One of the main reasons given was the perceived difficulty of learning to interpret fertility signs and applying the rules for identifying fertile and infertile days. Some even jokingly claim that NFP users must be like NASA scientists – constantly observing, analyzing, calculating, and interpreting unusual situations. Yet in everyday life, we master far more complex skills. Learning to understand our own fertility is not only entirely achievable but also immensely valuable – not just for the present moment, but for many stages of life still ahead.

One difficulty many people face is finding a reliable source from which to learn fertility awareness methods. Institutes and associations involved in Natural Family Planning (NFP) typically offer in-person courses; however, for many individuals, these seem too demanding and time-consuming. In response to these expectations, NFP educators have made learning more accessible by offering online courses, educational websites, and convenient tools for recording and analyzing fertility observations – most recently also in the form of mobile applications.

One of the most widespread yet false beliefs is that NFP methods are ineffective in avoiding pregnancy. What is this opinion based on? Certainly not on medical evidence. The effectiveness of the Rötzer method, confirmed by many years of research, reaches 99.8% in the preovulatory phase and 100% in the postovulatory phase. By comparison, the effectiveness of hormonal contraception ranges from 97% to 99.8%, depending on the method used (according to data from PTG, WHO, and J. Guillebaud).

The mistaken belief that fertility awareness methods are ineffective is mainly due to the following factors:

• Treating the calendar (rhythm) method as an NFP method. This is incorrect because fertility awareness methods do not rely on general calculations but on individual, real-time observation of current fertility signs, which vary in each woman’s menstrual cycle.
• Ignoring up-to-date research on the effectiveness of NFP methods and instead trusting unreliable information, especially from sources that promote contraception.
• Insufficiently trained users of NFP methods, who either record observations inaccurately or fail to follow the interpretation rules.

Another reason for the low popularity of natural fertility awareness methods is limited knowledge of reproductive physiology among both women and men, and low body awareness among women in particular. Natural physiological signs of fertility are often mistaken for pathology and unnecessarily treated. Numerous questions on internet forums, such as “can I be pregnant?” or “could my girlfriend be pregnant?” strongly confirm this lack of understanding.

The least controversial issue is the difficulty with periodic sexual abstinence, as it is indeed necessary during the fertile days. However, the ability to cope with short-term abstinence can be useful in many life situations (e.g., during a partner’s illness, a hospital stay, temporary separation, a high‑risk pregnancy, or the postpartum period). It also helps refresh the relationship and, in the long run, prevents routine and stagnation in a couple’s life.

Why, then, do so many women choose hormonal contraception? The reason most often given (as shown in the questionnaire mentioned earlier) is CONVENIENCE. All that is required is taking a pill; everything else is supposedly taken care of. There is no need to wonder whether a day is fertile or infertile, because hormonal contraception suppresses fertility altogether. However, this method is not as convenient as it may seem, because:

• When using birth control pills, many medications, herbs, juices, and substances that affect digestive metabolism must be avoided. Even a common cold, illness, or dietary change can become a complication.
• Malabsorption caused by vomiting or diarrhea can significantly reduce the pill’s effectiveness, requiring additional hormone doses. This often leads to anxiety, the need for backup methods, and sometimes even the use of "emergency" contraception.
• The pill must be taken at the same time every day; delays require the use of additional contraceptive methods.
• A frequent “inconvenience” is long‑lasting spotting or bleeding, headaches, nausea, mood swings, decreased libido, and recurrent infections. Is this truly convenient?

Another reason for the popularity of hormonal contraceptives is the belief in their effectiveness and safety. Yet combined oral contraceptive pills are no more effective than well-applied NFP methods, and the effectiveness of many other contraceptive methods is considerably lower. This confidence, however, is not complete, as a very common practice is the simultaneous use of hormonal contraception together with barrier methods.

The choice of hormonal contraception is often linked to a lack of understanding of how hormonal contraceptives work, which stems from the rather vague descriptions provided in patient information leaflets. Not every user knows what terms like “impairment of endometrial function” or “effects on fallopian tube motility” actually mean (that is, if fertilization does occur, the embryo may be unable to implant properly in the uterus because the endometrium is not prepared for implantation, and because its transport through the fallopian tube may be delayed).

The list of harmful and troublesome side effects of hormonal contraceptives is indeed very long, and it is important to recognize that these effects affect a significant proportion of users. On many internet forums, one can find numerous documented cases of thrombosis and embolism associated with the use of birth control pills. Women share their experiences, encourage one another to undergo medical tests – and yet continue taking synthetic hormones, reassuring themselves with thoughts such as, “it won’t happen to me”.

All it takes is to look at the leaflet that comes with birth control pills – the neutral information about the product’s composition, its effects, and dosage instructions is marked in green, while warnings, side effects, and adverse reactions are highlighted in red. Perhaps this visual contrast should give us pause…