Hormone-Free Contraception… What Are the Options?

The realm of hormonal contraceptives is vast—from the different generations of pills to rings, patches, implants and injections. However, there are effective hormone-free alternatives worth considering. In this article, we’ll explore various options that cater to different preferences, while emphasizing increased body awareness and shared responsibility.


In heterosexual relationships, people with uteruses tend to bear the responsibility of contraception. But contraception is the business of each partner. All partners need to discuss their sexual preferences outright, including methods of pregnancy prevention. To be honest, shared responsibility is quite a sexy contribution to a healthy relationship!

Natural Family Planning (NFP)

I’ll begin with my personal favourite: Natural Family Planning (NFP). Specifically, I will discuss the symptothermal method of contraception, making the distinction between NFP according to Sensiplan and NFP with cycle tools.

With the NFP method, we observe the basal body temperature on 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. After ovulation, the body temperature rises by at least 0.2°C and remains elevated until menstruation starts. We use this fact to observe the cycle’s two phases: the low phase (when the temperature is low) and the high phase (when the temperature is high).

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.

Body temperature is considered along with various other fertility signs that appear during the cycle—pain occurs, libido increases, the breasts tighten and cervical mucus changes consistency.

Our body shows clear signs of its fertility during our cycle. This allows us to choose to have unprotected sex during the infertile periods. By following your cycle, you also get to know and understand your body and cycle better. All in all, I think it’s very empowering!

NFP according to Sensiplan

The Maltese NFP working group has been active since 1981. Since its inception, the group has been monitored according to the scientific standards of the University of Heidelberg. As such, there are many thorough, rigorous studies attesting to the safety of this method which have contributed to its development.In NFP according to Sensiplan, body temperature and other symptoms are tracked using a cycle sheet. This requires thorough familiarity with cycle-tracking methods related to cervical mucus and temperature, in various circumstances (e.g., after taking the pill, during breastfeeding or menopause). Temperature is measured using a basal thermometer.

NFP with cycle tools

NFP cannot be tracked by manual means alone, but thankfully there are various apps and tools available to help. These apps evaluate the body’s symptoms via an algorithm, so each app always works a little differently. Many apps connect to a thermometer, which transmits the data to the app via Bluetooth.It’s important that all users have knowledge about their cycle to evaluate information from the app and put it into practice. While some tools evaluate temperature alone, I always recommend those that offer a symptothermal evaluation.Well-suited tools or apps:
Masturbation is an effective feel-good technique, but it’s also a great way to learn more about your body. By masturbating, we can learn about the body’s workings, its likes, its dislikes and its non-negotiables (Note: We recommend focusing on the likes). Lockdown offers you the chance to get even more comfortable with your sexuality and to prepare for all your post-Covid dates.

Copper contraception (intrauterine devices)

These devices can take the form of a coil (resembling a small T made of metal), a chain, a ring or a ball made of copper and, occasionally, gold. The ions in these devices kill sperm and prevent fertilisation. They are inserted into the uterus, and the procedure is relatively fast and painless.

For a long time, there were concerns that copper could cause permanent inflammation of the uterus or fallopian tubes, but this is now considered a thing of the past. The IUD must be measured correctly because, as with contraception in general, there is no one-size-fits-all model.

This is a highly safe and common contraceptive method. With copper, you have peace of mind for several years, as it can remain in the body for an extended period.

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

As the name suggests, these methods create a barrier which prevents sperm and egg from meeting and fertilising. The condom, worn over the penis, catches sperm after ejaculation. This applies to both the male condom and the femidom, which lines the vagina from the inside.

Fortunately, both methods also protect against sexually transmitted infections (STIs). Unfortunately, they are the only effective means of protecting yourself from STIs. Since a condom’s fit and sizing are important, hormone-free contraception is highly individualized.

Other methods, like the diaphragm or cervical cap, are worn inside the vagina, sealing the cervix. They are inserted before sex and worn for some time before removal. This ensures no sperm can reach the cervix. Though it requires practice initially, it becomes quite easy over time. Some methods, like the Caya, come in one size, while others need customisation for a proper fit. Your gynaecologist and counselling centres, such as pro familia, can assist in measuring. It’s important to note that the cervix can change due to surgery or childbirth, so periodic checks are advisable.

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.


In Europe, the popularity of sterilisation varies from country to country. Nevertheless, it has been established as a safe long-term contraceptive method. These are typically minor surgical procedures.

Sterilisation involves a closure of either the vas deferens, known as a vasectomy, or a closure of the fallopian, known as tubal ligation, depending on the person’s anatomy. The vas deferens is cut and the fallopian tube is sclerosed. In theory, this creates an internal barrier, preventing the release of sperm and eggs. Notably, the eggs are transported away via the “Douglas pouch” and do not remain in the body after ovulation. Both vasectomy and tubal sterilisation can be reversed.

Other Methods

For the sake of being thorough, I would like to mention some methods which, in my experience and opinion, are relatively unsafe. These include spermicides and spermiostatic drugs, coitus interruptus, contraception with plants and thermal heating of the testicles.
There are plenty of methods of hormone-free contraception. Explore what suits you and your body. As natural contraception has continued to evolve, hormones no longer need to be the primary choice.[All of this article’s resources are available in the original German translation.]


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