A recent study from England and Wales, published in BMJ Sexual and Reproductive Health, has sparked conversations about the increasing reliance on “natural” contraceptive methods, such as fertility tracking apps. The findings suggest a significant shift in contraception choices over the past five years, raising questions about their reliability, accessibility, and the broader societal factors influencing these decisions.
The study highlights that the use of natural contraceptive methods, such as fertility awareness-based apps, has increased from 0.4% in 2018 to 2.5% in 2023. While still a minority, this shift reflects growing interest in non-hormonal options. Fertility tracking apps use indicators such as body temperature to predict fertile days, offering a theoretical reliability of up to 93% with perfect use. However, typical use often reduces effectiveness to around 76%, meaning nearly one in four women relying on these methods may become pregnant within a year.
In contrast, hormonal contraceptives like the pill or long-acting methods such as implants and coils provide effectiveness rates of 91% to 99%, depending on usage. The data also revealed a troubling trend: more women are using no contraception at all—70% in 2023 compared to 56% in 2018.
Several factors appear to influence this shift toward natural methods and the decline in hormonal contraceptive use:
Accessibility Challenges: The COVID-19 pandemic disrupted healthcare services, making it difficult for many women to access long-acting contraceptives like coils or implants.
Misinformation and Social Media Influence: Platforms like TikTok have seen an uptick in content promoting natural contraception, often without medical context. Influencers and paid partnerships may unintentionally spread incomplete or misleading information.
Concerns About Side Effects: Many women are wary of the potential side effects of hormonal contraception, which range from mild issues like mood changes to rare but severe complications.
Desire for Non-Hormonal Options: Some women are motivated by concerns about long-term fertility or prefer avoiding hormonal interventions altogether.
Medical professionals and sexual health advocates emphasize the importance of informed decision-making when selecting contraceptive methods. Dr. Rosie McNee, lead researcher of the study, highlighted the need for scrutiny in the growing e-health market, particularly fertility apps. “The market has exploded,” she noted, urging women to seek medical advice before relying on such tools.
Tanya Lane of MSI Reproductive Choices UK and Dr. Melanie Davis-Hall of The Lowdown echoed these concerns, calling for better education about the limitations of fertility tracking. Both emphasized the need to address misinformation and provide access to a wider range of contraceptive options.
The findings underscore the importance of improving access to reliable contraception and investing in research to develop new methods. Despite advancements in healthcare, few new contraceptive methods have been introduced in the past five decades, reflecting a significant gap in innovation.
Advocates like Paula Baraitser of SH:24 argue for a broader conversation about contraception that includes not only effectiveness but also menstrual health and quality of life. Hormonal contraceptives, for example, offer benefits beyond pregnancy prevention, such as regulating periods and reducing menstrual pain.
Ultimately, the shift toward natural methods highlights the evolving priorities and challenges women face in managing their reproductive health. With the right resources, education, and access to care, women can make informed choices that align with their needs and values. Addressing these issues requires a collaborative effort from healthcare providers, policymakers, and society at large to ensure that all women have access to safe, effective, and diverse contraceptive options.
