After my instagram post “What you’re told about the pill VS What you should be told about the pill” went viral (if you missed it click here), the biggest question I received was…
“If not the pill, then what are non-hormonal birth control options?”
I’m going to be answering this question for you!
But first a disclaimer. I am not your doctor nor am I giving medical advice, the information below is for educational purposes only and it is up to you to seek further guidance & research about your options. I share resources below to help you out as well 😀
There are so many different forms of birth control – hormonal or not, and what works for one person, may not work for another. This is about empowering yourself with the information and having informed conversations with your doctor so that you can discover the best option for you and your health.
At the end of the day, when it comes to the pill, the implant, the patch, the depo, the hormonal IUD – these forms are effective at birth control, however they don’t come without their side effects and are not real solutions for fixing hormonal imbalances and period problems.
I wish all women were provided with more education around how their hormones work so that a deepened understanding is held around common signs and symptoms, what causes them and how to effectively manage them naturally instead of being prescribed hormonal birth control which is the conventional blanket prescription for anything hormone related.
Same goes for preventing pregnancy. Instead of using synthetic hormones, can we learn the inner workings of our own natural hormones to better understand our bodies, periods and prevent pregnancy? It is absolutely possible – we’ve just never been taught how!
So, let’s dive in to the different non-hormonal forms of birth control:
Fertility Awareness Method
Fertility Awareness Method (FAM) is something I wish I had known from when I had my first period, and I encourage all women to learn fertility awareness method as a valuable tool for not only planning for or preventing pregnancy but for those working to master their hormones & live life more in sync with their cycles. There are a few different versions of FAM, I personally recommend the Symptothermal Method as its most effective.
So, what is FAM? It is a non-hormonal approach to birth control designed to teach you how to recognise your body’s signs of ovulation. You’re then able to predict the days in the month in which you’re fertile and can either act to avoid or plan for pregnancy.
Before you dismiss this option, distrust it, put it in the too hard basket or confuse it with the rhythm method it's important to be open minded, get up to date with the research, how it really works and how effective it can be at preventing pregnancy.
Even if its not the right method for you, using it as means of connecting with your body & internal cyclic rhythm is incredibly empowering as it allows you to gain insights and be in control of your own body. It’s exciting stuff!
This method involves monitoring your bodies proven signs of fertility which include:
1. Measuring & recording changes in your basal body temperature – consistency of cervical fluid changes in response to different levels of oestrogen and progesterone.
2. Observing cervical fluid patterns
3. Monitoring the changing position of your cervix (not everyone does this, but the more you know the more effective this method will be!)
Understanding these signs can help to avoid or achieve pregnancy. All you need is a basal thermometer, a period tracking app or paper chart & a little help on how to effectively use this method.
FAM is based on the following factors:
In each menstrual cycle you only ovulate one egg
The egg can only live for 24 hours maximum after ovulation and the sperm must meet the egg within that period for pregnancy to occur
Sperm can survive on average up to 5 days (but in some cases 5-7 days) in highly fertile cervical fluid.
What this means is that women are potentially only fertile for around 7-8 days (being conservative) out of their entire cycle. If you’re avoiding pregnancy you either abstain from sex or use protection such as a condom during this fertile window.
FAM may seem overwhelming at first but once you know it, it is LIFE-CHANGING and absolutely worth it. It’s also important that you learn FAM before rushing into using it as a form of birth control so to ensure you are doing it correctly.
Effectiveness of the Symptothermal Method:
With perfect use, the Symptothermal Method is about 98-99% effective. When typical use is 80% to 88%. Here is a study for you to read. So when used correctly, the symptothermal method has been shown to have a first year pregnancy rate of 1.8 per 100 women. The same study shows that after 13 cycles the pregnancy rate was only 0.6 per 100 women with no unprotected sex in the fertile window.
When it comes to the Double Check Symptothermal Method its 99.4-96.6% effective with perfect use and 98.2% typical use. These stats are from this study here.
Next steps & additional resources:
For guidance on Fertility Awareness Method purchase the books Taking Charge Of Your Fertility by Toni Weschler, and The Fifth Vital Sign by Lisa Hendrickson. Toni Weschler estimates her book that the method she outlines is approximately 98% effective with perfect use.
I recommend a Fertility Awareness Method Practitioner to teach you how to practice this method effectively. You can find one here or Association of Fertility Awareness Professionals.
IMPORTANT: if you are going to self-teach yourself FAM - you must use barrier protection for the first 3 menstrual cycles whilst you learn to effectively implement the method.
RECOMMENDED DEVICES & APPS
The Tempdrop Smart Thermometer: a wearable device worn on your upper arm that takes your temperature multiple times throughout the night. It then puts those temperatures through an algorithm to tell you what your true basal temperature is each night.
For community & support join the Facebook Group: Fertility Awareness Method Birth Control
Recommended Devices to pair with FAM: A basal body thermometer from your local pharmacy (must measure 2 decimal places) like this one here.
Before you scrunch up your nose, condoms are not as bad as you think they are!
Not only are there SO many more options to choose from these days (yep, Im talking options outside of what your local pharmacy has to offer!), they are also especially awesome when combined with tracking your cycle and knowing your fertile days (FAM) as you only need to use them during this 6 to max 8 day window out of the entire month. Side note: Don’t forget that they also serve the purpose in preventing STIS & HIV
Also, FYI because this is a common question – when it comes to spermicides they are not shown to be more effective, but can actually shorten the life of a condom giving them a higher failure rate and there have also been links to increased rates of UTIs in women.
Effectiveness of condoms:
With correct use condoms are 98% effective, with typical use being about 85% effective.
The Withdrawal Method
The withdrawal method is when your partner pulls out his penis before he ejaculates during intercourse. In order for it to be done successfully the man must be confident in withdrawing his penis in time AND if you want to go for a second round, he must urinate before doing so to flush out any remaining sperm in his urethra. It’s more effective than most people think, however its effectiveness is in the males hands and does not protect against STIs.
Whilst I wouldn’t recommend relying on this as a full proof method to prevent pregnancy, there is some efficacy to the practice. Correct use is 96% effective and typical use is 80% effective. If you are going to use this method I highly recommend tracking your period and knowing your fertile window so as to use protection like condoms during those days.
What about “pre-cum” aka pre-ejaculate? There are a number of studies suggesting that pre-ejaculate secretions DO NOT contain live sperm. Woo hoo!
Paragard Copper IUD
The copper IUD is a T-shaped non-hormonal device placed by a doctor into your uterus and can stay in your uterus and prevent pregnancy for up to 10 years. Unlike the hormonal IUD options, the copper IUD doesn’t disrupt hormone balance or ovulation but instead works by causing an immune response that creates a hostile environment for sperm, thereby preventing fertilization of an ovum.
It has the highest user satisfaction rating of any contraceptive medication however that doesn’t mean everyone has a positive experience. Please know this option does not “fix” period problems and it isn’t without its risks. Like any form of birth control you need to weigh the pros and cons when considering what is going to work best for you. I’ve outlined the pros & potential side effects to be aware of in the diagram below so that you’re fully informed. It also covers the hormonal IUD.
Overall, the copper IUD is the better option than hormonal birth control especially if you’re someone who wants to avoid synthetic hormones but would like long term birth control that requires low user involvement.
Effectiveness: 99.2% effective and lasts for up to 10 years.
A diaphragm is a safe, non-hormonal, reusable and flexible silicone dome that fits over the cervix to prevent sperm from entering. It is inserted into the vagina before intercourse and has to be used in conjunction with a spermicide in order to prevent sperm from reaching an egg. Placing a diaphragm correctly can take practice and its recommended to speak with your doctor to discuss how to best use it successfully.
Compared to a condom (which only has 1% more in typical use rate) the benefit of a diaphragm that it’s putting birth control into YOUR hands so no worrying about whether or not he has a condom or not, you can carry it in your handbag and be protected when you want to be protected! Many people also report that its more pleasurable for both partners, however one argument against the diaphragm is that its not as particularly user-friendly as you have to remove it 6 hours after sex whilst condoms are easy to put on/pull off.
One other thing to be aware of is, that women will need to get fitted for a new diaphragm if they gain or lose a significant amount of weight, have a baby, misscarriage, abortion or undergo certain surgeries. Potential contraindications to be aware of are UTIs, vaginal infections like thrush and BV and discomfort when placed.
Correct use: 94% effective, and typical use is 88% effective when used with spermicide, and 80% effective when used without spermicide.
Recommended brand: Caya
Note: Diaphragms do not protect against the transmission of STIs.
At the end of the day no contraceptive is 100% effective at completely preventing pregnancy and they all have their pros and cons so my intention is to help you become more informed so that you can make a more educated decision when you choose which method is going to best suit your individual needs & circumstances. Every person has the freedom to make their own choices when it comes to contraception, and what will work for one person, may not work for the other.
For me personally, I experienced depression, anxiety, chronic UTI’s and thrush when I was on the pill which impacted my quality of life drastically – so the time and effort I put in to properly learning the symptothermal method which has 0 side effects and when done correctly is just as effective as the pill was really worth it for me. Sure it can be unforgiving when it comes to human error as the side effect of FAM is pregnancy, however I trust in myself and my body to implement it correctly and this its the best method that allows me to live my best life. Again, it is going to be different for everybody, FAM may not be for you and that’s okay!
Seeing a Naturopathic or functional medical doctor is excellent for discussing birth control options and a natural approach to hormonal imbalances.
Period Repair Manual – Lara Briden
8 Steps to Reverse Your PCOS – Dr Fiona McCulloch
The Hormone Cure – Dr. Sara Gottfried
Beyond The Pill – Dr Brighten
Sweetening the Pill – Holly Griggspall
Taking Char of Your Fertility – Toni Weschler
Women’s Bodies, Womens Wisdome – Dr CHristiane Northrup
Clinical Nutritionist Judy Cho,