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Amanda Zamani of Asheville, N.C., never really liked hormonal birth control and its effects on her body. She had a hard time remembering to take a birth-control pill at the same time every day, and she felt that the hormones exacerbated her emotional ups and downs.

"As a whole, I just try to avoid taking extra medications," said the mother of two toddlers. "I don't steer towards medicine as the first route for headaches or colds."

…[I]n 2006, she saw CycleBeads on sale at a health food store. A string of 32 color-coded beads, CycleBeads identify the 12 days in a woman's menstrual cycle during which she is likely to be fertile. Being aware of the days on which pregnancy is most likely can be helpful both for women who are looking to become pregnant — and for women such as Zamani who are not.

Zamani, 25, now keeps her CycleBeads in her bathroom and moves the black ring that is used to track days onto the next bead each morning.

"It's very helpful," she said. "I'm not planning on changing."

Deciding against the pill

Zamani is part of a small but dedicated number of women who are practicing medication-free birth control with a clinically tested approach that is part of their desire to embrace a back-to-basics lifestyle.

According to the Centers for Disease Control and Prevention's most recent study on the use of contraception and family planning services in the United States, 0.7 percent of women were using the calendar/rhythm method in 2002, and 0.2 percent were using other natural family planning methods.

Though use of the rhythm method has declined over time, from 1.8 percent in 1982, other natural family planning methods have remained steady. CycleBeads work in conjunction with one of them, the Standard Days Method, which was created by the Institute for Reproductive Health at Georgetown University in 2002 and now has an estimated 50,000 users in the United States and more than half a million women around the world, according to IRH.

Over the years, natural methods have not been given much credence: As the old joke goes, "What do you call people who use the rhythm method? Parents." But the Standard Days Method is backed by research that shows it is 95 percent effective if used correctly, according to IRH.

That is still not as effective as methods such as the pill (which is more than 99 percent effective when used correctly, according to Planned Parenthood), but for many women, natural family planning is a lifestyle choice beyond just birth control.

"I want to be connected to my body and know how I'm feeling," said Suran Thrift, a freelance writer in Los Angeles, noting that her decision to use CycleBeads was "part of an overall desire to educate myself more about my health and alternative means to health."

Learning about cycles

IRH set out to create a natural method that was based on research. It took data of more than 7,500 menstrual cycles obtained from the World Health Organization and calculated the probability of pregnancy on different cycle days, coming up with a formula that provided maximum protection, while minimizing the number of days of avoiding unprotected intercourse.

The Standard Days Method has a longer window of consecutive days of possible fertility than most other natural methods, and it works only for the estimated 80 percent of women who have regular cycles of 26 to 32 days. But with perfect use, it is effective 95 percent of the time, according to a study done by IRH. It has been particularly popular in developing nations.

"To our surprise, people in other settings where family planning was readily available, there was a spark of interest there as well," said the IRH director, Dr. Victoria Jennings. "There has become more interest in a method that works with your body and that maybe helps you learn something about your body, as opposed to a method that suppresses your body's normal function."

Methods like the pill and intrauterine device have proved to be safe and effective, but some women do experience side effects like nausea or emotional ups and downs with the pill and cramps or backaches with the IUD.

But what confounds experts like Dr. Rebekah Gee, an obstetrician/ gynecologist and clinical scholar at the University of Pennsylvania, is the lack of knowledge among women concerning what is happening inside the body.

"It's amazing what women don't know about their bodies and their cycles," Gee said. "Anything that they can use that helps them better understand their cycles and [their chances] for getting pregnant is a good thing."

"I think even when my daughter is old enough and starts her cycle, I would get them for her," Amanda Zamani said of CycleBeads. "Just to be aware of her cycle better than I was when I was younger."
[24March2008, Julie Onufrak, Columbia News Service,; PharmFacts E-News Update, 26 Mar 2008,]