The Ogino method, withdrawal, symptothermal method, cervical mucus observation... The term "natural contraception" encompasses approaches that have absolutely nothing in common. Some are as reliable as the contraceptive pill. Others are barely better than crossing your fingers tightly. The problem is that many gynecologists lump them all together with a resounding "it's dangerous, you'll get pregnant."
Ultimately, some women use completely ineffective methods believing they are protected, while others forgo serious alternatives out of fear. This article classifies 7 natural contraception methods, from riskiest to most reliableWith supporting figures, so you know exactly what to expect.
The main thing to remember
- La symptothermal method : the most reliable (98-99,6%), combines temperature + cervical mucus + daily rigor
- La MAMA method Very effective (98%), but only 6 months after childbirth, under strict conditions.
- The withdrawal and Ogino The worst cases (76-78%) have a high risk of unwanted pregnancy.
- They all require rigor A natural method applied incorrectly = almost guaranteed pregnancy
- Necessary learning 3 to 6 months of training with a symptothermal method consultant
- They do NOT protect against STIs : condom required if multiple or casual partners
- Not for everyone Irregular cycles, stress, postpartum = compromised effectiveness
Why a Ranking of Natural Methods
When we say "natural contraception," we're actually talking about methods that have nothing to do with it. There's a huge difference in effectiveness between the rigorous symptothermal method practiced for years by a trained woman, and the guy who withdraws "at the right time" thinking that's enough.
The problem is that all these methods are often lumped together under the umbrella of "natural contraception" with an average failure rate that is meaningless. Some are as effective as the contraceptive pillOthers have a failure rate of 24%which means that one in four women will become pregnant within the year.
⚠️ Important reminder
The Pearl Index measures the number of unintended pregnancies per 100 women during one year of use. The lower the index, the more effective the method. An index of 2 = 98% effectiveness. An index of 24 = 76% effectiveness.
The Complete Ranking: An Overview
Before you dietailleFor each method, a quick overview to know where you're going.
Detailed Methods (From Worst to Best)
Let's review each method, with what works, what doesn't work, and most importantly: the real reasons why some are catastrophic.
7️⃣ The Ogino Method (Calendar): Absolutely Avoid
The Ogino method involves calculating your fertile period solely based on your previous cycles. You count the days since the start of your period, do some simple calculations, and then say, "Okay, I'm fertile from day 10 to day 17, so I'll avoid those days."
Why it's bad Because ovulation doesn't follow a fixed schedule. Even in women with regular cycles, it can vary by 3 to 5 days from one month to the next due to stress, travel, illness, weight changes, etc.
Why doesn't it work?
- Prediction based on the past Your body isn't a clock. What happened in the last three months doesn't guarantee anything for this month.
- No real-time observations You don't know for sure if you're actually ovulating on day 14; you're just guessing.
- Irregular cycles = disaster If your cycles vary from 25 to 35 days, the method is unusable.
- Sperm survive 5 days Even if you avoid the "good days," intercourse on day 9 can lead to pregnancy if you ultimately ovulate on day 12.
💔 Our verdict Absolutely avoid this. If you really don't want to get pregnant, this method is a game of Russian roulette. One in four women will get pregnant within a year. It's almost as unreliable as using nothing at all.
6️⃣ Withdrawal (Interrupted Coitus): The Persistent Myth
The man withdraws before ejaculating. Simple, free, immediate. And completely random in terms of effectiveness.
Why doesn't it work well? Even when withdrawing "in time," pre-ejaculate (the fluid released before ejaculation) can contain sperm. Not always, but often enough to make the method unreliable.
The problems of withdrawal
- Pre-ejaculatory fluid contains sperm Especially if there has been recent ejaculation (even a few hours before).
- Demands perfect control The man must withdraw at the right time, every time, without exception.
- The pleasure is reduced For both partners, the end of the encounter is stressful rather than pleasurable.
- It rests solely on man The woman has no control
Forum testimony "We used the withdrawal method for 2 years without any problems. And then one evening, bam, pregnant. My boyfriend swears he withdrew on time as usual. Surprise baby at 23."
The withdrawal works... until the day it stops working. And you never know when that day will come.
💔 Our verdict Better than nothing, but barely. Withdrawal can be a useful backup on occasion, but using it as your primary contraception is like playing Russian roulette. A 22% failure rate is enormous.
5️⃣ Simple Periodic Abstinence: Approximate
Abstaining or using a condom during an "estimated" fertile period is done without really observing one's body. It's better than the Ogino method or withdrawal, but it's still approximate.
The difference with the following methods (Billings, temperature, symptothermal method) is that you don't make rigorous daily observations. You rely on vague signs, feelings, or an approximate calculation.
⚖️ Our verdict It might work for women who are very attuned to their bodies and have ultra-regular cycles, but it's too imprecise to be truly reliable. A failure rate of 15 to 25% is far too high if a pregnancy would be problematic.
4️⃣ Basal Temperature Alone: Better, But Incomplete
You take your temperature every morning upon waking, before getting out of bed, using a thermometer accurate to two decimal places. After ovulation, the temperature rises by 0,3 to 0,5°C and remains elevated until menstruation.
How it works Progesterone, secreted after ovulation, raises body temperature. Once the temperature has risen for 3 consecutive days, you are in the infertile phase until your next period.
Advantages of temperature alone
- Objective observation: a number on a thermometer
- Confirms with certainty that ovulation has occurred
- Easy to learn and to take notes
Limits of temperature alone
- Indicates ovulation AFTER it has occurred You cannot predict the fertile period, only confirm that it has passed.
- Sensitive to disturbances: fever, restless sleep, alcohol, and jet lag can skew the results.
- Long fertile period: Without observing cervical mucus, you must abstain from intercourse from day 1 of your cycle until 3 days after your temperature rise.
- No early warning: You don't know you're entering your fertile phase
⚖️ Our verdict While reasonably effective (95%), this method is incomplete. Temperature alone forces you to abstain for almost half your cycle. That's why the symptothermal method (temperature + cervical mucus) is much more practical and reliable.
3️⃣ The Billings Method (Cervical Mucus Alone): Good But Insufficient
The Billings method involves observing the appearance of your cervical mucus (vaginal secretions) daily. The mucus changes during the cycle: absent or thick at the beginning of the cycle, it becomes creamy, then liquid, then clear and stretchy ("egg white") at the time of ovulation.
How it works As soon as you see cervical mucus, you are potentially fertile (sperm can survive for 5 days in fertile mucus). After the peak of mucus production (clear, stretchy mucus), it dries up abruptly. Four days after the peak, you are infertile until your next period.
Advantages of cervical mucus alone
- Detects the approach of ovulation BEFORE it happens
- It allows for a reduction in the abstinence period compared to temperature alone.
- Works even with irregular cycles
- Requires no equipment
Limits of mucus alone
- Subjective observation The appearance of the mucus can be difficult to interpret at first.
- Possible interferences: vaginal infections, semen, sexual arousal, and lubricants can interfere with observation.
- Learning curve: It takes several cycles to properly recognize the different types of mucus.
- No confirmation of ovulation: You suspect it has occurred, but without certainty.
Blog testimonial "I used the Billings method for 2 years. It worked well but I always had a doubt: did I really identify my peak correctly? Was it really fertile cervical mucus or just... something else? I switched to symptothermal charting to get confirmation with temperature."
✅ Our verdict Good effectiveness (95-97%) but based on a single indicator. Works well for women who are very attuned to their bodies, but symptothermal methods (cervical mucus + temperature) offer valuable additional security.
2️⃣ Breastfeeding (LAM): Very Effective But Temporary
The Lactational Amenorrhea Method (LAM) is based on the fact that exclusive breastfeeding blocks ovulation in most women during the first few months after childbirth. Prolactin, the hormone responsible for milk production, inhibits ovulation when secreted in large quantities.
Approved by the WHO with an efficiency of 98-99% when all conditions are met.
The 3 MANDATORY conditions for the MAMA to work
- Your baby is less than 6 months old
- You haven't received your period yet. since childbirth (possible spotting)
- Exclusive breastfeeding No bottle, no pacifier, maximum 15% supplements
- Strict frequency : breastfeeding every 4 hours during the day and every 6 hours at night
- As soon as even one condition is no longer met, efficiency drops drastically.
⚠️ Warning: Situations where the MAMA no longer works
- Your baby is sleeping through the night (no longer nurses every 6 hours at night)
- You return to work and breastfeed less frequently
- You are introducing a variety of foods
- You have a return of menstruation (even a slight one).
- Your baby is over 6 months old
✅ Our verdict Excellent effectiveness (98%) for a very limited period (maximum 6 months). Perfect for spacing pregnancies immediately after childbirth, but requires another form of contraception as soon as the conditions are no longer met.
1️⃣ Symptothermal Method: The Most Reliable Method
Symptothermal methods combine the observation of basal body temperature AND cervical mucus. This combination is what makes all the difference compared to previous methods.
Effectiveness validated by the WHO : Pearl Index of 0,4 to 2 according to studies, i.e. an effectiveness comparable to the contraceptive pill (theoretical Pearl Index of 0,3, but typical of 9 with missed doses).
How does the symptothermal method work?
The symptothermal method identifies your fertile window by combining two independent biomarkers:
1. Cervical mucus ("sympto")
It signals the approach of ovulation. As soon as you see cervical mucus, you are potentially fertile. Fertile cervical mucus resembles egg white: clear, stretchy, and elastic.
2. Basal temperature ("thermie")
She confirms that ovulation has occurred. After ovulation, the temperature rises by 0,3 to 0,5°C and remains elevated until the next period.
The fertile window closes when The mucus dried up AND the temperature rose for 3 consecutive days. This double verification makes the method extremely reliable.
What it actually requires
Daily during the fertile period
- Take your temperature every morning upon waking, before getting out of bed (30 seconds)
- Observe your cervical mucus several times a day.
- Record your observations on a graph or application
- Abstain from sex or use a condom for approximately 8 to 12 days per cycle (fertile period)
Learning time
- 3 to 6 months of training with a certified consultant (Sensiplan, MAO, Cyclamen, Sympto...)
- Several observation cycles before using the method for contraception
- Initial investment: thermometer with two decimal places (~€10) + training (free to €200 depending on the method)
Advantages and Disadvantages
User Testimonials
Margot, 30 years old, 5 years of symptothermal charting "If I had to sum up my five years of practice, I would say that I regret not having discovered it sooner. Zero surprise pregnancies, zero side effects, a restored libido after stopping the pill."
Pauline, 32 years old, pharmacist "As a pharmacist, I had a very negative bias towards natural methods. Ogino and the like, for me it was just folklore. Then I discovered symptothermal methods and their Pearl Index of 99,4% in theory and 98% in practice. I was blown away. After training, I have been using it for 2 years without any problems."
Celia, symptothermal method blog "Symptomatic contraception is more than just a method. It's a true lifestyle that brings satisfaction without health risks. It strengthens the couple's bond through the variations of the cycle. My sweetheart is involved in my contraception, and that changes everything."
🏆 Our verdict The most reliable natural method available (98-99,6%), provided you are properly trained and follow the instructions rigorously. It requires discipline but offers comparable effectiveness to the pill without any hormonal side effects.
For Whom Do Natural Methods (Really) Work?
Not all natural methods are suitable for every situation. Some profiles are much more likely to succeed than others.
Profiles for Whom It Works Well
✅ Recommended natural methods
- If you have relatively regular cycles (between 25 and 35 days)
- You are rigorous and organized in your daily life
- You are in a stable relationship and your partner gets involved
- You can accept abstinence or condoms 8-12 days per month
- You want to truly understand your body and are ready to invest time in learning
- A pregnancy, although unwanted, would not be not catastrophic for you
- You refuse hormones for medical or personal reasons
Situations Where It Is Not Recommended
❌ Natural methods are not very suitable
- Very irregular cycles If your cycles vary from 20 to 45 days, tracking becomes very complicated.
- Postpartum The first few cycles after childbirth are unpredictable (except for the first 6 months with LAM).
- pre-menopause The cycles become chaotic, making observation almost impossible.
- Chronic stress Disrupts ovulation and makes cycles unpredictable
- Night work or irregular hours Taking a temperature becomes complicated
- adolescence The cycles are not yet stabilized.
- Multiple or occasional partners The condom remains mandatory (STI), so you might as well rely solely on it.
- A pregnancy would be dramatic Even a 2% failure rate is too high if a pregnancy would ruin your life.
How to Train in Symptothermal Methods
If you are interested in the symptothermal method, don't try it alone. Training with a certified advisor is essential to guarantee the method's effectiveness.
The Main Schools of Symptothermal Method
📚 Recommended books for beginners
- "The female cycle and natural contraception" by Audrey Guillemaud (also available in a beginner's version)
- "Become aware of your fertility" by Rose Bianchi
- "The Sensiplan Manual" by the Sensiplan Association
These books are a good start, but they do not replace personalized guidance.
Are you pregnant or trying to conceive?
Symptothermal methods also work to optimize your chances of pregnancy by precisely identifying your fertile window.
Natural Contraception: Yes, But Not Just Any Kind
Not all natural methods are created equal. Some are as reliable as the pill (symptothermal method at 98-99,6%). Others are only slightly better than guesswork (Ogino method at 76%, withdrawal at 78%). The difference between the two lies in the rigor of the observation and the combination of several biomarkers.
If you reject hormones and are willing to invest time in learning, the symptothermal method is a serious and effective alternative. It requires daily discipline, but it works. The numbers prove it, studies confirm it, and testimonials attest to it.
On the other hand, if you rely on withdrawal, the Ogino method, or approximate calculations, you're playing Russian roulette. An unwanted pregnancy is almost guaranteed within a year. Seek guidance from a certified counselor, learn thoroughly, and natural contraception can truly be a viable option.
Sources & Scientific References
This article is based on scientific studies published and validated by the WHO.
Effectiveness of the symptothermal method
- Frank-Herrmann P, et al. (2007). 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. DOI: 10.1093/humrep/dem003
- WHO. (1981). A prospective multicenter trial of the ovulation method of natural family planning. II. The effectiveness phase Fertility and Sterility. DOI: 10.1016/S0015-0282(16)45856-5
Natural contraception methods
- Pallone SR, Bergus GR. (2009). Fertility awareness-based methods: another option for family planning. Journal of the American Board of Family Medicine. DOI: 10.3122/jabfm.2009.02.080038
- Trussell J. (2011). Contraceptive failure in the United States. Contraception. DOI: 10.1016/j.contraception.2011.01.021
MAMA (breastfeeding)
- WHO. (2024). Lactational amenorrhoea method (LAM). World Health Organization. WHO Fact Sheet
Medical Warning: This article is for informational purposes only and is not a substitute for medical advice. To choose the right contraception, consult a healthcare professional and seek training from a certified counselor.
