Is tracking your cycle a safe form of birth control?

Is it too good to be true?

The burden of birth control is something almost all women are familiar with. Having been on the pill myself since my early years of high school, it’s something I (and many others) accepted as one of the joys of being a woman. But recently, it feels like the conversation around contraception is shifting.

Maybe it’s thanks to the decreasing stigma around sexual health, our culture’s ongoing ‘wellness’ discourse and an increase in much-needed research into women’s health, but more women around me are beginning to question hormonal contraception like the pill because of its effects on our mood and behaviour.

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So when I began receiving incessant sponsored ads all over social media for an app that was marketed as a “hormone-free and natural form of birth control”, I was intrigued. The app, called Natural Cycles, works by tracking your cycle and calculating your daily fertility status so you know when you can have unprotected sex without falling pregnant.

It’s the first ‘digital contraceptive’ that’s been approved by Australia’s medical regulatory body, the Therapeutic Goods Administration (TGA), as of 2020. But is it actually a safe and reliable form of birth control? 

How does it work?

Natural Cycles asks you to record your basal body temperature as soon as you wake up and enter it into the app, where an algorithm uses that information to tell you your fertility status. It will either tell you you’re ‘not fertile’ (the go-ahead to have unprotected sex) or let you know if you’re in the red zone of ‘peak fertility’, and need to use protection or abstain from sex.

Family Planning NSW‘s Medical Director, Dr Deborah Bateson, says the Swedish-designed app uses the same science that’s behind age-old fertility awareness methods. This revolves around finding your “fertile window”, which spans from the five days before ovulation, to one day after. 

The app can tell when these days are because of a very “small rise” in body temperature that occurs after ovulation. “Fertility awareness methods have been around for many, many decades,” Dr Bateson explains. 

Is it safe?

For just $14 a month, plus the cost of a Natural Cycles thermometer, it sounds like an ideal and convenient birth control alternative. But is it too good to be true? While the concept is certainly a valid form of contraception, Dr Bateson says there are a few factors women need to consider before deciding to replace their pill with the app altogether. 

Studies of the Natural Cycles app report a success rate of 93 per cent in typical use, similar to the efficacy of the contraceptive pill. But Dr Bateson says these studies have been “somewhat controversial”. “When you look at the effectiveness, it hasn’t been assessed in the same way as other contraceptive methods,” she notes. “This data relies on women reporting unwanted pregnancies honestly and accurately.”

Plus, there’s a “number of things” that can affect the accuracy of your resting body temperature and the subsequent fertility reading – including the amount of alcohol you had the night before, the time you took your temperature or even if you had a sleep in that day. 

“You also have to be willing, and have a willing partner, because it can be up to 10 days of no unprotected sex, [according to the app’s recommendations], ” Dr Bateson says.

In 2018, Swedish authorities recorded 37 unwanted pregnancies among women relying on the Natural Cycles app for contraception. “It appears a lot of those were because couples were having sex during those no-sex periods,” she notes. 

How do you know if it’s right for you?

“A lot of people are very interested in it, but then once they hear what’s involved, they often make the decision that it’s not for them,” Dr Bateson notes. Interestingly, research into Natural Cycles also revealed that about 54 per cent of women stopped using the app after one year.

“While the app calculates it for you, you have to be very dedicated and collect all your data daily. You can’t rely on the technology to do it for you and it can be onerous,” she says of the high discontinuation rate.

Despite this, there are some positives to the app. It allows women to understand their cycle in a way that’s “empowering”, which is helpful information for those looking to plan pregnancies in the future, too. 

It’s also relatively cheap. The subscription fee is certainly a far cry from the $80 I pay for a three-month pack of my current birth control. As it’s hormone-free, it tends to avoid the variety of unpredictable, unpleasant side effects that women often experience on the pill. 

Dr Bateson also warns that people’s hyper-focused concerns on the negative impacts of hormones can sometimes be a little misplaced. Of course, condoms and the copper IUD are among the most effective, non-hormonal birth control options already out there.

“You don’t have to be wary of apps like Natural Cycles, but you do have to be aware of the chances of it failing and what’s involved,” Dr Bateson explains. 

“It’s fantastic that women are being proactive and wanting to know what all the different methods are, because it means women are taking control of their fertility. We know that some women have difficulty finding the right birth control for them, and we need to keep doing more research into these methods as well.”

And when you consider the fact that research trials in the US weren’t required to include women until 1993, asking questions is a good thing – because we’ve likely still got a long way to go. 

For more on period tracking apps, try this.