‘The Pill’ Is Not Your Only Option: Common Non-Hormonal Birth Control Alternatives
In Canada, the pill is the most commonly used method of contraception and is among the most frequently used medication by young women. However, according to the Society of Obstetricians and Gynecologists of Canada (SOGC), we are starting to see a decline in pill users and I believe we are approaching a hormonal revolution. Women are starting to take control of their health and have a deep desire to understand their bodies on an intimate level. I am not suggesting that everyone get off the birth control pill, but we do know there can be consequences with long-term use.
Many women have come into my office seeking non-hormonal forms of birth control. Today I want to review the most common available methods of non-hormonal birth control, so you can understand your options, beyond the pill.
Non-Hormonal Forms of Birth Control
The modes of action of non-hormonal forms of birth control can vary widely. They can involve creating a barrier between sperm and egg, changing the chemistry in the reproductive tract, or can combine both of these actions. The most common forms of non-hormonal devices that my patients consider are the copper IUD and condoms. I don’t see female condoms, sponges, cervical caps, and diaphragms commonly used with young women, but that’s not to say they aren’t for you!
There are also other methods of birth control that do not rely on devices to prevent pregnancy, but instead focus on behavioural practices and observing the natural changes in the body that happen throughout a cycle. The main forms of natural contraception my patients are using include the fertility awareness method and the withdrawal method. When choosing the best method of contraception, you should understand how effective it is, how it works and the advantages and disadvantages.
Here I break it down:
IUDs are long-acting, reversible birth control methods that are continuing to grow in popularity amongst young women. In fact, they are the most effective form of birth control available. There are 2 types of IUDs: progestin-containing IUDs (hormonal) and copper IUDs (non-hormonal). Although the hormonal IUD is a great option for a lot of women, here we focus on the non-hormonal copper IUD. (Keep your eye out as we plan to talk about IUDs in more detail in the near future!).
How it works:
The copper IUD is a small, T-shaped device that is inserted into the uterus by a healthcare professional. It can remain in the uterus for up to 10 years. The presence of a foreign body in the uterus creates a hostile environment and does not allow a pregnancy to occur.
- 99.9% effective – the most effective form of birth control
- Contains no hormones
- Set it & forget it – once it is in, you don’t have to give much thought to pregnancy prevention
- Can stay put for up to 10 years
- Very effective birth control
- Allows for normal, healthy ovulation
- As soon as you remove it, fertility returns to normal
- More expensive up front
- Some pain or discomfort on insertion
- No protection against STIs
- Can have irregular bleeding or spotting initially
- May increase menstrual flow and cramping
- May increase pain during periods
- It can disrupt the vaginal microbiome and doubles the risk of Bacterial Vaginosis
- There is a very small risk that it can fall out
Ladies, don’t forget about condoms as a great option to not only prevent an unwanted pregnancy but to protect against STIs! Condoms are widely available, inexpensive and they don’t mess with your hormones.
How they work:
By acting as a barrier and keeping sperm away from an egg, fertilization cannot happen.
- Do not cause hormonal dysregulation
- Widely available without a prescription
- Inexpensive, safe and effective
- Protect against most STIs
- May be used in addition to other forms of birth control to increase the effectiveness
- Must be available at the time of intercourse
- May reduce sexual spontaneity
- May reduce sensitivity for either partner – but there are many forms available that may help with this!
- Require participation of both partners – but that’s fair
Fertility Awareness Method
The fertility awareness method (FAM) can be used to plan or prevent a pregnancy. It is based on observations and charting of proven signs of fertility to determine when you ovulate during a cycle and thus, the days you are most fertile. It works because you are only fertile for 6 days of a cycle. To avoid pregnancy, you simply abstain from intercourse or use protection, like a condom, during this fertile window.
How it works:
Throughout your cycle, there are changes in your basal body temperature, cervical fluid, and cervical changes that happen. By measuring these variables, we can determine ovulation and the fertile window. The easiest way to track these changes is with a thermometer and an app, I like Fertility Friend. There are some cool new tools that make this method even easier, like the iFertracker, Daysy, and Natural Cycles. FAM can teach you a lot about your cycle, however, it does require dedication and consistency. (Keep your eye out for a more in-depth article on the FAM coming soon!)
Because this method relies heavily on the individual, results have been mixed
- Increased body literacy – you get to understand your body on a deeper level
- Little cost – all you need is a thermometer
- Can be very effective, if used properly
- No hormonal dysregulation
- No side-effects
- Requires practice, consistency, and accuracy
- Cannot be used effectively if you have irregular cycles
- Takes about 3 cycles to understand your cycles before it can be used as birth control
One of the riskier forms of birth control, withdrawal or the pull-out method, has become more popular over the recent years. This is when there is an attempt to avoid ejaculating into the vagina during intercourse by withdrawing before ejaculation. It can be difficult to time and hard to control as there is some fluid released from the penis that contains sperm before ejaculation.
- 78% effective – although that may look like a high number to you, that means that 22/100 women become pregnant using this method. This is one of the riskier forms of birth control and you must accept that a pregnancy could happen.
How it works:
During intercourse, the male withdraws his penis from the vagina and away from the external genitalia of the female partner, prior to ejaculating.
- No cost
- No hormonal dysregulation
- No side effects
- The man must be trusted to understand when to “pull-out”
- No STI protection
When it comes to birth control methods, there is something for everyone. It may take some trial and error to find what method suits you best, but your body and your health are worth it. Just because the pill is the most commonly used form of birth control, doesn’t mean you have to use it. You, do you!
Are you ready to come off the pill? To understand how to make the transition easy, check out my article on Post-Birth Control Syndrome.
If you are interested in using FAM, use the discount code “bronwyn” to save on the iFertracker. It is a wearable thermometer that tracks your temperature for you!
As always, if you are looking for a Naturopathic Doctor in the Toronto area, I’d love to work with you! Let’s meet over a free 15-minute consult–Book in here.