Non-Hormonal Birth Control

You can control your period with hormones, but is it the right thing to do?

Are there methods of birth control that work as well as the Pill but don’t involve hormones? Compare the available hormonal and non-hormonal contraceptives to help make the choice that’s right for you.

There are things to consider to decide if non-hormonal contraceptives are right for you. Once you’ve had a look at the arguments for using non-hormonal and hormonal contraceptives you’ll be in a better position to make a choice.

Reasons for you to pick non-hormonal contraceptives:

• Personal preference – if you have had bad experiences with a hormonal contraceptives or you just don’t like the idea of using a hormonal contraceptive
• Health concerns – hormonal contraceptives like the pill come with a risk of side effects. These can include:
• Headaches
• Irregular bleeding
• Mood changes
• Increased risk of blood clots (combined pill)
• Increased risk of certain types of cancer
• Convenience – remembering to take the pill every day can be a hassle and the risk of pregnancy increases if you don’t plan properly. Some non-hormonal methods involve less planning.
• Political or ideological – some people may object to the pill on moral grounds. They may have a religious objection or may feel that the pill should not be the first choice for contraception
• Effectiveness – a non hormonal copper intrauterine device/ coil (IUD) is an extremely effective method of contraception.

Reasons for you to pick hormonal contraceptives like the contraceptive pill:

• Effectiveness – next to not having sex, hormonal contraceptives are one of the most reliable way to prevent pregnancy, as long as you use them properly.
• Easy to use – while taking a pill every day takes some organisation, swallowing a pill is an easy option for most people. Other, non-hormonal methods involve some practice to use or insert, and you may even need a healthcare professional to do it for you.
• Easy to adjust – if you have problems with side effects, you may be able to change the type of your hormonal contraceptive such as from a combined pill to a minipill.
• Non contraceptive benefits – there are non contraceptive benefits of most hormonal contraceptives such as the combined pill can help to improve acne symptoms. Some pills can also reduce the risk of certain types of cancer.
• Easy to buy – once you’ve started a contraceptive pill you can easily reorder up to 6 months worth at a time from an online doctor service or can usually request 12 months at a time from your GP or nurse.
• Lots of choice – there are many brands and types of oral hormonal contraceptives (pill), as well as some non-oral hormonal contraceptives too.

In order to know if a pill is right for you, you first need a healthcare assessment.

Some other, less common types of non-hormonal contraception are:

• Spermicides – usually come in a gel or tablet form and are best used with other forms of contraception, like condoms. They have an efficacy of 70-80%
• Abstinence (avoiding sex altogether) – is 100% effective in preventing pregnancy but unrealistic for a lot of people
• No contraception – this isn’t recommended if you don’t want to become pregnant as up to 15% of women will fall pregnant in the first year
• Practicing other forms of sex (i.e. other than just penetrative penis-in-vagina (PIV) sex, like oral sex or mutual masturbation) – there are more options than just PIV penetration which may reduce your chance of pregnancy. Although, you may prefer to have the option of PIV sex, in which case we recommend using at least 1 form of contraception. There is also the risk that sperm from other forms of sex will get accidentally transferred to your vagina and could cause pregnancy
• Permanent surgical methods of contraception (vasectomy for men or sterilisation for women) – these have an efficacy of more than 99.5% but aren’t suitable if you want the option of having children in the future as they generally can't be reversed.

Honourable mention – the IUS (intrauterine system) – this is technically a hormonal contraceptive but because the hormones are located inside the vagina, rather than throughout your whole body (like with the pill), the amount of hormone that reaches the rest of your body is minimal, it therefore deserves an honourable mention as a potential option if you would consider a coil. It is slightly more effective than the IUD.

From the table above, the most reliable contraceptive is the copper coil and it’s long-lasting. But the coil comes with a few drawbacks:

• Some women find it invasive – it has to go inside your vagina to be fitted in the womb
• You can’t use it by yourself – you have to make an appointment to have it inserted
• Not everyone can use it – if you have very heavy periods or any abnormalities with your womb you may not be able to use this
• You can’t stop it right away – you need to have it properly remove if you want to stop or switch contraceptives
• Heavier periods – some women may experience heavier periods

What’s best for you depends on what you’re looking for from a non-hormonal contraceptive. Check the scenarios below to see some suggestions:

• Don’t want to have to plan your contraception?
• Little planning required – go for one you don’t have to think as much about like the copper coil
• Takes a bit of organising – some devices take practice to use properly, like the diaphragm. Also planning methods like FAM require preparation and timing of sex during the right time in your menstrual cycle
• Is is important that your contraceptive is easy to use?
• Easiest to use – the abstinence method is the easiest to use but it isn’t really practical for most people. Male condoms are another easy to use option
• Require some effort – using devices like the diaphragm or female condoms can require a bit of practice to learn to use
• Do you need to be able to stop your contraception quickly?
• You can stop right away – using a one-use device like a condom means that as soon as you want to stop you just don’t use it the next time you have sex (we recommend only doing with with a partner you want to get pregnant with who you know does not have any STIs). There is also FAM which you can simply stop using at any time
• These won’t be easy to stop quickly or at all – permanent or semi-permanent choices won’t be right for you, like the coil or sterilisation
• Worried about side effects?
• No chance of side effects – FAM or abstinence don’t involve introducing something new to your body so there will be no reaction that could cause side effects
• A chance of causing side effects – devices like the coil or diaphragm can cause side effects in some people, so can spermicidal gels or condoms (which usually have spermicides applied to them)

Even though they’re non-hormonal, not all of these contraceptives can be considered ‘natural’. Many non-hormonal contraceptives are still made-made devices or chemicals like spermicides. If you’re looking for natural contraceptives you have the following options:

• Withdrawal – if you don’t ejaculate inside the vagina then the sperm can’t reach the egg in the womb and cause pregnancy. The problem here is often sperm do get transferred to the vagina accidentally, or else sperm are released before ejaculation, inside pre ejaculate or ‘precum’ (liquid that leaves the penis during sex before ejaculation) which can lead to pregnancy. Withdrawal or “pulling out” is not recommended if you do not want to become pregnant.
• Other types of sex – avoiding vaginal sex may reduce your risk of pregnancy.
• FAM – instead of controlling you periods with devices or medication, you plan around your period and just have sex when it’s safest to do so. While this method can work, it takes a lot of planning to set up and won’t work if your periods are irregular or unpredictable. You need to record your cycles in order to get an accurate timeframe for safe sex. Even then, this method is not that reliable and there will still be moderate risk of pregnancy
• Abstinence – this is really the only guaranteed way to avoid pregnancy but it is not why most people want contraceptives and for many people it’s not an appropriate lifestyle choice

What about natural versions of the pill? – you might be wondering if there are herbs or diets that can help prevent pregnancy. While there are some herbs that are thought to reduce fertility but they have not been proven to reliably prevent pregnancy, like genuine contraceptives.

The only permanent form of non-hormonal birth control is sterilisation. This has a number of disadvantages though:

• They can still fail – they aren’t 100% reliable
• They involve surgery – there are risks to the procedures for men and women
• If pregnancy does occur, the risk of ectopic pregnancy is increased – pregnancy can sometimes occur outside of the womb as a result of these procedures
• They are not easily reversed – they can sometimes be reversed but it’s not a sure thing. If you want biological children in the future this might not be worth the risk

There are some contraceptives that you can keep using without stopping:

• The withdrawal method – there is no reason to stop using this, except that it isn’t reliable
• The rhythm method – you can keep using this as long as your periods stay regular
• Abstinence or different forms of sex – these methods can be used consistently but they aren’t reliable or practical for everyone

There are also non-hormonal contraceptives that last a long time (semi-permanent):

• The coil – this can last 5-10 years
• The cup – this can last up to 1 year
• The diaphragm – this can last up to 1 year