Hormone-free Contraception. What are the options?

It is no secret that there is a wide range of hormonal contraceptives. The different generations of pills alone are hard to keep track of. Then there is the contraceptive ring, the patch, the implant, the injection – you name it. Some great contraceptive tools and methods can also be hormone-free. In this article, I will present a few options, because there are certainly more than you think. From increased body awareness to sharing birth control responsibilities, there is a contraceptive method fit for everyone.

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Often people with uteruses are responsible for contraception. But contraception is everybody’s business. If two people want to have sex, then they should not only talk about what is good for who and how, but also about how potential pregnancies can be prevented. By the way, joint contraception and shared responsibility is quite sexy and can also strengthen the relationship.

Contraception with Temperature or NFP Natural Family Planning

I would like to start with my personal favourite: NFP. This acronym stands for Natural Family Planning. Specifically, I will discuss the sympto-thermal method of contraception. I make the distinction between NFP according to Sensiplan and NFP with cycle tools.

With the NFP method, we observe the basal body temperature on the one hand, and other fertility signs on the other. The basal body temperature is the temperature of the body directly after waking up, but before getting up. It is used to determine whether ovulation has taken place or not. This is because after ovulation the body temperature rises by at least 0.2°C and remains elevated until menstruation starts. We therefore observe two phases during the cycle: A low phase (temperature low) and a high phase (temperature high).

Body temperature is taken into account together with other various fertility signs that appear during the course of the cycle: the cervical mucus changes its consistency, the cervix changes position and opening, the breasts tighten, pain can appear or the libido increases.

The exact time of ovulation itself cannot be determined. It is therefore assumed that there are six fertile days in a cycle: five days for sperm to survive in the body and one day for the egg.

With the symptothermal method, as the name suggests, the body’s symptoms are observed and evaluated together with the temperature. This combination makes the method very safe.

Our body shows us very precisely when it is fertile and when it is not. This has the advantage of letting you choose to have unprotected intercourse during the infertile time if you want to. You also get to know and understand your body and cycle better. In my opinion, that is just really great empowerment.

NFP according to Sensiplan

The Maltese NFP working group has been in existence since 1981. Currently monitored by the University of Heidelberg, the NFP working group is and has continuously been monitored scientifically.. There are therefore thoroughly conducted and representative studies that prove the safety of this method and help to further its development

In NFP according to Sensiplan,the body’s temperature and other symptoms are tracked with the help of a cycle sheet. This requires thorough familiarisation with the observing and evaluating rules regarding cervical mucus, temperature and how they are affected by different life situations (after the pill, breastfeeding, menopause). The temperature is measured with a basal thermometer.

An alternative to Sensiplan is NER (Natural Contraception according to Rötzer).

NFP with cycle tools

NFP cannot be exclusively tracked manually, but thanks to advanced technology, there are various apps and tools available nowadays. The evaluation of the body’s symptoms is done by an algorithm. Therefore, depending on the programming, it is always done a little differently. There is often a thermometer connected to the app, which transmits the data directly via Bluetooth.

There are tools that only evaluate the temperature and there are tools that evaluate both symptoms and temperature, i.e. symptothermal. However, it should always be a prerequisite for users to have cycle knowledge, because the mind always has to think along with these evaluations. In any case, I always recommend the sympto-thermal evaluation.

Well-suited tools or apps:

Masturbation, while an effective method to instantly feel better, also helps to learn more about your body and how it works, your likes, dislikes and absolute no-gos.(We recommend that you focus on the likes, though.) Use the lockdown as a time off, a chance to get even more comfortable with our sexuality, and an opportunity to get ready for all those post-Covid dates that await you.

Copper contraception (intrauterine devices)

These can be a coil (looks like a small T, made out of metal), a chain, a ring or a ball made out of copper and sometimes gold, whose ions kill sperm and prevent fertilisation. They are inserted in the uterus. The procedure is relatively fast and painless.

For a long time, people suspected that copper could cause permanent inflammation of the uterus or fallopian tubes, but. this is now a thing of the past. The IUD must be measured correctly, because, as with contraception in general, there is not one model for everyone.

This is also a very safe and common contraceptive method. With copper, you have peace of mind for several years, as it can stay in the body for a long period of time.

Barrier methods such as condoms, diaphragms, caya, cervical caps and many more.

As the name suggests, these are methods that create a barrier. Sperm and egg do not find each other, which makes fertilisation impossible. The way the condom works is well known, it catches the sperm after ejaculation. This applies both to the condom, which is worn over the penis, and to the femidom, which virtually lines the vagina from the inside.

Both also protect against sexually transmitted diseases, keyword: safer sex. Unfortunately, they are also the only effective means against STIs. Here it is important to make sure the condom fits well and to wear it in the right size (isn’t hormone-free contraception just super individual?).

The other methods, such as the diaphragm or the cervical cap, are worn inside the vagina and seal the cervix. They are inserted before sex and then worn for some time before they are removed again. This ensures that no sperm can reach the cervix. This requires a bit of practice at first, but eventually becomes quite easy.

Some, such as the Caya, only come in one size; all others should be customised to fit properly. Your gynaecologist and counselling centres such as pro familia can do the measuring. It is important to remember that the cervix can change due to surgery or childbirth, so it may be better to have it checked later.

 

Sterilisation

In Europe, sterilisation is rarely in the forefront and the numbers vary from country to country. However, it is a very safe and long-term method of contraception. There is either closure of the vas deferens (vasectomy) or the fallopian tubes (tubal sterilisation), depending on what is anatomically appropriate. These are usually minor surgical procedures.

The vas deferens is cut and the fallopian tube is sclerosed. In theory, this is also a kind of barrier, only internal. This means that the sperm and eggs cannot get out. Incidentally, the eggs are ‘transported away’ via the so-called Douglas pouch and do not remain in the body after ovulation. Vasectomy, like tubal sterilisation, can be reversed.

The removal of testicles or uteri is not a common contraceptive method in humans, unless existing diseases make such an intervention necessary.

Other methods

For the sake of completeness, I would like to mention the following methods, which, in my experience and opinion, are rather unsafe or still new: Spermicides and spermiostatic drugs, coitus interruptus, contraception with plants or thermal heating of the testicles.

As you can see, hormone-free contraception has a lot to offer. You can find out for yourself what suits you and your body. I think it is great that hormones no longer have to be the first choice and that natural contraception is constantly evolving.

 

Head over to the German translation to find all the article’s sources.

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