Are there reasons why fertility awareness methods of family planning are not widely promoted? [closed]

Question

Based on quite a bit of research into this area it seems that 'fertility awareness methods' can be very effective if not on par with many other popular contraceptive methods:

https://www.ncbi.nlm.nih.gov/pubmed/17314078

https://www.ncbi.nlm.nih.gov/pubmed/17371516

https://www.ncbi.nlm.nih.gov/pubmed/19264938

Clearly, this method is best used within a long-term monogamous relationship as it does not protect against STIs.

Are there other reasons why it is not widely-known and promoted by physicians given the fact that there are no side effects for both partners?

Answer 1

1. Fertility awareness methods are slightly different from the others in that they require you to have self control and not have sex when you might otherwise want. Many people don't like to do this. In this study "9.2 per 100 women dropped out because of dissatisfaction with the method".
2. Failure rates very widely depending the method of education, and the group receiving the education. For example, in this study, failure rate was around 21%! But in the aforementioned study, failure rates were only around 1-2%. My guess is this is because the effectiveness of this method is highly dependent on both how it is taught and implemented. Which leads me to my last point:

3. Public policy changes on something like this are likely going to be strongly affected by recommendations of medical organizations. However, medical professionals are likely to be more skeptical of something like family planning, because Doctors tend not to trust patients with treatments that depend too much on on the patient. From The silent world of doctor and patient:

   From the time of Hippocrates, physicians have been told how to behave toward their patients in order to maximize the beneficial effects of their ministrations and to educe the risk of harm, especially the harm that comes from patients' needless worries or, worse, from their mistaken choices

   See also this article arguing that Doctors should trust their patients - and why they don't. For example "Lack of trust in a patient's competence to understand medical issues may lead to withholding information."