Some Phone Apps Claim To Help Users Avoid Hormonal Birth Control And Take Charge Of Their Reproductive Health But They Have Been Criticized For A Lack Of Efficacy And Transparency
This story is the first in a two-part series about digital birth control. Read part 2 here.
After decades of stagnant birth control research, users are demanding more convenient and safer options particularly given the potential risks, such as breast cancer, depression and even changes in brain function, associated with hormonal methods.
For a small proportion of U.S. women, fertility awareness methods provide a hormone-free alternative and involve meticulous tracking of ones fertile window, which is the number of days within the menstrual cycle in which a person can become pregnant.This can be determined via measurements such as basal body temperature, cervical mucus patterns and the luteinizing hormone levels in urine. During the fertile window, FAM practitioners commonly rely on withdrawal or barrier methods such as condoms to avoid pregnancy.
While they were long considered relatively obscure and were commonly associated with religious populations, FAMs now reach a far broader audience via cell phone apps. Over 100 such apps exist, and they have been downloaded more than 200 million times. More broadly, a whole host of womens health apps are advertised to track periods and plan or prevent pregnancy, and often claim to empower users with detailed information on their reproductive health.
How Effective Is This Type Of Birth Control
FDA approval for this product is based on a multisite study that enrolled sexually active women ages 18 to 35 . Women who participated had regular menstrual cycles and a single male partner. They agreed to just use Phexxi for birth control except for morning-after, emergency birth control, if necessary and engage in heterosexual intercourse at least three times during each cycle throughout the study.
Results collected over seven cycles show that nearly 14% of 1,183 women who completed the study became pregnant.
Overall, the efficacy rate of Phexxi is 86% for typical use.
Phexxi can be combined with some other forms of birth control to increase the odds of preventing pregnancy. Compared with other nonhormonal birth control methods it seems to be more effective at preventing pregnancy than withdrawal natural family planning barrier methods such as condoms and diaphragms and most spermicides . However, as a nonhormonal option, the copper intrauterine device is far more effective.
So What’s So Special About This Digital Contraceptive App
There’s two key things that make this app different to others.
You have to enter in your daily basal body temperature and the dates you get your period. Then the algorithm calculates your fertile and non-fertile days .
So the more data you enter, the more accurate it’ll be.
And Dr Elizabeth Farrell, Medical Director of women’s health organisation Jean Hailes, says that’s an important thing to remember: you’re the one responsible for its effectiveness.
“Yes, it will be very helpful for some women, but you’ve got to be fairly rigid about taking the temperature on a daily basis and looking at the app and seeing when you can have sex or whether you need protected sex,” Dr Farrell told Hack. .
Dr Farrell says that just because the TGA has approved the app, it doesn’t mean they’re saying it’s a highly effective method.
She said even though the developers have funded some studies, it’s not going to have as much scientific evidence behind it like other contraceptives.
“Devices don’t have the same rigour of study that a medication does.”
Disadvantages Of Natural Cycles
- You may want to use extra protection as the app gets to know your unique cycle
- While you can use Natural Cycles if you have an irregular cycle, you may experience more red days
- You may forget to take your temperature, which will result in more red days
- There is a subscription fee, as opposed to alternative contraception methods available in the UK which are free on the NHS
Can You Use Birth Control Apps And Other Birth Control Methods
In fact, if youre trying to avoid pregnancy, most medical experts dont recommend using FAM as your sole method of birth control, given its high failure rate.
The Centers for Disease Control and Prevention reports that the failure rate can range from 2 percent to 23 percent with typical use.
While the above apps are great options for becoming more familiar with and tracking your cycle, theyre not 100 percent accurate.
That said, what you choose will really come down to what you feel is right for you, what youre hoping to get out of the app, and how much risk you and your partner may be willing to assume.
Some people will choose to use another birth control option only when they are having sex during their peak fertility window, while others will choose to use another birth control method all month long.
Again, if youre trying to avoid pregnancy, its generally recommended to pair your fave app with another form of BC.
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Is The ‘fertility Awareness’ Method For Me
Michaela from Camden NSW, has been using a fertility awareness app for five years after having a bad experience with taking the pill.
“I was having lots of issues with anxiety, it was affecting my mental health and libido and I was getting a lot of hormonal acne,” she said.
“So, I looked into a whole bunch of other options and this just felt like the best for me to try.”
Michaela thinks there’s not a lot of information out there about the ‘fertility awareness’ method and that leads to misconceptions.
” they told me I was silly and that I was going to get pregnant.
“It was perceived as a very alternative-like-hippy method, like why wouldn’t you want to take the pill, the pill’s safe.”
But Michaela is happy with her choice and hasn’t become pregnant while using the app method.
Making the right decision for yourself is something Dr Deborah Bateson, Medical Director for Family Planning NSW, strongly supports.
She said it’s all about people making informed choices, weighing up all the different options and finding out what works best for you.
“Fertility awareness methods and apps can help women better understand their bodies, are relatively cost-effective, and have no side-effects,” Dr Bateson said.
But she said for some people it’s just not going to suit – like if you’re not an organised person, or you have irregular cycles, or an illness. Dr Bateson also pointed out that this method is not the most effective contraceptive on the market.
Why Are So Many Women Choosing Hormone
Theres no-one-size-fits-all for birth control and we all have different experiences. For some, hormonal contraception is a great option. Others who can’t take hormonal birth control or get unwanted side effects may choose a hormone-free birth control option instead.
While Natural Cycles is not the only non-hormonal birth control method, we are the first birth control app to be cleared by the FDA in the United States, and we’re CE marked in Europe. We have over 2 million registered users.
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The Birth Control App
A new player in the contraceptive landscape, the birth control app, Natural Cycles, offers a non-hormonal birth control option for the modern woman. Unlike traditional fertility awareness-based methods, the app is assisted by an algorithm that works to identify ovulation through a rise in basal body temperature which happens after ovulation.
Natural Cycles requires women to take their temperature first thing in the morning when they wake up, and enter it into the app. The algorithm then learns the unique pattern of their cycle and can find the fertile window and give green days and red days . Natural Cycles is 93% effective with typical use.
What You Need To Know Before Using Natural Cycles The First Fda
Natural Cycles, a birth control app, hasnt exactly had the best press so farits currently under investigation in the U.K. and Sweden after 37 users made claims of unwanted pregnancies. But then, just last week, it was approved by the U.S. Food and Drug Administration as a method of contraception to prevent pregnancy. This makes Natural Cycles the first FDA-approved app-based birth control.
“Consumers are increasingly using digital health technologies to inform their everyday health decisions, and this new app can provide an effective method of contraception if its used carefully and correctly, Terri Cornelison, assistant director for the health of women in the FDAs Center for Devices and Radiological Health, said in a press release.
However, Cornelison added, Women should know that no form of contraception works perfectly, so an unplanned pregnancy could still result from correct usage of this device.
But, while the Natural Cycles website claims that their digital birth control method is 93 percent effective under typical use and 99 percent effective when used perfectly , it also warns that it takes between one and three cycles for the app to “get to know you. Also, remember that this method doesn’t actually confirm whether or not you’ve ovulated. So you should be especially careful in those first few months of using it .
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What Are The Disadvantages Of Non
Non-hormonal IUDs can make your periods heavier and cause cramping, especially in the first 3-6 months. And you may have some IUD cramps when you first get your IUD. For many people, these side effects get better once your body gets used to the IUD. So if you can stick it out for a few months, theres a good chance the side effects will ease up. Read more about side effects.
Its normal to have some cramping during your period with a copper IUD. But if your cramps are really bad and over-the-counter medicine doesnt help, talk with your nurse or doctor. Its also a good idea to call your nurse or doctor if youre still having bad IUD cramps after a year, or you have pain or IUD cramps when youre not on your period this can be a sign your IUD has moved, and they may want to check to make sure its still in place.
IUDs are one of the most effective and convenient ways to prevent pregnancy, but they don’t protect you from sexually transmitted infections. So use condoms with your IUD every time you have sex to lower the chance of getting or spreading STDs.
The Practicalities Of Period Tracking
As well as knowing when in your cycle you are at risk of becoming pregnant, using a birth control app can provide information on other key events in the menstrual calendar. Period tracking means youll know when in the month to stock up on pads and tampons. On top of that, you can anticipate PMS and the app will also tell you the best time to carry out a self-breast exam.
While many of us dont choose birth control first and foremost as a means to learn more about our bodies, Natural Cycles regular period tracking offers an educational side-effect. Cyclers, users of the app, are often surprised to learn how little they dont know about their bodies.
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Look Into Hormonal Birth Control
Hormonal birth control methods like the hormonal IUD, implant, pill, patch, ring, or shot can really help with period cramp relief, PMS, and other period problems. If you have hella bad cramps that ruin your life every month , hormonal birth control can be a real menstrual GOAT. Our Spot On app also has birth control reminders and handy tips n tricks to help you get the most out of your method.
Who Should Use Natural Cycles
- You must be over 18 years old
- People unable to use other types of contraception due to medical conditions
- Those wanting a form of contraception that doesnt affect their periods
- Those that are able to take their temperature every morning
- Those happy to abstain from sex or use other forms of contraception on red days
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What Are Birth Control Apps
Birth control apps, also known as digital birth control, are a new player in the landscape of contraceptive health. While monitoring fertility through period tracking is no new concept, advances in technology and the age of the smartphone have made this more user-friendly and accessible.
Different fertility trackers use different methods. For example, the Natural Cycles birth control app is powered by an algorithm which identifies fertility and allocates green days and red accordingly.
How I Learned What My Cycle Was Trying To Tell Me
I first learned about cycle tracking from a book called Taking Charge of Your Fertility. It provided an explanation of how to monitor your temperature and cervical mucus to determine fertility. I began using the provided chart to track my highly irregular and painful cycles. After a month, I felt a shift that I can only describe as spiritual: I developed a new and healthy relationship with my cycle.
Previously, I believed my period condemned me to pain each month. Now, I felt a sense of reverence for my bodys wisdom.
My cycle here to tell me something! I realized. I delved into further research about how I could balance my cycles. This led me to write Quit PMS: Naturally End Your Menstrual Misery, which became an Amazon bestseller.
In the years since writing Quit PMS, my relationship with my cycle continued to deepen. Because I am in communication with my cycle, I understand and predict fluctuations in my emotions, energy levels, and libido.
Cycle tracking also provides and approach to birth control that doesnt require synthetic hormones. I hold the opinion that artificial hormones arent in synergy with the human body. However, you dont have to agree with me to use Natural Cycles. Natural Cycles does believe that hormones have a place in birth control, but they do offer an alternative.
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Effectiveness Of Nonhormonal Birth Control Gel
When used as directed by a medical professional, Phexxi is 93 percent effective, according to the company. But in typical use , its effectiveness drops to 86 percent.
That means it may not work for roughly 14 out of every 100 people who use Phexxi as their sole method of birth control.
Nonhormonal birth control gel has a higher effectiveness than that of a male condom, female condom, or spermicide, per the FDA . However, its less effective at preventing pregnancy than oral contraception, the patch, shots, IUDs, or surgical sterilization.
Using Phexxi with some other types of birth control can make the gel more effective, though. While it cant be used with vaginal rings, it can be used with:
While Phexxi doesnt come with the same side effects as hormonal birth control, it does have certain risks.
The most common side effects of the nonhormonal birth control gel include:
- vaginal burning, itching, or discomfort
- yeast infections
- bacterial vaginosis
- vaginal discharge
In clinical studies of the gel, a few cases of bladder and kidney infections were reported, one of which was serious.
With that said, side effects are uncommon, and when they do happen, they tend to be mild. Fewer than 2 percent of participants in clinical trials stopped using Phexxi due to an adverse reaction, according to the manufacturer.
You should not use Phexxi if you or your partner are allergic to the birth controls ingredients, which include:
A Different Nonhormonal Birth Control Option
- By Huma Farid, MD, Contributor
Until recently, people seeking hormone-free birth control have found few options available. The most effective and long-lasting nonhormonal option is the copper intrauterine device . Barrier methods sometimes are paired with spermicide to boost pregnancy prevention rates, or spermicides may be used alone . Apps and tests to track fertile days bring a high-tech sheen to the so-called rhythm method, but most ob/gyns do not recommend these as a way to prevent pregnancy.
Not until 2020 did the FDA approve a new nonhormonal birth control, Phexxi, which came on the market last fall. Should you try it if youre looking for a new option?
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What Are The Benefits Of Non
The copper IUD is really good at preventing pregnancy, and its totally hormone free. So its a good option for people who prefer non-hormonal birth control, or cant use methods with hormones because of medical reasons.
The copper IUD can be used as emergency contraception a way to prevent pregnancy AFTER unprotected sex. IUDs are the most effective form of emergency contraception. If you get one inserted within 120 hours after having unprotected sex, its more than 99% effective against pregnancy. And you can leave your copper IUD in to keep preventing pregnancy for as long as you want, up to 12 years.
There are lots of other benefits to IUDs too. Theyre super convenient once your copper IUD is in place, you dont have to think about birth control for up to 12 years. IUDs are also one of the most effective methods of birth control you can get. Theyre more than 99% effective at preventing pregnancy. But if you decide you want to get pregnant, you can get your IUD removed whenever you want and your fertility will go back to what’s normal for you right away.
Fertility Cycles Can Be Hard To Predict
Since Natural Cycles algorithm is proprietary, its unclear exactly how it learns a woman’s fertility cycle, which can be extremely unpredictable. This is why even the most diligent rhythm method users have gotten pregnant, and why this app isnt a contraception method that many OB-GYNs would jump to recommend, especially for young women and teens.
While some women have cycles that range the average 28 days, many have more erratic cycles. Even women who have a history of predictable cycles could be thrown off by a list of factors, says Swiner.
Sleep, stress or recently coming off of can create irregular periods, Dr. Swiner says. Dr. Abdur-Rahman adds that even aggressive exercise can throw off your cycle.
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