Institute for Reproductive Health - Georgetown University


Standard Days Method:

10 Reasons to Integrate into
Family Planning Programs

Have you ever seen this string of beads and wondered what it was?

This tool, called CycleBeads®, helps women and couples use the Standard Days Method® (SDM), a highly-effective, inexpensive and modern family planning method.

Developed by Georgetown University's Institute for Reproductive Health, SDM helps women prevent pregnancy by identifying the fertile days of their menstrual cycle.

SDM Effectiveness in Preventing Pregnancy


Why include SDM in family planning programs?   Next   Continue scrolling for 10 good reasons.

Slide 1

Family planning methods currently
available to women are not meeting
all of their needs.

222 million women in developing countries want to avoid pregnancy but are not using a modern method of family planning.

What's this? We did our research.
Visit the resources below to find out where we found the facts.

Slide 2

SDM addresses women's concerns about
family planning and helps fill a critical gap
in family planning programs.

SDM addresses the top 3 reasons women cite for not using
family planning in the following ways.

Side Effects / Health Concerns

Side Effects / Health Concerns

Most women who choose SDM do so because it is side-effect-free. SDM has no negative health consequences.



SDM encourages men and women to talk about family planning. SDM overcomes many religious and cultural concerns about family planning.

Infrequent Intercourse

Infrequent Intercourse

SDM identifies when a woman is fertile so she can avoid unprotected intercourse on those days. SDM helps facilitate negotiation of condom use with partners.

Hear from SDM users around the world. Watch Video
Zarina Community Health Worker, India

It made me sad that in my community couples have more than eight children and women are like machines that produce children. After being completely convinced about SDM's effectiveness, I started informing other women in my community about it. I found that this method would suit many couples because it would not interfere in any way with our religious beliefs as women do not have to ingest or insert anything.

Marciana Health Care Provider, Rwanda

Our healthcare center had trouble managing the side effects of hormonal contraceptives, with people giving up or lost to follow-up. After SDM was introduced in our family planning department, the method helped me manage the issue around side effects stemming from other family planning methods. Women who experienced side effects and who met the eligibility criteria chose SDM.

Health care worker, Guatemala

It is important to mention that in Guatemala there are numerous religious barriers to family planning. For individuals who, for religious reasons, do not want to use a contraceptive, there is now an option. It is an alternative for these people, many of whom believe that it is a sin to use other methods. They also like it because it is a safe method—it is safe for the woman's health.

What's this? We did our research.
Visit the resources below to find out where we found the facts.

Country Reports

Slide 3

When used correctly and consistently—and
most users do so—SDM is 95% effective.

Contraceptive failure rates of user-directed methods

SDM compares favorably with other short acting methods
and is a viable choice for some women.

What's this? We did our research.
Visit the resources below to find out where we found the facts.

Slide 4

Adding SDM to the method mix expands
choice, increases contraceptive prevalence,
and reduces unmet need.

India from 24% to
El Salvador from 45% to

Adding a new method like SDM to the existing method mix
can raise contraceptive prevalence.

More choice = more likely to find a method

What's this? We did our research.
Visit the resources below to find out where we found the facts.

Slide 5

SDM brings new users to family planning.

This graph demonstrates previous method use by clients who chose SDM after it was integrated into programs in India, Peru, and Rwanda.
The majority of SDM users were new to modern family planning use.

SDM does not "siphon off" users of other modern methods. The vast majority of 
SDM users are those who have never used family planning before.

Some initial SDM users eventually switch to other modern methods, suggesting that offering SDM opens the door to family planning for many women. In addition, SDM has brought back to family planning women who have dropped out of using other modern methods due to side effects.

(read more)

What's this? We did our research.
Visit the resources below to find out where we found the facts.

Slide 6

SDM is easy and inexpensive to
integrate into programs.

Cost of family planning method per user for the first year of use.

Studies in Guatemala, India, and Rwanda found that SDM was more cost effective than other birth-spacing methods, including condoms and oral contraceptives. It is easy to train providers to offer SDM whether at a facility or within the community. It takes as little as two hours to learn it and be able to instruct others.

Time needed to counsel users (e.g., how to manage the fertile period) is equivalent to other methods. It is an inexpensive, low-maintenance addition to family planning programs. Once a client has a set of CycleBeads, there is no need for re-supply. In fact, there is no need for clients to return for follow-up unless they choose to do so. CycleBeads are inexpensive and available through the USAID | DELIVER PROJECT, UNFPA's AccessRH, as well as the manufacturer.

(read more)

What's this? We did our research.
Visit the resources below to find out where we found the facts.

Slide 7

SDM helps bring new partners
to the family planning field.

There is an array of community organizations and faith-based institutions that are educating women and couples about family planning by offering SDM to their constituencies. Even community groups outside the health sector can offer SDM while referring for other methods.

While the majority of women who use SDM throughout the world do not choose it primarily based on religious reasons, Catholic, Muslim and Protestant organizations find that SDM is an appropriate and simple entre into discussing reproductive health and family planning. This opens the door for a transformation of community norms about family planning, even in conservative settings.

(read more)

Marie Marie, Health Center Worker, Rwanda

Social mobilization around SDM in our area of influence helped to strengthen our cooperation with religious bodies. At first, they were unforthcoming about our family planning services, but now they often help us to mobilize the community, whenever needed.

Shopkeeper Mali

They gave me information about CycleBeads, namely how to use it, eligibility criteria and the principles of fertility. After they had provided me with this information, we traveled together to visit shopkeepers and women's associations in our district, with me serving as an interpreter and facilitator. This activity lasted one week. When the sponsors left, some of the women who bought CycleBeads came to see me so I could show them once again how to use it, and they often took the opportunity to ask me whether I had any condoms to manage fertile days.

Religious leader Democratic Republic of the Congo

After attending a training on family planning methods, I decided to preach about these methods, specifically the Standard Days Method (SDM), during my sermon at the Friday prayer service. It was the first time I had ever talked about a subject like that at the mosque. Considering the sensitivity of faithful Muslims to nuanced topics like family planning that are challenging to explain within an Islamic context, I prepared my presentation carefully. After presenting CycleBeads and describing the advantages of using them, I noticed that everyone was captivated by what I was saying.

What's this? We did our research.
Visit the resources below to find out where we found the facts.

Slide 8

SDM improves access to family planning by being available beyond the health system.

Available through...


Studies show that pharmacy sales clerks can provide SDM. Because there is less interaction than with a clinic-based provider, clients rely more on printed information received with their CycleBeads. However, they are just as able to understand how to use the method as women who received counseling from a family planning provider.


CycleTel is a unique mHealth service that offers a family planning method directly to a user's mobile phone via SMS. IRH is testing and scaling up the service in India.

iCycleBeads & CycleBeads Online

Women can also use SDM through an electronic app, iCycleBeads™ or CycleBeads Online. iCycleBeads™ is the first smartphone app that enables a woman to plan or prevent pregnancy using SDM, and CycleBeads Online is a digital, web-based application for use of SDM, accessible online via a computer, tablet or phone. Both apps screen and enroll women based on her period start date, track monthly cycles, and alert women of their unsafe days.

Social Marketing

In partnership with PSI, CycleBeads® have successfully reached women in need of family planning through social marketing. Study results demonstrate the potential for selling CycleBeads through pharmacies and small shops in several countries across Africa.

SDM can be offered by non-health personnel
in the community and by pharmacists.

Evidence confirms that CycleBeads can be a successful socially marketed product, and women are able to use the method correctly even when purchasing CycleBeads from a pharmacy. Innovative use of communication technologies such as mobile phones extends the reach of SDM even further.

What's this? We did our research.
Visit the resources below to find out where we found the facts.

Slide 9

SDM involves men in family planning
and improves condom counseling.

Improved Communication

CycleBeads can help women and men talk about the method. And even if they don't talk about it, CycleBeads are very visual — the man can see when the woman is on a fertile day, and he understands what they need to do to avoid pregnancy.

Improved Cooperation

Research shows that couples who use SDM have sex about the same number of times a month as other couples — they just have sex on the days outside the fertile window. Couples cope with fertile days in different ways. They can abstain from intercourse but find other ways to show affection, and some couples use barrier methods during those days.

Perspectives on Involving Men

"I feel good that my husband now understands how my body works. He pays attention to my suggestions and respects my wishes. For the first time he asks me if we can have intercourse. I am happy that he cares about me."

- Female User, India

Perspectives on Involving Men

"SDM has helped us to become closer, understand each others' needs. Unlike earlier, we now discuss intimate things with each other & this has added pleasure to our otherwise monotonous sex life."

- Male User, India

Because SDM depends on couple cooperation it also engages men actively
in family planning—through outreach, counseling, and practice.

Offering SDM encourages and offers programs an opportunity to make serious efforts to reach men with information and services and to incorporate gender issues into family planning counseling. Studies in multiple countries have demonstrated that men are interested in SDM and participate in method use by purchasing condoms for use during the fertile days and helping their wives keep track of their fertile days. Both men and women report that communication between the couple improved as a result of using SDM.

Introducing SDM into family planning programs has even improved providers' ability to counsel on condom use. Research from India, for example, shows significant improvements in condom counseling after incorporating SDM into public sector programs. Similarly, data from Guatemala show that once providers began offering condoms as part of SDM instruction, they felt more comfortable offering them to all of their clients.

(read more)

What's this? We did our research.
Visit the resources below to find out where we found the facts.

Slide 10

SDM contributes to
women's empowerment.

Women's Empowerment Indicators Pre- and Post-SDM Introduction (India)

A community survey conducted in India after SDM introduction yielded improvement 
in indicators of women's empowerment, as illustrated by the graphs. ?

User experience suggests that SDM use is empowering for many women. They report that knowledge about their bodies and menstrual cycles and being able to prevent unwanted pregnancies has increased their self-confidence and their ability to care for their health. In many cases, this has made it possible for women to talk openly with their husbands about how to manage the fertile days to avoid pregnancy.

What's this? We did our research.
Visit the resources below to find out where we found the facts.


Is SDM reaching those who need it?   Find Out

Bias—usually rooted in misinformation—often means unfair criticism or dismissive attitudes toward a worthwhile innovation. This is true of fertility awareness-based methods of family planning, including SDM. Although SDM is increasingly included in programs and even scaled up in several countries, this innovative method has not reached its full potential to meet the needs of women and couples. Lack of accurate information and misapplied bias against fertility awareness-based methods continue to limit its availability.

Is SDM for everyone? YesNo

No family planning method is right for all women and couples. That is why having a wide variety of methods permits clients to choose the method that works best for them. Women whose menstrual cycles are irregular (i.e. fall outside the range of 26-32 days), or couples who find it difficult to avoid unprotected intercourse during the fertile days should not use SDM. For example, women whose partners are prone to excessive alcohol use or domestic violence should consider another method. Even with that proviso, SDM is an excellent choice for the large number of women and couples who wish to avoid pregnancy by using a simple, inexpensive and natural method with no side effects.

Help ensure women have
a full range of options.

Integrate SDM

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CycleBeads are available to programs through the USAID | DELIVER PROJECT, UNFPA's AccessRH, and through the manufacturer.

Get tips on forecasting CycleBeads procurement.