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Contrary to what we’re all told, hormonal contraceptives are not the only effective option for birth control. If you’ve decided to finally ditch the hormones forever, or if you’re contemplating taking the leap, you’ll still need to know how to manage your fertile window if abstinence isn’t your thing.

Contraception can be used during the learning phase of fertility awareness and charting, when you’re still learning about your body’s unique menstrual cycle, and on wonky days when you’re just not sure (they happen to everyone!).

So forget what you were told in sex ed, I’m breaking down for you the most effective contraceptive options for managing your fertile window that are 100% hormone-free.

 

Here’s what we cover in this episode:

• If you want to have sex during your fertile window, you’ll need a back up!
• How effective is the Fertility Awareness Method on its own?
• Why you might still need to keep some condoms in your purse
• Withdrawal – is it as risky as its reputation suggests?
• Diaphragm – the forgotten one
• Copper IUD (yes it’s hormone-free)

EPISODE TRANSCRIPT

Hello, and welcome to episode 30 of The Mana Women’s Wellness Podcast. I’m your host, Rachel and today we are talking about how to manage your fertile window with non-hormonal contraceptive options.

Contrary to what we’re all told, hormonal contraceptives are not the only effective option for birth control. And if you’ve taken the plunge and decided to say goodbye to the hormones forever, or if you’re contemplating doing so, you are in the right place. And if you want to know more about the effects hormonal contraception like the Pill has on the body as well as my steps for coming off the pill and what to expect, check out Episodes 19 and 20.

Managing Your Fertile Window

So now that you’ve taken that leap, or you’re already charting your cycles and wanting to use fertility awareness for birth control, you might have found yourself wondering what your options are for managing your fertile window. Of course, the only 100% effective method of avoiding pregnancy during your fertile window is not to have sex, but if abstinence isn’t your thing, you’re going to want to find another option. This option is useful not just for your fertile window, but also for the learning phase of fertility awareness, when you’re still learning what a typical cycle looks like for you, which I recommend for at least 3 cycles before relying on charting alone as a birth control method. And sometimes, even if you’ve been charting for 5, 10, 20 years, sometimes there are just days where your BBT is wonky or you’re feeling wet and seeing mucus, or you had sex last night and want to go again this morning – there are times when you will need to consider yourself fertile and you will need a back up method. And that’s exactly where these non-hormonal methods play their role.

Some you might not know much about, some might have been glossed over or ridiculed in sex ed. But a very convenient part about not relying on hormones for birth control is that you can mix and match. You can manage each and every fertile window differently. And that, my friend, is true empowerment.

And so, if you want to learn more about charting your cycle, understanding your body’s natural fertile signs, how to get started with fertility awareness, you can grab my free Fertility Roadmap over at today’s shownotes, fertilityco.com.au/30. This is my 3 step system to completely understanding those messages your body is sending you every single day. Your body is sending them to you, so you might as well listen right? You can grab the Roadmap over on the shownotes page too.

So forget what you were told in sex ed, I’m breaking down for you the most effective contraceptive options for managing your fertile window that are 100% hormone-free.

The fertile window is the only window of time in your menstrual cycle where pregnancy is possible, so if you absolutely want to avoid pregnancy, abstinence is your best option. On those days where you observe fertile cervical mucus, or days where your observation is impaired in some way, like during your period, after sex or you just weren’t paying attention – on any day that you need to consider yourself fertile, if you want to have sex, you need a back up method to avoid pregnancy.

Any time you have sex, even with a barrier method of contraception, you are potentially masking fertile cervical fluid, so the day after intercourse needs to be considered potentially fertile. So if you’re having sex daily, you’ll need to be pretty confident that you can still observe mucus and not confuse it with sex juices, in order to know whether or not you’re fertile.

The thing to remember here is that contraception only needs to be used during our fertile window. We don’t need to use it every single time we have sex if we know whether or not we are fertile and where we are in our menstrual cycle. Contraception can be used during the learning phase of fertility awareness and charting, when you’re still learning about your body’s unique menstrual cycle and fertility, and it will also be used to manage your fertile window if abstinence isn’t your thing. You’re also going to use contraception on any days during your cycle that you’re just not sure. And we all get wonky days now and then, that’s totally normal, but contraception means we can still have sex on those wonky days.

The Fertility Awareness Method, when used effectively, is 99.4% effective for preventing unplanned pregnancy. This is about the same as the pill, but the pill and other hormonal contraceptives just aren’t an option when using fertility awareness, because of the way they impact our natural hormone balance and effect they have on our menstrual cycles and preventing ovulation. So, this leaves us with some other non-hormonal methods that we’ll be exploring in this episode. An important thing to remember here is that when you use an alternative method of birth control that we’ll talk about today, your risk of pregnancy will be the effectiveness of that method of birth control. So while Fertility Awareness is 99.4% effective, this effectiveness ultimately comes from avoiding sex during your fertile window. A condom, on the other hand is 98% effective. So if you practice Fertility Awareness but you have sex during your fertile window and use a condom, you’re relying on that 98% effectiveness which increases your risk of pregnancy to 2%.

So, let’s talk about the most effective contraceptive options for managing your fertile window:

Condoms

Condoms are made of rubber or plastic and are designed to stop the spread of body fluids, which means not only do they prevent pregnancy but they are also effective at preventing STIs. So, if you’re having sex where there’s a risk of infection transmission, always wear a condom regardless of whether you are in your fertile phase. That said, they cannot protect you from STIs that are spread through skin to skin contact, like herpes, genital warts or syphilis.

Condoms are the most effective barrier method of contraception. When used correctly, they’re 98% effective at preventing pregnancy but unfortunately they have a 15% user failure rate, meaning a significant percentage of males are not actually wearing them properly. This increases the risk that it comes off or breaks, and ultimately means you are having unprotected sex.

So, here’s a refresher on your high school sex ed – The condom needs to be removed from the packet carefully and held at the top as it’s rolled down the erect penis. When the fun is all over, it needs to be held carefully at the base as it’s removed to avoid leakage of semen and disposed of far away from the female’s genitals.

So I’ve been talking about the more common male condom to this point, but there are also female condoms that are inserted into the vagina and are about 95% effective. The condom sits inside the vagina but the outer ring will stay outside. But you shouldn’t use both a male and female condom at the same time, just like you should not use 2 male condoms at the same time. The added friction will just lead to breakage or slipping off, which makes them useless.

If the condom does break or come off during sex, the woman needs to know in case emergency contraception is needed. More on this soon. Breakages can occur with oil based lubricants and massage oils and they do have an expiry date and should be stored in a cool place. Condoms don’t really have any side effects, unless you have a latex allergy. Female condoms are made of polyurethane.

To recap, condoms are the most effective barrier method and should always be used if there is a risk of STI. Here are some advantages and disadvantages to help you to consider this as an option for birth control:

Advantages:

• Safe to use
• Small and easy to carry
• Easy to buy (no prescription required)
• Also protects against STIs

Disadvantages:

• Can only be used once
• Perishable – need to be stored in a cool place and used before the expiry date
• Male condoms can only be used with water-based lubricants
• Female condoms can be hard to insert/remove

Withdrawal

Withdrawal is, in my opinion, an under-rated method of birth control. Sure, for some couples it won’t work, but for others it certainly will. And the reason why it works so well for some couples but not others is all because of pre-cum.

Pre-cum, or pre-ejaculatory fluid, the stuff that comes out of the penis before ejaculation and orgasm, is a potential risk for pregnancy because there is a chance it contains live sperm. So the argument against withdrawal is that pre-cum happens while the penis is still inside the vagina, so if it contains live sperm then pregnancy is absolutely possible.

And the research here has mixed results. Some studies say that even if there is sperm in pre-ejaculatory fluid, there isn’t enough for fertilisation of the egg to occur and the opinion does seem to be that this myth has been copied from one textbook to another without anyone really taking the time to do new research. Research also says that about 50% of males will have sperm in their pre-cum, and the other 50% won’t.

So where does that leave you and your man, if you don’t know which half he falls into. Well, here is where we need to look at the anecdotal evidence for the effectiveness of withdrawal. If you and your partner have already been using withdrawal during your fertile window and you’re not pregnant, there’s a good chance you can continue to use it effectively. Experience does make this method more effective over time. If you’ve never used withdrawal before with your current partner – that makes all the difference here – and you are very much in the camp of I cannot under any circumstances get pregnant, then I’d suggest not relying on withdrawal during your fertile window.

Here’s what makes withdrawal as effective as possible:

• Both the male and female partner consider themselves responsible for contraception and the male has genuine concern for preventing pregnancy. Because if he’s not concerned, he is less likely to pull out in time.
• Neither partner is affected by drugs or alcohol.
• The penis is completely withdrawn before ejaculation occurs, away from the female partner’s genitals.
• Intercourse is not repeated. This is a big one – if you’re going for round 2, there will be sperm in his pre-cum, so withdrawal will not be effective if sex is repeated.
• Withdrawal has been used as a method of contraception for a long time in a well-established relationship. Inexperience using this method will significantly reduce its effectiveness.

Diaphragm

The diaphragm is a shallow cup made of silicone. You can get one at some chemists and family planning clinics, as well as online. In Australia, it’s sold as Caya and is used with a special spermicidal gel. It’s about 86% effective at preventing pregnancy but this obviously will drop if not used correctly, such as not inserting it properly or removing it too soon after sex.

The diaphragm is inserted up to 2 hours before having sex. You place a small amount of gel into the cervical cup and around the rim, then squeeze and fold the diaphragm for easier insertion. Similar to if you were inserting a tampon or menstrual cup, find a comfortable position where you are relaxed and insert it into your vagina. When inserted correctly, the cervix will rest inside the cup and the rim of the removal dome is tucked up behind the pubic bone. You should be able to feel the cervix through the cap when it’s in the right position.

The diaphragm forms a physical barrier to prevent sperm entry into the cervix, meaning sperm dies quickly in the vagina. It should remain in place for at least 6 hours after sex, but never for more than 24 hours. It has a removal dome for easy removal and then you just wash it with soap and water and allow it to air-dry. It’s reusable, and can be used for about 2 years before it needs replacing.

Here are some reasons why the diaphragm may fail:

• Not inserted correctly
• Used without spermicidal gel
• Removed less than 6 hours after sex
• Torn or damaged
• Past it’s expiry date

Now let’s go through some advantages and disadvantages to help you to consider if a diaphragm suits your needs:

Advantages:

• Can be inserted up to 2 hours before having sex
• Minimal side effects
• Does not contain hormones
• No prescription required

Disadvantages:

• May irritate the vagina or penis
• Increased risk of bladder infection (so always wash your hands carefully before inserting or removing it)
• Is the wrong shape for 1 in 7 women, so may be unable to insert and use correctly
• Risk of toxic shock syndrome (a very rare blood infection)

The diaphragm may not be a good option for you if:

• You are prone to bladder infections
• Have given birth in the past 6 weeks
• Cannot feel if your cervix is correctly covered by the diaphragm
• Not comfortable inserting or removing it

Copper IUD

The copper IUD is a tiny plastic device with a fine copper wire wrapped around the frame. It is placed inside the uterus by a doctor and can last for 5-10 years, depending on the type you select. Attached to the IUD is a fine nylon thread that comes out through the cervix into the top end of the vagina. It is 99.5% effective at preventing pregnancy.

The copper IUD prevents pregnancy because:

• It is toxic to the egg and sperm, therefore prevents fertilisation.
• Slows transport of the egg to reduce the chances of egg and sperm meeting.
• Changes the lining in the uterus so that it cannot support implantation and development of a fertilised egg.

The copper IUD is an effective method of birth control for women who want a reliable, non-hormonal, long-term contraceptive. You can use it if you’re breastfeeding and between pregnancies.

It might not be suitable for you if you:

• think you might be pregnant
• have had pelvic inflammatory disease
• have had any unusual bleeding from your vagina
• have Wilson’s disease or you are allergic to copper
• have painful or heavy, long-lasting periods
• have anaemia
• have had a recent STI
• have uterine fibroids
• have had problems in the past with an IUD (such as coming out by itself)
• are unable to have a follow-up check-up after the IUD is inserted

Only a specially trained doctor or nurse can insert your IUD and you will likely need two visits. First you will need to go through health screening questions, as well as a vaginal exam, cervical screening test and a test for infection. Inserting the IUD takes about 10 minutes and some women can find it to be quite uncomfortable. Some clinics will provide a local anaesthetic.

After the IUD has been inserted, you might notice cramps or bleeding in the first couple of days. You should avoid sex, using tampons, swimming or having a bath for the first couple of days to reduce your risk of infection, and you’ll go back to your doctor for a check up 4-6 weeks later. You will also be taught how to check the IUD nylon thread after each period to make sure your IUD is still in the right place.

If you want to get pregnant or you want your IUD removed sooner than 5-10 years, it can be taken out by your doctor. If you are having it inserted and you’re over age 40, it might be recommended that you keep it in until menopause.

Now, let’s talk about the advantages and disadvantages of a copper IUD:

Advantages:

• 99.5% effective
• Can remain in place for 5-10 years
• Initial upfront cost, but no added costs once in place
• Does not contain hormones
• Fertility returns immediately after removed
• Can be used as emergency contraception if inserted within 5 days of unprotected sex

Disadvantages:

• Does not protect against STIs
• Requires a procedure to be inserted/removed from a trained doctor or nurse, which can be uncomfortable
• Insertion has a risk of damage to the wall of the uterus and infection
• May come out by itself
• Periods can become heavier and last longer
• May experience irregular, spot-bleeding in the first few months after insertion

Let me wrap this episode up now with some food for thought. Contraception should without a doubt be reliable, harmless, immediately reversible, inexpensive, it should not impact the body’s delicate natural processes, it should not affect a couple’s pleasure during sex and it should encourage a positive sexual and emotional relationship – guess what meets all of this criteria?

Some of the options we’ll consider for managing our fertile window don’t meet all of these criteria quite like fertility awareness and charting does, but they are effective and they are immediately reversible and don’t have the long-term side effects that hormonal options do.

So your homework this week is to have a think about how you will manage your fertile window. Unless you’re abstaining from sex when you are fertile, you’ll need a method of contraception to avoid pregnancy. This is crucial particularly during your first three cycles of charting when you are still in the learning phase and you really should be using an alternative form of contraception until you are absolutely confidence using charting as your primary method of birth control. So weigh your options and make a decision.

If you learnt something new about these birth control methods, or found value in today’s episode, I’d love to hear from you! Send me an Instagram DM and let me know your thoughts and tell me what you want me to talk about in upcoming episodes. This podcast is for you and so I want to talk about the things that are most important to you!

I will see you in next week’s episode, where we are talking about how you can use fertility awareness and track your menstrual cycle in under 5 mins a day.

 

Ok, bye for now and don’t forget that knowledge is power!

When you truly understand your body, you are empowered to make informed decisions and take control of your health!

Until next time.

LINKS & RESOURCES

Want to say goodbye to hormonal contraceptives and their weird and unpleasant side effects?

Want to improve your chances of conceiving quickly and naturally?

You need my Fertility Roadmap – My simple 3-step system to understanding your body’s natural fertile signs and pinpointing ovulation day so that you can use this knowledge to achieve (or avoid) pregnancy.

Related Episodes:

Episode 1 – Menstrual Cycle 101

Episode 2 – Am I Ovulating? The One Check You Can Do Every Day to Know For Sure When You’re Fertile

Episode 12 – The Menstrual Phase – Menstrual Cycle Masterclass Part 1

Episode 13 – The Follicular Phase – Menstrual Cycle Masterclass Part 2

Episode 14 – The Ovulatory Phase – Menstrual Cycle Masterclass Part 3

Episode 15 – The Luteal Phase – Menstrual Cycle Masterclass Part 4

Episode 18 – Is My Cervical Mucus Normal?

Episode 19 – Coming Off The Pill (Part I)

Episode 20 – Coming Off The Pill (Part II)

OTHER FREE RESOURCES

Does your pelvic floor need a little extra TLC? Take the Pelvic Floor Quiz and find out how to start strengthening your pelvic floor today!

 

Want to make sure you’re exercising safely during your pregnancy? Get your Free Guide: 10 Exercises to Avoid During Pregnancy.

 

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