COLUMN: Although popular, the rhythm method isn't safe for teens

Wednesday, June 9, 2010 | 10:49 a.m. CDT; updated 4:25 p.m. CDT, Wednesday, June 9, 2010

* The rhythm method is one of several birth-control methods that relies on determining when a woman is fertile. A previous version of this article mistakenly referred to another method.

* A previous version of this column listed an incorrect address for this website.

The first time I heard about fertility awareness birth control, it was from a friend whose religious gynecologist wouldn’t give her an intrauterine device and instead suggested she give natural family planning a whirl. She passed on the offer and looked into other options (and doctors), as I would have too. Chancing it on the calendar, I joked, was probably the reason all of my Catholic aunts and uncles have many more children than my parents. Although it's fine for couples who could risk the 25 percent failure rate, it wasn’t for my friend and me.

It appears, however, that another group of women sees things a little differently. A new report published earlier this month by the Centers for Disease Control and Prevention on unmarried U.S. teenagers' sexual activity found that since 2002, there has been a significant increase in the number of female teens using the rhythm method, a natural but incredibly risky form of birth control that requires women to avoid sex on days when they're most fertile.

The report, which included interviews with 2,767 teens, 1,381 female and 1,386 male, between July 2006 and December 2008, questioned them on sexual activity, contraceptive use as well as any child-birthing experiences. In terms of how many female teens are hitting the sheets these days, the report didn’t find a significant change from previous years — about 42 percent compared to 46 percent in 2002. The most common reason among those not sexually active was religious or moral objection to premarital sex, the same as 2002.

However, some of the results weren’t so expected. Blogs such as ** call attention to the 10 percent of females ages 18 to 24 who had sex before the age of 20 and “really didn’t want it to happen at that time” and the 14 percent of female teens who would be "a little pleased" or "very pleased" if they got pregnant.

But the new rhythm method statistic is giving me the blues. The percentage of teens who are using what the study calls the “less effective” method increased from 11 percent in 2002 to 17 percent in 2006 to 2008. The rhythm method simply isn’t the best option for teens, but until birth control becomes more accessible, affordable and — most importantly — safer, *it will remain an attractive, although incredibly reckless, option. 

For those unfamiliar, the calendar or rhythm method is part of fertility awareness birth control. It requires a woman to keep track of her fertility cycle and essentially avoid having sex on days when she’s most likely to conceive. According to the CDC, if a woman has a regular menstrual cycle, she has about nine or more fertile days each month. If she doesn’t want to get pregnant, she doesn’t have sex on those days.

This method is about 75 to 99 percent effective at preventing pregnancy. Planned Parenthood reports that between 12 and 25 out of every 100 couples who use fertility awareness-based methods each year will have a pregnancy if “they don't always use the method correctly or consistently.” (Copper IUDs and Mirena are more than 99 percent effective. Oral contraceptives, birth control patches and the NuvaRing are 92 to 99 percent effective and male condoms work 85 to 98 percent of the time.) The problem is with the phrase “If a woman has a regular menstrual cycle.” Because of hormonal changes, most female teens don’t.

It’s possible that teens are using the rhythm method in addition to other forms of birth control, but the study also found that that oral pill and injectable contraceptive use has not significantly changed since 2002. Although these two facts combined do not necessarily mean teens are at a greater risk of contracting STDs or becoming pregnant, it does conclude that the lack of change in risky behaviors between 2002 and 2006 to 2008 is consistent with recent trends in teen pregnancy. Not to mention that between 1988 and 2002 when there were declines in sexual activity and increases in contraceptive use among teens, there was a decrease in teen pregnancy and birth rates.

The reasons why teens are using the rhythm method aren’t outlined, but accessibility, affordability and safety are all good guesses. Even though obtaining other means of birth control is much easier than previously, it still isn’t exactly a piece of cake. Resources like Planned Parenthood offer affordable birth control, but unless a parent is willing to use health insurance to pay for contraceptives such as oral birth control pills, it can be expensive. This also hinges on parents and teens being comfortable enough to talk to each other about sex, and if I’ve learned anything from watching the teen drama “The Secret Life of the American Teenager,” it’s that not even brat-pack-teen-queen-turned-sitcom-mom Molly Ringwald can give an effective sex talk. I’d venture to guess that real-life parents don’t have it much easier.

Also, even if price or general lack of sexual health knowledge isn’t an issue, other means of birth control often come with health risks. For instance, Yaz, a pill often prescribed to younger women because it regulates menstrual cycles and treats acne, has been recently linked to a greater risk of blood clots. IUDs can come loose, or in rare instances, implant themselves in the wearer’s uterus. The choice becomes a balancing act, but as Planned Parenthood points out, it’s safer than childbirth.

The rhythm method isn’t a bad way to go for older women with regular cycles, those in committed relationships or for those who use it with other contraception, but it shouldn’t be the first line of defense for teens.

Amanda Woytus is the managing and calendar editor for Vox Magazine and a copy editor for the Missourian.


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Laura Wershler June 9, 2010 | 2:22 p.m.

Dear Amanda,

I appreciate the thoughtfulness of your column on the subject of teen girls and the rhythm method. At the same time I am concerned about the confusion caused by your interchangeable use of the terms “fertility awareness”, “natural family planning” and “rhythm method”. You have left the impression that these distinct methods of natural birth control are one and the same. Unfortunately, this misrepresentation of natural birth control methods, and the misleading information presented about how they work and how effective they are, is very common in media stories about the subject.

I wrote about this same story for re:cycling, the blog of the Society for Menstrual Cycle Research: I also co-wrote the information on Natural Birth Control Methods for the website managed by the Society of Obstetricians and Gynecologists of Canada:

I hope both these links will help you expand your knowledge and understanding of natural birth control methods. As a young journalist, you will have many future opportunities to provide the public with accurate information about this topic.

All the best,
Laura Wershler
Executive Director, Sexual Health Access Alberta

(Report Comment)
Amanda Woytus June 9, 2010 | 4:31 p.m.

Hi Ms. Wershler,

Thank you for your comment. In the writing process, I realized that I should make the distinction between natural family planning and the rhythm method, because, you're right, they're two different things. In the editing process, one of the references was not changed. It has been changed now.

(Report Comment)
Ellis Smith June 9, 2010 | 5:03 p.m.

Reminds me of a very old joke:

Q: What is another designation for couples who practice the rhythm method of birth control?

A: Parents.

I believe that actually appeared once upon a time in the Readers' Digest magazine.

(Report Comment)

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