Organic Birth Control: Women are Ready to Cut Artificial Hormones Out of Sex
I belong to a small minority of women in the United States who are of reproductive age, have had sex, and have never used any type of contraceptive method. I am 25 years old, I have sex regularly, and I do not use contraceptives, but according to the Guttmacher Institute, less than 1% of women in this category are like me [1] . I have never taken a single dose of the Pill, have never had an IUD or diaphragm placed in me, have never had my husband use a condom, and have never resorted to the withdrawal method. I am married and I have one baby (planned), but have not been pregnant in the last 13 months, and don’t want to become pregnant within the foreseeable future until I am ready to have another baby.
So far in reading this article you either (a) think I am lying, or (b) want to keep reading to see how the hell this is possible and see what steps you can take to making the same decision I did when it came to abstaining from contraceptives and using natural methods of contraception.
I will include a medical perspective below, as I know research on the reproductive system is the most persuasive, but I want to start with a general comment on our Western, sexualized culture. I see our society, both with men and with women, shifting to a health conscious, environmentally respectful state. If there is an option to make or purchase a product or service that is understood as organic, natural, non-GMO, paraben-free, etc., a consumer would prefer to opt for that “greener” product or service, sometimes even spending more money because of the positive impact it has on the body or ecosystem. In America, we have already seen the decline of cigarette smoking in America; the rise of modern fitness trends (i.e. yoga, marathon training, CrossFit, FitBit, OrangeTheory, SoulCycle, etc.); the expansion of dieting, superfoods, and healthy eating; and the change in our other habitats (i.e. workplaces, schools, fitness centers, etc.) to adapt to these positive health trends.
What if I told you that, as a woman, your access to our culturally-defining practice of sex has been coming at a steep price? You might be seeing the financial impact of contraceptives when you scan your explanation of benefits from the insurance company (if you’re lucky enough to have it covered by insurance). What about the impact that contraceptives, especially hormonal contraceptives, have on your body and mind? What I find fascinating is that we inspect every packaged meat product at the grocery store for hormonal additives before buying them, but we don’t hesitate to ingest inordinate proportions of artificial hormones just to have care-free sex. That is hypocritical of our values of health, and it is terrifying.
This is not meant to be a lesson in medicine, but some historical and biological facts should be established before making the case for natural methods of avoiding pregnancy. References to medical journals are linked at the bottom of this article.
A condensed history of movements in women’s reproductive health starts in 1960 when the first oral contraceptive was introduced in America and made available to women[2] . Since then, pharmaceutical companies and doctors have developed various versions of contraceptives, but the Pill remains one of the most popular birth control methods in America, comprising over 25% of current contraceptive use[3]. Interestingly, not much has changed since 60 years ago when this contraceptive was first introduced: “In the world of contraception, scientific and technological innovation has been moribund for decades.” R&D has stagnated in the industry and the popularity of contraceptives has been floating not on the innovation of new products, but on the level of marketing: “Marketing decisions, rather than scientific innovations, have guided the development and positioning of next-generation contraceptive products in recent years.” Even Carl Djerassi, the pharmacist who first synthesized the progesterone that led to the possibility of oral hormonal contraception, noted, “All we can expect well into the beginning of the 21st century are minor modifications of existing methods.”[4]
Now that we’ve established that we haven’t missed much in the past 60 years of the commercialization of hormonal contraception, I can reassure you that there has been other development for the benefit of women, but it hasn’t been in the area of hormonal contraceptives. While pharmaceutical companies were busy shuffling funds around the marketing of the Pill[5] , medical professionals in the 1950s and 1960s were developing alternative, natural methods to avoiding or achieving pregnancy based on a woman’s biomarkers that appeared during certain points of her menstrual cycle. To this day, the option to use these methods to achieve pregnancy and not just avoid it differentiates natural methods from hormonal contraceptives. These natural methods came to be collectively known as natural family planning (“NFP”) or fertility awareness methods (“FABM”). NFP methods are taught today by medical practitioners as well as certified instructors (taught by medical practitioners), and women/couples interested in NFP can take courses in person or online to learn which method is best for them.
In order to use any method of NFP, a woman (or, ideally, a couple) must first understand the biology of the natural female and male reproductive systems. This is different from simply using a hormonal contraceptive, since avoiding pregnancy with hormonal contraceptives is accomplished with just a proper dosage or proper application of a device. NFP requires and rewards knowledge, while artificial birth control methods disregard it. In addition, compelling both the man and the woman who are in a relationship to take a course on NFP places the burden of success on both individuals, not just on the woman, as is true with most contraceptives. NFP incentivizes equality between the sexes, while artificial birth control methods oppress just one (usually the woman).
For avoiding pregnancy, NFP designates available and unavailable days for having sex based on the fluctuating hormones in our cycles (defined as the whole cycle of physiological changes from the beginning of one menstrual period to the beginning of the next[6]). Barring any abnormalities of naturally-occurring infertility, a man is always fertile, while a woman is only fertile during a certain window of time before and during ovulation[7]. “Spermatozoa can survive for at least six days in the cervix when estrogenic mucus is present.” However, “mature human ova (the female eggs) have a more limited lifespan of 12 to 24 hours.”[8] What does this mean? If you’re able to isolate the 12 to 24 hours that you know you will be releasing an egg, and plan to avoid sex around that time, you will have achieved organic birth control. You are leveraging your existing natural reproductive process in order to know when you would get pregnant. The beauty is that a woman’s body indicates when this is happening, and you can measure those indications by looking at things called biomarkers (discussed below).
When using artificial birth control, women are silencing and manipulating their natural reproductive cycles for the sake of more convenient sex. And with the technology and medical research we have now, we don’t want to settle for that anymore.
An NFP instructor would walk through all of this with you, but I’ve included a very high-level hormonal overview of a woman’s menstrual cycle below. This graph depicts the length of one cycle and the key naturally-occurring hormones that stimulate ovulation, followed by menstruation.
This is all happening inside your body without you even knowing it, but there are evident changes before and after ovulation that indicate whether your egg has been released. These hormonal changes are measureable by tracking certain factors present in your body: “The use of biomarkers help women recognize ovulation.”[10] What are some of these biomarkers?
Estradiol: “Estradiol has a logarithmic increase from baseline of approximately 1.5 times per day for 5 days to reach the estrogen peak, which occurs 24 to 36 hours before ovulation.”[11]
LH (Luteinizing Hormone): “The LH peak is responsible for triggering the mechanisms that will cause follicle rupture and therefore ovulation. The LH surge lasts 48 hours, and ovulation occurs 32 to 35 hours after its initiation.”[12]
Progesterone: “After ovulation takes place, a massive rise in progesterone occurs, so ovulation can be confirmed measuring plasma progesterone or pregnanediol glucuronide (PdG) in urine.”[13]
Cervical mucus: “The beginning of the fertile window occurs with the first statistically significant rise in estrogen levels. This causes the secretion of estrogenic cervical mucus with the characteristic changes in the vaginal discharge. During this period, the mucus is aqueous, transparent, fluid and crystalline, giving the woman a slippery sensation at the vulva.”[14]
Temperature: “During the menstrual cycle, basal body temperature rises after ovulation as a result of ovarian activity, associated with progesterone action.”[15]
Guess what? There is technology that tracks these biomarkers. You can track these biomarkers. You can know when you are ovulating and when you can abstain from sex. There are apps, there is wearable health tech, there are organizations, and there are guides for tracking your own fertility. Don’t suppress your fertility, which is a sign of health[16] that not every woman enjoys. Embrace the health of your natural cycle to know when you should avoid sex.
The following examples of methods were researched, tested, and released to the public as medical information for how to examine biomarkers to identify the stage of a woman’s menstrual cycle. The best part is that these methods are not outdated; they are still widely used and just as effective as hormonal contraceptives.
Marquette Method (the one I use!): “Developed by professional nurses and physicians at Marquette University in the late 1990s. The Marquette Model (MM) system of NFP brings 21st century technology to NFP by using the ClearBlue Easy Fertility Monitor, a device used at home which measures hormone levels in urine to estimate the beginning and end of the time of fertility in a women’s menstrual cycle. A recent (2007) study published in the Journal of Obstetric, Gynecologic, and Neonatal Nursing demonstrated a 97–98% efficacy of the MM in avoiding pregnancy when taught by a qualified teacher and correctly applied.”[17]
Creighton Model: In 1952, a group of doctors published “a schemata of the events that occur relative to the changes in the cervical mucus as ovulation approaches. It was noted that as ovulation approached, the stretchability and clarity of the mucus increased along with its quantity of production. The most pertinent observation, however, was the indication that the survival of the spermatozoa was directly related to the presence or the absence of an ovulatory or periovulatory type of mucus produced from the cervix.” Based on this analysis of cervical mucus, a methodology, now called the Creighton Model, was developed and is taught by certified teachers and medical professionals to women and couples.[18]
Sympto-Thermal Method: “The sympto-thermal method is a temperature method of fertility control and includes the self-observation of symptoms of the ovulatory period, particularly the increased cervical mucus discharge. In regard to avoiding conception, the sympto-thermal method offers effectiveness equal to the oral contraceptives.”[19]
The development of NFP methods was a counterrevolution to the commercialization of the Pill. Why don’t we hear about it today? If it’s organic and healthier, why isn’t it wildly popular? Here are the common rebuttals to using NFP, as well as my personal, light-hearted responses to these rebuttals.
“I have to abstain from sex during a part of my cycle? What if I really want to have sex during the time I might be fertile?” Always succumbing to sexual temptations doesn’t sound like female sexual liberation to me, it sounds like female sexual enslavement to one’s own desires. Try not to contribute to the sexualization of our culture, where every decision needs to be made based on sex. There are other ways to be intimate during those days when your body is signaling you are fertile.
“So I can’t have spontaneous sex anymore? What if I meet a guy at a bar and we go home together?” Think about if the hook-up culture is really that emotionally healthy in the first place. We meet someone briefly in order to use them for their body, and then you both agree to discard each other and never look back. This behavior contributes to our throwaway culture.
“What if I’m taking hormonal birth control for other medical reasons? It has really helped with my acne and my period cramps.” The most important thing is that you are educated on your options. Sometimes, the only solution to your medical problem is using a hormonal treatment and contraception is just a byproduct of the treatment. However, there are many OB/GYN medical professionals who can actually do a hormonal profile on you (a series of tests for several different hormone levels) and see what the deeper issues with these symptoms are. Additionally, there are alternative natural hormonal treatments you can use to treat those same issues. Using something intended for contraception for other medical issues is like putting an artificial lab-made Band-Aid on a bullet hole. Linked here is a list of physicians, endorsed by FEMM Health, who offer these hormonal profiles and who can help you understand your options.
“But do these NFP methods actually work?” It’s not a secret that it’s going to take more discipline in order to use a method of NFP, but when you stick with the protocol, the effectiveness of these methods in avoiding pregnancy are more effective, if not just as effective, as artificial birth control methods. The Sympto-Thermal Method of NFP, for example, has a documented 99.6% rate of effectiveness. Something to keep in mind is that there is no birth control method (natural or artificial) that is 100% effective when you are sexually active. As a helpful note that any instructor would tell you, if you do choose to start a method of NFP, please be strict in your adherence to the protocol. Just like a doctor would tell you to take your Pill regimen consistently every day, NFP only works as well as you discipline yourself to stick to the rules. I tell you this because I want you to still have the power to make the decision on whether you become pregnant or not.
I want to focus this article on the benefits of NFP and I could write an entire article (or even a book) on the risks of taking hormonal contraceptives. I want to keep this article positive, but as a brief introduction to some of the risks, take a look at the following studies on the impact that hormonal contraceptives have on your body and the environment.
Hormonal contraceptives linked to increased risk of blood clots, stroke, heart attack, and cancer (references to medical research included in this summary): https://ccli.org/docs/ccl-hormonal-contraceptives-brochure.pdf
Research links hormonal contraception, depression, and poor academic performance among females attending college in the United States: https://www.ncbi.nlm.nih.gov/pubmed/30245373
Male fish mutating into females because of waste chemicals and hormonal contraceptives disposed in rivers, expert warns: https://www.independent.co.uk/environment/environment-fish-changing-sex-gender-chemicals-pollution-rivers-water-charles-tyler-fisheries-a7821086.html
Consider the benefits of natural family planning, the technology and support available for these methods, and the risks of hormonal contraceptives. As a woman, are you taking responsibility for your own reproductive health? Do you know how your body naturally works, and how strong hormonal contraceptives have to be in order to be able to halt that natural cycle? Are we being medically and environmentally ethical when we use hormonal contraceptives, or are we setting medical ethics aside for the sake of our and men’s sexual conveniences?
It is possible to live a life free from all artificial hormones, including those we use to suppress our fertility. I have been doing this my whole life, and I am proud to say my sex life is organic and the decision to become pregnant is still mine. Furthermore, I know I can avoid pregnancy without living in fear of dangerous side effects resulting from hormonal contraceptives. I am excited to use NFP every day, to understand the natural cycle of my body, and to use the same method to one day achieve pregnancy again. From a personal perspective, my sex life is engaging when I know every single day isn’t always available in my cycle, and that the decision is entirely mine (not the result of a hormonal contraceptive developed in a pharmaceutical lab) if I will be having sex during my natural cycle.
We weren’t made to be applying unnatural substances to our bodies with food, with drinks, with drugs, with beauty products, with clothing, or with sexual lifestyle choices. If we want to truly be organic, let’s consider natural methods as the first step to our bodily and environmental cleanse.
Below are some useful links to organizations, reading materials, and apps that can help you get started with natural family planning methods!
FEMM Health: A Comprehensive Women’s Health Program
Ava Fertility Bracelet: Detect your most fertile days by measuring basal body temperature
Marquette University: Marquette Method of Natural Family Planning
References
[1] Daniels K et al., Current contraceptive use and variation by selected characteristics among women aged 15–44: United States, 2011–2013, National Health Statistics Reports, 2015, №86.
[2] Contraception. 1999 Jan;59(1 Suppl):11S-16S.
[3] Daniels K et al., Current contraceptive use and variation by selected characteristics among women aged 15–44: United States, 2011–2013, National Health Statistics Reports, 2015, №86.
[4] Am J Public Health. 2012 August; 102(8): 1462–1472.
[5] Am J Public Health. 2012 August; 102(8): 1462–1472.
[7] BMJ. 2000 Nov 18; 321(7271): 1259–1262.
[8] Author: Pilar Vigil MD, PhD, FACOG, Contributors: Juan Pablo del Río MD, Natalia Molina BMed, Pedro Gutiérrez MD, Carolina Lyon Nrs, Yanara Bernal Nrs, Felipe G. Serrano BSc,. MSc (2019) Reference within publication: Royston, J.P. Basal body temperature, ovulation and the risk of conception, with special reference to the lifetimes of sperm and egg. Biometrics. 38(2): 397–406 (1982).
[9] Author: Pilar Vigil MD, PhD, FACOG, Contributors: Juan Pablo del Río MD, Natalia Molina BMed, Pedro Gutiérrez MD, Carolina Lyon Nrs, Yanara Bernal Nrs, Felipe G. Serrano BSc,. MSc (2019) Reference within publication: Royston, J.P. Basal body temperature, ovulation and the risk of conception, with special reference to the lifetimes of sperm and egg. Biometrics. 38(2): 397–406 (1982).
[10] Ovulation, a sign of health, The Linacre Quarterly. Author: Vigil P., Lyon C., Flores B., Rioseco H., and Serrano F.G. (2017)
[11] Author: Pilar Vigil MD, PhD, FACOG, Contributors: Juan Pablo del Río MD, Natalia Molina BMed, Pedro Gutiérrez MD, Carolina Lyon Nrs, Yanara Bernal Nrs, Felipe G. Serrano BSc,. MSc (2019) Reference within publication: Boyers, S.P. Temporal relationships between ovulation and defined changes in the concentration of plasma estradiol-17 beta, luteinizing hormone, follicle-stimulating hormone, and progesterone. I. Probit analysis. World Health Organization, Task Force on Methods for the Determination of the Fertile Period, Special Programme of Research, Development and Research Training in Human Reproduction. Am J Obstet Gynecol. 138(4):383–90 (1980).
[12] Author: Pilar Vigil MD, PhD, FACOG, Contributors: Juan Pablo del Río MD, Natalia Molina BMed, Pedro Gutiérrez MD, Carolina Lyon Nrs, Yanara Bernal Nrs, Felipe G. Serrano BSc,. MSc (2019) Reference within publication: Vigil, P., Garcia, M., Villalobos, T., Cordova, A. & Morales, P. Predicción de Ovulación en Mujeres Normales. Rev Lat Ester Fert. 6(3): 87–91 (1992).
[13] Author: Pilar Vigil MD, PhD, FACOG, Contributors: Juan Pablo del Río MD, Natalia Molina BMed, Pedro Gutiérrez MD, Carolina Lyon Nrs, Yanara Bernal Nrs, Felipe G. Serrano BSc,. MSc (2019) Reference within publication: Blackwell, L.F., Brown, J.B. & Cooke, D. Definition of the potentially fertile period from urinary steroid excretion rates. Part II. A threshold value for pregnanediol glucuronide as a marker for the end of the potentially fertile period in the human menstrual cycle. Steroids. 63(1): 5–13 (1998).
[14] Author: Pilar Vigil MD, PhD, FACOG, Contributors: Juan Pablo del Río MD, Natalia Molina BMed, Pedro Gutiérrez MD, Carolina Lyon Nrs, Yanara Bernal Nrs, Felipe G. Serrano BSc,. MSc (2019) Reference within publication: Blackwell, L.F. & Brown, J.B. Application of time-series analysis for the recognition of increases in urinary estrogens as markers for the beginnings of the potentially fertile period. Steroids. 57: 554–62 (1992).
[15] Author: Pilar Vigil MD, PhD, FACOG, Contributors: Juan Pablo del Río MD, Natalia Molina BMed, Pedro Gutiérrez MD, Carolina Lyon Nrs, Yanara Bernal Nrs, Felipe G. Serrano BSc,. MSc (2019) Reference within publication: de Mouzon, J., Testart, J., Lefevre, B., Pouly, J.L. & Frydman, R. Time relationships between basal body temperature and ovulation or plasma progestins. Fertil Steril. 41(2): 254–9 (1984).
[16] Author: Pilar Vigil MD, PhD, FACOG, Contributors: Juan Pablo del Río MD, Natalia Molina BMed, Pedro Gutiérrez MD, Carolina Lyon Nrs, Yanara Bernal Nrs, Felipe G. Serrano BSc,. MSc (2019)
[18] Cohen MR, Stein IF and Kaye BM: Spinnbarkeit: A Characteristic of Cervical Mucus. Fertil Steril, 3: 201, 1952
