Going Hormone Free: Natural Contraception

There’s a trend at the moment of people avoiding hormonal contraception in favour of natural contraception alternatives[1] Many health blogs and websites are spruiking the benefits of hormone-free, or non-hormonal contraception. As with anything that encourages us to take a closer look at our health, this is largely a positive thing. We should always be aware of what we’re putting into our bodies and how it may react with our lifestyles or other medication we’re taking.

For those who are unfamiliar with Natural Contraception, you might know it by one of its many other names; the Rhythm Method, Natural Family Planning, the Fertility Awareness Method (FAM) and collectively sometimes referred to as a Calendar Based Contraceptive Methods. These are systems of non-hormonal contraception based on the understanding of when a woman is fertile and can become pregnant.

While FAM has been around for centuries, they’ve experienced a renewed popularity thanks to our current social focus on more organic and natural lifestyles. This has also been made easier with the integration of smartphone apps into our lives, making tracking fertility periods much easier.

However, there’s also a lot of misinformation out there around natural contraception. Many people don’t realise that FAM is only as effective as the regularity of your cycle. If your body isn’t running like clockwork, it can be very easy to miscalculate your period of fertility. Even if you have a regular cycle, it can be thrown off by things like illness, stress, or medication. For most of us though, a completely regular cycle is a foreign concept. In this case use of the Rhythm Method requires constant monitoring of cycle symptoms; levels of mucous measurements, basal body temperature checks, cervical changes, breast tenderness, abdominal irregularity and more. Without keeping careful track of these indicators it can be easy to miss your fertility window and risk accidental pregnancy.

When used typically, the failure rate for Natural Family Planning is between 22% – 25%[2]. By contrast, the Withdrawal Method or Pull Out Method has a failure rate of 27%[3].

Regardless of the risks of unplanned pregnancy associated with them, more and more people are turning towards non-hormonal contraception methods as an alternative to the hormone-based contraception options available.

There is a tendency for people to view anything hormone-based as being inherently bad for the body. So let’s take a moment to find out exactly how many hormones are in the average hormonal contraceptive.

Synthetic vs Natural Hormones

There’s a focus these days on ensuring that what we put into our bodies is ‘natural’ and ‘organic’. While this is a worthy goal, it has meant that there’s now a lot of confusion between natural and healthy. For instance, arsenic is both natural and organic but that doesn’t make it healthy or good for your body.

When it comes to hormones a lot of people are concerned about the use of synthetic hormones in contraception, because it seems unnatural. The word synthetic makes us think it’s fake, but in medicine it simply means that it’s synthesised. A synthetic hormone is made in a laboratory, sure, but it’s identical in every way  to the ones that your body produces. It has to be; otherwise it can’t do its job. In fact the foundation for these hormones is often taken from wild yams and soybeans – which are organic.

By contrast, an example of a natural hormone is contained in a brand of conjugated estrogens tablets, a medication that combinations natural estrogens often used to treat people with severe menopause symptoms. This naturally occurring estrogen is harvested from pregnant horses. Whilst it isn’t found in the human body, it is typically used in Hormone Replacement Therapy (HRT), which can have some rare but serious side effects[4].

In short, the ‘synthetic’ hormones found in contraceptives are typically going to be identical to the ones your body would be making by itself, they just happen to be made in a lab instead of in your pituitary gland.

How many hormones are in The Pill?

The Pill, also known as the Combined Oral Contraceptive, is a combination of two synthetic hormones; oestrogen and progestogen. These two work in conjunction to help stop your body from ovulating. This means, rather than using Fertility Awareness Method to avoid having sex during your fertile time, you’re skipping your fertile time completely.

There’s a broad variety of pill types on the market, each of them combining different levels of the two hormones to achieve different results. For example some have higher hormone levels to help combat painful menstrual symptoms. 

The median hormone levels found in The Pill are similar to those experienced during natural ovulation. This means if you’re on The Pill you’re not subjecting your body to hormone levels outside of what it would naturally produce. Even brands of The Pill with higher doses still never exceed hormone levels found in the first 12 weeks of pregnancy.

How many hormones are in the Mini Pill?

The Mini Pill is a progestogen-only oral contraceptive. This means it’s similar to The Combined Pill in the way that it’s used, but unlike The Pill it doesn’t contain oestrogen. The Mini Pill prevents pregnancy by thickening the cervical mucus, which makes it impenetrable for sperm, but it doesn’t prevent you from ovulating.

Most versions of The Pill contain progesterone at around 150 micrograms. The Mini Pill only has 30 micrograms. That might still sound like a lot, but to help give you a sense of scale, the Morning After Pill contains 1500 micrograms (1.5mG).

Because the Mini Pill dosage is so low, it means it’s safe to use while breastfeeding, which is why most women use it for that exact reason. The downside is, you have to take it within the same 3-hour window every day, otherwise it won’t work!

How many hormones are in the Hormonal IUD?

When people hear about IUDs, they often assume that it means inserting this hormone generating contraption into your body that’s going to flood you with all the hormones ever. In reality, the Copper IUD doesn’t contain any hormones at all, and the Hormonal IUD has less hormones than any other method of hormonal contraception.

The Hormonal IUD, like the Mini Pill, is a progestogen-only method of contraception. However, due to its placement in the uterus, it doesn’t require you to do anything (like remember to take a pill each day). This means it has a much higher efficacy rate than any oral contraception. It can also make your periods lighter and shorter or they may stop altogether while the device is in place. Because of this, it can be a good treatment if you experience period pain.

Because the Hormonal IUD is placed in your uterus it also means that the hormones it releases are almost exclusively localised to your reproductive system. With an oral contraceptive, it relies on entering your bloodstream via your digestive tract in order to work. With a Hormonal IUD, the amount of hormones reaching your bloodstream will be minimal, meaning hormonal side effects should also be minimised.

The hormone level in a Hormonal IUD is the equivalent of between 2 -3 Mini Pills per week (as opposed to the seven you’d be taking if you were relying on the Mini Pill for contraception).

Ultimately contraception is a personal choice. It’s up to each of us to decide what we are and aren’t comfortable with putting in our bodies. But part of making that decision requires us to be informed about the efficacy and dosage amounts of the available options. There’s nothing dangerous about synthetic hormones, and the amount of hormones you’re putting in your body with contraception is rarely more than your body would produce on its own during your natural cycle.