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CONTEXT: Fertility awareness-based methods of family planning help women identify the days of the menstrual cycle when they are most likely to become pregnant. To prevent pregnancy, women avoid unprotected [...]

Gershwin's song 'I Got Rhythm' serves here as a backdrop representing the social context of the inter-war years. On center stage is a particular aspect of the history of birth control--the application of a new theory of ovulation to contraception. Starting in 1928, a series of experiments revealed a biochemical rhythm in the female reproductive cycle, which contradicted the widespread idea that ovulation and pregnancy could occur at any time. This discovery was applied to a new contraceptive method, the rhythm method, which enjoyed significant popularity during the 1930s, especially among Catholics. For a short period, women could join Ethel Merman in the refrain 'I got rhythm, I got my man, who could ask for anything more?' But the rhythm method has not lived to its promise, and the play goes on ...

This prospective study was conducted among experienced users of periodic abstinence methods in Sydney, Montreal, and Birmingham (England) in order to describe the relationship between a laboratory measurement of ovulation and the natural symptoms of fertility during breastfeeding. Daily urinary estrogen and pregnanediol glucuronide assays were used to estimate the date of ovulation and to determine potentially fertile days. A standard set of Symptothermal Method (STM) rules was applied to daily STM records to assess the correspondence of the natural symptoms of fertility to the underlying hormonal profile. The STM symptoms and rules accurately identified 77-94 percent of the women's potentially fertile days, but abstinence was also recommended on about half of the days when the women were not fertile. An integrated set of common rules for STM use during breastfeeding is highly sensitive but not specific in its ability to screen for ovulation. (STUDIES IN FAMILY PLANNING 1995; 26,2: 107-115), The efficacy of periodic abstinence methods to prevent pregnancy, when used by women having normal menstrual cycles, has been demonstrated through several clinical trials (Liskin, 1981; Kambic, 1991). However, little [...]