Can I Still Use NFP in Perimenopause?
Question
I am now well into the perimenopausal stage of my female life cycle and with that I have had an almost complete loss of cervical mucous. I have also had a number of years of closely watched gynecological exams due to dryness and tissue atrophy. My doctor thinks I should go on some form of birth control since I may be in for another five years before menopause but my husband and I both wish to stay with NFP. We had been mainly using the mucous observation method since my temperatures were erratic. What can you suggest for us? Pam
Answer
Last Updated: November 20, 2014
Dear Pam-
Unfortunately there is a lot of confusion about the perimenopausal years. Yes, most women want to avoid pregnancy at that time of their lives. Yet, why use a product when the ingredients of it have been placed on the Human Carcinogen List (2002) in the US and by the research arm of the World Health Organization?
There are things you can do and happily continue to use NFP. It seems that the medical concern is vaginal atrophy and dryness. This can be treated with bio-identical hormone cream. This is estrogen cream that is identical to what your body makes and in the same proportions. For instance, Premarin cream contains estradiol (5-19%), estrone (75-80%), and Equilin (5-15%). Estrone seems to be associated with hormone associated cancers. Bio-identical hormones (made by a compounding pharmacist) contains the same profile of human estrogen: Estradiol (10-20%), Estrone (10-20%), Estriol (60-80%).
If the only symptom of lower estrogen levels is vaginal atrophy and dryness, then you could use the vaginal cream to help alleviate those symptoms. Yes, you do get systemic absorption with using vaginal creams. And yes, you may get interference with reading your cervical mucus signs. You could consult with an NFP teacher to help you manage your chart.
Additionally, bio equivalent oral dosing can be used for hot flashes and night sweats, etc. The studies that were done a few years ago were on Premarin (different profile of estrogens) and Provera. The research has not been done on long term effects of bioequivalent hormones for menopausal women. A compounding pharmacist such as at Kubat Pharmacy or professionals at Pope Paul VI Institute, both in Omaha, could help answer concerns about long terms risks.
I hope that this helps!
Gretchen V. Marsh, D.O
Unfortunately there is a lot of confusion about the perimenopausal years. Yes, most women want to avoid pregnancy at that time of their lives. Yet, why use a product when the ingredients of it have been placed on the Human Carcinogen List (2002) in the US and by the research arm of the World Health Organization?
There are things you can do and happily continue to use NFP. It seems that the medical concern is vaginal atrophy and dryness. This can be treated with bio-identical hormone cream. This is estrogen cream that is identical to what your body makes and in the same proportions. For instance, Premarin cream contains estradiol (5-19%), estrone (75-80%), and Equilin (5-15%). Estrone seems to be associated with hormone associated cancers. Bio-identical hormones (made by a compounding pharmacist) contains the same profile of human estrogen: Estradiol (10-20%), Estrone (10-20%), Estriol (60-80%).
If the only symptom of lower estrogen levels is vaginal atrophy and dryness, then you could use the vaginal cream to help alleviate those symptoms. Yes, you do get systemic absorption with using vaginal creams. And yes, you may get interference with reading your cervical mucus signs. You could consult with an NFP teacher to help you manage your chart.
Additionally, bio equivalent oral dosing can be used for hot flashes and night sweats, etc. The studies that were done a few years ago were on Premarin (different profile of estrogens) and Provera. The research has not been done on long term effects of bioequivalent hormones for menopausal women. A compounding pharmacist such as at Kubat Pharmacy or professionals at Pope Paul VI Institute, both in Omaha, could help answer concerns about long terms risks.
I hope that this helps!
Gretchen V. Marsh, D.O
Answered By:
Gretchen Marsh, D.O.
Dr. Marsh graduated from Western University of Health Sciences in 1987 in Pomona, CA and is board certified in Family Medicine by the American Osteopathic Board of Family Physicians. She has been certified as a NaProTechnology® Medical Consultant (NaPro) and Creighton model Fertility Care System (CrMS) teacher since 2001. She and her husband, Jon, have 5 sons and live in the Reno region, where she sees patients in person, in addition to her telehealth services offered via MyCatholicDoctor.com
