New Birth-Control Tech Monitors Fertility
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If your method of birth control involves abstaining from sex on the days when you’re most fertile, you might be monitoring changes in your body — such as subtle temperature fluctuations — to help determine exactly where you are in your menstrual cycle.
One of the tricky things about this approach is that you need to remember to take your temperature first thing every morning.
Now there’s a contraception app that can make this easier by syncing with a device on your finger that records your temperature while you sleep.
What Is This Technology?
Natural Cycles was approved by the U.S. Food and Drug Administration (FDA) in 2018 as the first direct-to-consumer contraception app. It helps prevent pregnancy by calculating the days each month when people are most likely to be fertile according to slight increases in body temperature that occur around the time of ovulation.
When the app first came out, one downside was that users had to remember to take their temperature each morning and enter that information manually.
To eliminate this hassle factor, Natural Cycles partnered with the smart-ring maker Oura. The FDA cleared the app in 2021 to be paired with wearables like the Oura Ring that collect temperature data, and this new partnership reflects efforts by both companies to make this integration seamless.
“We started evaluating various existing wearables on the market a few years ago and the Oura Ring stood out in initial testing as being extremely accurate in terms of temperature data,” says Elina Berglund, PhD, the cofounder and co–chief executive officer of Natural Cycles.
“[Testing] showed that the performance when using the ring was at least equivalent to an oral thermometer,” Dr. Berglund says.
While no form of birth control is 100 percent effective, Natural Cycles can be up to 98 percent effective with perfect use — meaning users always log their temperatures and abstain from sex or use condoms during fertile days, according to the company. It’s also 93 percent effective with more typical use.
Oral contraceptives are also about 93 percent effective with typical use, according to the U.S. Centers for Disease Control and Prevention (CDC). Other forms of long-acting and implanted birth control options are more than 99 percent effective with typical use, the CDC notes.
How Effective Are Contraception Apps in Real Life?
Birth control methods like the pill and intrauterine devices (IUDs) have decades of research and real-life usage showing their effectiveness. Apps aren’t as well studied or as well established as older birth control methods.
Over time, apps may not be as effective as birth control pills for many people, says Dominick Shattuck, PhD, an associate scientist at the Bloomberg School of Public Health at Johns Hopkins University in Baltimore who researched early versions of another FDA-approved contraceptive app, Clue Birth Control.
Part of the reason is that after the first few months, users tend to have more unprotected sex even during the window each month when they’re most fertile, Dr. Shattuck says.
“Women who are successful with fertility-awareness-based methods are often those with multiple motivations beyond pregnancy prevention,” Shattuck says. “Those reasons include religious convictions and management of severe side effects from hormonal methods.” Plus, he adds, “They infrequently have sex, and they have a supportive partner who will abstain or use condoms during the fertile window.”
Apps may also work for women who are concerned about taking hormones or who live in places where contraceptive care is inaccessible, says Victoria Jennings, PhD, a professor emerita in obstetrics and gynecology at Georgetown University in Washington, DC.
But more long-term studies with larger groups of women are still needed before we have a clear picture of how well technology like apps and wearables might work for family planning.
“It will also be important for researchers to address whether — and how — women actually use wearables,” says Dr. Jennings. “They need to be used consistently and under proper conditions, and we know very little about how women use them.”
Cost of Natural Cycles App and Oura Ring
The FDA has approved the Natural Cycles app as birth control for women 18 and older. It’s free to download, but costs at least $100 annually to use. Oura Rings, meanwhile, retail for around $400. It’s not clear whether the app and device would be more affordable than other forms of contraception.
With insurance, birth control and an annual physical may be free for many women, according to Planned Parenthood.
Fertility Apps May Play a Role in Sex Education
Birth control apps that shed light on the ovulation cycle might play a useful role in sex education, Shattuck suggests. “These methods should be taught in schools and other settings so that girls and boys are able to understand how their bodies function and open critical conversations about family planning, sex, pregnancy risks, and healthy relationships,” Shattuck says.
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