The beads, my boy, the beads don't lie

A New Bead on Birth Control

It looks like an uncommonly ugly necklace, made up of 32 oblong plastic beads. Slightly more than half are a translucent amber brown, a dozen are white, like piña colada jelly beans. One bead in the center is throat-lozenge red, and next to it is a small black plastic cylinder, which bears the necklace's brand name: CycleBeads.

CycleBeads are not jewelry, exactly. They're integral to a new pregnancy-prevention method called the Standard Days Method, developed at the Institute for Reproductive Health (IRH) at Georgetown University.

The necklace is a tool that helps a woman track her menstrual cycle: Slide the little black gasket onto the fat part of the red bead on the first day of a period. Then advance that gasket across the brown beads, at the rate of one a day. When the gasket reaches the 12 white beads, pregnancy is likely if a woman has unprotected sex. (This danger zone is easy to confirm in the darkness of the bedroom, since the white beads glow in the dark.) After the gasket slides past the white beads, it resumes its march across brown beads, and pregnancy is unlikely once more.

According to two studies in the peer-reviewed journal Contraception -- one published this year and one two years earlier -- the method, used correctly, is more effective than a diaphragm and nearly as effective as a condom. ...

CycleBeads are the latest variation on one of the oldest methods of birth control: periodic abstinence, commonly known as the rhythm method. Of course, the old joke about people who use the rhythm method is that they're called parents. But experts say gains in knowledge about women's fertility make "natural family planning" methods far more dependable than they were decades ago. ...

The catch: They require more effort than taking a pill, slapping on a contraceptive patch or slipping on a condom. Today's methods -- which include the basal body temperature method, ovulation/cervical mucus method and the symtothermal method -- all depend on pinpointing the day a woman ovulates, so she can avoid unprotected intercourse and therefore pregnancy. ...

CycleBeads are Georgetown's attempt to make natural family planning user-friendly: no thermometer, no cervical mucus, no math -- just move that black rubber gasket across a bead each day.

This approach just might appeal to women who don't want to take the pill or can't do so (because of a history of blood clots, for example), or who are put off by a barrier method of contraception, or who are religiously opposed to medical contraception, says Lawrence B. Finer, associate director for domestic research at the Alan Guttmacher Institute in New York. ...

Until recently, medical experts have had a poor track record at pinpointing when a woman is likely to ovulate each month. In the late 19th century, doctors assumed that women ovulated just before menstruation, as many animals do, explains Andrea Tone, a professor in the social studies of medicine at McGill University in Montreal.

"Doctors advised women wishing to avoid pregnancy to have intercourse only mid-cycle," said Tone, the author of "Devices and Desires, A History of Contraceptives in America" (Hill and Wang, 2001). This meant that women were advised that pregnancy was unlikely at precisely the moment when they were most likely to conceive. ...

It wasn't until the 1920s that surgical retrieval of eggs from the fallopian tubes revealed that women tend to ovulate sometime around the middle of their cycle. ...

"The Standard Days Method isn't right for everyone," said Jennings. "It's only appropriate for women who have regular cycles of 26 to 32 days long. Women with cycles longer or shorter than that should use another method." (Indeed, if a woman using CycleBeads discovers that she has more than one cycle that is "out of bounds," the package insert instructs her to find another method of family planning.) ...

Of course, the big question for CycleBeads users is, what does a couple do if the woman is in her fertile period but they're in the mood? The question is not just hypothetical. A study by Wilcox published last month in the journal Human Reproduction found that the six days of the month when a woman was most likely to have sex are the same six days as her fertile window -- whether or not a couple is planning to conceive a child.

Wilcox suggests that ovulation may be tied to changes in libido or feelings of attractiveness that make intercourse more likely or be linked to increased secretions of pheromones, chemicals though to communicate sexual desire. ...