Natural birth control is a loose term which refers to methods of birth control that are considered "natural"; though what is considered "natural" varies widely. Generally, natural birth control does not involve hormonal contraception, nor synthetic chemicals including synthetic spermicide. Other methods may also be excluded, depending on how the term "natural" is defined.

Some definitions of "natural" are more lenient and include barrier contraception used without synthetic spermicide, and occasionally the copper IUD, which contains no hormones. Some definitions exclude the use of devices, but include the use of herbs, natural substances, and behavioral methods. The term "Natural Family Planning" is the most exclusive in its definition of what is "natural".

http://en.wikipedia.org/wiki/Natural_birth_control

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Coitus reservatus, also known as karezza, is commonly thought of as a form of sexual intercourse in which the man does not attempt to ejaculate within his partner, but instead attempts to remain at the plateau phase of intercourse for as long as possible. In fact, the goal of this practice, is to enable the man to actually separate orgasm from ejaculation, being able to experience one without the other. The term "karezza" was coined by the physician Alice Bunker Stockham. It is akin to sexual practices in Buddhist Tantra. Importantly, Stockham's contribution was to apply this same philosophy to women as much as men. The principles of karezza also apply to masturbation, whereby a man attempts to delay his ejaculation as long as possible to prolong pleasure in a process known as "edging."

The primary purpose of karezza is the maintenance, and indeed intensification, of desire within the context of long term relationships. According to Stockham, it takes two weeks to a month for the body to recover from ejaculation. If ejaculation is experienced more frequently, the effect is to 'drain the basin' before it has been replenished. This, in turn, induces feelings of irritation and rejection of the lover, as the body seeks to prevent further ejaculation. However, and arguably especially in modern Western culture where 'more is better', people often pursue orgasms, and therefore ejaculations as a way of trying to overcome those feelings, thus compounding the problem. The result is that over time - and reportedly within two to four years - the 'honeymoon of desire' is over, leading to substantial change in the nature of the relationship. Stockham's advocacy was that this same 'honeymoon period' could be maintained in perpetuity through limiting the frequency of ejaculation.

Once love making is no longer undertaken as a means to orgasm, Stockham suggested, the nature and purpose of love making changes dramatically, being focused on communication and physical communion. Orgasm should, she suggested, occur when 'the basin' overflows, perhaps once a month and no more than once a fortnight.

Coitus reservatus is not a reliable form of preventing a sexually transmitted infection, as the penis leaks pre-ejaculate which may contain all of the same infectious viral particles and bacteria as the actual semen. Beyond that, it is also unreliable for contraception, even if ejaculation is successfully avoided, because pre-ejaculate may contain sperm. The method is also unreliable because of the difficulty of controlling ejaculation.

Another difficulty of this method is that, if the man begins to orgasm (before ejaculation proper begins), the muscles can tense tightly in the lower body, such as legs and buttocks, causing the removal of the penis to be difficult. This could cause some ejaculate to enter his partner.

http://en.wikipedia.org/wiki/Coitus_reservatus

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PIP: A study in Boston, Massachusetts, and another study in New York City examined samples of pre ejaculate fluid from HIV seropositive and HIV seronegative men to determine whether HIV was or was not present in pre ejaculate fluid. The researchers found macrophages and CD4 lymphocytes in most samples, indicating that HIV was present. The more significant finding, however, was that most pre ejaculate samples did not contain any sperm and those that did had only small clumps of a very small amount of sperm which seemed to be immobile. A larger study is needed to verify these results. If these results are confirmed, they may dispel the myth that pre ejaculate fluid contains sperm. An ongoing WHO/USAID study shows that the pregnancy rate caused by men with 3 million sperm/ml/ejaculation is very low; fertility clinics consider men with a sperm count of no more than 5 million/ml to be infertile, particularly if is there is low motility. The average ejaculation has about 100 million sperm/ml, but about 10 million sperm pass through the cervical mucus, about 1 million make it to the top of the uterine tract, and just about 100,000 sperm reach the fallopian tubes. Thus, only a couple of sperm, assuming motility, would reach the fallopian tubes in the case of the pre ejaculate samples with some sperm, which tended to be immobile (sperm levels only in the 1000s). Thus, the probability of pregnancy is very low if pre-ejaculate fluid enters the vagina. Pre-ejaculate fluid of 6 of the 9 HIV seropositive donors in Boston and 6 of the 14 HIV seropositive donors in New York contained HIV, regardless of symptom status or antiretroviral therapy status. Thus, the risk of HIV transmission may be higher than unplanned pregnancy, so people should use condoms before the penis enters the vagina, mouth, or anus.

Researchers find no sperm in pre-ejaculate fluid

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Complications of vasectomy: review of 16,000 patients.

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http://en.wikipedia.org/wiki/Vasectomy

Complications of vasectomy: review of 16,000 patients

Late failure of vasectomy after two documented analyses showing azoospermic semen.

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http://en.wikipedia.org/wiki/Tubal_ligation

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http://en.wikipedia.org/wiki/Sterilization_%28surgical_procedure%29

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http://en.wikipedia.org/wiki/Sexual_abstinence

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http://en.wikipedia.org/wiki/Fertility_awareness

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http://en.wikipedia.org/wiki/Emergency_contraception

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Coitus interruptus, also known as withdrawal or the pull out method, is a method of contraception in which, during sexual intercourse, the penis is removed from the vagina prior to ejaculation, primarily to avoid introducing semen into the vagina. Coitus interruptus may also more generally refer to any extraction of the penis prior to ejaculation during intercourse. This method has been widely used for at least 2,000 years and was used by an estimated 38 million couples worldwide in 1991.

Effectiveness

Like many methods of birth control, reliable effectiveness is achieved only by correct and consistent use. Observed failure rates of withdrawal vary depending on the population being studied: studies have found actual failure rates of 15-28% per year.[2] In comparison the pill has an actual use failure rate of 2-8%,[3] while the diaphragm has an actual use failure rate of 10-39%.[4][2] The condom has an actual use failure rate of 10-18%.[2]

For couples that use withdrawal correctly at every act of intercourse, the failure rate is 4% per year. In comparison the pill has a perfect-use failure rate of 0.3%, while the diaphragm has a perfect use failure rate of 6%. The condom has a perfect-use failure rate of 2%.[5]

The primary cause of failure of the withdrawal method is the lack of self-control of those using it. Poor timing of the withdrawal can result in semen on the vulva, which can easily migrate into the female reproductive tract. Some medical professionals view withdrawal as an ineffective method of birth control.[6] In contrast, a recent study in Iran found that provinces with higher rates of withdrawal use do not have higher fertility rates, and that the contribution of withdrawal use to unintended pregnancies is not markedly different from that of other commonly used methods such as the pill or condom.

It has been suggested that the pre-ejaculate ("Cowper's fluid"), fluid emitted by the penis prior to ejaculation, contains spermatozoa (sperm cells), which can easily pass into the upper female genital tract in the presence of cervical mucus.[8] However, several small studies[9][10] have failed to find any viable sperm in the fluid. While no large conclusive studies have been done, it is now believed the primary cause of method (correct-use) failure is the pre-ejaculate fluid picking up sperm from a previous ejaculation.[11] For this reason, it is recommended that users of withdrawal have the male partner urinate between ejaculations, to clear the urethra of sperm, and wash any ejaculate from objects that might come near the woman's vulva (e.g. hands and his penis).[12]

Advantages

The advantage of coitus interruptus is that it can be used by people who have objections to or do not have access to other forms of contraception. (Some men prefer it so they can protect their partners from possible adverse effects of contraceptives.)[13] It has no monetary cost, requires no artificial devices, has no physical side effects, and can be practiced without a prescription or medical consultation.

Disadvantages

The method is largely ineffective in the prevention of STDs, like HIV, since pre-ejaculate may carry viral particles or bacteria which may infect the partner if this fluid comes in contact with mucous membranes. However, a reduction in the volume of bodily fluids exchanged during intercourse may reduce the likelihood of disease transmission due to the smaller number of pathogens present.[10]

The method may be difficult for some couples to use. The interruption of intercourse may leave some couples sexually frustrated or unsatisfied.[14]

Prevalence

Worldwide, 3% of women of childbearing age rely on withdrawal as their primary method of contraception. Regional popularity of the method varies widely, from a low of 1% on the African continent to 16% in Western Asia. (Data from surveys during the late 1990s).[15]
In the United States, 56% of women of reproductive age have had a partner use withdrawal. In 2002, 2.5% were using withdrawal as their primary method of contraception.

http://en.wikipedia.org/wiki/Coitus_interruptus

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http://en.wikipedia.org/wiki/Contraception

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