I'm Anita Nelson, professor of obstetrics and gynecology at the Western University of Health Sciences, an emeritus professor of OBGYN at David Geffen School of Medicine at UCLA, and adjunct professor of OBGYN at the Keck School of Medicine at the University of Southern California.

I'm also medical director of research for essential access health.

But I'm here with you today to go over the robust research, the clinical studies, and the peer-reviewed data that we have that substantiate the effectiveness of natural cycles.

We have over 30 peer-reviewed studies.

Ten of them are about pregnancy prevention.

fertility and pregnancy planning, and also general women's health.

Anita, help me understand the difference between an FDA-cleared device or method and one which you can just download from the App Store.

Well, I think it's important that you make this distinction because this means the FDA has evaluated it.

It doesn't mean that it's approved for a method, but they have evaluated the data that are there.

And there's been a significant effort in documenting and providing information about how well it works, as opposed to just saying, well, we have this app and you could use it for this.

It hasn't been validated.

And as I mentioned earlier, we have the studies today showing that using the algorithm that's with natural cycles, you get a much better estimate of the at-risk days, that those trackers in general don't give you nearly the accuracy.

And then that introduces and robs from what we just heard from Cheryl, the confidence that they can rely on that method to protect them and guide them whether they should use contraception, maybe they should avoid intercourse, whatever they've decided to do on those at-risk days.

Therefore, can you help me understand just how the average patient appears to interpret the contraceptive effectiveness and associated benefit of the natural cycles method?

But how do we make sure that our patients, with all this good data now, actually observe the safe versus unsafe days and follow their instructions from the method? Anita?

Well, I think this gets to the basis of the woman herself, and certainly the couple is part of it.

If the couple isn't communicating, if she doesn't have a say in when intercourse is going to occur, all of those things are going to be red flags about whether this method is going to be successful for them or not.

But I'm kind of interested in this issue of will my patient comply? being focused on this particular method when, golly gee, is he going to put a condom on if we're relying on the condoms? Is she taking her pill every day? The buy-in from the patient is always important.

And here, as Cheryl has stressed, it's really the buy-in of the couple.

And we want to make sure as we're talking as practitioners to our patients is do they have that conversation? Does she have a vote? Is he going to be involved in this and adhere? If they're going to rely on the male condom for their method during the red days, then is he willing to do this? And are there times in their lives when maybe judgment is overwhelmed by passion, when influenced by a little alcohol or something? So you really want to assess that.

as you would with any method and particularly the barrier methods, the ones that you use around the time of coitus.

Anita?