As a nutritionist who works with fertility (and a lot of infertility), I’ve spoken to hundreds of women who’ve been on one form or another of hormonal contraceptives. I’ve never heard one of them say, “I loved how I felt,” or, “It fixed all my problems.” Instead, I’ve heard—time and again—how it led to weight gain, mood swings, depression, and problems getting pregnant later in life.
Yet so many women feel like hormonal contraceptives are their only option if they’re sexually active and don’t want to conceive. Beyond that, many women are put on the Pill, hormonal IUD, or implant to improve irregular cycles, acne, or other hormone-related problems. Hormonal birth control has been touted as a miracle pill, but much like placing your hands over your eyes doesn’t erase your surroundings, birth control doesn’t fix hormone issues either. It just temporarily masks them.
Birth control is hailed as a way for women to gain independence from the risk of pregnancy or from horrible cycle symptoms. Pregnancy avoidance has, somehow, become an almost exclusively female issue because it’s women who carry pregnancies. But the truth is that women are only fertile for four to seven days each cycle, whereas men are always fertile.
As someone who has two kids, I can wholeheartedly understand women who aren’t ready or able to become mothers—it is all consuming, and while I wouldn’t change that for a second, each woman’s story is her own. She should have the freedom to determine when and if she wants to conceive.
But in my view, when it comes to true women’s health, birth control can’t really be considered progress when we suppress the natural emotional balance and benefits that women gain from natural ovulation. Ovulation and fertility aren’t curses on women—they’re powerful hormonal events that contribute to our wellness. Allowing natural ovulation to take place doesn’t mean you have to get pregnant, however. If you understand your cycle, you can ovulate naturally while avoiding pregnancy at the same time; this is what I’d call truly harnessing the power of your reproductive cycle—or really, the power of being a woman.
Ovulation isn’t just for the sake of potential pregnancy. The body produces progesterone after ovulation each cycle, and this helps to counterbalance the estrogen that runs the first half of the cycle. As in most things, balance brings the best results. When women experience hormone problems, it means a disruption to the balance has occurred. This should be investigated and corrected, not simply suppressed or turned off. Particularly since most women report feeling at their best—mentally, emotionally, and physically in the few days leading up to and during ovulation. Even if you don’t want to make a baby, you deserve to feel the highs of hormone balance and avoid the lows of artificially suppressed ovulation.
Rethinking women’s health
I think the burden of avoiding pregnancy must be shared between both partners if we intend to view family planning as a feminist issue. Suppressing a woman’s hormones 365 days a year, just to avoid pregnancy for the approximately 78 days a year a woman is fertile, makes no sense when you consider it from an objective perspective. Of course there are other ways to avoid pregnancy (and no, I don’t just mean abstinence), but you would be shocked at the number of women who message me with the false belief that their options are birth control or unplanned pregnancy, and that’s it.
Birth control isn’t a harmless drug. It’s a prescription medication like any other, and it comes with a hefty dose of side effects, including increased risk for blood clots, stroke, increased risk of certain cancers, and cholesterol problems. It can also deplete the body of critical nutrients, including B vitamins which are necessary for a healthy nervous system and balanced mood, as well as selenium and magnesium, which are required for a healthy thyroid and metabolism.
The good news is that, thanks to science, hormonal birth control is not the only way to prevent pregnancy while prioritizing one’s health. Women should feel that they have true choice in this matter. Nearly every client I’ve worked with did not feel as if she had any choice, especially since most of their doctors recommended hormonal contraception as the only solution to a host of health-related disorders such as long cycles, short cycles, endometrial pain, acne, and painful cramping. In reality, all these have roots in hormone dysfunction in the body that, with a little extra testing, can be corrected, instead of masked.
Non-hormonal contraceptives abound, and while hormonal birth control might be the most convenient for some, I believe the host of side effects and the requirement to use it all the time when women are only fertile for less than a week each cycle, is a hefty price to pay.
Natural options for fertility management
The FDA has recently registered two natural family planning tools that can help women understand their cycles and avoid pregnancy. While these do come with small risks for pregnancy, so do every other form of contraception, including hormonal birth control. According to the CDC, most birth-control pills have a typical use failure rate (where you think you’re taking them correctly, but they can fail due to interactions with other medication or perhaps taking them an hour or two later than usual) of 7 percent wherein women get pregnant. When that happens, the children conceived are at risk for birth defects. Plus it’s common that missing a dose or taking the Pill with antibiotics can result in ovulation and possible conception.
The first FDA-registered fertility device is the Ava bracelet, which I recently purchased myself out of curiosity. It comfortably fits on your wrist and you wear it every night while you sleep. In the morning, you sync it with your smartphone app, and it gives you a real-time update on whether you’re fertile or not. You need to use it for a few cycles before it reaches peak accuracy, but there seems to be a host of glowing reviews. The FDA-registered medical device determines and tells you when you’re fertile, as it is happening, by tracking numerous physiological markers. According to the Ava bracelet website, the device is not considered a contraception because it focuses on peak fertility, but "if you’re practicing NFP or FAM, Ava could be a great complementary tool," they say.
The second FDA-registered natural option is Natural Cycles, a fertility tracking app that calls itself “the birth control app.” Natural Cycles comes with a 93 percent success rate with typical use—even higher for people who are meticulous. This option is less expensive than the Ava bracelet, but requires users to manually take their oral temperature each morning with a special thermometer and enter it into the smartphone app. I tried Natural Cycles for a few months, but since it offered no different features from the other natural family planning app had I been using (Fertility Friend), I went back to the one I was more familiar with.
While there are many variations on natural tracking apps or other devices, these two are the most backed by research as effective. Also backed by research? Condoms and abstinence. Between these options—and the reality that women are not fertile all the time—women have many options for preventing pregnancy that don’t involve shutting down hormones entirely.
Women have too often been made to feel as if ovulation or the ability to get pregnant is a curse. But I prefer to view it as a superpower. You don’t have to get pregnant every time you ovulate to take full advantage of this unique attribute that only women have.
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*This article originally stated the Ava bracelet is an FDA approved contraception. We regret the error.