Lactational Amenorrhea Method (LAM) - Gynecology

What is Lactational Amenorrhea Method (LAM)?

The Lactational Amenorrhea Method (LAM) is a form of natural contraception that relies on the post-partum infertility that occurs when a woman is exclusively breastfeeding. The method is based on the hormonal changes that occur during lactation, which can suppress ovulation.

How Does LAM Work?

LAM works because the act of breastfeeding inhibits the release of gonadotropin-releasing hormone (GnRH) from the hypothalamus, which in turn inhibits the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. This suppression prevents the ovaries from releasing an egg, thereby preventing ovulation and subsequent pregnancy.

What Are the Criteria for LAM?

For LAM to be effective, three key criteria must be met:
The baby must be less than 6 months old.
The mother must be exclusively breastfeeding, meaning the baby receives no other food or drink, not even water, and breastfeeding occurs at least every four hours during the day and every six hours at night.
The mother must not have experienced the return of her menstrual periods since giving birth.

What is the Efficacy of LAM?

When all three criteria are strictly followed, LAM is over 98% effective in preventing pregnancy. This is comparable to many other forms of contraception. However, the effectiveness can drop significantly if any of the criteria are not met.

What Are the Benefits of LAM?

The benefits of LAM include:
It is a natural and non-hormonal method of contraception.
It encourages and supports exclusive breastfeeding, which has numerous health benefits for both the mother and the baby.
It is cost-effective and does not require any medical intervention or prescription.

What Are the Limitations of LAM?

There are several limitations to consider:
Strict adherence to the criteria is essential for effectiveness.
It is only effective for up to six months post-partum.
It does not protect against sexually transmitted infections (STIs).
It may not be suitable for all women, particularly those who cannot or choose not to exclusively breastfeed.

When Should a Woman Switch to Another Contraceptive Method?

A woman should consider switching to another contraceptive method if:
Her menstrual periods return.
She stops exclusively breastfeeding or introduces supplemental feeding.
Her baby reaches six months of age.

Can LAM be Used in Combination with Other Contraceptive Methods?

Yes, LAM can be used in combination with barrier methods such as condoms to provide additional protection against pregnancy and STIs. However, the use of hormonal contraceptives may interfere with the breastfeeding process and should be discussed with a healthcare provider.

Conclusion

The Lactational Amenorrhea Method (LAM) is an effective, natural form of contraception when used correctly. It not only helps in family planning but also promotes the health benefits of exclusive breastfeeding. However, it requires strict adherence to specific criteria and is only a temporary method, effective for up to six months post-partum.

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