumpy. The conditions for penetrating sperm are getting worse, and the chance of fertilization is inexorably decreasing.
- 5th phase: in the premenstrual phase, mucus production continues to decline, and the body prepares for menstruation. Regular and continuous study of the structure of mucus is fundamental when using the cervical method, this makes it possible to record even minor changes and evaluate your own body more objectively.
Is the cervical method reliable?
Female mucus production depends on many different factors. Mental stress, bacterial infections, and taking medications (such as ointments or suppositories) that are used vaginally can affect the structure and amount of cervical mucus. In addition, hormonal fluctuations that impede the objective analysis of symptoms affect its quality. The production and quality of mucus can be influenced by the nutrition of a woman. In addition, it is important to consider that the above symptoms can be expressed differently in different women. It is for this reason that the cervical method requires constant monitoring of your own body. The method is not suitable for everyone also because in some women cervical mucus undergoes such insignificant changes during the cycle that they cannot be detected with the naked eye. Besides the method of determining the moment of ovulation for conception, the cervical method can also be used as a natural method of contraception. However, as an independent method of protection, it is considered unreliable. Therefore, it is recommended to combine the cervical method for both
The cervical mucus method, also called the Billing method, is a method of natural family planning.
The cervical mucus method is based on careful observation of mucus samples during the menstrual cycle. Before ovulation, the cervical discharge changes - an environment is created that helps the sperm to pass through the cervix, uterus and fallopian tubes to the egg. By tracking changes in the characteristics of cervical mucus, it is possible to predict ovulation, which can help you determine when you can become pregnant.
If you are planning a pregnancy, you can use the cervical method to determine the best days for intercourse. Similarly, if you hope to avoid pregnancy, it will help you know which days you should avoid unprotected sex.
Using the cervical mucus method to prevent conception requires motivation and diligence. If you do not want to conceive, you and your partner should avoid sex or use the barrier method of contraception every month.
Benefits
The cervical method can be used as a way of determining fertile days, or avoiding unprotected sex. Monitoring the state of cervical mucus to conceive and prevent pregnancy is an affordable way and has no side effects. Some women prefer to use the cervical mucus method for religious reasons.
This method of natural family planning is sometimes combined with others, such as tracking or. It is sometimes called the symptomatic method.
The risks
Using the cervical mucus method to stimulate fertility and control conception poses no risks, but does not provide protection against sexually transmitted infections. In addition, the risk is slightly higher than with other methods of contraception.
It is estimated that 23 out of 100 women practicing cervical mucus for contraception become pregnant in the first year of using this method. But with the most correct application, the pregnancy rate can reach 3 out of 100 women per year using this method.
To master the cervical method, formal training is required. Constant and thorough daily monitoring is also required. In addition, for 10-17 days of each cycle, abstinence or use of contraceptives is necessary.
How to prepare?
In order to use the cervical mucus method, it is important to understand how the discharge changes during the menstrual cycle. Typically, you will have:
- No noticeable cervical discharge within 3-4 days after the end of menstruation
- Lean, cloudy and clammy discharge over the next 3-5 days
- Profuse, clean and moist discharge, reminiscent of egg white, during the next 3-4 days - the period before and during ovulation
- There is no noticeable cervical discharge for 11-14 days until the next menstruation
Although the specific length of these phases may be different, contact your gynecologist if the discharge does not correspond to the general scheme. You may have an infection that requires medical attention.
If you want to use the cervical method for contraception, first contact your doctor if:
- You had your first menstruation recently, you gave birth or stopped taking hormonal contraceptives
- Do you have a baby while breastfeeding?
- You are approaching menopause
- You have a disease that interferes with regular ovulation, such as
Your doctor may prohibit the use of the cervical mucus method if you have a chronic infection of the reproductive organs.
How to check cervical mucus?
- Wash and dry your hands first.
- Choose a comfortable position while sitting on the toilet, squatting or standing and putting one foot on the edge of the bath or toilet.
- Place one or two fingers inside your vagina. Index or middle will probably work best. Be careful not to scratch yourself. Depending on how much cervical mucus you secrete, you may not need to get deep, but getting a sample near the cervix is \u200b\u200bstill ideal.
- Remove the finger from your vagina and examine the consistency of the mucus that remains on the finger. Do this by looking at the mucus and rubbing it between two fingers (usually the thumb and forefinger). Try squeezing your fingers and then slowly spread them apart.
Viscous transparent mucus in large quantities speak of maximum fertility right before ovulation.
What do you need to know?
To use the cervical mucus method:
- Record your secretions over several cycles. Starting from the day the menstrual bleeding stops, observe and note the discharge on the chart. In order not to confuse cervical secretions with sperm or normal sexual lubrication, avoid sex or use the barrier method of contraception during the first cycle. Also avoid douching, because of this you may not notice a change in the nature of the discharge.
- Check discharge before and after urination. Write down the color (yellow, white, transparent or cloudy), the consistency (thick, sticky or elastic) and the sensations (dry, wet or slippery) of your discharge. Also pay attention to the sensation of dryness or humidity in the vulva.
- Plan sex carefully during fertile days. Such are the days when cervical secretions are plentiful, transparent, elastic, wet and slippery - like raw egg white. If you are hoping to get pregnant, it's time to have sex. Ovulation most likely occurs during or one day after the last day of this type of cervical secretion, also known as peak day.
- If you hope to avoid pregnancy, unprotected sex is undesirable in the period from the beginning of cervical discharge to the peak day and another 4 days after it (this is about 6-9 days in a row, starting from the 3rd or 4th day after menstruation with a 28-day cycle - approx.ed.). If you have unprotected sex before the discharge begins, you need to avoid sex the next day so as not to confuse semen and lubrication with cervical secretions.
Interpreting and mapping cervical mucus can be a daunting task. Most women need more than one briefing to recognize the structure of mucus in a typical menstrual cycle. Consult your doctor for any questions or concerns.
Only one day a month is reserved for nature so that a woman can become pregnant: that is how much an egg awaits fertilization from the moment it leaves the bursting follicle until the end of the journey through the fallopian tube. Knowing when exactly these important 24 hours will come, you can successfully plan a pregnancy or, conversely, effectively protect yourself from it. But how to determine the time of onset of ovulation?
Ovulation: what happens in your ovaries
The stock of eggs in a woman is huge and measured by the beginning of puberty in the hundreds of thousands. However, not all of them, fortunately, are at the same stage of maturation. Each month, out of a dozen or two of the most mature follicles (a follicle is an egg surrounded by layers of epithelial cells and connective tissue), one is released, less often two or three, which begin to develop more intensively than others. Such a follicle is called dominant. The peak of development is the rupture of the follicular membrane and the exit of the egg ready for fertilization to “free swimming”, that is, getting into the uterine (fallopian) tube.
” Follicles begin to grow and develop not spontaneously, but under the influence of cyclically released hormones. In particular, luteinizing hormone (LH) is “responsible” for the ovulation process.
In addition to the imperceptible rupture of the follicular membrane for most women, it causes a lot of concomitant phenomena in the woman’s body that can be used to judge the onset of ovulation.
Determination of ovulation by saliva
An increase in the concentration of LH and estrogen can be easily detected in the blood, urine and saliva. Oddly enough, it is saliva - a simple, affordable and reasonably accurate object for home research. It is applied to a glass slide (you can use a simple smooth glass with a flat surface), wait for drying and look under a magnifying glass in good light.
” On the day of ovulation, dried saliva solidifies with a “frosty pattern” resembling a fern leaf pattern. Important! Saliva analysis should be performed immediately after sleep, before you have breakfast and brush your teeth.
It is much more convenient to use not a home magnifier, but special mini-microscopes to determine ovulation, resembling in appearance a children's kaleidoscope toy. Only instead of multi-colored glass in it - one, with your saliva. It is simple and convenient to look at the resulting pattern.
For women who are not sure that they see a fern leaf, compact saliva analyzers, reminiscent of powder boxes, are produced. You no longer need to peer at the drawing - just spit, and a text message will appear on the small screen. Let's be honest, while users are more likely to criticize these miracle devices: both expensive and not too reliable. But scientists and engineers are constantly improving them, so the appearance of an ideal analyzer is not far off.
Determination of ovulation by urine
Test strips for determining ovulation today offer several companies that produce tests for pregnancy. They act in exactly the same way, but instead of chorionic gonadotropin (like pregnancy tests) they are “tuned” to luteinizing hormone.
” The test strip is lowered into the urine container for the time specified in the instructions, and if ovulation is close, you will see two lines on it. If not, then only one, control. Important! Unlike pregnancy tests that need to be done in the morning, it is better to collect urine to determine ovulation in the middle of the day.
Manufacturers guarantee the high reliability of such tests, and they are absolutely right. The problem is different - our body is not too “reliable”. There are frequent cases of changes in the concentration of LH, not associated with ovulation, which give false-positive test results.
Determination of ovulation by cervical mucus
A change in the hormonal background also affects the mucous plug located in the cervical canal. On other days, it is quite viscous and dense and effectively protects the uterine cavity from infection. However, on the eve of ovulation, it liquefies and partially flows out of the canal - this makes it easier for sperm to enter the uterine cavity and subsequent fertilization.
Changes in the cervical canal are clearly visible to the gynecologist, moreover, even 50 years ago it was one of the most reliable ways to determine ovulation. Many women also notice that in the middle of the cycle they have transparent odorless mucous discharge - this is cervical mucus. If you do not notice a fundamental difference in the volume of vaginal discharge, then try to examine them.
” Mucus, like saliva, can be applied to glass, dried and examined under a microscope: on the eve of ovulation, a picture of “fern twigs” will also appear on it.
In the last century, the Billings method was popular: a drop of mucus from the vagina was proposed to be applied to the finger, and, touching the other finger, try to stretch the drop. On the day of ovulation, the mucus becomes viscous, like egg white, and is easily pulled into a string. It is possible that it will seem convenient to you today.
Determination of ovulation by basal temperature
Another popular method for determining ovulation is throughout the cycle. If your daily routine is strictly ordered, you always wake up at the same time, then this method is worth a try.
” Important! Basal temperature is our temperature in a state of complete rest. It should be measured immediately after waking up, lying in bed, after at least 6 hours of sleep.
The method of measuring temperature is not fundamental: you can do this orally, vaginally or rectally, but it is not recommended to put a thermometer under the arm; temperature fluctuations that are too small have to be monitored.
” Immediately before ovulation, the basal temperature drops slightly (by 0.1 - 0.2 degrees), and after it (and throughout the second half of the ovulatory cycle, right up to the menstrual period) - it increases by 0.4 - 0.6 degrees.
Unfortunately, this method is not particularly accurate (according to statistics, every fourth woman who is protected by the method of changing the basal temperature becomes pregnant within a year). Too many factors influence the temperature background - stress, physical activity, any, even minor inflammatory diseases ... even a blanket that is too warm can make its “correction” to the results.
Ultrasound determination of ovulation
Ultrasound examination will be completely accurate and reliable only - it should be carried out by a specialist in a medical institution. As a rule, several examinations are carried out during one ovulatory cycle: first, the doctor determines the dominant follicle, then monitors its growth and development and, finally, fixes the fact of follicle rupture.
” In contrast to the "home" definition of ovulation, this method of research is much more informative. The doctor will not only accurately determine the moment of ovulation, but will also see the whole picture if the cycle somehow “fails”. It is important to know whether a dominant follicle appears at all and, if it does, then at what point does its development stop.
How and why to determine the moment of ovulation
As you noticed, determining the moment of ovulation is not the easiest task. Why should they do it and when is this ovulation better to look for?
If you have a regular menstrual cycle, and you do not want the pregnancy to come soon, then it will be useful for you to know the "dangerous" days in which conception is most likely. This is especially useful for women who do not use any means of pregnancy protection on a regular basis. On the day of ovulation (as well as three days before it and the day after) you should not have sex, or you should use barrier contraceptives.
” On average, ovulation occurs two weeks before the next menstruation. Therefore, remember how long your shortest menstrual cycle lasted and subtract from this number 14. The resulting number is the day of the proposed ovulation, which must be counted from the start of the next menstruation.
For example, your shortest cycle (from the first day of one period to the beginning of the next) lasted 24 days, 24-14 \u003d 10. So, you need to wait for the next menstruation and after 10 days begin to "catch" ovulation.
It is better to use several methods at once, for example, observing saliva and measuring basal temperature. After 3-4 cycles, you will know exactly on which days ovulation is most likely. This method of protection is called "calendar." He is not very reliable, but, subject to a thorough study of his menstrual cycle, allows 9 out of 10 women to avoid an unwanted pregnancy throughout the year.
” Please note, if you have an irregular menstrual cycle, you cannot protect yourself with the calendar method!
However, women with an irregular menstrual cycle usually have exactly the opposite problems: pregnancy does not occur even when it is desired. In addition, the anovulatory cycle may indicate serious health problems, sometimes not even directly related to the reproductive system.
In this case, the tactics of monitoring the onset of ovulation will be determined by your attending physician and, most likely, will include several ultrasound examinations in the plan and offer to pass tests for sex hormones. This will determine the causes of the pathology and choose an effective scheme ovulation stimulation .
Prepared by Anastasia Sergeeva
A fertile or reproductive period in a woman’s life is considered to be the period during which she is capable of childbearing. It starts from the moment of the first menstruation in the girl (at 10-12 years), and ends with the onset of menopause (menopause) at 45-50 years. At this time, in a woman under the influence of hormones, monthly cyclic changes occur in the ovaries and endometrium (the inner layer of the uterus), called the menstrual cycle. Its duration is an average of 28 ± 7 days; The cycle is divided into three phases:
- Follicular (proliferative) phase- the first half of the cycle - lasts from the first day of menstruation to the time of ovulation. It is regulated by follicle-stimulating hormone (FSH), which is released by the pituitary gland - the gland located in the brain. FSH triggers egg growth in the ovary. Each egg develops and matures inside a kind of bubble - the follicle. Although several follicles (vesicles with eggs) can develop in the ovaries, only one of them can reach sufficient maturity every month. During growth, the follicle secretes a hormone, estrogen, into the bloodstream. Estrogen stimulates the cells lining the uterus, preparing them for attachment (implantation) of a fertilized egg.
- Ovulatory phaseaccounts for about the middle of the menstrual cycle. It begins in response to a significant increase in the concentration of luteinizing hormone (LH), which is also produced in the pituitary gland. An increase in the concentration of LH causes a rupture of the mature follicle and release of the egg into the abdominal cavity, and from there into the fallopian (uterine) tube. This is called ovulation. Ovulation is the most favorable period for conception.
- Luteal phaseoccurs after ovulation and lasts until the end of the menstrual cycle. During this period, the egg moves along the fallopian tube, into which it enters from the abdominal cavity. Here she can be fertilized with the sperm of a man. If the egg and sperm meet, then the fertilized egg (embryo) moves along the fallopian tube into the uterus. Then the embryo attaches to the wall of the uterus and begins to grow. During the luteal phase, the ruptured empty follicle in the ovary forms the corpus luteum, which continues to produce the female sex hormones estrogen and progesterone. Estrogen and progesterone affect the maturation of the uterus and contribute to the development of a nutrient medium for the embryo by the cells lining the uterus - the endometrium. If fertilization does not occur or the embryo does not attach to the uterus, the corpus luteum ceases to produce hormones and disappears. In response to this, menstruation begins - a new menstrual cycle.
Natural method of family planning as a means of contraception
Benefits:
- lack of health risk, side effects and free of charge (with contraception);
- male involvement in family planning;
- the possibility of planning pregnancy;
- deepening knowledge of the reproductive system.
Disadvantages:
- low efficiency (9-25 pregnancies per 100 women during the 1st year of use);
- the need to abstain from sexual activity in the fertile phase of the cycle;
- the need for a thermometer to measure basal temperature;
- do not protect against sexually transmitted diseases;
- effective only for women with a regular menstrual cycle.
When a couple can not use EMPS for contraception?
- if a woman has an irregular menstrual cycle;
- if partners do not want to abstain from sexual activity on certain days of the cycle;
- immediately after an abortion, childbirth;
- if the woman’s age, the number of births in the past or her health condition make pregnancy dangerous.
In all these cases, it is necessary to consult a gynecologist and choose a method of contraception, taking into account the individual characteristics of the couple.
Counting the days
Knowing the physiology of the reproductive system and the periods of fertility of her menstrual cycle, a woman can use natural methods of family planning:
- for the purpose of conception- planning intercourse in the middle of the cycle (10-15th day), when fertilization is most likely;
- for contraception- abstinence from sexual intercourse during the phase of the menstrual cycle during which the probability of conception is greatest. In this case, there is no need for the use of drugs, various devices and manipulations.
With natural methods of family planning (EMPS), alternations are used during the menstrual cycle of periods of reduced and increased fertility; takes into account the duration of the ability of germ cells to fertilize.
When calculating fertility, it should be borne in mind that under favorable conditions, spermatozoa retain the ability to fertilize the egg up to 5 days, and the egg is capable of fertilization within 24 hours from the moment of ovulation.
Bearing in mind the possibility of fertilization, three phases can be distinguished in the menstrual cycle (absolute sterility, relative sterility and fertility).
Relative sterility (phase 1) lasts from the first day of the menstrual cycle to ovulation.
The duration of this phase of the menstrual cycle depends on the speed of the follicle's response to the action of the pituitary hormones, which, in turn, may depend on the emotional background, environmental, climatic conditions, etc. That is, ovulation can occur a little earlier or a little later, depending on certain environmental factors.
In this phase, contraception sometimes occurs, since the duration of the phase can vary from cycle to cycle within a few days, even with a stable duration of the menstrual cycle as a whole. This fact should be taken into account and if you want to get pregnant in this cycle, that is, you should not count on one sexual intercourse on the day of the proposed ovulation: the result will be guaranteed if there is sexual intercourse once every 2-3 days.
Fertility Phase (Phase 2) starts from the moment of ovulation and ends 48 hours after ovulation.
These 48 hours include the time during which a mature egg is capable of fertilization (24 hours); the next 24 hours are allotted to the inaccuracy of determining the time of ovulation.
Absolute sterility (phase 3) begins 48 hours after ovulation and continues until the end of the menstrual cycle. The duration of this phase is quite constant and is 10-16 days.
For example, the first day of menstruation occurred on October 1. With an average duration of the menstrual cycle of 28 days, the next menstruation begins on October 29, the phase of relative sterility is October 1-14, the phase of fertility is October 14-16, and the phase of absolute sterility is October 16-28.
If we are talking about contraception, then it is rational to consider the last 10 days of the cycle as a phase of absolute sterility.
What are the methods?
Natural planning methods include: calendar (or rhythmic), temperature, and cervical mucus method.
Calendar (rhythmic) method.When analyzing the menstrual calendar for 6-12 months, the shortest and longest cycles are distinguished. The number 18 is subtracted from the number of the shortest and the day of the onset of the “dangerous” period is obtained, and the number 11 is subtracted from the figure of the longest menstrual cycle and the last day of the “dangerous” period is recognized.
Here is an example of calculating the “dangerous” period with a constant menstrual cycle of 28 days.
The beginning of the "dangerous" period: 28-18 \u003d 10th day.
End of the dangerous period: 28-11 \u003d day 17 inclusive.
The dangerous period is 8 days. It begins on the 10th day of the menstrual cycle, and ends on the 17th day.
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How to calculate the "dangerous" period - the most likely days of conception |
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If your shortest cycle was (number of days) |
Your first fertile (dangerous) day |
If your longest cycle was (number of days) |
Your last fertile (dangerous) day |
Attention! This method can be used only with a strict accounting of all menstrual cycles in the calendar and with a small spread of the menstrual cycle during the year. If you did not measure the temperature for 6-12 months and did not even mark the duration of the menstrual cycle on the calendar and can not say with accuracy about the stability of the cycle, this method is not suitable for contraception, as well as for calculating the most favorable days for conception.
The days least likely for pregnancy do not completely exclude the possibility of becoming pregnant - especially when it comes to changing the climate, the disease, and a restless mental state.
Temperature method.This method of determining ovulation is based on recording the central and local hyperthermic (i.e., associated with an increase in temperature) effect of progesterone. The change in basal temperature (temperature in the rectum) is made in the morning, at the same time. A woman, without getting out of bed, inserts a thermometer into the anus to a depth of 4-6 cm. The measurement duration is 5 - 7 minutes. The thermometer readings are recorded or immediately applied to the "temperature" curve, and the thermometer is washed with soap. It is undesirable to use the same device for measuring axillary temperature (in the armpit). In the first half of the menstrual cycle, the temperature in the rectum is usually lower than 37 ° C, in the middle of the cycle before the day of ovulation it drops sharply, and then rises to 37.5 ° C. The moment of ovulation is recognized by analyzing the curve by the decrease in temperature by 0.2 - 0.4 ° C and the subsequent rise by 0.6-1.0 ° C. Days of the transition of temperature from low to high numbers are a likely period for conception. Knowing her ovulation day, a woman determines a period of +5 days as probable for conception.
If, on the eve of the expected menstruation, and especially on the time of the expected, but delayed menstruation, a slightly elevated temperature in the rectum remains, this allows you to suspect an already existing pregnancy.
This method of determining the period of increased fertility assumes normal living conditions (a separate room), sufficient discipline of the woman and the exclusion of rush in the morning. The period of increased fertility often occurs on the 7-18th days of the cycle; even more often these are the 10-15th days.
Method of cervical mucus.After the end of menstrual bleeding for one or several days, there is a lack of mucus and the vaginal area is dry to the touch. These are the so-called dry days.
Before ovulation, mucus begins to be released into the vagina, which becomes viscous at the time of ovulation.
3 days after the appearance of sticky, viscous mucus, a sterility phase occurs during which, before the start of the next menstruation, pregnancy will be impossible.
If natural methods of family planning were used with a motivation for pregnancy and it did not occur within a year, a survey of the couple on infertility in a specialized institution is necessary.
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