If you are a woman who has been searching for non-hormonal contraception, you may have heard about some of the more recent fertility awareness apps and devices on the market. Not like your mother’s “rhythm method,” these apps use precise algorithms to analyze a woman’s basal body temperature and other signs to determine which days she is actually fertile during her cycle.
The apps are promising, especially for women who can’t or don’t wish to use hormonal birth control, but Swedish app Natural Cycles is facing some criticism. News broke yesterday that Södersjukhuset (SÖS), a Stockholm hospital, is reporting the app to Läkemedelsverket, the governing Medical Products Agency of Sweden. According to reports, the hospital is claiming that 37 women seeking abortions had become pregnant while using the app.
Natural Cycles was approved as a certified contraceptive in Sweden in February of last year, officially making it the world’s first birth control app. Currently, the app is available in the US as a “fertility monitor,” although the company says they are exploring options in the States for further expansion.
Originally developed by particle physicist Dr. Elina Berglund and her husband, also a physicist, Natural Cycles requires that users take their body temperature every morning upon waking and input the reading, along with menstrual cycle data, into the app to determine if they have a “green” or “red” day. A “green” day means the user is fertile and “good to go” for sex without a chance of getting pregnant, while a “red” day means potential fertility, and that the user should abstain or use a barrier method while having sex. As the app “learns” a user’s cycle, it becomes more accurate in predicting green and red days. And because things like a poor night of sleep or a fever can affect a woman’s body temperature, users are also educated on when not to input their temperatures. The app itself is also programmed to disregard extreme temperature outliers.
The science and studies backing the app are impressive. Last year, the app was determined to actually be more effective than the contraceptive pill, earning an effectiveness score of 93% with “typical” use, i.e. how most women will use the app, not just picture-perfect use. A spokesperson from Natural Cycles also tells Babble that the app has gone through — and continues to go through — rigorous testing in order to retain its ranking as a certified contraceptive. From following EU regulation for a medical device of class IIb to clinical studies to an annual audit by the regulatory body TÜV SÜD, the app, algorithm, and company are under close scrutiny.
According to the spokesperson, women who use the app report the major benefit of learning how their menstrual cycle actually works and affects them every month, as well having an “effective non-intrusive and non-hormonal contraceptive method.” However, as the spokesperson went on to explain, an app like Natural Cycles is definitely not an ideal contraceptive method for everyone based on their lifestyle and preference, the need for barrier methods on red days, or individuals with highly irregular cycles.
When asked about the claims against the app from the 37 women, Natural Cycles issued the following response to Babble, noting that they hope to work with the medical community to ensure more effective contraceptive options for women:
“We have not been involved in the study that SÖS is referring to so we cannot comment on specifics. However, we understand that it sounds alarming, but when Natural Cycles’ user base increases, naturally so will the amount of unwanted pregnancies coming from users using us, just as it would do with any kind of new contraception. We’d like to reassure the medical and community and the public that Natural Cycles is a safe, clinically proven and certified form of contraception which women worldwide trust as their birth control to prevent or plan a pregnancy.
Furthermore, SÖS is following protocol when submitting their analysis to Läkemedelsverket. This is something we welcome as it helps the medical community and the public bring transparency on such an important topic as birth control and its efficacy levels. Just as we have in the past, we look forward to work with and assist Läkemedelsverket in their work.”
Even with the current investigation into the app, Natural Cycles is standing behind their work, and perhaps equally as important, their belief that women deserve to have science-backed, non-hormonal options for birth control.
“We believe it is important for women to have an effective non-hormonal option so that she can make an informed choice on what will suit her and her needs the best based on all options on the market today,” notes the company’s spokesperson.