New research published in BMJ Sexual & Reproductive Health reported a shift in contraception use from traditional hormonal contraceptives, such as the Pill, to fertility awareness-based methods, also known as natural contraceptive methods, in the last five years.
The study looked at data from the British Pregnancy Advisory Service (Bpas) to explore what methods of contraception women who requested abortions were using. The researchers compared two periods: January to June 2018, which included 33,495 women, and January to June 2023, which included 55,055 women.
Findings revealed that reported use of fertility awareness-based methods around the time of conception increased from 0.4% in 2018 to 2.5% in 2023. This rise "needs investigating," say experts, according to the Mirror. Additionally, the average age of women using fertility awareness-based methods fell from almost 30 to 27, indicating that younger women are increasingly adopting these methods, according to The Sun.
According to BBC News, the use of hormonal contraceptive methods fell from 19% in 2018 to 11% in 2023 among tens of thousands of women, indicating a growing reluctance to use hormonal contraception. In 2010, around half of women of reproductive age in the UK were using the Pill, but recent trends suggest a decline in its use.
According to The Guardian, the proportion of women who reported using no form of contraception when they became pregnant increased from 56% in 2018 to nearly 70% in 2023, highlighting a shift in contraceptive behavior. The study also found that the use of long-acting reversible contraceptive implants fell from 3% to 0.6% between 2018 and 2023, according to The Independent.
"Something that really needs scrutiny is the surge in the use of e-health, including fertility apps and period trackers. The market has exploded. There are hundreds of them and some are more reliable than others. Plus you don't need a prescription, and so you may not get all the information you need," said lead researcher Dr Rosie McNee, according to BBC News.
"The shift in preference towards [fertility awareness methods] is coupled with reported increases in difficulty in accessing the more effective methods of contraception following the COVID-19 pandemic due to workforce changes and a reduction in primary care and sexual health care capabilities," the researchers pointed out, as stated in medicalxpress.com.
"There appears to have been a significant increase in the proportion of individuals attending Bpas for abortion who use fertility awareness-based methods as a form of contraception and are using no method of contraception," they added, according to BBC News.
Researchers noted reports that social media is fueling hormone hesitancy, which has been observed in other European countries, according to The Independent.
"The new study may indicate women are making different contraceptive choices or can't get the methods they want," said Dr Patricia Lohr, noting a rise in the use of fertility awareness-based methods and a decline in hormonal contraception, according to The Guardian. She stated, "Abortion remains a vital option either as a backup when contraception fails or when there is none available, but at the same time, women need access to modern, innovative contraceptive methods that suit their lives," as reported by The Independent. She concluded, "Women deserve a full range of options that meet their needs without compromise," according to The Guardian.
Bekki Burbidge agreed there seemed to be a greater interest in fertility awareness-based contraceptive methods as people shift away from hormonal-based methods. "Fertility awareness-based methods can work well for some people but they're typically less effective at preventing pregnancy," she said, according to The Independent. Burbidge added, "There are now fewer appointments available and fewer health professionals trained in providing the most effective long-acting methods of contraception." "Having clear information about the advantages and disadvantages of each method of contraception is essential," she concluded.
"This could be a result of the rise in popularity of social media platforms like TikTok, which has seen more people sharing their experiences... and content creators doing paid partnerships with brands of fertility awareness methods that might be influencing people to choose this option," explained Tanya Lane, contraception lead at MSI Reproductive Choices UK, according to BBC News. She added that long waits for appointments at GP surgeries and sexual health clinics could also be a factor.
The researchers noted that the precise fertility awareness method used wasn't recorded, so the rise in the use of app technologies can only be assumed. They acknowledged that this is an observational study, precluding firm conclusions about cause and effect.
Experts have pointed out that fertility awareness-based methods can have higher typical failure rates compared to hormonal methods. According to The Guardian, the typical failure rate for fertility awareness-based methods ranges from 2% to 23% in every 100 women in the first year of use, compared to 7% in 100 women for the pill and fewer than 1% for the coil.
"When used perfectly, some of these methods, particularly when supported by accurate temperature measurements from wearables or morning temperature checks, can be up to 99% effective at preventing pregnancy," said Valentina Milanova, women's health expert and founder of gynecological health company Daye, according to The Independent. She added, "However, with typical use, effectiveness rates are generally lower—around 76-88% for most methods. It's also crucial to understand that even with perfect use, no contraceptive method is 100% effective, and non-hormonal contraception is more prone to user error."
Miss Meg Wilson, consultant gynecologist at London Gynaecology, explained that natural methods can appeal to women seeking a more "natural" approach to contraception and a better way to understand their body and cycle. "It has no side effects or need for prescription," she noted, according to The Independent. However, she emphasized that "from a practical point of view, to use fertility tracking apps effectively, you need to be pretty organized and have a relatively regular daily routine." She added, "The additional information of temperature readings and the app's algorithms makes this a more reliable method, and the evidence published so far is very encouraging."
According to The Independent, the researchers concluded that while further research is needed to understand the reasons driving these changes, the trends correspond to a rise in abortion rates and have wider implications for healthcare services. They stated, "Informing the public about the efficacy of such methods in order to facilitate informed contraceptive choices is needed," according to Mirage News.
This article was written in collaboration with generative AI company Alchemiq