Fertility awareness method use and gender, pleasure, and other shifts in couples' intimate relationships

Women's ability to control their fertility is a cornerstone of gender equity. Research suggests that fertility awareness methods (FAM), such as the Standard Days Method® (SDM) and the TwoDay Method® (TDM), can meet women's reproductive needs and address gender issues. As “couple” methods, they can transform reproductive health services by providing practical approaches to addressing gender equity and sexuality. However, there are concerns that promoting FAM may disempower women and interfere with healthy sexual expression. Men's ability to use FAM and their influence on the couple relationship and women's autonomy were assessed through quarterly interviews with 2,422 FAM users followed for up to two years. Data was collected in 16 settings in seven countries in Asia, Latin America and Africa. In-depth interviews and focus groups were conducted with current and discontinued male and female users. Findings suggest men are interested in FAM and able to use it. Couples report improved sexual relationships and strengthened communication. In India, 93% of women reported increased communication and affection. Some reported enhanced sexual relationships, citing feelings of control, mutual respect and heightened eroticism related to the timing of sex and non-coital practices. Women's scores on gender equity scales increased after three cycles of method use, suggesting a positive effect on women's empowerment. Introducing FAM contributes to efforts to improve gender equality because their use promotes couple communication and negotiation. As FAM are scaled up and efforts implemented to engage men and promote couple dialogue, FP programs could have a greater impact on gender equity.