As I’m now hitting my sixth week postpartum, I find my mind overrun with a topic most women have at some point in their lifetime: birth control. Because of my negative experience with the birth control choice I made following my first son’s birth, I’ve made the decision to pursue birth control options alternative to those offered by the medical industry. But are there really other options? Since I was about nine or ten years old, when I first discovered my mother’s birth control pills, I’ve known about and understood the purposes for contraceptives. I clearly remember learning about the need for condoms in my sixth-grade sex ed. class and, as the years passed, the other options for preventing pregnancy; the shot, the patch, the IUD, and even the implant. Birth control is no secret in this country. Actually, according to the CDC, 62% of women of child-bearing age are using some form of contraception with the pill being the most common preference. But as much as we hear about birth control, not much is really explained regarding effectiveness, and more importantly, safety. Women are not presented with alternative options, though they do exist, so most are left with the belief that the only way to prevent pregnancy is birth control or abstinence. The good news? There is scientific evidence on many natural forms of pregnancy prevention that have been proven at least as effective as birth control offered by the pharmaceutical industry.
What are the Problems with Conventional Birth Control?
According to the FDA, there are several different types of reversible birth control options available, which all come with a number of potential undesired side effects. These side effects can range from mild cramping, headaches, and irregular periods, to the more severe: uterine perforation, stroke, and ectopic pregnancy. All forms of birth control, besides the copper-containing Paragard IUD, contain synthetic hormones in order to aid in preventing pregnancy. With your body already naturally producing these hormones, many wonder how the synthetic versions of them affect the woman’s body, and its ability to get pregnant in the future. Many medical professionals have long been interested in the link between hormones and mental illness, and it has even been determined that the use of hormonal contraceptives could greatly impact mental health. Researchers discovered that after just six months of use women, and more especially adolescents, were at a 40% increased risk of developing depression, than women who were not taking synthetic hormones.
And mood disorders are, sadly, only the tip of the iceberg. Since 1980, scientists have recognized a possible link between hormonal birth control and liver issues; including tumors of the liver, and liver cancer. The reason for this is because it is up to the liver to break down these hormones, and because they are not naturally occurring, this process can be very taxing on the organ. And, impacting the liver has the potential to disrupt the entire body. Take the gallbladder, for instance. The gallbladder’s main purpose is to take bile, created by the liver, and store it. So, when the liver is affected, the gallbladder often is, too. According to Dr. Lewis, gallbladder removal surgeries are on a significant rise in the United States, and interestingly, the patients are getting younger and younger. Gallbladder disease also disproportionately affects females over males, and it’s been discovered that one reasoning for this is because of the excess estrogen introduced into the body via hormonal birth control. This extra estrogen “can increase cholesterol levels in bile and decrease gallbladder contractions, which may cause gallstones to form.” Hormonal birth control has also been documented as robbing women blind of vital nutrients and vitamins, including zinc, B6, and B12, and Vitamin E [8, 9, 10, 11, 12] Scientists also are beginning to recognize the link between hormones and bone health, and when it comes to long-term (2+ years) hormonal birth control use it has been documented that a woman’s bone density is reduced. This is especially concerning, as women are already naturally at a higher risk of developing osteoporosis. Really, when you think about it, it’s hard to come up with a way that synthetic hormones don’t affect us. The American Cancer Society even categorizes oral contraceptives in the same group as tobacco and formaldehyde, as known human carcinogens. In fact, contraceptives may even interfere with the very way we choose our life partners. A woman’s natural hormones impact the men that she finds attractive and wishes to mate with. For instance, when a woman is ovulating, science has shown that she seems to prefer more masculine male features and a partner that is genetically dissimilar to herself. However, women taking hormonal birth control miss out on those fluctuating hormones, and tend to have “more steady hormonal conditions associated with pregnancy.” Because of this shift in hormones, a woman’s attractiveness to men can actually be reduced which can, effectively, have “long-term consequences on the ability of couples to reproduce.”
What about Non-Hormonal Options?
With the introduction of IUD’s, or intra-uterine devices, many women have turned to these longer forms of birth control. Because some women react badly to hormonal versions of birth control, they believe they will have a better experience when choosing Paragard, a non-hormonal IUD. Unfortunately, as more research emerges, we are beginning to understand that the Paragard IUD may not be a better option after all. Instead of hormones, Paragard actually slowly releases copper into the woman’s body to help prevent pregnancy, is placed into the uterus by a physician, and can stay in place for up to 10-12 years.
Many people wonder how copper, released into the uterine cavity, actually prevents pregnancy. And honestly, that’s a very good question. As with any heavy metal, one may be concerned about its effects on the body, and also the potential to contract something called copper toxicity. The way the Paragard works is because copper is an extremely effective spermicide, inhibiting the motility of the sperm, and even detaching the heads of the sperm from their tails. The copper IUD also increases the number of prostaglandins produced, which also helps prevent sperm from reaching the egg, but can also cause inflammation during the menstrual cycle. As a woman sheds the lining of the uterus, prostaglandin secretion is already increased to help the uterus contract and release all that’s inside. Because the inflammation is increased to a more unnatural level, women with a copper IUD are at a higher risk of more severe cramping and heavier bleeding during a period, anemia, breakthrough bleeding (or, bleeding between periods), vaginitis, and pain during intercourse. And, science has shown that while some of these issues may get better over time (3-6 months after insertion), many do not. There is also the risk of the IUD either not being placed correctly or becoming dislodged and traveling somewhere else. This can result in IUD expulsion, uterine embedment, and even uterine perforation[19, 20, 21].
So, What are the Natural Options?
The ‘pull-out’ method, or coitus interruptus, is one of the most commonly known natural forms of preventing pregnancy. It is also one of the most frowned upon, because when not done properly, can result in an unwanted pregnancy. This method relies purely on self-control of the man, and is done by withdrawing the penis from the vagina, and away from the female’s external reproductive organs, prior to ejaculation. Often, this method of birth control is looked at as ‘better than nothing’, but not very effective at all. Contrarily, studies have shown that when conducted properly, as with almost any form of conventional birth control, the withdrawal method can be nearly as effective as the male condom. According to research done at the Guttmacher Institute in New York, if the man “withdraws before ejaculation every time a couple has vaginal intercourse, about 4% of couples will become pregnant over the course of a year.”
That means, when done correctly, the pull-out method can be about 96% effective. With the bad name it’s received over the years, that number comes as a shock to many. Of course, we’ve all heard about the dangers of pre-ejaculate, and that’s where things get interesting. Two studies conducted in the United States found that most sample of pre-ejaculate didn’t contain any sperm at all[23, 24]. And, what about those small samples that did? The sperm seemed to be immobile. Many other studies have backed this finding, and according to the National Institute of Health, “to date, no study has found motile sperm in the pre-ejaculate.”
Pretty much everyone knows about male condoms. They’re easily accessible, fairly convenient and, when used correctly, about 98% effective at preventing pregnancy. One reason condoms are so well known is because of their ability to help prevent the transmission of STD’s, so they are frequently recommended for people having sex outside of a monogamous relationship. One issue that can be found with condoms is the risk of the woman contracting infections. Research into condoms coated with spermicide has concluded that these types of condoms do increase a woman’s risk of developing a UTI. Lubricants used on condoms also have the ability to disrupt the very precise pH of the vagina and could result in a yeast infection. Some condoms also contain toxic ingredients, like the cancer-causing N-nitrosamines. When in contact with bodily fluid during intercourse, these nitrosamines can be released from the condom, and into the vagina and penile skin. Exposure can lead to liver tumors and cervical cancer.
Testing for Ovulation/Cervical Mucus Method
Also known as the ‘ovulation method’ this version of birth control simply uses the consistency of cervical fluid to determine fertility. This type of contraception takes some getting used to, as a woman learns the ins and outs of what is ‘normal’ for her body, so it’s important to use another type of protection as she is learning. Throughout a woman’s natural cycle, she has different forms of cervical fluid, and recognizing these forms and what they mean is key to preventing pregnancy when using this method. In this method, women check their cervical mucus daily, chart it, and determine when they are fertile. As this method grows in popularity, more resources become available to women who choose to go this route. Phone applications, like Ovia Fertility, and Kindara help women track their cycle with ease. For those new to understanding cervical mucus, this method can seem extremely confusing. In general, the discharge produced by a woman’s vagina follows a pattern during her cycle. We all know about menstruation, which typically lasts anywhere from 3 to 7 days. This is followed by several ‘dry’ days where a woman is deemed likely infertile. These dry days are followed by a period of about 10 ‘wet’ days, where the cervical mucus goes from creamy (think lotion), to wet and watery, to sticky (think egg whites). This wet period is known as the fertile period, with the wettest, or Peak day being around the time of ovulation. This fertile period is then followed by about 10 more dry, or infertile, days before menstruation begins.
One of the most common types of tracking cervical mucus for contraception are the Billings Method. The Billings Method follows four simple rules to help a woman prevent pregnancy: avoid intercourse on days of heavy bleeding, have intercourse on alternate evenings of you BIP (or ‘dry days’ following menstruation), when BIP changes wait and see, and wait until the 4th day after Peak to have intercourse. When conducted properly, the Billings Method has been proven up to 99% effective in preventing pregnancy. A huge advantage of this method is that the woman begins to know and understand her body, which can come in handy when trying to conceive, and recognizing anomalies in her body.
When learning her own body, another way to know exactly when a woman is ovulating is by taking an ovulation test. These tests are similar to pregnancy tests, in the pee-on-a-stick way, and will tell you precisely when you have ovulated. When first becoming accustomed to her cycle, a woman can take these tests daily to determine her most fertile times. These ovulation predictor strips can be purchased in bulk for relatively cheap on Amazon.
Neem, an herb originating from the Azadirachta indica tree which grows on the Indian continent, has long been used as a form of birth control. In many developing countries where the neem tree grows, conventional forms of birth control simply aren’t available, so this requires the natives to search for their own ways to prevent unwanted pregnancy. Through research, though it is still limited, neem oil has proved to be the most effective form of contraceptive, especially when used applied as a lubricant prior to engaging in intercourse.
The way that neem works via lubrication is because it is naturally an extremely potent spermicide. Studies have shown that “human spermatozoa became totally immotile within 30 seconds of contact with the undiluted oil.” When tested on rats, rabbits, monkeys, and human volunteers showed that when neem oil was applied vaginally prior to sexual intercourse, pregnancy was prevented 100% of the time. If unprotected sex does occur, neem oil is almost a natural version of the Plan B pill, and if taken within 2 to 7 days, neem oil can completely prevent implantation. While many vaginal spermicides cause severe irritation in the vaginal canal, neem oil left no ill effects in these tissues.
Interestingly, neem leaves can also be used as a form of male birth control. You read that right, ladies, male. birth. control.
In both India and the United States, studies conducted on monkeys have found neem to be an effective form of male contraception. Not only was fertility reduced, which was completely reversible after discontinuing use, but neither libido nor sperm production was altered. Neem leaf (found here) and neem oil (found here) are always kept in stock at my house!
Natural Family Planning/Fertility Awareness Method
Natural family planning is kind of like the cervical mucus method on steroids. This type of pregnancy prevention combines and tracks cervical mucus, basal body temperature, and the calendar. This is extremely precise, and like the Billings Method, takes a few cycles to really understand what your body is doing. When using this method, the first goal is to understand your cycle, and what is normal for you. This type of birth control is most effective when you are committed to it and it is used precisely, and when combined with other forms of birth control or abstinence during your fertile days.
First, when considering the fertility awareness method, it’s important to understand how your cycle and how your body works. Each month on your Peak, or ovulation, day, your ovary releases an egg. For about one day, the egg hangs out in the fallopian tubes waiting to be fertilized by sperm. It’s also important to note that sperm can live within your body for up to 5 or 6 days after sex, so theoretically you could get pregnant up to 1 week after sex. If the egg isn’t fertilized, it dissolves, and you get your period. This means that for about 7 days out of every month, you could potentially get pregnant. This is considered your ‘fertile’ period, and the whole purpose of the fertility awareness method is to identify when this is.
Basal Body Temperature – Throughout the month, your body temperature naturally fluctuates, increasing slightly after ovulation. In order to properly identify and record your basal body temperature, it must be the first thing you do every morning. Before checking your phone, before you get out of bed, check your temperature! You’ll want a thermometer that records temperature to the 100th degree, meaning that it measures up to two decimal places. For instance, my BBT was 97.05F this morning. Some people record their temperature on paper, but apps like those linked above will help track your temperature and some like OvuView will even predict your fertile window for you.
Along with tracking cervical mucus to identify fertility, many women will also record and track their cervical positioning. Throughout your cycle, just like the mucus, the position of your cervix changes. During your period your cervix is firm, like the tip of your nose, slightly open, and close to the opening of your vagina in order to allow blood to pass. The cervix remains this way until you begin to approach ovulation when it softens, like your chin, and goes higher into the birth canal. As you ovulate, your cervix continues to soften, think of the way your pursed lips feel, and goes so high and soft that it almost seems to blend into the vaginal walls. At this point, you have entered your fertile window. One great way to remember your fertile window is with the acronym SHOW – soft, high, open, and wet. In the period directly following ovulation, the cervix begins to harden again and close tight, and lower into the vaginal canal once again.
Finally, the last component of tracking fertility is through calendar tracking. Tracking your cycle on the calendar takes a bit more time (at least 6 months). On a calendar, thankfully many fertility apps do this for you, calculate the length of your cycle. This can be done by counting the number of days between the beginning of your first period and the beginning of the next one. Planned Parenthood gives an extremely informative way to determine ‘safe days’ to have sex throughout your cycle.
To predict the first fertile day (when you can get pregnant) in your current cycle
Find the shortest cycle in your past record.
Subtract 18 from the total number of days in that cycle.
Count that number from day 1 of your current cycle, and mark that day with an X. (Include day 1 when you count.)
The day marked X is your first fertile day.
Many women are simply tired of the status quo, and simply dealing with the negative side effects that come from using conventional birth control. For this reason, more natural versions of pregnancy prevention are popping up, like the Fertility Awareness Method. Not only are these options for contraception more appealing because of their lack of side effects, but they also give women a better chance of becoming pregnant when she wants to. When on traditional forms of birth control long-term, it can sometimes take months or even years for your body to ovulate again. These choices allow you to become the boss of your own body, and allow your own natural hormones to run the show.
Until next time,