The FDA Made a Big Mistake With Natural Cycles

The FDA slapped a seal of approval on birth control app Natural Cycles this week, meaning the app can market itself as a valid contraceptive. Natural Cycles allows women to track their body temperature using a basal thermometer, plug their information into the app, and then get insights as to which days they’re more likely to get pregnant, using a color system in which green means “you’re good to go,” and red means, “use a condom, you’re quite fertile.”

This method is called fertility awareness, and sounds a bit bullshitty to me. It’s not that I don’t believe there’s accuracy to it, but nothing is as effective at preventing pregnancy in sexually active women as good, old-fashioned birth control. In the FDA’s study, Natural Cycles failed 1.8% of the time in perfect use and 6.5% of the time with typical use. With an oral contraceptive, perfect use only fails 0.1% of the time, and typical use about 1%. Typical use basically means not following the rules to a T, which is how most of us are. So with Natural Cycles, that would mean having unprotected sex on a red day, and with an oral contraceptive that would mean missing a pill here and there.

Look at that math. Natural Cycles’ fail rate is 5.5% higher than birth control pills. And there are quite a few more variables at stake with the app than with pills. Women using Natural Cycles need to take their temperature at the same time every day for accurate insights. The pill, on the other hand, has at least a three-hour window for when you can take it, though that window does vary from pill to pill.

Even the FDA stated, “an unplanned pregnancy could still result from correct usage of this device.” Ladies, if you don’t want to get pregnant, use a contraceptive. There are so many options out there. Having unprotected sex because this app tells you it’s a “green day,” isn’t a viable solution. Sperm can survive in a woman’s body for up to five days, so even if you have unprotected sex before you’re ovulating, you can still get pregnant.

“The app doesn’t really make sense to me in terms of pregnancy prevention,” says Dr. Stacey Madoff of Healthquest OB/GYN. “Basal body temperature charting is a means to determine if your ovulating. So generally patients who are having issues with fertility can see if they are actually ovulating. However for conception itself, by the time the temperature rises, you have already ovulated and have missed the window for conception. So I’m not really clear on how this app would help prevent someone from conceiving. Obviously they cite studies available to show its efficacy, but from a medical standpoint, it is concerning.

Fertility awareness is beneficial. Tracking ovulation is especially important for women who are trying to get pregnant, and for those trying not to, it’s good to know what their bodies are doing. While there is validity to Natural Cycles, the FDA shouldn’t allow it to be called contraceptive. For one thing, it isn’t a drug, so why is the Food and Drug Administration even acknowledging it? It isn’t a drug or a medical device. This approval seems misleading, and I wouldn’t be surprised if it led to several unwanted pregnancies. In fact, in January this year, a single Swedish hospital reported 37 patients who had been using Natural Cycles as contraceptive seeking abortions.

Fertility awareness has been around for a long time—tracking the menstrual cycle was how people prevented pregnancy before the introduction of modern birth control methods. And throughout the 20th century, many women fought for our rights to freely protect ourselves from pregnancy, pushing for the legalization of modern contraception. When Margaret Sanger opened a birth control clinic in 1916, she was jailed for 30 days. Eventually in the 1950s, Sanger helped raise money and pushed for research for the contraceptive pill, which was finally approved by the FDA in 1960. But the story doesn’t end there—initially, the drug was only legalized for married women, and it wasn’t until 1972 that all women could protect themselves from unwanted pregnancy.

Our road to birth control wasn’t easy, and now so many women are turning their noses up to oral contraceptives. In a survey of 2,000 young women, 70% said they stopped taking birth control pills it or considered abandoning it. While many are turning to IUDs for the convenience factor, other women ditch the pill for what Cosmopolitan calls the “Goop factor,” or a fear of artificial hormones as the natural wellness industry gains speed. One woman on Buzzfeed even referred to birth control as “poison.” Margaret Sanger is rolling in her grave.

There are decades of research, studies, trials, and proof behind the birth control pill. The doctors who prescribe the medication have been through at least eight years of schooling and know what they’re talking about. In a Goop-filled world, of course words like “artificial” and “hormones” make us feel uneasy, but can’t we trust that medical professionals know what they’re talking about?

And before anyone starts with the “but what about all of the awful side effects of birth control” argument, let’s dispel a few rumors and face a few facts.

Birth control will not cause weight gain. You might experience water retention that makes it seem like you’ve gained weight, but that will go away.

Being on birth control pills over an extended period of time will NOT make you infertile.

There are short and long-term benefits to birth control, like shorter and lighter periods, or a decreased risk of ovarian and uterine cancers after being on the pill for at least one year.

There are dozens of different birth control pills (not to mention IUDs and implants), so just because one pill didn’t sit right with you, that doesn’t mean none will. It takes two to three months to determine if a pill is right for you, so it might take a bit of work to find the right one. Just work with your gynecologist to help him or her help you.

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