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Periodic abstinence and withdrawal:
- Always available
- Can promote reproductive health awareness
- High pregnancy rates in typical use
- No STI protection
- Require considerable motivation
- Periodic abstinence is difficult for young women
with irregular menstrual cycles
- Training about fertility awareness essential
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The traditional contraceptive methods of periodic abstinence
and withdrawal, or coitus interruptus, are always available
to youth and, unlike modern methods, do not cost anything. Withdrawal
is the practice of removing the penis from the vagina before
ejaculation. Periodic abstinence means abstaining from sexual
intercourse during the woman's fertile time. Some adolescents
use these traditional methods, especially as they begin sexual
activity, because they lack knowledge of or access to other
methods.
Use of these methods can promote reproductive health awareness
and skills. However, traditional methods have high pregnancy
rates in typical use compared to other methods of contraception.
Also, neither method protects against STIs. Both withdrawal
and periodic abstinence require couples to be highly motivated
and knowledgeable about their bodies and to use great self-control.
Practicing these methods successfully can be difficult for adults
and youths alike. Correct use of withdrawal requires that a
man remove his penis from his partner's vagina before ejaculation
and ensure that ejaculation occurs away from his partner's genitalia.
Even when withdrawal is used successfully, pregnancy is still
possible because pre-ejaculatory fluid may contain semen.
In the months immediately after menarche, the menstrual cycle
tends to be irregular, making periodic abstinence difficult
to practice using the calendar method. This point should be
emphasized in counseling. The modern approach to periodic abstinence,
called natural family planning (NFP), provides ways for women
to track their fertile period more accurately than the previously
used calendar method. It requires knowledge of reproductive
physiology, including fertility. Tracking fertility can be done
with thorough training and practice by measuring basal body
temperature, checking cervical mucus patterns and other signs
to determine the time of ovulation, or using a device called
"Cycle Beads," which is similar to a necklace with
different colored beads. NFP can be effective when used consistently
and correctly.
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