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Interest in Natural Birth Control Apps Is Rising. Here's Why

More young women are ditching the birth control pill and embracing the rhythm method, a natural birth control option that pinpoints ovulation by tracking basal body temperature.

The fertility awareness method, AKA the rhythm method, is a hormone-free family planning strategy that involves tracking body temperature and other signs of ovulation to identify when a woman is most fertile.

The rhythm method is one of the oldest forms of family planning. It began as a calendar-based method in the 1930s, which tracked ovulation based on previous menstrual cycles. Then, after scientists discovered that body temperature spikes and cervical mucus changes can indicate ovulation, the rhythm method, initially coined the Sympto-Thermal method, emerged on the scene.

At the time, the rhythm method was popular among women who wanted to control their fertility, as birth control options were limited.

That is, until 1950, when a highly effective hormone-based oral contraceptive, simply called the pill, became available. After its invention, other family planning methods, including the rhythm method, fell by the wayside.

However, despite the recent overturn of Roe v. Wade, the rhythm method is making a comeback, driven by young women who are pushing aside hormone-based contraceptives in favor of natural birth control smartphone apps, including rhythm method apps cleared by the U.S. Food and Drug Administration (FDA).

Why are women walking away from hormone-based contraceptives?

Maria Jones, a 26-year-old geological engineer from Wisconsin, tells Healthnews that she believes the birth control pill played a role in severe gastrointestinal issues she was experiencing — issues that cleared up after stopping the drug.

When she first chose the pill at age 15, the prescription was for a brand-name product.

I never had any issues, but then [my] insurance switched, and I was prescribed a generic version of the pill. And that's when I started noticing that I was having digestive issues.

Jones

Jones says her digestive problems were similar to irritable bowel syndrome (IBS), with severe cramping and an urgency to have a bowel movement soon after eating, and this would happen up to three times a week. She would also have vomiting episodes.

"I just couldn't figure out what the digestive issues were connected to. I tried no dairy, going gluten-free, and it didn't do anything," Jones explains. "The only thing I was taking was the birth control pill."

Christine Greves, M.D., a board-certified obstetrician and gynecologist at Orlando Health and contributor at Drugwatch, tells Healthnews, that, like all medications, the pill may have side effects.

"And in this case, gastrointestinal issues may be a side effect in some people. For example, an upset stomach, nausea, vomiting, or constipation may occur," Greves explains.

However, in addition to digestive problems, Jones says her libido was nonexistent, adding to her growing suspicions about whether the pill was to blame.

Then, at age 25, she ditched the pill.

After almost a year, her digestive symptoms disappeared, and her libido dramatically improved.

Looking for an alternative, Jones and her friend stumbled across the Natural Cycles App on social media. The app, which the FDA cleared for marketing as a contraceptive option in 2018, is essentially a digital version of the rhythm method.

"Me and my friend talked about doing it for a long time because we're both on the pill, and she was having weight and depression issues," Jones says.

Greves tells Healthnews that typically, women like to try the pill first because that is the easiest option and offers the benefits of decreasing the flow and pain of a period.

"However, if they find that the pill is not for them, regardless of the reason, that is usually the reason that they explore the rhythm method," Greves says.

How can a smartphone app prevent pregnancy?

Melina West, a healthcare worker from North Carolina, tells Healthnews that interest in non-hormonal birth control options like fertility tracking apps such as Ovia, Clue, and Natural Cycles are "definitely trending right now."

"There are several apps that offer period tracking that can help with fertility awareness by tracking monthly patterns, [including the] Natural Cycles [app] that uses an algorithm with your daily temperature to predict fertile and infertile days," West explains.

The app works by tracking a woman's basal body temperature every morning by mouth or a device such as the Oura ring or Apple Watch. Basal thermometers differ from the types people usually use, as they measure temperature in tenths of a degree.

However, a woman needs to take her temperature using the basal thermometer immediately upon waking up, around the same time every day, and record the reading in the app. Those wearing a smart ring or watch may not need to manually record their reading, as the wearable device automatically sends the information to the phone app via Bluetooth.

West says using a wearable device like an Apple watch is ideal for someone who might not remember to take their temperature regularly.

"The app uses an algorithm based on temperature to predict and confirm ovulation, as temperature rises after ovulation," West notes. "With time, the algorithm has the option to include Luteinizing Hormone (LH) [test] strips to help the algorithm detect ovulation and give more green (infertile) days. LH rises prior to ovulation."

On the Natural Cycles app, fertile days, which are colored red, indicate the need to avoid sex or use another form of birth control, and the infertile "green" days suggest that no contraception is needed.

While fertility tracking apps are typically free to download, some require a subscription. However, the costs may be covered by some health insurance plans or reimbursed by FSA/HSA.

Are fertility awareness apps suitable for everyone?

While anyone can use the fertility awareness method, it might not be the best choice for some. For example, if a woman's cycle is highly irregular, the app may have difficulty tracking fertile and infertile days effectively.

Greves says that women with a medical condition where pregnancy would pose a significant risk to the mother or the fetus or those currently using birth control or hormonal treatments that inhibit ovulation should not use fertility apps.

After using the app, Jones concludes that it's best suited for a responsible person with a regular daily schedule. For example, women at specific life stages, such as when they are attending college, may have an irregular sleep schedule, which can make it challenging to track morning temperatures.

"I think if you want to have kids in the near future, you would be an ideal candidate for this because they say you should be off of birth control for six months a year before you try to conceive," Jones says. "I think [it would also be a good option for] someone who has tried everything and has experienced problems with the IUD, the implant, or the NuvaRing."

Jones explains that a person needs to have patience when first starting a fertility awareness app since it takes some time for the app to learn an individual's cycles.

"And, if you're having sex, you need to have a partner who's respectful of it," Jones says.

Open dialogue helps increase awareness

Women may be more aware of the potential downsides of the pill and other hormone-based contraceptives because of an increase in open and honest discussions about it.

"Now it's widely talked about — like women's issues obviously are nowadays," Jones says. "People are like, 'Ooh, you don't have any libido. I don't have any libido, either. We're both on the pill. Yeah, like, what's wrong with us? It must be the pill.'"

West tells Healthnews that she would have switched sooner if she had known about effective non-hormonal methods.

"I thought my anxiety was just a part of getting older, but after I had my hormonal IUD removed, my anxiety went away," West explains. "I have shared my experience with many other women who have since had a similar experience and satisfaction with getting off hormonal birth control."

Awareness of natural birth control options, especially FDA-approved methods, also comes from healthcare providers. However, Jones and West say many doctors don't seem to know enough about it.

Jones tells Healthnews that when she told her doctor about stopping the pill and beginning the app, she was told she would get pregnant.

"I have personally found this method is not provided as an option as much as it should be, and many providers are unfamiliar with the different app options," West says.

She believes it's essential for women to know that there are effective non-hormonal options available.

Other non-hormonal birth control options

Aside from the fertility awareness, or rhythm method, Greves says the copper IUD is very effective and does not contain hormones.

"The condom is an option, but [it] may break and not be as effective as the IUD," Greves adds. "Other options include contraceptive gel or a spermicide, but those are all less effective than the IUD."

Still, condoms and spermicides may be birth control options that women can use with their fertility awareness app.

*Maria Jones' name has been changed for privacy reasons.


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