Written by Natasha Richardson
Many people are now ditching “the pill” and looking for more natural alternatives. Thankfully there is a way to stop unwanted pregnancies without hormonal intervention.
Why I ditched the pill
After 4 years of having taken the contraceptive pill (microgynon 30 specifically) I was sick of the constant thrush/cystitis cycle I found myself in. I’d been getting informed and empowered about the amazing benefits of ovulation to mind and body and I wanted to experience it for myself.
When I was about 19 I was taught how to use the hormone-free fertility awareness method as a contraceptive by an NHS nurse. Little did I know how incredibly rare this service is!
Although my experience with the contraceptive pill was negative in the end, I had taken it for many years without issue before then.
The pill’s side effects
While your contraceptive provider is there to help you, there is a chasm of difference between the side effects they think you need to know about and the ones that so often lead to people quitting their hormonal contraceptives. When I was researching the history of the contraceptive pill for my masters this became more obvious than ever (1).
The research papers which looked into the side effects of the contraceptive pill would list life-threatening illnesses such as blood clot risk. But the reasons why people would stop taking their contraceptives would range from hair loss to loss of libido. Hardly life-threatening, but incredibly important to the lives of those taking them. As women and anyone with wombs get more informed and empowered about their bodies they’re less likely to put up with those life-changing side effects and are instead seeking out natural alternatives.
The most effective hormone-free contraceptive
The most effective hormone-free contraceptive is the fertility awareness method. With an effectiveness rate of 99% when used correctly it works better than the most popular hormonal contraceptive with an effectiveness rate of 91%; the pill (2).
The fertility awareness method
The fertility awareness method works by teaching you how to read the signs of your body. If you keep track of two out of three things; your waking body temperature, cervical mucous and/or cervix position you will be able to tell when you’ve ovulated. Because an egg only lasts up to 48hrs in the female reproductive system before dying you only have up to 48hrs where it can come into contact with sperm (3). However, because sperm lives for up to 10 days in fertile cervical mucous, if you’ve had sex in the 10 days beforehand, it’s possible you will get pregnant.
Having said that, this is a very conservative estimate, there is only a 5% chance sperm will survive more than 4.4 days and a 1% chance sperm will live more than 6.8 days in a fertile woman (4). By knowing when you are producing the sort of cervical mucous which would keep sperm alive, versus the mucous which actually acts as a barrier to sperm you can know when to avoid and when to have sex. I learnt the method through an NHS registered FAM practitioner, but you can learn it through books and I teach it in my Periods 101 online course too. What’s nice about this method is that you can choose how cautious you wish to be.
When I was learning it, I continued to use a barrier method for 6 months and abstained during my fertile phase. Once I felt more comfortable then I dropped the barrier method during the non-fertile days with my long-term partner. At my most cautious I had 3 contraceptives in my defence system! The first was FAM, the second was a condom, and the backup plan was the emergency contraceptive pill if a condom failed and I was near a fertile day. When the time came to try to conceive, I got pregnant on the very first month of trying (much to my husband’s surprise!). After over 10 years of using the method I don’t chart anymore, I just instinctively know when I’m ovulating.
Barrier methods vary in efficacy. A rate of 98% means that for every 100 men having sex with a male condom 2 will get pregnant:
- Male condom is 98%
- Female condom is 95%
- Diaphragm and caps (when used in combination with a spermicide) have a 92-96% effectiveness (5)
The diaphragm and cap have really fallen out of popularity and aren’t completely side-effect free because the spermicides that make them so effective change the Ph of the vagina, can cause local irritation and can damage the epithelial cells too (6). If you want to use them, perhaps in combo with another method, you’ll need to request to have one fitted by your doctor/obgyn.
For me personally, there is another element to going hormone-free when it comes to contraceptives. When you become attuned to your body it becomes intolerable to artificially alter your hormones. You notice how they change your mental state, your libido, your agility, your physical well-being and more. I enjoy being on the natural rollercoaster of hormones now that I know how to work with them, rather than against them. My research into the history of the contraceptive pill looked at why people chose to use it in the first place. The most common answer was to manage the regularity of their periods. Specifically that the irregular nature of their period was too much of an inconvenience. Why? Because most of the working world is constructed around male physiology which fluctuates less. It can also be extremely hectic, busy and high pressured and often doesn’t allow us time to rest, time to dream, or time to be. One benefit coming from the pandemic is the flexibility of the working world now. I hope that women can spearhead a new cyclical way of working which sees the benefits of rest at the core of it and natural contraception use will most likely grow along with that.
- Inoue K, Barratt A, Richters J. 2015. Does research into contraceptive method discontinuation address women’s own reasons? A critical review. Journal of Family Planning and Reproductive Health Care. 2015;41:292-299
- Statista.com, 2019. Methods of contraception used by women in the United Kingdom (UK) in 2018. [online] Available at: https://www.statista.com/statistics/1063613/contraception-use-among-women-in-the-uk/ [Accessed 12 May 2022]
- Knight, J. 2016. The Complete Guide to Fertility Awareness. Routledge: UK.
- Ferreira-Poblete, A. 1997. The probability of conception on different days of the cycle with respect to ovulation: An overview. Advances in Contraception. 12, (2-3), p.83-95.
- nhs.uk. 2022. Contraceptive diaphragm or cap. [online] Available at: <https://www.nhs.uk/conditions/contraception/contraceptive-diaphragm-or-cap/> [Accessed 11 May 2022]
- Bishop, K. 2022. It’s Your Power Portal: Take Control of Your Vaginal Health with Herbal and Holistic Care. Aeon publishing: London