Sharing is caring!

Choosing how to manage your fertility is a deeply personal decision. When it comes to deciding between hormonal birth control vs natural methods, it’s normal to feel overwhelmed or uncertain about which method suits your needs, goals, and lifestyle. 

Women have been managing their fertility since time began, using knowledge passed down through generations to control when and how we bring life into the world. And while politics have always tried to interfere with our autonomy, we continue to organize and work together under the radar to take back what is ours. Natural birth control methods are not new, yet remain sidelined by dominant culture. To put it plainly, these methods may never get the validity they deserve in dominant culture, because the medical industrial system, and drug companies, simply do not benefit from them. 

Fertility Management Is Ancient. Birth Partner by Shauna Wiley-Naefke

It’s not entirely fair, then, to compare hormonal birth control vs natural methods. These methods exist in entirely different worlds—FAM is sidelined culturally, leaving it on the back foot in most of our minds. That said, I’m going to compare them anyway (despite my obvious bias!). Why? Because I believe in informed choice. And we can’t achieve that if we push one method above the other on moral or ethical grounds. At the same time, we won’t achieve that if we continue to ignore the fact that Hormonal Contraceptives (HCs) are pushed on economic grounds. 

So, let’s take a balanced look at the pros and cons of hormonal birth control and FAM. May you choose what’s best for your body and your life. 

Hormonal Birth Control (HCs): The Pros and Cons

What Is Hormonal Birth Control?

I am using the term HCs to encompass the pill, patch, implant, or IUD, which all work by altering your natural hormonal cycle. Most of them prevent ovulation through the release of synthetic hormones which create a stasis in the body similar to that of menopause. They may also thicken cervical mucus to block sperm, thin the uterine lining to reduce the likelihood of implantation, and in the case of the copper IUD, kill sperm by creating a toxic environment in the uterus. 

The pros and cons of hormonal birth control

The Pros:  

1. Highly effective: When used correctly, hormonal methods have a failure rate of less than 1%, making them a reliable option for preventing pregnancy.  

2. Convenience: Options like the implant or IUD are “set-it-and-forget-it,” requiring little daily effort.  

3. Cycle Shut Down: Due to the suppression of natural menstrual cycle hormones, which may be disregulated due to inflammation, stress, energy or nutrient deficiency, or an underlying health condition such as PCOS or endometriosis, HCs can temporarily reduce the symptoms of this issue such as heavy and painful periods, acne or intense mood swings. 

4. Non-contraceptive benefits: It’s often prescribed to help manage conditions like endometriosis or adenomyosis, providing temporary symptom relief in some cases.

The Cons: 

1. Side effects: Many people experience mood swings, weight changes, headaches,  reduced libido and even become more susceptible to depression while on hormonal birth control.  

2. Reduced immune function: HCs can suppress immune responses, making individuals more susceptible to infections like HPV and increased risk of cervical dysplasia. 

3. Gut health: Long term HC use disrupts the balance of friendly bacteria in the digestive tract and can lead to increased risk of developing irritable bowel syndrome (IBS). HCs use is also associated with nutrient depletion, and thus may contribute to long-term health issues which persist after discontinuation.

4. Increased bacterial infections: HC use has been shown to impact vaginal microflora, leading to increased cases of bacterial infections such as bacterial vaginosis (BV) and candida albicans (yeast infections). This issue typically resolves after discontinuing HCs.  

5. Liver health: The liver is responsible for metabolizing hormones, and prolonged use of synthetic hormones can lead to liver strain or even liver damage over time.

6. Reduced bone health: The teen and early adult years are critical for building bone density, and hormonal contraceptives—especially the Depo-Provera shot—have been linked to reduced bone mineral density. This may increase the risk of osteoporosis later in life, particularly if bone mass wasn’t adequately developed during those formative years.

7. Other Health risks: Although rare, there’s an increased risk of blood clots, stroke, or other complications, especially for smokers or those with certain medical conditions. 

8. Suppresses natural hormones: Hormonal methods disrupt the body’s natural rhythm, which can make it harder to recognise and resolve underlying health issues.  

9. Transitioning off: Cycle irregularities, hormonal imbalance and delayed return of ovulation are common when discontinuing HCs.

Fertility Awareness Methods: The Pros and Cons

What is FAM?

The Fertility Awareness Method is a natural approach that involves tracking physical signs of fertility, such as cervical mucus and basal body temperature, to identify when you are fertile or not. Methods like the Symptothermal Method combine multiple indicators for accuracy. 

The Pros:  

1. Non-invasive and hormone-free: FAM works with your body, not against it, making it an excellent choice for those avoiding synthetic hormones and maintaining your natural creative rhythm.  

2. Empowering: Learning to understand your cycle fosters a deep connection with your body, improving self-awareness and reproductive autonomy.  

3. Highly effective when done correctly: Studies show the Symptothermal Method can have a perfect-use efficacy rate of up to 99.4%.  

4. Holistic health insights: Tracking your cycle provides valuable information about your hormonal health. This can help you identify issues like irregular ovulation, thyroid problems, or stress-related imbalances, and support the management of ongoing conditions like endometriosis, fibroids, Hypothalamic Amenorrhea or PCOS (etc).  

5. Accessible and cost-effective: All you need is education, a thermometer, and some dedication—no prescriptions or ongoing costs.  

6. Ability to conceive: Not only increases your chances of getting pregnant when/if you do wish to, but also provides insight into your overall reproductive health, making it easier to spot any issues that could affect conception.

The Cons:  

1. Learning curve: FAM requires commitment to learn and practice correctly, which may feel overwhelming at first.  

2. Daily effort: You need to chart regularly, which can be a challenge if you’re traveling, work inconsistent night shifts, or forget to take your temperature.  

3. Less effective with inconsistent use: Forgetting to chart or misinterpreting signs can lead to a higher risk of unintended pregnancy.  

4. Barrier Methods needed: Unlike with HCs, your fertility is not suppressed, and so condoms, abstinence and other barrier methods may be required during your fertile phase.

What About People with Irregular Cycles or Hormonal Conditions?

One common misconception is that FAM only works for people with “perfect” cycles, but this isn’t true. For those with irregular cycles, PCOS, or endometriosis, FAM can be a powerful tool for understanding what’s happening in your body. It allows you to track whether ovulation is occurring, detect patterns, and work towards solutions for hormonal imbalances.  

On the other hand, hormonal birth control can sometimes help temporarily reduce the symptoms of these conditions, but it doesn’t address the root causes. It’s worth considering whether symptom management or uncovering the underlying issues aligns better with your long-term health goals. 

Your body your choice: Artwork by Cory Feder, 2021

How to Choose What’s Best for You

When deciding between hormonal birth control vs natural methods, consider the following:  

1. **Your health goals**: Are you looking for a short-term solution, or do you want to better understand your body and cycles?  

2. **Lifestyle and commitment**: Are you comfortable with daily tracking, or would you prefer a hands-off method?  

3. **Side effect tolerance**: How do you feel about potential side effects or disruptions to your natural hormones?  

4. **Effectiveness and peace of mind**: Both methods are highly effective when used correctly, but your confidence in practicing FAM or consistency with hormonal methods is key. 

Final Thoughts

Both hormonal birth control and natural methods like FAM ( learn with me!) have their place in reproductive health. There’s no one-size-fits-all answer—it’s about finding what feels right for you. If you’re curious about FAM and want to learn how to use it effectively, I offer personalised coaching to help you master the Symptothermal Method and align your fertility goals with your overall health.  

Whether you choose hormonal birth control, FAM, or a combination of methods, the most important thing is that you feel informed and confident in your decision. 

References

Hassan, M.A.M. and Killick, S.R., 2004. Is previous use of hormonal contraception associated with a detrimental effect on subsequent fecundity?. Human reproduction, 192, pp.344-351.

Gnoth, C., Frank-Herrmann, P., Schmoll, A., Godehardt, E. and Freundl, G., 2002. Cycle characteristics after discontinuation of oral contraceptives. Gynecological Endocrinology, 164, pp.307-317.

Nassaralla, C.L., Stanford, J.B., Daly, K.D., Schneider, M., Schliep, K.C. and Fehring, R.J., 2011. Characteristics of the menstrual cycle after discontinuation of oral contraceptives. Journal of Women’s Health, 202, pp.169-177.

Marks, M., Gravitt, P.E., Gupta, S.B., Liaw, K.L., Tadesse, A., Kim, E., Phongnarisorn, C., Wootipoom, V., Yuenyao, P., Vipupinyo, C. and Sriplienchan, S., 2011. Combined oral contraceptive use increases HPV persistence but not new HPV detection in a cohort of women from Thailand. Journal of Infectious Diseases204(10), pp.1505-1513.

Frank-Herrmann, P., Heil, J., Gnoth, C., Toledo, E., Baur, S., Pyper, C., Jenetzky, E., Strowitzki, T. and Freundl, G., 2007. The effectiveness of a fertility awareness based method to avoid pregnancy in relation to a couple’s sexual behaviour during the fertile time: a prospective longitudinal study. Human Reproduction22(5), pp.1310-1319.

Mena, G.P. and McLindon, L.A., 2023. Fertility awareness education improves fertility cycle knowledge and may reduce time-to-pregnancy in subfertile women. Human Fertility26(2), pp.405-412.

Vigil, P., Blackwell, L.F. and Cortés, M.E., 2012. The importance of fertility awareness in the assessment of a woman’s health a review. The Linacre Quarterly79(4), pp.426-450.