Natural Cycles: A Contraceptive App?

Yesterday I watched Twitter blowing up in debate over an app called Natural Cycles. Marketed as an "effective method of contraception without side effects" and allowing you to "know exactly when you need to use protection", Natural Cycles have a huge online marketing presence with sponsored videos, blog posts and Instagram ads constantly popping up on my social media feeds. Watching this debate unfold made me feel like the only person in the blogosphere not being paid to use this thing, which is exactly why I wanted to write an unbiased stance on whether this app can be used as contraception, who it's suitable for, and how I'd advise starting out with this method of "contraception".

*I will add a disclaimer now that this post features periods, sex and fertility so if you are shy of these subjects please be aware that this post will not be for you.


Let's start at the beginning: with the definition of contraception. Defined as "the deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse" barrier methods (aka. condoms, caps), hormonal contraception (i.e. the pill, the injection, the implant) and intrauterine devices (such as the coil) are listed as the most common methods of contraception. It is likely that if you are sexually active you may have already tried one or more of these methods, and hopefully received some sex education about the different options available.

However, despite there being so many different choices available to us, contraception is an incredibly personal decision and what suits one person may not be right for another. Let's be realistic: we wouldn't have so many options available to us if everybody was able to, happy to, or responsible enough to always rely on using condoms (which are perhaps the most obvious method of contraception.) Varying health conditions can make any method of family planning unsuitable for some - latex allergies, family history of breast or ovarian cancers or thrombosis, just to name a few, can throw a spanner in the works. I have really struggled in the past finding contraception that is right for me. I've tried countless different brands of the pill, none of which I felt able to stay on long term due to the various side effects. I noticed all the pills I tried had a detrimental correlation with my emotional wellbeing. Reluctant to use hormonal contraception for this reason, I tried the copper coil - it was fine for several years until it dislodged meaning I had been unknowingly at risk of getting pregnant. I went back on the pill, trying several more options, but I wasn't happy and neither was my doctor due to a prominent family medical history of blood clots. This was when I started to look into "natural family planning", a method listed on the NHS contraception guide which essentially is what Natural Cycles is based on.

Fertility awareness (natural family planning) consists of analysing your fertility signals and menstrual cycle. This can be done by documenting temperature, cervical secretions, or your menstrual cycle. The most effective success rates come from documenting and analysing all three of these factors, which differ during different stages of your cycle and allow you to analyse when you are unlikely to become pregnant, and when you are fertile and at risk of becoming pregnant. This method has no side effects as you are not taking any hormones or using any devices, but means that you must use protection if you want to have sex on days where you are likely to be fertile. When used properly this method is as effective as the pill and condoms, however like with all methods of contraception there are factors which mean this is not a suitable method for everybody.

Natural family planning can work brilliantly if you have regular periods, a regular partner and would prefer not always to rely on condoms. However you still need to be disciplined enough to use protection (or abstain from sex) during your fertile window. This method is not suitable for people suffering with medical conditions which could disrupt the signs of fertility, such as polycystic ovary syndrome or an over or underactive thyroid. It is not suitable for those with very irregular periods (therefore making it unsuitable for many teenagers) and of course it is does not protect against the risk of sexually transmitted diseases.

So where does Natural Cycles come into this if fertility awareness works so well? When you buy a year's subscription to the Natural Cycles app (which comes with a basal thermometer, and costs £39.99 for the year) you take your temperature using said thermometer each morning. Of course you can only get pregnant when you ovulate, and your body temperature changes minutely around the time of ovulation. The app analyses your cycle and body temperature for you, and comes up with "red days" (where you need to use protection) and "green days" where you are unlikely to become pregnant. It accounts for how long both the ovum and sperm can live within the body, the likelihood that some people ovulate twice, and gives a result based on these factors. It will become more accurate to each individual as more data is input over time, and if it is unsure it will give a "red" result. Over time you will get more "green" days as the app analyses your data. You can also choose not to include your morning temperature reading as part of your prediction if you have been ill, are hungover, or have had very little sleep.

I am part of Natural Cycles' target demographic, somebody the app is suitable for, hence why it appealed to me. I am sexually active, I am actively trying not to get pregnant, I have (mostly) regular periods, no major health issues (touch wood!), a regular enough routine (in that I'm not jet lagged or hungover all the time) and a trusted monogamous partner responsible enough to use condoms when required, I've been put off the coil and I don't want to use hormonal contraceptives. My partner and I bought the Natural Cycles app to use as an extra precaution in conjunction with condoms and fertility awareness methods we are already using. However despite being a user I personally would not recommend using this app as a sole contraceptive (nor can it be relied on as one unless you choose to abstain from sex on fertile days). If you wanted to come away from your existing method of contraception, I personally recommend downloading a period tracking app (I recommend Clue) and inputting as much data as possible over time.

I freaking love Clue. If you've not used it before, here's a couple of screenshots from the app. It allows me to track all the different factors in my cycle (PMS, cramps, secretions, bloating, bad skin, all the joys) and over time has made me aware of typical patterns, and when to expect certain symptoms including ovulation. Over time it has become incredibly accurate at predicting my cycle, but also has made me very aware of any fluctuations which is great because that allows me to feel so much more in touch with my body and has made me analyse any changes and take time to listen more to my body. It also predicts a fertile window in which I am most at risk of becoming pregnant based on my average cycles and input data. I would highly recommend tracking cycles to anybody looking to use fertility awareness, as your periods will change and may be unpredictable when coming off contraceptives such as the pill or coil and for this reason I wouldn't recommend forgoing other methods of protection until they have fully settled down. Now that I've been off the pill for well over a year, I do trust the science within Natural Cycles but I will still be checking the results alongside my own calculations which I like to record on Clue - to me that's just common sense.

As a response to the Natural Cycles backlash: I think Natural Cycles' marketing has backfired on this occasion. They have sponsored so many posts and advertorials which market their method as an absolute go-to with little mention of who it may or may not be suitable for. As a user myself, I feel strange about seeing so many paid adverts for it everywhere as in my opinion any method of contraception is not to be taken lightly and certainly shouldn't be sold as the next must-have product. No wonder Natural Cycles has ruffled some feathers in its marketing, as I feel if it is going to sponsor posts they should take more responsibility to ensure these adverts explain the required criteria to ensure this method is suitable for each individual user. It shouldn't be sold as a wonder invention, particularly because the basic science involved is no new concept.  I'm not knocking it - I bought it, after all. But at the end of the day it's really just a method to aid preventing pregnancy made a little more convenient for people like me.

I do also think, however, the backlash has made me realise people aren't always completely clued up about the factors that are necessary to conceive in the first place. There were so many sarcastic tweets about how your body temperature is as likely to indicate whether you've ovulated as whether it's raining outside or if it's a full moon. I get it - it sounds ridiculous, "I use an app for contraception. I take my temperature and it tells me if I can have unprotected sex." But let's remember - although it is possible to get pregnant on any day of your cycle, that's dependent on the person, their own health and cycle length - you have to ovulate to get pregnant, your body will give signs that you're ovulating, and the science of the app is based on the fact that with proper use of the thermometer this will be picked up on. As I said to my friends who were sending me memes of a pregnant Beyonce when I told them I was using Natural Cycles: just because you don't understand exactly how something works doesn't mean it won't work. They think I'm crazy for using it, and I think they're crazy for taking the pill - only because I know that didn't work for me. Each to their own, no two people are the same, and personally I'm just happy and grateful that I'm lucky enough to be able to use a method which does not give me side effects and allows my body to remain free of synthetic hormones and foreign objects while avoiding pregnancy.

A last word on contraception: no method is infallible. The only real way to absolutely, 100% protect against pregnancy and sexually transmitted diseases is to abstain from sex entirely. The only way to protect yourself from most - not all - sexually transmitted diseases is by using condoms. Remember to consider these things when picking your own method of protection. If you are with somebody who refuses to use condoms, you should reconsider having sex with them. And if you are sexually active and living in the UK, you can get condoms for free so I advise taking advantage and having some on standby... just in case.