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Las Cuatro Llaves Para un Matrimonio Feliz y Saludable

Por: Bonnie Borel-Donohue

¿Quién podría ser el mejor ejemplo de cómo amar a su cónyuge que el Máximo Amante, Dios? Pero, ¿cómo ama Dios?

Después de haber meditado sobre esta pregunta, el Papa Pablo VI y el Papa Juan Pablo II discernieron cuatro características claves del amor de Dios. El amor de Dios es siempre: libre, total, fiel y fecundo. Cada llave es también una de las cuatro cualidades esenciales del amor conyugal auténtico. Este folleto le dará a conocer estas cuatro llaves muy importantes para iniciarse, o volver al camino hacia un gran matrimonio. A través de las gracias que vienen con el sacramento del Santo Matrimonio, junto con la oración y recibiendo regularmente los sacramentos de la reconciliación y de la eucaristía, los esposos reciben toda la fuerza y el poder para amarse uno al otro como Jesús ama a su Iglesia: libremente, totalmente, fielmente y Estas son las cuatro llaves para el amor conyugal auténtico. A través de los sacramentos y aprendiendo más acerca de las cuatro llaves para el amor conyugal presentadas en este folleto, las parejas pueden abrir la puerta a un matrimonio más satisfactorio y gratificante.1

LPurple key imagea primera llave es libre–Para que un matrimonio sea feliz y saludable, los cónyuges deben entrar al matrimonio, así como a cada acto conyugal libremente, dándose uno al otro y recibiéndose uno al otro sin coerción, manipulación, fuerza o coacción. Esta llave requiere auto-control y la posibilidad de aplazar o sacrificar los propios deseos por el bien de la persona amada. Aunque la violación marital es una violación evidente de esta llave, vicios más sutiles como la impaciencia, el orgullo y la lujuria también pueden interferir con la práctica de esta llave. Las virtudes de la paciencia, la humildad y la castidad son necesarias, asi como los esposos a menudo tienen que esperar a que el otro esté listo para amar “libremente.” Esta llave consiste en darse cuenta de que cada persona puede tener necesidades físicas, emocionales o trabajos que deben cumplirse, como por ejemplo la mujer necesita de una cierta cantidad de tiempo para hablar y compartir, o la necesidad del hombre de meterse a su cueva un rato a solas antes de que la intimidad pueda suceder.2, 3 Para que esta llave funcione bien, ambas partes deben estar libres de adicciones, incluyendo las adicciones al alcohol, las drogas, el sexo, la pornografía, la co-dependencia, etc.4

LRed key imagea segunda llave es total–El matrimonio sacramental es una vocación, un llamado de Dios y el principal medio por el cual los esposos se santifican. Este compromiso con el cónyuge debe ser total, tomando el primer lugar y viene incluso antes del compromiso con los hijos, la familia de origen, o el trabajo,–lo cual no quiere decir que estos no sean importantes.

Para que el amor conyugal sea auténtico, todo de sí mismo se da a la persona amada, y todo es recibido y aceptado del amado incluso, el cuerpo, la mente, la fertilidad, las finanzas y hasta las condiciones de salud desconocidas en el futuro. Ocultar o mantener información crítica al prometido–(a) o esposo (a) viola esta llave, al igual que los acuerdos pre-nupciales. Estas acciones indican una falta de confianza y la decisión de compartir sólo una parte de si mismo con el cónyuge. Las parejas que intencionalmente excluyen, dañan, enferman o mutilan sus órganos reproductivos, o permiten que su cónyuge lo haga, violarían esta llave. Su don de sí mismo no es total.

Esta llave no significa que los cónyuges deben perder su identidad, que se fundan el uno al otro renunciando a los límites saludables, o que se dejen abusar. Más bien, significa que cada cónyuge aporta su don total dado por Dios de su singularidad y personalidad al matrimonio.

Esta llave implica aceptar que los hombres y las mujeres son diferentes y tienen necesidades diferentes, no siendo las necesidades de uno superiores a las del otro, sólo son diferentes. Por ejemplo, los hombres generalmente tienen una mayor necesidad de ser “respetados” (es decir, no criticados por su esposa) más que sentirse “queridos”, mientras que las mujeres tienen una mayor necesidad de sentirse “amadas”. 3, 5 Algunas parejas han encontrado útil el descubrir los lenguajes del amor de cada uno o maneras en que los dos se sienten queridos. Algunas personas experimentan o sienten amor sobre todo a través del tacto, otros a través de palabras como decir “te amo”, y otros por el tiempo que comparten juntos. Otros pueden sentirse amados si se le dan regalos, o mediante la recepción de actos de servicio, o una combinación de estos aspectos.6

Yellow key imageLa tercera llave es Fiel–Para que un matrimonio sea feliz y saludable, los cónyuges deben ser fieles. Esta llave implica la promesa de proteger el corazón, los ojos y el cuerpo, reservando el don especial de la sexualidad exclusivamente para la persona amada. Coquetear con otros, que no sean su cónyuge, mirar a otros deseándolos, ver telenovelas en forma adictiva, o leer novelas románticas, ver pornografía, y tener relaciones extramaritales violan esta llave.

Una práctica importante para esta llave es evitar las ocasiones próximas de pecado cuidando de no ponerse en cualquier situación con alguien del sexo opuesto solo, donde el potencial de tentación pudiera surgir, tales como almuerzos, cenas, deportes, otras actividades, o socialmente hablar por teléfono, enviar mensajes de texto o chat en el Internet.

Green key imageLa cuarta llave es fructífero–el amor auténtico es siempre fructífero, es creativo y realmente trae más amor y más vida. Cada vez que una pareja casada se une en el abrazo conyugal, si el acto es una expresión auténtica de amor, se dicen uno al otro y con Dios (tal como lo hicieron en sus votos originales) que amorosamente aceptan cualquier hijo que pueda resultar de esta unión. Ellos permanecen abiertos al fruto que Dios quiera hacer surgir de su amor. La anticoncepción, la esterilización y el aborto evitan que un matrimonio sea fructífero. Son pecados graves, y en consecuencia, llevan a la esterilidad, la enfermedad, la infelicidad, y la muerte.7

Mientras que las parejas nunca deben intencionalmente hacer cualquier acto marital estéril, ya sea antes, durante o después de su unión, la planificación natural familiar (PNF)8 puede ser usada para evitar el embarazo por causas serias y justificadas y no viola esta llave. Una pareja puede tener razones legítimas para espaciar sus hijos, y la Iglesia enseña que el uso de los períodos infértiles del ciclo de la mujer en esos momentos no viola esta llave, ya que cada abrazo marital todavía sigue abierto a la posibilidad de crear nueva vida. Sin embargo, la PNF puede ser objeto de abuso si se utiliza sin razones de peso para evitar un embarazo, o porque una pareja egoístamente se niegan a ser generosos y abiertos al don supremo de Dios de los hijos.

La maternidad no es el único “fruto” que Dios puede traer a un matrimonio santo. En el plan de Dios, algunas parejas no pueden tener hijos, o tantos como quisieran. La buena noticia es que hay métodos científicos modernos, sin embargo, moralmente aceptables, que pueden ayudar a un gran porcentaje de parejas que sufren de infertilidad,9 pero no todos van a tener éxito. Las parejas pueden tener la tentación de tratar de “tener hijos” a cualquier costo, incluso por medios inmorales tales como la fertilización in vitro o la maternidad subrogada. Tales medios son moralmente censurables y pecaminosos porque tratan al hijo como un “objeto” o “cosa” que se crea, se compra o se vende, lo cuál es opuesto a crear un hijo por un acto de amor. A través de la oración se pide la humildad para aceptar la voluntad de Dios, y para encontrar otras maneras de dar fruto (por ejemplo, mediante la adopción, hogares de tránsito, el cuidado de los miembros de la familia y de la comunidad), Dios bendecirá abundantemente con gran fruto a todas las parejas que siguen Su Voluntad.

Notas de pie de página4 keys spanish image

  1. Ver Humanae Vitae por el Papa Pablo VI, Amor y Responsabilidad por Karol Wojtyla y Hombre y Mujer los creó: El amor humano en el plan divino por Juan Pablo II para un mayor desarrollo de las ideas presentadas en este folleto.
  2. A nivel nacional el aclamado psicólogo clínico Willard F. Harley, Jr., les dice a los esposos que planeen dar el regalo de por lo menos 20 minutos para hablar íntimamente/ compartir tiempo antes del abrazo marital, para dar a sus esposas el tiempo que necesitan para que crezca el deseo. Ver His Needs, Her Needs: Building an Affair Proof Marriage por Willard F. Harley, Jr.
  3. Para construir intimidad, es importante que las parejas aprendan a hacer un hábito de compartir sentimientos y apreciaciones regularmente y aprendan cómo manejar con seguridad los conflictos. Intimacy: A 100-Day Guide to Better Relationships, por matrimonio muy respetado consejero Douglas Weiss, PhD, es un gran lugar para comenzar.
  4. Para obtener ayuda para superar las adicciones, se recomienda hacer una confesión sacramental y buscar el asesoramiento de un sacerdote. Para encontrar un terapeuta católico que es fiel a las enseñanzas del Magisterio de la Iglesia, vaya a www.Catholictherapists.com.
  5. Es importante que las mujeres aprendan a respetar a los esfuerzos de su marido, compartiendo lo que aprecian de ellos, y aprender a lidiar con el conflicto de la manera apropiada, sin hacer que ellos se sientan criticados. Para obtener más información acerca de las diferencias importantes entre hombres y mujeres, ver El amor que ella más desea, el respeto que se necesita desesperadamente por Emerson Eggerichs.
  6. El clásico libro Los Cinco Lenguajes del Amor: Como expresar devoción sincera a su cónyuge por Gary Chapman, ha ayudado a innumerables parejas.
  7. “Porque la paga del pecado es muerte.” (Romanos 6:23) New American Bible, Edición Revisada.
  8. Para obtener más información acerca de los diferentes métodos de PNF y saber cuál es el mejor para usted, vaya a https://onemoresoul.com/marriage-children/natural-family-planning/natural-family-planning-links.html
  9. Puede Ir a www.fertilitycare.org para aprender más sobre el Modelo Creighton FertilityCareTM System y la NaProTECNOLOGIA, cuya eficacia es igual o mayor que la fertilización in vitro para ayudar a las parejas que sufren infertilidad a lograr el embarazo.

Problemas asociados con el uso de hormonas para el control de la natalidad

por
Mario Maldonado, MD (Endocrinólogo)
Edwin Bernardo, MD (Médico de Familia)
Michael Fragoso, MD (Pediatra) y
Fr. Juan R. Vélez, MD (Ex Internista)
Traducido por Lili Cote de Bejarano, MD, MPH

Como médicos, nosotros no prescribimos anticonceptivos hormonales para el control de la natalidad. Las razones médicas para esta decisión son las siguientes.

Los anticonceptivos orales (y todos los demás anticonceptivos hormonales para el control de la natalidad) son utilizados habitualmente para prevenir el embarazo, aunque a veces se prescriben para tratar otras condiciones médicas. Los anticonceptivos hormonales pueden causar muchos posibles efectos adversos de tipo médico, social y espiritual. La gran mayoría de las recetas de anticonceptivos hormonales son dadas por los médicos a mujeres sanas, a veces a adolescentes sin enfermedad conocida. A algunas mujeres se les prescriben anticonceptivos hormonales para el control de la natalidad, por una sencilla razón—para impedir una condición completamente normal: el embarazo.

Dado que todos los medicamentos tienen potencialmente efectos secundarios no deseados, algunos de ellos graves, es importante que los médicos sopesen los riesgos y beneficios cuando se prescribe algún medicamento. De ello se deduce que no es ético exponer mujeres sanas a riesgos para la salud a fin de evitar una situación normal. El error de exponer las mujeres a estos riesgos es todavía peor dado el hecho de que otros métodos de planificación familiar existen, como la Planificación Natural de la Familia (PNF), los cuales no tienen efectos secundarios cuando se utilizan correctamente.

Los anticonceptivos hormonales tratan la fertilidad de la mujer y la maternidad como una enfermedad

Aunque puede haber razones legítimas de índole médica y personal para evitar el embarazo, la fertilidad femenina y la posibilidad del embarazo en sí no son una enfermedad, y por tanto no necesitan “tratamiento” con una pastilla (un parche, una inyección, o un DIU).

Los anticonceptivos hormonales causan abortos

Cuando los anticonceptivos orales no suprimen la ovulación en una mujer sexualmente activa y otros mecanismos que impiden la fertilización fallan, puede ocurrir la concepción.

Los anticonceptivos hormonales interfieren con la implantación de un nuevo ser humano mediante la reducción del grosor del revestimiento del útero, y alterando moléculas y factores relacionados con la implantación. Las dosis bajas de anticonceptivos hormonales impiden la liberación del óvulo femenino solamente en un 65-75% de los ciclos.1, 2 Por esta razón, es posible que en aproximadamente un 30% de sus ciclos si una mujer tiene relaciones sexuales en su periodo fertil, existe la posibililad que suceda un embarazo y posteriormente un aborto químico.

Los anticonceptivos hormonales contribuyen a una mentalidad anti-vida

Los anticonceptivos hormonales como la Píldora, el parche, el DIU o la Inyección, sustentan la práctica del aborto. La gente inconscientemente concluye: “Si fracasa el control de la natalidad, el aborto es la solución.” En los Estados Unidos una encuesta a nivel nacional indicó que el 54% de las mujeres que tuvieron un aborto estaban utilizando anticonceptivos el mes anterior.3

Los anticonceptivos hormonales aumentan el riesgo de cáncer de seno

Las mujeres se enfrentan a un mayor riesgo de desarrollar cáncer de seno, cuando usan anticonceptivos hormonales, y este riesgo continua por lo menos diez años después de que dejan de usar hormonas anticonceptivas. Si la Píldora se toma antes de que una mujer de a luz por primera vez, hay un incremento del 44% en el riesgo de cáncer de seno.4,5

Un estudio reciente de mujeres menores de 40 años de edad en los Estados Unidos (1976-2009), también demostró un aumento estadísticamente significativo en la incidencia del cáncer de seno metastásico.6 Este tipo de cáncer de seno podría estar asociado con el uso en mujeres jóvenes de anticonceptivos orales (carcinógenos del Grupo I).

Los anticonceptivos hormonales aumentan el riesgo de trombo-embolismo pulmonar

Un estudio de 1524 pacientes en los Países Bajos, llegó a la conclusión de que los anticonceptivos hormonales aumentan el riesgo de trombosis venosa cinco veces comparado con el no uso.7

El riesgo es mayor para las mujeres que utilizan anticonceptivos hormonales y que tienen sobrepeso, fuman, o son mayores de 35 años.8

Los anticonceptivos hormonales provocan un cambio continuo en el metabolismo saludable del cuerpo

Un estudio reciente reportó que el uso de anticonceptivos hormonales vía oral, vaginal o transdérmica, produjo un aumento de los marcadores de inflamación crónica un factor de riesgo para la enfermedad cardiovascular. También, el uso de anticonceptivos combinados deterioró la sensibilidad a la insulina en mujeres jóvenes y sanas.9

Además, el uso de anticonceptivos hormonales puede producir dolores de cabeza tipo migraña, aumento de peso, cambios en el humor, y pérdida de la libido. Estos contribuyen a un aumento prematuro de la perdida de masa osea.10 Se asocian con infertilidad tras un uso prolongado, e incluso en cierta medida con el uso a corto plazo.

Los anticonceptivos hormonales aumentan la incidencia de cáncer de cuello uterino

Existe una asociación entre el uso de anticonceptivos hormonales y un aumento significativo del cáncer de cuello uterino.11 Es probable que esto sea causado por la infección con el virus del papiloma humano (VPH), el cual es transmitido sexualmente, dado que un número considerable de las mujeres que utilizan anticonceptivos hormonales tienen relaciones sexuales fuera del matrimonio y por tanto un mayor riesgo de contraer enfermedades de transmisión sexual.

Los anticonceptivos hormonales aumentan el riesgo de tumores hepáticos

Hay alguna evidencia de que los anticonceptivos orales aumentan el riesgo de ciertos tumores benignos y malignos del hígado.12

Los anticonceptivos hormonales aumentan el riesgo de ataques al corazón

Tanto la primera como la segunda generación de anticonceptivos orales han sido vinculados a un mayor riesgo de ataques al corazón (infartos de miocardio)13 y accidentes cerebro-vasculares.La tercera generación de anticonceptivos orales está asociada con un incremento en enfermedad cerebrovascular isquémica.14

Los anticonceptivos hormonales tienen efectos nocivos para el matrimonio y la sociedad

Las hormonas para el control de la natalidad fomentan la mentalidad de que los hombres y las mujeres son incapaces del auto-control y por lo tanto no son capaces de abstenerse de tener relaciones sexuales. La introducción de los anticonceptivos hormonales fue el catalizador de la revolución sexual y produjo un incremento dramático del sexo pre-marital, el adulterio, el divorcio, el aborto, y los nacimientos fuera del matrimonio. Los anticonceptivos hormonales han tenido un papel indirecto en el aumento abrumador de padres solteros, madres solteras, pobreza y otros males sociales en los Estados Unidos.15,16

Los métodos de PNF son un medio excelente para planificar la familia

PFN está libre de efectos secundarios perjudiciales para la mujer y para la familia, y cuando se utiliza por motivos serios, puede ser  muy bueno para el matrimonio.17

Referencias

1. Chowdhury V, et al. Escape ovulation in women due to the missing of low dose combination oral contraceptive pills. Contraception. 1980; 22(3): 241-247.

2. Baerwald AR, et al. Effects of oral contraceptives administered at defined stages of ovarian follicular development. Fertil Steril. 2006 Jul; 86(1): 27-35. Epub 2006 Jun 9.

3. Jones, RK ,et al. Contraceptive use among U.S. women having abortions in 2000-2001. Perspec Sex Reprod Health. 2002; 34(6): 294-303.

4. Kahlenborn C. Breast Cancer, Its Link to Abortion and the Birth Control Pill. One More Soul, 2000.

5. Kahlenborn C, et al. Oral contraceptive use as a risk factor for pre-menopausal breast cancer: a meta-analysis. Mayo Clin Proc. 2006; 81(10): 1290-1302.

6. Johnson, R. H., Chien, F. L., & Bleyer, A. (2013). Incidence of breast cancer with distant involvement among women in the United States, 1976 to 2009. JAMA: The Journal of the American Medical Association. 309(8), 800-805.

7. van Hylckama Vlieg A, Helmerhorst FM, Vandenbroucke JP, Doggen CJ, Rosendaal FR. The venous thrombotic risk of oral contraceptives, effects of oestrogen dose and progestogen type: results of the MEGA case-control study. BMJ. 2009 Aug 13; 339: b2921.

8. Poulter NR. Risk of fatal pulmonary embolism with oral contraceptives. Lancet. 2000; 355(9221): 2088.

9. Piltonen T, Puurunen J, Hedberg P, Ruokonen A, Mutt SJ, Herzig KH, et al. Oral, transdermal and vaginal combined contraceptives induce an increase in markers of chronic inflammation and impair insulin sensitivity in young healthy normal-weight women: a randomized study. Hum Reprod. 2012 Oct; 27(10): 3046-3056.

10. Wooltorton, E. Medroxyprogesterone acetate (Depo-Provera) and bone mineral density loss. CMAJ. 2005 Mar 15; 172(6):746. Epub 2005 Mar 2.

11. Smith J., Cervical Cancer and use of hormonal contraceptives: a systemic review, Lancet, 2003; 361: 1159-1167.

12. Giannitrapani, L, et al. Sex hormones and risk of liver tumor. Ann NY Acad Sci, 2006 Nov; 1089: 228-236.

13. Tanis, BC, et. al. Oral contraceptives and the risk of myocardial infarction. N Engl J Med. 2001; 345(25): 1787-1793.

14. Baillargeon, JP, et al. Association between the current use of low dose oral contraceptives and cardiovascular arterial disease: a meta-analysis. J Clin Endocrinol Metab. 2005; 90(7): 3863-3870.

15. Akerlof, GA, et al. An analysis of out-of-wedlock childbearing in the United States. Q J Econ. 1996 May; 111(2): 277-317.

16. Akerlof, GA. Men without children. Econ J. 1998 Mar; 108(447): 287-309.

17. Hilgers TW, Standford JB. The use effectiveness to avoid pregnancy of Creighton model naproeducation technology: a meta-analysis of prospective trials. J Reprod Med. 1998; 43: 495-502.

Sterilization Reversal Book 2013 Edition

Sterilization-Reversal

The Theme of the Book

Sterilization Reversal – A Generous Act of Love is a compilation of 20 stories of couples who were sterilized and then sought sterilization reversal. It is the first book that discusses, from a Roman Catholic perspective, the destructive impact that sterilization has on marriage and the joyous spiritual and marital renewal experienced by couples after reversal. As such, Sterilization Reversal – A Generous Act of Love is a unique resource for clergy, religious educators and laypeople. It is an especially useful tool for the pastoral counseling of persons who have repented their sterilization. It is also a particularly effective means of informing people who are considering sterilization of the emptiness and heartbreak that often follow as well as the NFP alternative that nourishes the marital relationship rather than attacks it. (more…)

¿Por qué usar la Planificación Natural de la Familia?

La Planificación Natural de la Familia acepta nuestra fertilidad.

La Planificación Natural de la Familia (PNF) es la aceptación completa dentro del matrimonio del don divino de la fertilidad, un método por medio del cual la pareja observa sus síntomas de fertilidad para determinar sus períodos fértiles e infértiles a fin de lograr o posponer el embarazo. No debe de confundirse con el antiguo y significativamente menos efectivo “método del ritmo” que estima y proyecta los períodos fértiles e infértiles de la pareja basándose en la observación de cuando ocurrieron estas fases en los ciclos anteriores.

La PNF tiene fuerte base científica.

La gran efectividad de la PNF se debe a métodos más precisos y sistemáticos por los cuales, dependiendo del método, las parejas observan los cambios en las mucosidades cervicales de la mujer, los cambios de temperatura y/u otras señales para determinar las fases fértiles o infértiles. Puesto que tanto las mucosidades cervicales como la temperatura responden a los cambios químicos/hormonales que regulan la fertilidad, las parejas que usan la PNF pueden determinar con gran certeza cuando están fértiles y cuando no. El anticuado método del ritmo era más que todo una adivinanza educada que se basaba en lo que a menudo era suposición equivocada de que los ciclos de fertilidad son constantes de mes a mes.

(more…)

What Do We Do Now? Making the Switch from Contraception to Natural Family Planning

By Patty Schneier

Schneier-FamilyDiscovering the Truth about contraception can be one of the most defining moments in a couple’s marriage. But quite often, the joy of this discovery is accompanied by fears, doubts, and many questions. My husband Larry and I experienced all of the above in January, 2002 when, after 13 years of marriage, we finally decided to live our lives according to God’s plan for love and life. We literally threw out the contraception. This was the best decision we ever made, and we have never looked back. It was THE defining moment in our marriage.
Today, we continue to joyfully celebrate our conversion. We celebrate the beginning of a whole new way of life together and a whole new way of loving each other. But we also vividly remember how difficult it was to be in the middle of this conversion process. Our transformation wasn’t so “joyful” when we were actually going through it. To be honest, we were a mess. We stayed up night after night until the wee hours of the morning trying to figure out, “HOW ARE WE GOING TO LIVE THIS???” Discovering the Truth about love wasn’t enough. What to do with this Truth proved to be a far greater challenge.
Perhaps you have struggled with the issue of contraception. Perhaps you have ignored the Church’s teachings in your marriage for many years. Perhaps you or your spouse has been sterilized. But now, for whatever reasons, you find yourself wanting to change, wanting something better, wanting authentic love and unity in your marriage. This longing is the first step on the road to holiness and healing. Do not ignore this longing! The road ahead may be filled with obstacles; it may be frightening and uncertain. But take comfort in Sacred Scripture, set your foot to the path, and take one tiny step forward. I hope the following suggestions will encourage you on your journey and help you take the next step. Be not afraid! Joy awaits you! Authentic love and real freedom await you! Just say “yes” and take one tiny step.

#1 Receive the Sacrament of Reconciliation

No matter how often Larry and I may have rationalized it, using contraception was a sin in our marriage. In order to start anew, we needed the grace of this sacrament. This was the first and most important step for both of us. It was through the Sacrament of Reconciliation that we resolved to “never go back.”
Find a priest who understands the Church’s teaching. Make an appointment if necessary, and do not delay in confessing this sin. Resolve to amend your life. It doesn’t matter what you’ve done, where you’ve gone, or how long you’ve been away—NO sin is too great. Remember, you can just throw out the contraception—or you can throw out the contraception AND experience redemption, mercy, peace, and healing through the Sacrament of Reconciliation. The choice is yours.

#2 Gain Knowledge of the Truth—Read, Read, Read!

Larry and I literally had to re-learn how to love each other. We didn’t know that every sexual union was meant to be a renewal of our marriage vows; we had never heard that real love is free, total, faithful, and fruitful. We didn’t understand why the Church says what it says, and we were still unsure about many issues regarding sex. But when we discovered the Theology of the Body, it was like finding “the pearl of great price” for our marriage. The Theology of the Body is a collection of talks given by Pope John Paul II on the meaning of human sexuality. The truths revealed in the Theology of the Body reflected the deepest desires of our hearts. We immersed ourselves into this teaching in order to understand the language of our bodies and how we communicate. It was only then that we saw the beauty of God’s original plan for our sexuality. This is what we had been searching for! Our hearts were transformed, and to this day, we are still in awe of the Theology of the Body.
You may have many questions that are still unanswered. Perhaps your spouse considers the Church’s teachings to be a burden and is therefore reluctant to change. Pray for faith and reason; search for answers! Gain knowledge and understanding of authentic love—the only love that satisfies. Read books or listen to CDs together. Re-learn the meaning of your marriage, and immerse yourselves in Truth. Go to onemoresoul.comCouple-reading-scripture for a wealth of resources. I recommend the following to get you started: Good News About Sex and Marriage by Christopher West, Theology of the Body for Beginners by Christopher West, Contraception: Why Not by Professor Janet E Smith, “Prove It, God!”. . . And He Did by Patty Schneier

#3 Take a Class on Natural Family Planning

Natural Family Planning (NFP) is fertility awareness that is simple, scientific, and reliable. It is basic knowledge that can be used either to achieve a pregnancy or to avoid a pregnancy when there are serious reasons for doing so. Many people don’t realize, however, that there are different methods of NFP—all of which are in harmony with Church teaching. The most widely used methods include the Sympto-Thermal Method, Creighton Model, Ovulation Method, and Marquette Model. Each has different levels of instruction and different physical observations. Find out which method is right for you and sign up for a class. Both spouses should attend together. A National directory of NFP Teachers and NFP Centers is available at onemoresoul.com (800-307-7685). Call your Diocesan Family Life Office or local Catholic hospital for information about classes in your area.

#4 Switch to an NFP-Only Physician

This may sound drastic but, if it is at all possible, find an NFP-only physician. For me, this was a very important step—one that I didn’t want to take, because I “loved” my former Ob-Gyn who had delivered all our children. Soon after our conversion, however, I realized that his practice of prescribing contraception no longer fit with our values. I couldn’t follow his advice, and I didn’t agree with his assumptions. When I found my new physician, I felt as if I had truly come home to an entire practice that understood me and valued my fertility as a gift and a blessing—not a disease or an inconvenience that needed to be “controlled.” Despite a much longer commute to this new practice, it has been well worth it!
An NFP-only physician will affirm your decision, help you make the switch, and lend great support with medical truths and NFP experience. If you have been given hormonal contraceptives for “medical reasons,” an NFP-only physician can evaluate the underlying problem and utilize natural hormones or surgeries to restore proper function of your body. An NFP-only physician may also be able to assist couples who seek sterilization reversal. Because physicians have such a powerful influence on their patients and have a relationship built on trust, it is crucial that you find an NFP-only physician. Go to https://onemoresoul.com/nfp-directory to find your nearest NFP-only physician. If none is available in your area, ask an NFP teacher to recommend an NFP-friendly physician. If switching physicians is not possible, you may need to educate your current physician. Get materials, take them to your physician, and encourage him/her to learn the scientific facts and moral reasoning behind modern methods of NFP. Unfortunately, many physicians remain unaware and uneducated in this area. You can help change that!

#5 Connect with Others

When Larry and I converted to the Church’s teachings, we knew five other couples who did not use contraception. That’s it—five other couples out of our entire parish, list of acquaintances, colleagues, neighbors, and relatives. But these five couples were more than enough. These were the families we had always admired and respected. They soon became our confidants and closest friends. It felt so good to be able to talk with them! We swapped books and CDs; we swapped stories and experiences; we shared laughter and tears. Through it all, we witnessed their joy and learned how beautiful marriage can be. They encouraged us, taught us, and loved us throughout our entire journey. We are forever grateful.
Chances are, you know of at least one other family that practices NFP. You may not know them well, but you probably know who they are. Perhaps their marriage and family life have been an inspiration to you. Seek them out and share your story. The best place to look is within your own parish. These families can be a tremendous support for you. I strongly recommend that men seek out other men who have gone through this journey. Despite the initial awkwardness of discussing these personal issues, it can be most encouraging. You are not alone!

#6 Remain Grounded in Sacred Scripture

There were so many Scripture passages that strengthened me when I was afraid or confused. Two verses in particular were crucial at these times: Mark 1:17 “They dropped their nets and followed him.” I knew that contraception was my “net,” and I needed to drop it in order to follow Jesus. Luke 5:37 spoke to my heart as well: “No one pours new wine into old wineskins.” I wanted “new wine” in my marriage. But in order to get that, I had to get rid of the old wineskins. There was no other way. . . . The truths of these scriptures helped me to stay focused on God. His Word sustained me throughout this journey.
Pray for wisdom, strength, perseverance, and purity. Read the Bible. I recommend reading the following verses over and over again: Romans 12:1-2, Philippians 1:9-11, Ephesians 1:3-4, and Ephesians 3:14-21. Let them sink into your heart and speak to you personally. Know that you can be pure and blameless; know that you can be rooted and grounded in real love; trust that through grace you will be strengthened with power and Truth!
Finally, I share with you the life-changing question that Larry asked me after reading Good News About Sex and Marriage. I was extremely confused, frightened, and in turmoil after discovering the truth about contraception, and I didn’t know what to do. He simply asked, “What do you want for our marriage?” I replied, “I don’t know. . . but I want what’s in that book.” That was it. That’s how we began our journey together—reading, learning, praying, and talking. Then we took one step at a time to build the marriage we had always wanted. With time, our communication, our physical relationship, and our entire lifestyle changed for the better. May you be abundantly blessed as you discover God’s plan for your marriage, and may you be steadfast in your search for Truth. Make the switch. It could be THE defining moment in YOUR marriage.

NFP Contact Information

Sympto-Thermal
Couple to Couple League www.ccli.org 513-471-2000
Northwest Family Services www.nwfs.org 503-215-6377

Ovulation
Family of the Americas Foundation www.familyplanning.net 301-627-3346
Billings Ovulation
Billings Ovulation Method Association www.boma-usa.org 651-699-8139
Creighton
Pope Paul VI Institute www.popepaulvi.com 402-390-6600
Marquette
Marquette U. School of Nursing www.marquette.edu/nursing/NFP 414-288-3854

The Morning After Pill and other types of “Emergency Contraception”–Myths and Realities

by Liliana Cote de Bejarano, MD, MPH

What is “emergency contraception”?

Emergency contraception (EC) is the use of pills or devices after sex to try to prevent pregnancy.1 EC is promoted when a woman has been raped, when a couple has chosen to have sex without using any form of contraception, or when there is a suspected contraceptive failure. Types of EC may include pills or the insertion of the Copper-T Intrauterine Device (IUD) up to five days after intercourse. The use of other drugs as emergency contraception is under investigation.2

What is the “Morning After Pill”?

The phrase “Morning After Pill” (MAP) describes a set of contraceptive pills taken after a sexual act, to prevent pregnancy. One type of MAP contains only the synthetic progestin levonorgestrel (LNG), which is the main drug in other commercial contraceptives. Commercial names for the MAP include Plan B One Step, Take Action, Next Choice One Dose, My Way, and others.3 The Food and Drug Administration has approved Plan B One Step for sale without age restrictions. A second type of MAP is the anti-progesterone “Ella”, available with prescription in the United States. A third type of MAP is the “off label” use of combined oral contraceptive pills. A fourth type of EC is the abortion pill Mifepristone (RU 486), used outside the USA.

How does the Morning After Pill work?

blastocyst

The new baby (blastocyst) migrates from the fallopian tube to the uterus where it implants 5-7 days after conception.

Conception of a new human being is possible only during a few days in the woman’s cycle. Sperm can survive in the woman’s body 3-5 days, and the ovum dies 12-24 hours after ovulation. Fertilization normally occurs in the fallopian tube after ovulation. The new human being (blastocyst) moves from the fallopian tube to the uterus where it implants 5-7 days after conception. A delicate hormonal balance is necessary for the baby’s survival.

Some studies seem to show that Plan B works by changing the cervical mucus or by attacking sperm. More recent studies, however, show that these effects may happen when the drug is taken regularly (like birth control pills), but NOT after one dose (like EC).4,5

Advocates of EC claim that the active ingredient in Plan B works mainly by stopping or delaying ovulation Available studies show that when Plan B was given to women in the fertile part of their cycle, 80% OR MORE of them ovulated, although NONE of them became obviously pregnant (see diagram below).6,7 If sperm and an egg are present in the woman’s body but no obvious pregnancy develops, then abortion is the most likely cause.8 Some studies also show that Plan B disturbs the hormonal balance needed to maintain pregnancy.9,10

What about other types of emergency contraception?

Copper-T IUDs—Copper ions released from an IUD are toxic for sperm and the ovum, decreasing the probability of fertilization.11  Also, the Copper-T IUD lowers the chances of survival of any embryo that may be formed before it reaches the womb. The Copper-T IUD stops the lining of the womb from accepting a newly formed embryo.12 Thus the Copper-T IUD may have a post-fertilization effect, meaning it destroys a young human embryo.

Ella and Mifepristone (RU-486) change the body’s ability to react to some hormones. They can block the action of the hormone progesterone,13 thereby destroying a new human life through chemical abortion. Ella can also delay or block ovulation if taken before ovulation.14

If conception (fertilization) has already taken place, then the only way the IUD and the morning after pill (MAP) can be effective is by destroying the new life. When a woman takes theses pills or when the IUD is inserted, there is currently no way for her or her doctor to know whether or not she has already conceived. A pregnancy test cannot give this information before implantation. Whenever these pills are taken, or a Copper-T IUD is inserted after sexual activity, there is the risk that a new human life will be destroyed.

Remember that a new life is destroyed when implantation is prevented.

Remember that
a new life is
destroyed
when implantation
is prevented.

Does this mean that emergency contraception is an abortifacient— that it can cause an abortion?

A new human life begins at conception, also called fertilization. However, in September 1965, the American College of Obstetricians and Gynecologists (ACOG) attempted to redefine “pregnancy” as beginning at the time of implantation, and not at the time of conception. The effectiveness of pills and devices that do not prevent fertilization depends on destruction of a new human life. This should be called an “abortion” in spite of the medical definition from the ACOG.

In a recent study 8 out of 10 women who took the MAP ovulated. This means that if they had sex, some of these 8 women likely became pregnant. None had an obvious pregnancy, so the women who became pregnant probably experienced an early abortion.

How effective is emergency contraception?

The Copper-T IUD prevents 99% of expected pregnancies. Ella and Plan B prevent some of expected pregnancies after unprotected intercourse.15 The effect of EC in reducing unintended pregnancies and induced abortions has not yet been proven. Available studies show that EC may have no effect on unintended pregnancies, it may even increase them.16, 17, 18,19 Women with high body mass may also find that EC has decreased or no effectiveness in preventing pregnancy.20 In addition, providing emergency contraception in advance has the negative effect of increasing risky sexual behavior.21 Overall, the evidence suggests that the Morning After Pill is not effective for preventing unintended pregnancies.

How safe is emergency contraception?

A Morning After Pill that contains LNG can cause heavier or lighter menstrual bleeding, nausea, vomiting, abdominal pain, fatigue, headache, dizziness, breast tenderness, delay of menses (up to 7 days), and diarrhea. The use of LNG also increases the risk of ectopic pregnancy.22 The use of Ella has been connected with headache, abdominal or upper abdominal pain, nausea, dysmenorrhea, fatigue, and dizziness.23 Women who use the Copper-T IUD can experience uterine cramps and other undesirable effects such as ectopic pregnancy, septic abortion, pelvic infection, perforation, embedment, anemia, backache, painful periods, pain during intercourse, vaginal discharges, prolonged menstrual flow, menstrual spotting, cramping, and vaginitis.24

One study reported that women may repeatedly use EC due to an exaggerated perception of its effectiveness.25 Another study found that over-the-counter access to EC leads to increased Sexually Transmitted Infections by approximately 12% for women ages 15-44 due to increased risky sexual behavior.26 More time and research are needed to know the long-term effects of emergency contraception on the health and safety of women.

Are there other options?

If you are single, the surest way to avoid pregnancy or a sexually transmitted infection is abstinence, and it always works. If you are married, the modern methods of Natural Family Planning (NFP) are the safest, healthiest, least toxic, and least expensive means for family planning. Victims of rape or sexual abuse need and deserve the best medical care and human support possible. The additional stress and health risks of emergency contraception add further harm. (Pregnancy due to rape is estimated at 5%).27 For the vast majority of these women, emergency contraceptives impose significant health risks with no benefit. If conception has already occurred, then a very early abortion is the only means for emergency contraception to be effective. Abortion carries with it many serious adverse consequences such as increased rates of breast cancer, depression, anxiety, suicidal behaviors, and substance use disorders.28 A far safer approach is to carry the child to term. Adoption is always an option.

Confidential pregnancy assistance services are available throughout the U.S. and Canada by calling Option Line at 800-395-HELP (4357) and Abortion Pill Reversal Network at 877-558-0333.

REFERENCES:

1. Trussell J, PhD and Raymond, EG, MD, MPH. Emergency contraception: a last chance to prevent unintended pregnancy. Retrieved from: http://ec.princeton.edu/questions/ec-review.pdf, July 28 2015.

2. Jesam C, Salvatierra AM, Schwartz JL, & Croxatto HB. (2010). Suppression of follicular rupture with meloxicam, a cyclooxygenase-2 inhibitor: Potential for emergency contraception. Human Reproduction (Oxford, England), 25(2), 368-373.

3. Emergency Contraception Pills. Retrieved from http://ec.princeton.edu/info/ecp.html, July 28 2015.

4. Nascimento JA, Seppala M, Perdigao A., Espejo-Arce X, Munuce MJ, Hautala L, et al. (2007). In vivo assessment of the human sperm acrosome reaction and the expression of glycodelin-A in human endometrium after levonorgestrel-emergency contraceptive pill administration. Human Reproduction (Oxford, England), 22(8), 2190-2195.

5. Hermanny A, Bahamondes MV, Fazano F, Marchi NM, Ortiz ME, Genghini MH, et al. (2012). In vitro assessment of some sperm function following exposure to levonorgestrel in human fallopian tubes. Reproductive Biology and Endocrinology : RB&E, 10, 8-7827-10-8.

6. Brache V, Cochon L, Deniaud M, Croxatto, HB. Ulipristal acetate prevents ovulation more effectively than levonorgestrel: analysis of pooled data from three randomized trials of emergency contraception regimens. Contraception. Nov 2013; 88(5): 611-618.

7. Noe G, Croxatto HB, Salvatierra AM, Reyes V, Villarroel C, Munoz C, et al. Contraceptive efficacy of emergency contraception with levonorgestrel given before or after ovulation. Contraception. Nov 2011; 84(5): 486-492.

8. Kahlenborn C, Peck R, & Severs WB. (2015). Mechanism of action of levonorgestrel emergency contraception. The Linacre Quarterly, 82(1), 18-33.

9. Croxatto HB, Brache V, Pavez M, Cochon L, Forcelledo ML, Alvarez F, et al. Pituitary-ovarian function following the standard levonorgestrel emergency contraceptive dose or a single 0.75-mg dose given on the days preceding ovulation. Contraception. Dec 2004; 70(6): 442-450.

10. Hapangama D, Glasier AF, Baird DT. The effects of peri-ovulatory administration of levonorgestrel on the menstrual cycle. Contraception. Mar 2001; 63(3): 123-129.

11. Ortiz ME, Croxatto HB. Copper-T intrauterine device and levonorgestrel intrauterine system: biological bases of their mechanism of action. Contraception. Jun 2007; 75(6 Suppl): S16-30.

12. Gemzell-Danielsson K, Berger C & Lalitkumar PGL. (2013). Emergency contraception–mechanisms of action. Contraception, 87(3), 300-308.

13. Keenan JA. Ulipristal acetate: contraceptive or contragestive? Ann Pharmacother. Jun 2011; 45(6): 813-815.

14. Brache V, Cochon L, Jesam C, Maldonado R, Salvatierra AM, Levy DP, et al. Immediate pre-ovulatory administration of 30 mg ulipristal acetate significantly delays follicular rupture. Hum Reprod. Sep 2010; 25(9): 2256-2263.

15. Fred F. Ferri M.D., F.A.C.P. (2016). Ferri’s clinical advisor 2016 Elsevier, Inc

16. Rodriguez MI, Curtis KM, Gaffield ML, Jackson E, Kapp N. Advance supply of emergency contraception: a systematic review. Contraception. May 2013; 87(5): 590-601.

17. Raymond EG, Trussell J, Polis CB. Population effect of increased access to emergency contraceptive pills: a systematic review. Obstet Gynecol. January 2007; 109(1): 181-188.

18. Walsh TL, Frezieres RG. Patterns of emergency contraception use by age and ethnicity from a randomized trial comparing advance provision and information only. Contraception. Aug 2006; 74(2): 110-117.

19. Glasier A, Fairhurst K, Wyke S, Ziebland S, Seaman P, Walker J, et al. Advanced provision of emergency contraception does not reduce abortion rates. Contraception. May 2004; 69(5): 361-366.

20. Glasier A, Cameron ST, Blithe D, Scherrer B, Mathe H, Levy D, et al. (2011). Can we identify women at risk of pregnancy despite using emergency contraception? data from randomized trials of ulipristal acetate and levonorgestrel. Contraception, 84(4), 363-367.

21. Belzer M, Sanchez K, Olson J, Jacobs AM, Tucker D. Advance supply of emergency contraception: a randomized trial in adolescent mothers. J Pediatr Adolesc Gynecol. Oct 2005; 18(5): 347-354.

22. Zhang J, Li C, Zhao WH. Xi X, Cao SJ, Ping H, et al. (2015). Association between levonorgestrel emergency contraception and the risk of ectopic pregnancy: A multicenter case-control study. Scientific Reports, 5, 8487.

23. Ulipristal Acetate. http://www.pdr.net/drug-summary/ella?druglabelid=1278 August  10 2015

24. Intrauterine Copper Contraceptive Paragard. Retrieved from http://www.pdr.net/drug-summary/paragard?druglabelid=572 August 10 2015

25. Melton L, Stanford JB, Dewitt MJ. Use of levonorgestrel emergency contraception in Utah: is it more than “plan B”? Perspect Sex Reprod Health. Mar 2012; 44(1): 22-29.

26. Mulligan K. (2015). Access to emergency contraception and its impact on fertility and sexual behavior. Health Economics (Published Online).

27. Holmes MM, Resnick HS, Kilpatrick DG, Best CL. Rape-related pregnancy: estimates and descriptive characteristics from a national sample of women. Am J Obstet Gynecol. August 1996; 175(2): 320-324.

28. Fergusson DM, Horwood LJ, Ridder EM. Abortion in young women and subsequent mental health. J Child Psychol Psych. January 2006; 47(1): 16-24.

Four Keys to Happy Healthy Marriage

By Bonnie Borel-Donahue

Who could be a better role model for how to love one’s spouse than the Ultimate Lover, God? But, just how does God love?
Having meditated on this question, Pope Paul VI and Pope John Paul II discerned four key characteristics of God’s love. God’s love is always: free, total, faithful and fruitful. Each key is also one of the four essential qualities of authentic married love. This brochure will introduce you to these four very important keys for starting out on, or getting back onto, the road to a great marriage. Through the graces that come from the sacrament of Holy Matrimony, together with prayer and regular reception of the sacraments of Reconciliation and the Eucharist, spouses are given all the strength and power to love each other as Jesus loves His Church: freely, totally, faithfully and fruitfully. These are the four keys to authentic conjugal love. Through the Sacraments and learning more about the four keys to marital love presented in this brochure, couples can open the door to an ever more satisfying and fulfilling marriage.1 (more…)

Obey Mandate or Scripture

The One More Soul “newspaper” response to the HHS mandate.

One More Soul is pleased to offer this “newspaper” response to the HHS mandate as a supplement to the resources already available from the USCCB and other sources. It is an educational piece that draws attention to several “concerns” prompted by the HHS mandate. They are concerns for all of us, whether involved in Catechesis, Bible Study, Faith Sharing, Altar-Rosary, Knights of Columbus, St Vincent De Paul, Catholic Charities and Social Services, Catholic hospitals, high schools, and universities. Please fit this issue into your agenda for as long as required to end the HHS assault on our Constitution and our Church.Our Lord Jesus told us to, “be not afraid”, and “cast out into the deep”. Our God will provide; our God is merciful; our God has a plan.Our Faith is being tested. How shall we respond? (more…)

Published NFP Studies

Updated Review of Published NFP Studies

New Method of FA/NFP (Potential and Actual)

  1. Freundl, G., Frank-Herrmann, P., Brown, S., & Blackwell, L. (2014). A new method to detect significant basal body temperature changes during a woman’s menstrual cycle. The European Journal of Contraception & Reproductive Health Care : The Official Journal of the European Society of Contraception, 19(5), 392-400.
  2. Mulcaire-Jones, G., Fehring, R. J., Bradshaw, M., Brower, K., Lubega, G., & Lubega, P. (2016). Couple beads: An integrated method of natural family planning. The Linacre Quarterly, 83(1), 69-82.
  3. Soler, F., & Barranco-Castillo, E. (2010). The symptothermal (double check) method: An efficient natural method of family planning. The European Journal of Contraception & Reproductive Health Care : The Official Journal of the European Society of Contraception, 15(5), 379-80; author reply 381-2.
  4. Ryder, R. E. (1993). “Natural family planning”: Effective birth control supported by the catholic church. BMJ (Clinical Research Ed.), 307(6906), 723-726.

Method Specific Efficacy Studies

  1. Bouchard, T., Fehring, R. J., & Schneider, M. (2013). Efficacy of a new postpartum transition protocol for avoiding pregnancy. Journal of the American Board of Family Medicine : JABFM, 26(1), 35-44.
  2. Fehring, R. J., & Mu, Q. (2014). Cohort efficacy study of natural family planning among perimenopause age women. Journal of Obstetric, Gynecologic, and Neonatal Nursing : JOGNN, 43(3), 351-358.
  3. Fehring, R. J., & Schneider, M. (2017). Effectiveness of a natural family planning service program. MCN.the American Journal of Maternal Child Nursing, 42(1), 43-49.
  4. Fehring, R. J., Schneider, M., & Barron, M. L. (2008). Efficacy of the marquette method of natural family planning. MCN.the American Journal of Maternal Child Nursing, 33(6), 348-354
  5. Fehring, R. J., Schneider, M., Barron, M. L., & Pruszynski, J. (2013). Influence of motivation on the efficacy of natural family planning. MCN.the American Journal of Maternal Child Nursing, 38(6), 352-358.
  6. Warniment, C. B., & Hansen, K. (2012). Is natural family planning a highly effective method of birth control? yes: Natural family planning is highly effective and fulfilling. American Family Physician, 86(10), 1-2.

Accuracy of Fertility (Ovulation) Indicators

  1. Ecochard, R., Leiva, R., Bouchard, T., Boehringer, H., Direito, A., Mariani, A., et al. (2013). Use of urinary pregnanediol 3-glucuronide to confirm ovulation. Steroids, 78(10), 1035-1040.
  2. Fehring, R. J., Raviele, K., & Schneider, M. (2004). A comparison of the fertile phase as determined by the clearplan easy fertility monitor and self-assessment of cervical mucus. Contraception, 69(1), 9-14.

Psychological Dynamics, Attitudes, and Characteristics of NFP/FA Users

  1. Berendt Emil., & Leonard, Judith. (2006). Profiles of responders to a natural family planning awareness campaign. Catholic Social Science Review, 11, 31-46.
  2. Fehring, R. J. (2015). The influence of contraception, abortion, and natural family planning on divorce rates as found in the 2006-2010 national survey of family growth. The Linacre Quarterly, 82(3), 273-282.
  3. Smith, A. D., & Smith, J. L. (2014). billingsMentor: Adapting natural family planning to information technology and relieving the user of unnecessary tasks. The Linacre Quarterly, 81(3), 219-238.

Probabilities of Pregnancy

  1. Frank-Herrmann, P., Jacobs, C., Jenetzky, E., Gnoth, C., Pyper, C., Baur, S., et al. (2017). Natural conception rates in subfertile couples following fertility awareness training. Archives of Gynecology and Obstetrics, 295(4), 1015-1024.

Time to Pregnancy/ Timing Intercourse

  1. Ecochard, R., Duterque, O., Leiva, R., Bouchard, T., & Vigil, P. (2015). Self-identification of the clinical fertile window and the ovulation period. Fertility and Sterility, 103(5), 1319-25.e3.

Menstrual Cycle Physiology/Medical Tx

  1. Cai, B., Dunson, D. B., & Stanford, J. B. (2010). Dynamic model for multivariate markers of fecundability. Biometrics, 66(3), 905-913.
  2. Hilgers, T. W., Keefe, C. E., & Pakiz, K. A. (2015). The use of isomolecular progesterone in the support of pregnancy and fetal safety. Issues in Law & Medicine, 30(2), 159-168.
  3. Vigil, P., Salgado, A. M., & Cortes, M. E. (2012). Ultrastructural interaction between spermatozoon and human oviductal cells in vitro. Journal of Electron Microscopy, 61(2), 123-126.

Twelve-Year Review (2000-2012) of Published NFP Studies

By Richard J. Fehring, PhD, RN, FAAN—Marquette University

New Method of FA/NFP (Potential and Actual)

  1. Arevalo, M., Jennings, V., and Sinai, I. Efficacy of a new method of family planning: the Standard Day Method. Contraception. 65 (2002): 333-338.
  2. Arevalo M, Jennings V, Nikula M, Sinai I. Efficacy of the new TwoDay Method of family planning. Fertility and Sterility. 2004;82:885-892.
  3. Blackwell, L.F., Brown, J.B., & Vigil, P., et al. Hormonal monitoring of ovarian activity using the Ovarian Monitor, Part I. Validation of home and laboratory results obtained duringovulatory cycles by comparison with radioimmunoassay. Steriods. 2003;68:465-476.
  4. Burkhart, M.C., de Mazariegos, L., Salazar, S., & Lamprecht, V.M. Effectiveness of a standard-rule method of calendar rhythm among Mayan couples in Guatemala. International Family Planning Perspectives. 26 (August, 2000):131-136.
  5. Brosens I, Hernalsteen P, Devos A, Cloke B, Brosens JJ. Self-assessment of the cervical pupil sign as a new fertility-awareness method. Fertility and Sterility, 2009 Mar;91(3):937-9.
  6. Dunlop, A.L., Allen, A.D., & Frank, E. Involving the male partner for interpreting the basal body temperature graph. Obstetrics & Gynecology. 98(2001):133-138.
  7. Dunlap AL, Schultz R, Frank E. Interpretation of the BBT chart: using the “Gap” technique compared to the Coverline technique. Contraception, 2005;71:188- 192.
  8. Fehring RJ, Schneider M, Raviele K, Barron ML. Efficacy of cervical mucus observations plus electronic hormonal fertility monitoring as a method of natural family planning. Journal of Obstetric, Gynecological, and Neonatal Nursing, 2007;36:152-160.
  9. Hadziomerovic D, Moeller KT, Lict P, Hein A, Veitenhansel S, Kusmitsch M, Wildt L. The biphasic pattern of end-expiratory carbon dioxide pressure: a method for identification of the fertile phase of the menstrual cycle. Fertility and Sterility, 2008 Sep;90(3):731-6.
  10. Wang, J., Usala,S.J. and O’Brien-Usala, F. et al., “The fertile and infertile phases of the menstrual cycle are signaled by cervical-vaginal fluid die swell functions. The Endocrinologist, (2009) 19(6): 291297.

Method Specific Efficacy Studies

  1. Arevalo, M., Jennings, V., and Sinai, I. Efficacy of a new method of family planning: the Standard Day Method. Contraception. 65 (2002): 333-338.
  2. Arevalo M, Jennings V, Nikula M, Sinai I. Efficacy of the new TwoDay Method of family planning. Fertility and Sterility. 2004;82:885-892.
  3. Burkhart, M.C., de Mazariegos, L., Salazar, S., & Lamprecht, V.M. Effectiveness of a standard-rule method of calendar rhythm among Mayan couples in Guatemala. International Family Planning Perspectives. 26 (August, 2000):131-136.
  4. Fehring RJ, Schneider M, Raviele K, Barron ML. Efficacy of cervical mucus observations plus electronic hormonal fertility monitoring as a method of natural family planning. Journal of Obstetric, Gynecological, and Neonatal Nursing, 2007;36:152-160.
  5. Fehring, R. J., M. Schneider M, and M.L. Barron. “Efficacy of the Marquette method of natural family planning,” MCN, American Journal of Maternal Child Nursing 33 (2008):348-54.
  6. Fehring R., Schneider, M., Barron, M.L. and K. Raviele. “Cohort comparison of two fertility awareness methods of family planning,” Journal of Reproductive Medicine. 2009 Mar;54(3):165-70.
  7. Fehring, R, Schneider, M, & Raviele, K. (2011). Pilot Evaluation of an Internet-based Natural Family Planning Education and Service Program, Journal of Obstetrics, Gynecology,and Neonatal Nursing. 40(3):281-91.
  8. Frank-Hermann P, Gnoth C, Baure S, Strowitski T, Freundl G. Determination of the fertile window: reproductive competence of women – European cycle databases. Gynecology Endocrinology, 2005; 20: 305- 312.
  9. Frank-Herrmann P, Heil J, Gnoth C, Toledo E, Baur S, Pyper C, Jenetzky E, Strowitzki T, Freundl G. The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple’s sexual behavior during the fertile time: a prospective longitudinal study. Human Reproduction, 2007; 22:1310-1319.
  10. Jennings, V. & Sinai, I. Further analysis of the theoretical effectiveness of the TwoDay method of family planning. Contraception. 64(2001):149-153.
  11. I. Sinai, R. I. Lundgren, and J.N. Gribble. “Continued use of the Standard Days Method.” Journal of Family Planning and Reproductive Health Care, (2011): published ahead of print.

Review Articles Efficacy Studies

  1. Che, Y., Cleland, J.G. and Mohamed, M.A. Periodic abstinence in developing countries: an assessment of failure rates and consequences. Contraception. 2004;69:15-21.
  2. Grimes DA, Gallo MF, Grigorieva V, Nanda K, Schulz KF. Fertility awareness-based methods for contraception. Cochrane Database Systematic Review, 2004 Oct 18;(4):CD004860. Review. PMID: 15495128
  3. Grimes DA, Gallo MF, Grigorieva V, Nanda K, Schulz KF. Fertility awareness-based methods for contraception: systematic review of randomized controlled trials. Contraception, 2005;72:85-90.
  4. Leite IC, Gupta N. Assessing regional differences in contraceptive discontinuation, failure and switching in Brazil. Reproductive Health, 2007;4:6. (BioMed Central)
  5. Mansour, D, and P. Inki, and K. Gemzell-Danielsson. Efficacy of contraceptive methods: A review of the literature. The European Journal of Contraception and Reproductive Health Care 15 (2010): 4-16.
  6. Moreau C, Cleland K, Trussell J. Contraceptive discontinuation attributed to method dissatisfaction in the United States. Contraception, 2007, Oct;76(4):267- 72.
  7. Moreau C, Trussell J, Rodriquez G, Bajos N, Bouyer J. Contraceptive failure in France: results from a population-based survey. Human Reproduction, 2007;22:2422-2427.
  8. Mosher,WD and J. Jones. Use of contraception in the United States: 1982-2008. Vital and Health Statistics Series 23, Number 29 (2010): 1-77.
  9. Ranjit, N., Bankole, A., Darroch, J.E. & Singh, S. Contraceptive failure in the first two years of use: differences across socioeconomic subgroups. Family Planning Perspectives. 33 (2001):19-27.
  10. Trussell J. Contraceptive failure in the United States. Contraception. 2004;70:89-96.
  11. Wiebe ER, Trussell J. Contraceptive failure related to estimated cycle day of conception related to the start of the last bleeding episode. Contraception 2009; 79: 178-181.

Accuracy of Fertility (Ovulation) Indicators

  1. Alliende ME, Cabezon C, Figueroa H, Kottmann C. Cervicovaginal fluid changes to detect ovulation accurately. Obstetrics and Gynecology, 2005;193:71-75.
  2. Attar, E., Gokdemirel, S., Seraroglu, H., & Coskun, A. Natural contraception using the Billings ovulation method. The European Journal of Contraception and Reproductive Health Care. 2002;7:96-99.
  3. Behre, H.M., Kuhlage, J., & Gassner, C. , et al. Prediction of ovulation by urinary hormone measurements with the home use Clearplan Fertility Monitor: comparison with transvaginal ultrasound scans and serum hormone measurements. Human Reproduction. 12 (2000):2478-2482.
  4. Blackwell, L.F., Brown, J.B., & Vigil, P., et al. Hormonal monitoring of ovarian activity using the Ovarian Monitor, Part I. Validation of home and laboratory results obtained duringovulatory cycles by comparison with radioimmunoassay. Steriods. 2003;68:465-476.
  5. Brosens I, Hernalsteen P, Devos A, Cloke B, Brosens JJ. Self-assessment of the cervical pupil sign as a new fertility-awareness method. Fertility and Sterility, 2009 Mar;91(3):937-9.
  6. Ecochard, R. Boehringer, H., Rabilloud, M., & Marret, H. Chronological aspects of ultrasonic, hormonal, and other indirect indices of ovulation. British Journal of Obstetrics and Gynecology. 108 (2001): 822-829.
  7. Fehring, R. Accuracy of the peak day of cervical mucus as a biological marker of fertility. Contraception. (2002): 836-47.
  8. Fehring, R., Raviele, K. and Schneider, M. A comparison of the fertile phase as determined by the Clearplan Easy Fertility Monitor and self-assessment of cervical mucus. Contraception. 2004;69:9-14.
  9. Freundl, G., Godehardt, E., Kern, P.A., Frank-Hermann, P., Koubenec H.J. and Gnoth, Ch.Estimated maximum failure rates of cycle monitors using daily conception probabilities inthe menstrual cycle. Human Reproduction. 2003:18(2):2628-2633.
  10. Hadziomerovic D, Moeller KT, Lict P, Hein A, Veitenhansel S, Kusmitsch M, Wildt L. The biphasic pattern of end-expiratory carbon dioxide pressure: a method for identification of the fertile phase of the menstrual cycle. Fertility and Sterility, 2008 Sep;90(3):731-6.
  11. Scarpa B, Dunson DB, Colombo B. Cervical mucus secretions on the day of intercourse: an accurate marker of highly fertile days. European Journal of Obstetrics and Gynecology and Reproductive Biology, 2006; 125:72-78.
  12. Wang, J., Usala,S.J. and O’Brien-Usala, F. et al., “The fertile and infertile phases of the menstrual cycle are signaled by cervical-vaginal fluid die swell functions. The Endocrinologist, (2009) 19(6): 291297.
  13. Blackwell1, P. Vigil, B. Gross, C. d’Arcangues, D.G. Cooke, and J. B. Brown. “Monitoring of ovarian activity by measurement of urinary excretion rates of estrone glucuronide and pregnanediol glucuronide using the Ovarian Monitor, Part II: reliability of home testing.” Human Reproduction. Advance Access published November 29, 2011).

Special Circumstances/Breastfeeding/Post OC

  1. Arevalo, M., Jennings, V. and Sinai, I. Application of simple fertility awareness-based methods of family planning to breastfeeding women. Fertility and Sterility. 2003;80:1241-1248.
  2. Gnoth, C., Frank-Hermann, P., & Schmoll, A., et al. Cycle characteristics after discontinuation of oral contraceptives. Gynecological Endocrinology. 2002;16:307-317.
  3. Fehring RJ, Barron ML, Schneider M. Protocol for determining fertility while breastfeeding and not in cycles. Fertility and Sterility, 2005;84:805-807.
  4. Tomaselli, G.A., Guida, M., & Palomba, S, et al. Using complete breast-feeding and lactational amenorrhoea as birth spacing methods. Contraception. 61 (April, 2000):253-257.
  5. Bouchard, T, Schneider, M & Fehring, R. “Efficacy of a New Postpartum Transition Protocol for Avoiding Pregnancy“ Journal of the American Board of Family Medicine. Accepted for publication 8/12.
  6. I. Sinai and J. Cachan, “A bridge for postpartum women to Standard Days Method, I. Developing the bridge,” Contraception (2012): e-published ahead of print.
  7. I. Sinai, and J. Cachan, “A bridge for postpartum women to Standard Days Method, II. Efficacy study,” Contraception (2012): e-published ahead of print.

Psychological Dynamics, Attitudes, and Characteristics of NFP/FA Users

  1. Audu, B.M., Yahya, S.J., & Bassi, A. Knowledge, attitude and practice of natural family planning methods in a population with poor utilization of modern contraceptives. Journal of Obstetrics and Gynecology, 2006;6:555-560.
  2. den Tonkelaar, I. & Oddens, B.J. Factors influencing women’s satisfaction with birth control methods. The European Journal of Contraception and Reproductive Health Care. 6(2001):153-158.
  3. Gribble JN, Lundgren RI, Velasquez C, Anastasi EE. Being strategic about contraceptive introduction: the experience of the Standard Days Method Contraception. 2008 Mar;77(3):147-54.
  4. Janssen, C.J.M., & van Lunsen, R.H.W. Profile and opinions of the female Persona user in The Netherlands. The European Journal of Contraception and Reproductive Health Care. 5 (2000):141-146.
  5. Leonard CJ, Chavira W, Coonrod DV, Hart KW, Bay RC. Survey of attitudes regarding natural family planning in an urban Hispanic population. Contraception, 2006;74:313-317.
  6. Mikolajczyk, R.T., Stanford, J.B., & Rauchfuss, M. Factors influencing the choice to use modern natural family planning. Contraception. 2003;67:253-258.
  7. Moreau C, Cleland K, Trussell J. Contraceptive discontinuation attributed to method dissatisfaction in the United States. Contraception, 2007, Oct;76(4):267-72.
  8. Mosher WD, Martinez GM, Chandra A, Abma J, Willson SJ. Use of contraception and use of family planning services in the United States: 1982-2002. Advance Data from Vital and Health Statistics. CDC Number 350, December 10, 2004.
  9. Research Group on Methods for the Natural Regulation of Fertility. Periodic abstinence and calendar method use in Hungary, Peru, the Philippines, and Sri Lanka. Contraception. 64 (2001): 209-215.
  10. Severy, L.J. Acceptability of home monitoring as an aid to conception. The Journal of International Medical Research. 29(2001,Suppl 1):28A-34A.
  11. Severy, L.H., Klein, C.T., & McNulty, J. Acceptability of personal hormone monitoring for contraception: longitudinal and contextual variables. The Journal of Social Psychology. 142 (2002): 87-96.
  12. Severy LJ, Robison J, Findley-Klein C, McNulty J. Acceptability of a home monitor used to aid in conception: psychological factors and couple dynamics. Contraception, 2006;73:65-71.
  13. Severy LJ, Robison J, Findley-Klein C, McNulty J. Acceptability of a home monitor used to aid in conception: psychological factors and couple dynamics. Contraception, 2006;73:65-71.
  14. Sinai I, Lundgren R, Arévalo M, Jennings V. Fertility awareness-based methods of family planning: predictors of correct use. International Family Planning Perspectives, 2006;32:94-100.
  15. Stanford, J.B., & Smith, K.R. Characteristics of women associated with continuing instruction in the Creighton Model Fertility Care System. Contraception. 61 (February, 2000):121-129.
  16. Tommaselli, G.A., Guida, M., Palomba, S. et al., The importance of user compliance on the effectiveness of natural family planning programs. Gynecological Endocrinology. 14 (2000):81-89.
  17. VandeVusse, L., Hanson, L., Fehring, R.J. Couples’ views of the effects of natural family planning on marital dynamics. Journal of Nursing Scholarship. 35 (2003):171-176.

Attitudes of Health Professionals to FA/NFP

  1. Fehring, R.J., Hanson, L., & Stanford, J.B. Nursemidwives’ knowledge and promotion of lactational amenorrhea and other natural family planning methods for child spacing. Journal of Midwifery & Women’s Health. 46 (Mar/April, 2001):68-73.
  2. Steinauer J, La Rochelle F, Rowh M, Backus L, Sandahl Y, Foster A. First impressions: What are preclinical medical students in the US and Canada learning about sexual and reproductive health. Contraception, 2009 Jul;80(1):74-80.

Probabilities of Pregnancy

  1. Colombo B, Mion A, Passarin K, Scarpa B. Cervical mucus symptom and daily fecundability: first results from a new database. Statistical Methods in Medical Research, 2006; 15:161-180.
  2. Dunson, D.B., Sinai, I., & Colombo, B. The relationship between cervical secretions and the daily probabilities of pregnancy: effectiveness of the TwoDay Algorithm. Human Reproduction. 16(2001):2278-2282.
  3. Keulers MJ, Hamilton CJCM, Franx A, Evers JLH, Bots RSGM. The length of the fertile window is associated with the chance of spontaneously conceiving an ongoing pregnancy in subfertile couples. Human Reproduction, 2007;22:1652-1656.
  4. Stanford, J.B., Smith, K.R., & Dunson, D.B. Vulvar mucus observations and the probability of pregnancy. Obstetrics & Gynecology. 2003;101:1285-1292.
  5. Wilcox, A.J., Dunson, D., & Baird, D.D. The timing of the “fertile window” in the menstrual cycle: day specific estimates from a prospective study. British Medical Journal. 321 (November, 2000):1259-1262.
  6. X. Bilianm Z. Heng, And W. Shang-Chun, et al., “Conception probabilities at different days of menstrual cycle in Chinese women,” Fertility and Sterility (July 5, 2009) Epub ahead of print.

Time to Pregnancy/ Timing Intercourse

  1. Bigelow JL, Dunson DB, Stanford JB, Ecochard R, Gnoth C, Colombo B. Mucus observations in the fertile window: a better predictor of conception than timing of intercourse. Human Reproduction. 2004;19:889-892.
  2. Colombo B, Mion A, Passarin K, Scarpa B. Cervical mucus symptom and daily fecundability: first results from a new database. Statistical Methods in Medical Research, 2006; 15:161-180.
  3. Gnoth, C., Godehardt, D., Godehardt, E., et al. Time to pregnancy: results of the German prospective study and impact on the management of infertility. Human Reproduction. 2003;18:1959-1966.
  4. Robinson JE, C.Stat MW, Ellis JE. Increased pregnancy rate with use of the Clearblue Easy Fertility Monitor. Fertility and Sterility, 2007;87:329- 234.
  5. Scarpa B, Dunson DB. Bayesian methods for searching for optimal rules for timing intercourse to achieve pregnancy. Statistics In Medicine, 2007;26:1920-1936.
  6. Sinai I. Arevalo M. It’s all in the timing: coital frequency and fertility awareness-based methods of family planning. Journal of Biosocial Science, 2006;38:763-777.
  7. Snick HKA. Should spontaneous or timed intercourse guide couples trying to conceive? Human Reproduction, 2005;10:2976-77.
  8. Snick, H.K., J.A. Collins, and J. L. H. Evers. What is the most valid comparison treatment in trials of intrauterine insemination, times or uninfluenced intercourse? A systematic review and meta-analysis of indirect evidence. Human Reproduction, 2008; 23(10):239-2245.
  9. Stanford, J.B., White, G.L., & Hatasaka, H. Timing intercourse to achieve pregnancy: current evidence. Obstetrics & Gynecology. 100 (December, 2002):1333- 1341.

Menstrual Cycle Physiology/Medical Tx

  1. Fehring, R., Schneider, M., & Raviele, K. (2006). Variability in the phases of the menstrual cycle. Journal of Obstetric, Gynecologic & Neonatal Nursing, 35(3), 376-384.
  2. Fehring RJ, Schneider M. Variability in the hormonally estimated fertile phase of the menstrual cycle. Fertility and Sterility. 2008 Oct;90(4):1232-5.
  3. Menarguez M, Pastor LM, Odeblad E. Morphological characterization of different human cervical mucus types using light and scanning electron microscopy. Human Reproduction, 2004;18:1782-1789.
  4. Mikolajczyk, RT, Buck Louis, GM, Cooney, MA, Lynch, CD, Sundaram, DR. Characteristics of prospectively measured vaginal bleeding among women trying to conceive. Paediatric and Perinatal Epidemiology 24 (2009): 24-30.
  5. Stanford, JB, Parnell, TA, and Boyle, PC (2008) Outcomes from treatment of infertility with natural procreative technology in an Irish general practice. Journal of the American Board of Family Medicine 21:375-384.
  6. Vigil, P. Contreres, JL Alvarado, A Godoy, A.<. Salgado, M.E. Cortez. Evidence of subpopulations with different levels of insulin resistance in women with polycystic ovary syndrome. Human Reproduction, 2007 Nov;22(11):2974-80.
  7. Vigil, P. Cortes, ME, Zuniga, A., Riquelme, J., Ceric, F. Scanning electron and light microscopy study of the cervical mucus in women with polycystic ovary syndrome. Journal of Electron Microscopy. 2009; 58(1):21-27.
  8. Wiebe ER, Trussell J. Contraceptive failure related to estimated cycle day of conception related to the start of the last bleeding episode. Contraception 2009; 79: 178-181.

Vasectomy Safe and Simple?

by
Liliana Cote de Bejarano, MD, MPH

About 1.5 million couples in the United States opt for sterilization every year .1 According to the Guttmacher Institute, 9.9% of couples in the US use vasectomy as a contraceptive method, and more than 500,000 vasectomies are performed in the United States every year.2 The medical community and most family planning advocates consider vasectomy safe and simple. This pamphlet provides current research on vasectomy that indicates the procedure has a number of short- and long-term complications and is not a healthy choice.

What is required for fertilization?

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