I love those brave people who dare to ask the questions that others don't.

“Do you need a speculum?” I was asked recently, when talking about about how to check vaginal fluid.

“Nope", I said, "there's no need for a big performance with a speculum and mirror*. It usually just means you notice it when you go wipe after going to the loo.” [Yeah, OK, you’re allowed one Eww]

A friend once said she knew “Tonight’s the night” when she noticed strings of stretchy stuff like raw egg white coming out of her. Sure enough, 9 months later her first child was born.

Egg white fluid is released into your vagina by the cervix (the entrance to your womb). It is like the “sperm motorway” and can

Checking cervical fluid is one of the things that can put people right off using fertility awareness as contraception.

Of course we shouldn't hate our bodies and what comes out of them. Cervical fluid is very cool stuff.

And yet it can seem like a bit of a hassle.

Do you have to use a scoring system for stretch, colour and texture? Do you have to buy a speculum kit from the lovely people at the Beautiful Cervix Project? 

"I was on the pill for 3 years for contraceptive reasons. During this time I developed digestive problems, and would experience nausea and vomiting around twice a week.

I thought maybe I had a weak stomach, and got on with life.

My sister went on the pill and six months later had to come home from university due to depression and anxiety. This led me to research the undiscussed side effects the pill can have.

This article was published in the Journal of Family Planning and Reproductive Health Care in April 2013. It was written by myself (Sarah Panzetta) and Dr Jill Shawe. Log in here if you have Athens access to the journal.

Background and Guidance

The Lactational Amenorrhea Method of contraception (LAM) was formalised over 20 years ago[i] and the Faculty of Sexual & Reproductive Healthcare (FSRH) guidance on postnatal sexual and reproductive health [ii] is clear: 

“Women may be advised that if they are<6 months postpartum, amenorrhoeic and fully breastfeeding, the lactational amenorrhoea method (LAM) is over 98% effective in preventing pregnancy.

Women using LAM should be advised that the risk of pregnancy is increased if the frequency of breastfeeding decreases (stopping night feeds, supplementary feeding, use of pacifiers), when menstruation returns or when >6 months postpartum”

Yet a recent survey[iii] found “particular inconsistencies” in the advice given to breastfeeding women in the UK

Are you a Catholic?" is something I'm often asked. I'm not, but I do have a Catholic hero.

Catholics, and non-Catholics, often have extreme views about both natural family planning, and fertility awareness for contraception. It is either hailed as a panacea, the only contraception anyone will ever need, or dismissed out of hand.

My hero promoted a more balanced view. His name was Professor John Marshall and he's my hero for the work he did in his spare time as a natural family planning (NFP)* teacher for 40 years from 1959 to the 1990s, and for the book he wrote about this work. [He also did amazing work on stroke in his day job as a neurologist, but that's another story.]

Strictly speaking, natural family planning is the Catholic cousin (or grandmother?) of fertility awareness based

Research shows that 90 per cent of the UK population think that the contraceptive effects of breastfeeding are a myth. Equally unhelpful, is the belief that breastfeeding alone can work as reliable contraception. A Mumsnet/BPAS survey linked this belief to a rise in abortion rates among women with babies and young children in the UK.

The truth is that breastfeeding and following the simple but strict lactational amenorrhoea method (LAM) rules is over 98% effective as contraception - as good as condoms. The LAM rules are that your baby

Contraception is a straightforward business for most women and couples in the UK. They buy condoms, or they visit the doctor or family planning nurse, and they get on with their lives. Nothing wrong with that. Having a range of contraceptive options is one of the blessings of the modern world. The side effects can be a blessing as well. Hormonal contraception can help with irregular, heavy or painful periods and with acne and other health concerns.

But not all side effects are helpful. It is very rare for side effects to be life-threatening, but they can have a big impact on our quality of life. Many women will go back to their doctor time and time again due to concerns about side-effects like irregular (or constant) bleeding, weight gain, headaches, nausea, or

Wandering around the affordable art fair on Hampstead Heath last weekend, I noticed some poignant images of women with their heads replaced by feathers. They got me thinking that an image of an unknown woman might work on our banknotes. Something in the spirit of the tomb to the unknown soldier in Westminster Abbey.

An unknown woman could remind us of all the millions of women whose voices aren’t heard and whose talents are wasted (and have been wasted) because of sexism, poverty and lack of education. Not to mention the lack of access to suitable contraception and to safe, legal abortion,  even here in the UK (big

I understand you’re on the group that will tomorrow decide whether data from clinical trials will be made public. This is important to me because of my 20 years as an NHS librarian, and because of my work as a fertility awareness (natural family planning) teacher. Women usually see me because they have not got on with the pill for one reason or another and want to learn how to avoid pregnancy without using hormones. There is a perfectly respectable evidence base for this work – though it is not as big as it could be, partly because this is not a big business.

Despite my jealousy of the money that Big Pharma is able to put into research and marketing, I  am a supporter of much of their work. I immunised my daughter at the height of the MMR jab scares. I have