S2k-Guideline Non-hormonal Contraception, Part 1: Natural Family Planning, Lactational Amenorrhea, Barrier Methods, Coitus Interruptus

Abstract

Aim This official guideline was published and coordinated by the DGGG, OEGGG and SGGG with the involvement of other medical societies. The aim was to provide a consensus-based overview of non-hormonal forms of contraception based on an evaluation of the relevant literature. The first part of these summarized statements and recommendations presents natural family planning methods such as lactational amenorrhea, barrier methods and coitus interruptus. The second part will focus on intrauterine devices and sterilization methods.

Methods This S2k-guideline was developed by representative members from different medical professions on behalf of the guidelines commission of the DGGG, OEGGG and SGGG using a structured consensus process.

Recommendations The guideline provides recommendations on the indications for, safety of use, benefits, and limitations of the different methods as well as recommendations on providing advice and other aspects of non-hormonal contraception. Natural family planning methods, lactational amenorrhea, barrier methods and coitus interruptus are discussed.

Keywords

guideline - side effects - alternative contraception - effectiveness - pregnancy - Pearl Index

Publication History

Received: 27 April 2024

Accepted: 29 April 2024

Article published online:
06 August 2024

• References

• 1 Bundeszentrale für gesundheitliche Aufklärung. Verhütungsverhalten Erwachsener. 2020 Accessed August 15, 2023 at: https://shop.bzga.de/verhuetungsverhalten-erwachsener-2020-13317300
• 2 Bitzer J, Oppelt PG, Deten A. Evaluation of a patient-centred, needs-based approach to support shared decision making in contraceptive counselling: the COCO study. Eur J Contracept Reprod Health Care 2021; 26: 326-333
• 3 Bundeszentrale für gesundheitliche Aufklärung. Verhütungsverhalten Erwachsener. Ergebnisse der repräsentativen Befragung 2018. Accessed August 15, 2023 at: https://shop.bzga.de/verhuetungsverhalten-erwachsener-2020-13317300
• 4 Trussell J. Contraceptive failure in the United States. Contraception 2011; 83: 397-404
• 5 Raith-Paula E, Frank-Herrmann P. Natürliche Familienplanung heute. 6. Aufl.. Berlin, Heidelberg: Springer; 2020
• 6 Pearl R. Factors in human fertility and their statistical evaluation. The Lancet 1933; 222: 607-611
• 7 Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. Journal of the American Statistical Association 1958; 53: 457-481
• 8 Trussell J, Grummer-Strawn L. Contraceptive failure of the ovulation method of periodic abstinence. Fam Plann Perspect 1990; 22: 65-75
• 9 Trussell J, Grummer-Strawn L. Further analysis of contraceptive failure of the ovulation method. Am J Obstet Gynecol 1991; 165: 2054-2059
• 10 World Health Organization and Johns Hopkins Bloomberg School of Public Health. Center for Communication Programs SaRHaR. Family Planning – A global handbook for providers. 2022 Accessed November 21, 2023 at: https://www.who.int/publications/i/item/9780999203705
• 11 Sundaram A, Vaughan B, Kost K. et al. Contraceptive Failure in the United States: Estimates from the 2006–2010 National Survey of Family Growth. Perspect Sex Reprod Health 2017; 49: 7-16
• 12 Peragallo Urrutia R, Polis CB, Jensen ET. et al. Effectiveness of Fertility Awareness–Based Methods for Pregnancy Prevention: A Systematic Review. Obstet Gynecol 2018; 132: 591-604
• 13 Prospective European multi-center study of natural family planning (1989–1992): interim results. The European Natural Family Planning Study Groups. Adv Contracept 1993; 9: 269-283
• 14 Prospective European multicenter study of natural family planning (1989–1995): efficacy and drop-out. The European Natural Family Planning Study Groups. Adv Contracept 1999; 15: 69-83
• 15 Frank-Herrmann P, Freundl G, Baur S. et al. Effectiveness and acceptibility of the symptothermal method of natural family planning in Germany. Am J Obstet Gynecol 1991; 165: 2052-2054
• 16 Frank-Herrmann P, Freundl G, Gnoth C. et al. Natural family planning with and without barrier method use in the fertile phase: efficacy in relation to sexual behavior: a German prospective long-term study. Adv Contracept 1997; 13: 179-189
• 17 Frank-Herrmann P, Heil J, Gnoth C. et al. The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a coupleʼs sexual behaviour during the fertile time: a prospective longitudinal study. Hum Reprod 2007; 22: 1310-1319
• 18 Van der Wijden C, Manion C. Lactational amenorrhoea method for family planning. Cochrane Database Syst Rev 2015; 2015 (10) CD001329
• 19 Schwartz JL, Weiner DH, Lai JJ. et al. Contraceptive efficacy, safety, fit, and acceptability of a single-size diaphragm developed with end-user input. Obstet Gynecol 2015; 125: 895-903
• 20 Kulier R, OʼBrien PA, Helmerhorst FM. et al. Copper containing, framed intra-uterine devices for contraception. Cochrane Database Syst Rev 2007; (04) CD005347
• 21 Rowe P, Farley T, Peregoudov A. et al. Safety and efficacy in parous women of a 52-mg levonorgestrel-medicated intrauterine device: a 7-year randomized comparative study with the TCu380A. Contraception 2016; 93: 498-506
• 22 Heinemann K, Reed S, Moehner S. et al. Comparative contraceptive effectiveness of levonorgestrel-releasing and copper intrauterine devices: the European Active Surveillance Study for Intrauterine Devices. Contraception 2015; 91: 280-283
• 23 Trussell J, Strickler J, Vaughan B. Contraceptive efficacy of the diaphragm, the sponge and the cervical cap. Fam Plann Perspect 1993; 25: 100-105 135
• 24 Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines. 2021 Accessed November 23, 2023 at: https://www.cdc.gov/std/treatment-guidelines/default.htm