Billings method

Billings method: what is it?

The Billings method is a natural contraceptive practice based on the observation - and subsequent evaluation of the appearance - of cervical mucus. In other words, the Billings method allows us to recognize the ovulatory period of the woman through the "simple" subjective analysis of the cervical mucus.

Theoretically, the woman is in full ovulatory phase (corresponding to the period of maximum fertility) when the secreted cervical mucus appears particularly abundant, fluid and filamentous, causing an unpleasant sensation of "wet or wet".

More than a proper contraceptive practice, the Billings method - or Billings ovulation method - should be considered a tool for birth control and natural regulation of fertility . In fact, the Billings method can be used both to avoid pregnancy and to plan it. For example, men and women who do not want children should refrain from unprotected sexual intercourse on days when the cervical mucus has the characteristics just described. Conversely, by identifying the period in which the woman's body is most prone to conception, the couple can use the Billings method to plan a pregnancy.

At first glance, this (anti) conceptional strategy seems infallible. In fact, the effectiveness of the Billings method in avoiding an unwanted pregnancy does not come close to that of barrier contraceptives (eg, female / male condom, diaphragm, etc.), nor to that of hormonal contraceptives (eg estrus pill progestin, contraceptive ring, contraceptive patch etc.).

The Billings method is not very reliable because it does not take into account possible and possible secondary factors that can alter the cervical mucus (eg vaginal infections, administration of some drugs, use of vaginal eggs, stress, etc.).

Interpretation of cervical mucus

Women who use the Billings method as a first choice contraceptive must understand and interpret every tiny signal sent by their body. The Billings practice - as well as all natural contraceptive methods - requires an excellent mastery and awareness of one's body: the woman must learn to grasp the typical modifications of the various phases of the menstrual cycle.

As mentioned, the Billings method involves the analysis of cervical mucus to plan (or avoid) pregnancy.

But how do the characteristics of cervical mucus change during the menstrual cycle?

In every phase of the menstrual cycle, the mucus produced by the glands of the cervix varies - in terms of consistency, appearance and pH - in response to hormonal stimuli.

Let us briefly recall that estrogens (whose production is maximum near ovulation) stimulate the cervical cells to produce a transparent and viscous mucus. Conversely, the lack of estrogen and the increase in progesterone (whose production is maximum after ovulation) favor the secretion of a particularly dense and acidic cervical mucus, which opposes the passage of spermatozoa.

Also the pH of the vaginal mucus changes during the different phases of the menstrual cycle:

• During the non-ovulatory phase, the pH of the cervical mucus is more acidic (3.5-4.5) → the acidity prevents the survival of the spermatozoa and hinders the development of pathogenic germs
• During ovulation, the pH becomes more basic (8) → favors the survival of the spermatozoa, therefore the fertilization of the egg

Changes in cervical mucus

The table shows the general modifications of the cervical mucus during the menstrual cycle.

Infertile Basic Model (BIP) A : sensation or perception of dryness around the genital area. The number of these days can vary in each menstrual cycle: they can be many in a long menstrual cycle, but few, or absent, in a short cycle (BIP) Aa : stable losses in terms of quantity and characteristics
	Fertile phase B : the loss of the sensation of dryness indicates that the mucus begins to be produced. If days of dryness do not appear after menstruation, mucus production has nevertheless begun. The transition from stable losses in quantity and characteristics to "something else" marks the possible fertility C: Mucus development phase (variable number of days, not fixed), which prolongs sperm survival. Conception can occur in case of any genital contact in the days of the mucus prior to ovulation and in the three days preceding the peak
D : at the point of maximum fertility the mucus gives a feeling of definitive lubrication. The last day of this sensation is marked as the peak. This point is very close to the ovulation period. Clear and clear mucus filaments can be observed one or two days before the peak but disappear leaving the feeling of slippery. The vulva is swollen E: after the peak there is no sensation of humidity or slipperiness. On the day after the peak, the cervical mucus becomes cloudy or sticky or disappears completely leaving a feeling of vulvar dryness. Even on days two or three you can observe a cloudy and sticky mucus or the feeling of dryness. Conception can occur in case of any genital contact in these three days following the peak. Infertile phase F: the length of the period between the peak of the mucus and the beginning of menstruation is about two weeks. The period of infertility begins again from the fourth day after the peak. If present, the mucus observed in this dry period is generally sticky and opaque. The released egg cell is dead. Only just before menstruation can the mucus become wet.

Reliability

Of all the natural contraceptive methods (eg Ogino-Knaus, coitus interrupted, basal temperature method, etc.), the Billings method used to prevent pregnancy is probably one of the most reliable. However, it still presents a failure rate varying from 3 to 22%, a value that is evidently much higher than the hormonal, barrier or implantable contraceptive practices.

To exploit the Billings method to its maximum effectiveness, it is estimated that the couple should abstain from sexual intercourse without protection for 14-17 days at each cycle.

CONTINUE: Billings Method: advantages and disadvantages »