Contraception without messing with your hormones

You may have seen my articles on the pill and the hormonal IUD where I share my not so positive thoughts on hormonal birth control. 

So what are the best alternatives? In this article I share the full lowdown on all the non-hormonal birth control options so you can make an informed choice.

Before I begin let’s have a quick biology lesson. 

Did you know that women are only fertile for 6 days of their cycle? The 24hrs after ovulation and the 5 days prior to ovulation thanks to our magical cervical fluid which keeps sperm alive. Men however are fertile every. single. day. from puberty until they die!

When we are making our contraception choice, we want to know how effective it’ll be. Duh, obviously! There’s what we call “perfect use” and “typical use” success rates. I’ve listed below the “typical use” success rate which reflects that contraception is not always used exactly as it says on the instructions.

Ready to learn more? Let’s dive in!

Male vasectomy (over 99% effective)

  • In my opinion, this option is not talked about enough so that’s why I’ve put it first on the list! For a couple in their 30s and 40s who feel their family is complete, I believe this should be the first birth control option they discuss.
  • The operation is usually carried out under local anaesthetic, where they’re awake but don’t feel any pain, and takes about 15 minutes
  • It doesn’t affect your sex drive or ability to enjoy sex. They’ll still have erections and ejaculate, but their semen won’t contain sperm.
  • It’s very difficult to reverse, so obviously you need to consider if it’s right for you and your partner.

Barrier method 

  • 87% Condoms – it’s important to use the right size and this and this websites give size options, and there’s a new condom here
  • 83% Diaphragm or cervical cap
  • The barrier methods are the only contraceptives that prevents transmission of STIs
  • Best to avoid spermicides as they can affect the vagina’s microbiome

Copper IUD (99.2% typical use)

  • Copper ions emitted by the copper IUD are toxic to sperm and stop them  reaching the egg
  • Can be used for up to 10yrs
  • Periods can become longer, heavier or more painful
  • Many women report painful insertion of the IUD
  • There is the risk of copper excess and/or small risk of uterine perforation

Fertility Awareness Method (85% typical use)

  • Bodily changes are tracked to identify your 6 day fertile window, such as your cervical fluid, basal body temperature and cervical position
  • It is most effective when you work with a fertility awareness practitioner, like my friend and colleague Louise Ryder (who is a guest expert on my 6-week course Embrace Your Cyclical Power)
  • Penis in vagina sex should be avoided or barrier methods used during your fertile window

Fertility Tracking Devices

  • The femtech industry has exploded over the last 5-10 years with Apps, thermometers and wearables that claim to track when we are fertile
  • With Apps, the most reliable one are those which ask for information beyond just your cycle length, such as your basal body temperature and cervical mucus. If they don’t ask you for this, the App is just using the calendar method, guessing when your next period is due based on your last periods. Stress, illness and life in general can affect when we ovulate each month, so we don’t want to rely only on an algorithm!
  • As for devices, Natural Cycles, which uses a thermometer linked to an App, is the only FDA and EU approved contraceptive. It has a 93% typical use. Although it records your daily temperature it still uses an algorithm (using yours and other users’ data) to predict when you will ovulate. For the reasons I mentioned above critics feel this is less than ideal.
  • Some other popular devices include Daysy Fertility Monitor (which claims to have a 99.4% accuracy), Ava Fertility Bracelet, iFertracker, Mira Fertility Tracker, OvuSense and Tempdrop
  • With all femtech, do check how the companies intend to use your data. Clue is very clear it doesn’t sell your data

Female sterilisation (over 99% effective)

  • Long term and very difficult to reverse

Phew, that was a lot of information, hey? At least I hope it’s given you a good overview of all the options you have that don’t mess with your hormones.

If you’re keen to be fully informed about your contraceptive choices and ways to support your health through your 30s and 40s, you will love my 6-week live course Embrace Your Cyclical Power.

“PMS kind of switched me into a Mr Hyde every month and I was very upset about it - I felt I was fighting a losing battle of self-control. Now I have learned to be kinder to myself and I can handle PMS and perimenopause much better”.

Christel Ong, Massage Therapist, Singapore