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Natürliche Familienplanung – aktueller Stand

Natural family planning – current status

  • Leitthema
  • Published:
Der Gynäkologe Aims and scope

Zusammenfassung

Hintergrund

Natürliche Familienplanung (NFP) ist ein Sammelbegriff für zahlreiche Methoden, die sich hinsichtlich Sicherheit, Praktikabilität und Akzeptanz erheblich unterscheiden. NFP-Methoden beruhen auf der Erkennung des fertilen Fensters und der Beschränkung des ungeschützten Sexualverkehrs auf die nichtfruchtbaren Tage.

Ziel der Arbeit

Um Orientierung zu ermöglichen, hat die Deutsche Gesellschaft für Gynäkologische Endokrinologie und Fortpflanzungsmedizin (DGGEF) eine Leitlinie zum aktuellen Stand der natürlichen Familienplanungsmethoden verfasst.

Methodik

Herangezogen wurden wissenschaftliche Publikationen („peer reviewed“) zur Empfängniswahrscheinlichkeit innerhalb der fertilen Phase und zur kontrazeptiven Sicherheit natürlicher Methoden der letzten 30 Jahre, deren Daten überwiegend aus prospektiven Kohortenstudien mehrerer europäischer und amerikanischer Datenbanken sowie einer WHO-Datenbank stammen.

Ergebnisse

Bei heutigen NFP-Methoden beobachten die Anwenderinnen Veränderungen von Körpersymptomen im aktuellen Zyklus, sie sind daher nicht mehr auf einen regelmäßigen Zyklus angewiesen. Die alten Kalendermethoden sind zumindest im europäischen Kontext obsolet. Unter den verschiedenen NFP-Methoden wird aktuell die Sensiplan®-Methode empfohlen, da sie wissenschaftlich überprüft ist und in die Kategorie der sehr sicheren Familienplanungsmethoden eingeordnet werden kann (Methodensicherheit 0,4 Schwangerschaften/100 Frauenjahre). Einige andere NFP-Methoden, auch Zykluscomputer, weisen eine mittlere Sicherheit auf, häufig fehlen jedoch entsprechende Studien.

Diskussion

Die guten Ergebnisse mit der Sensiplan®-Methode wurden nach Beratung durch ausgebildete NFP-Berater/innen erreicht. Ob die hohe kontrazeptive Sicherheit auch nach Information durch qualifizierte Internet-Ressourcen gegeben ist, sollte überprüft werden.

Abstract

Background

Natural family planning (NFP) is a collective term for a variety of methods that differ considerably in efficacy, practicability and acceptability. The NFP methods are based on knowledge of the fertile window and the restriction of unprotected sexual intercourse to only non-fertile days. They are also known by the term fertility awareness based methods (FAM).

Aim

To facilitate orientation the German Society for Gynecological Endocrinology and Reproductive Medicine has compiled guidelines regarding the current status of the methods of NFP.

Methods

Scientific publications (peer reviewed) concerning the probability of conception within the fertile window and the contraceptive efficacy of natural methods from the last 30 years were included. The data are predominantly derived from prospective cohort studies of several European and American databases and from a World Health Organization (WHO) database.

Results

In modern NFP methods users observe changes in body symptoms during the current cycle. They are therefore no longer dependent on a regular cycle. The old calendar methods are obsolete, at least in the European context. Of the different NFP methods, the Sensiplan method is the one that is currently recommended because it has been scientifically validated and can be assigned to the category of very effective family planning methods (method-related efficacy of Sensiplan 0.4 pregnancies/100 women years). Several other NFP methods, including cycle monitors, offer an average efficacy; however, efficacy studies for many natural methods are often lacking.

Discussion

The good results with the Sensiplan method were achieved after counseling by trained NFP teachers. Whether this high contraceptive efficacy is also achieved after information through qualified internet sources should be investigated.

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Author information

Authors and Affiliations

  1. Abt. Gynäkologische Endokrinologie und Fertilitätsstörungen der Universitätsfrauenklinik, Universitätsklinikum, Im Neuenheimer Feld 440, 69120, Heidelberg, Deutschland

    Petra Frank-Herrmann, T. Rabe & T. Strowitzki

  2. Sektion Natürliche Fertilität der Deutschen Gesellschaft für Gynäkologische Endokrinologie und Fortpflanzungsmedizin, Universitätsklinikum, Heidelberg, Deutschland

    S. Baur, G. Freundl & C. Gnoth

Authors
  1. Petra Frank-Herrmann
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  2. S. Baur
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  3. G. Freundl
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  4. C. Gnoth
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  5. T. Rabe
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  6. T. Strowitzki
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Correspondence to Petra Frank-Herrmann.

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Interessenkonflikt

P. Frank-Herrmann, S. Baur, G. Freundl, C. Gnoth, T. Rabe und T. Strowitzki geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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M. Ludwig, Hamburg

T. Strowitzki, Heidelberg

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Frank-Herrmann, P., Baur, S., Freundl, G. et al. Natürliche Familienplanung – aktueller Stand. Gynäkologe 48, 657–666 (2015). https://doi.org/10.1007/s00129-015-3758-0

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