NEW YORK, Nov 25 (Reuters Health) -- Most doctors who see women about contraceptive concerns underestimate the effectiveness of natural family planning options and rarely or never mention them, according to results of a new survey.
Dr. Joseph B. Stanford, now at the University of Utah in Salt Lake City, and associates at the University of Missouri-Columbia asked doctors how often they discuss two natural "rhythm" methods for preventing pregnancy: the cervical mucus method and the symptothermal method.
Using the mucus method, a woman monitors her vaginal discharge, which increases and becomes more watery just before an egg is released. She should stop having intercourse when the amount of mucus starts to increase and not start again until at least 4 days after she observes the greatest amount.
Using the symptothermal method, a woman determines when an egg has been released by monitoring her vaginal discharge and also by taking her temperature each morning while she is still in bed. The temperature falls slightly before an egg is released and rises slightly after the egg is released. The woman also stays alert for other symptoms of egg release, such as slight cramping pain.
The researchers sent surveys to 840 primary care doctors and obstetrician-gynecologists in Missouri. A total of 375 doctors reported that they counsel women about contraception, and that group was the subject of the study. The results are published in the November issue of Obstetrics & Gynecology.
Overall, fewer than half of the doctors (47%) said that they mention the temperature method or the mucus method at least sometimes when discussing contraception with their patients. Forty percent said that they sometimes discuss the mucus method, and 54% said that they sometimes discuss the symptothermal method.
In addition, the doctors underestimated the effectiveness of natural family planning. Only 22% knew that the best possible effectiveness of the two "rhythm" methods is greater than 90%, and only one third knew that the typical effectiveness is greater than 70%.
Stanford told Reuters Health that many physicians seem to lack up-to-date information on natural family planning. Often, "what they think they know (is) wrong," he explained, or is "based on old or outdated information."
He and his colleagues note that natural family planning has important advantages for many patients. These include low cost, "lack of side effects, education of women about their bodies, shared responsibility between female and male partners for family planning issues, and compatibility with religious or philosophical values of those who might not wish to use various contraceptive technologies."
The authors add that "rhythm" methods are helpful for infertile couples, not just those who want a natural method of contraception. The methods can also help couples identify the best times to have intercourse, when the woman is most fertile.
