Natural Cycles and other contraceptive options

Helping women to better understand their bodies and cycles can help them to better understand the various contraceptive options available – and whether Natural Cycles is right for them. The information and questions provided below are designed to support your counseling so that you and your patients can make an informed choice.

Who is Natural Cycles suitable for?/Who is Natural Cycles less suitable for?

Please see our webpage The right patient.

Getting your patient started on Natural Cycles

Once you and your patient have decided that Natural Cycles is the right contraceptive option for her, she needs to go through the following steps:

1. NATURAL CYCLES ACCOUNT

A woman can access Natural Cycles via her web browser: www.naturalcycles.com and download the Natural Cycles app through the App Store or through Google Play. She then completes the sign-up for a monthly or an annual subscription, or tests the app for free before signing up.

2. BASAL THERMOMETER

If she does not have a Natural Cycles basal thermometer (it’s included in the annual subscription), she can order one from our webshop, or go to her nearest pharmacy to purchase one.

3. TEMPERATURE MEASUREMENTS

After signing up, the woman is required to measure her temperature under the tongue every morning before getting up and out of bed. She then enters the temperature reading into the app and is informed if she has a “red day” or a “green day”, depending on whether she is fertile and whether she must use protection during sex on this day (condoms are recommended).

4.LH TEST (OPTIONAL)

An optional feature is LH testing (ovulation test) with urine test strips a few times per cycle on the days leading up to her expected ovulation. Ovulation tests are particularly recommended if she is planning a pregnancy since these help pinpoint her most fertile days.

Aspects to consider before recommending Natural Cycles

More red days in the beginning

The app works effectively right from the beginning. However, you need to inform your patients that it may take around 1-3 cycles of measuring and entering data for the app to become familiar with a woman’s individual cycle and detect ovulation.Therefore it is normal that she initially detects more red days.

You need to reassure her that patience is required in the first few weeks and she must keep measuring. Once the app gathers more data and starts to regularly detect her ovulation, the number of red days will decrease and she will see more green days in the app view.

Users with fairly regular cycles, who enter temperature data 5 times or more per week, can expect to get around 60% green days per cycle after 3 months of usage (i.e. no need for protection on these days)1. Note that the ratio of red & green days can affect user satisfaction and ultimately, discontinuation rates.

THE FOLLOWING FACTORS MAY INCREASE THE NUMBER OF RED DAYS:
  • Having recently stopped hormonal contraception
  • Highly irregular cycles
  • Atypical fluctuating temperatures

Women discontinuing hormonal contraception

For women who have recently stopped using hormonal contraception, it is not unusual to experience anovulatory cycles for a couple of months, so she need not be worried.

She can start with measuring a few days after discontinuing hormonal contraception. This way, Natural Cycles can detect her first ovulation before her natural menstruation sets in. Until her first ovulation is detected, she should expect many red days as a Prevent user.

IMPORTANT: women should not measure while still on hormonal contraception since the hormones inhibit ovulation and also affect her temperature and cycles. Therefore a combination of hormonal contraception and Natural Cycles is not possible.

Women with irregular cycles

Small irregularities are quite common, especially if a woman has recently stopped using hormonal contraception. The Natural Cycles algorithm takes factors such as cycle regularity and temperature fluctuations into account when analysing her individual cycle and calculating her status for the day.

It may be less suitable as a contraceptive if her cycle is very irregular since she will get more red days. Yet by tracking her cycle she will get to know how her own individual cycle.

 


1Berglund Scherwitzl E, Lindén Hirschberg A, Scherwitzl R. Identification and prediction of the fertile window using NaturalCycles. The European Journal of Contraception & Reproductive Health Care. 2015;20(5):403-408.

Contraceptive counseling

Choosing a contraceptive is a very personal decision. The goal is to find what is right for each individual woman and what method suits her lifestyle best.

Every method of contraception has its advantages and drawbacks; there is no one size fits all. Therefore, women need to discuss all available options with their HCP and make an informed decision, weighing up both the advantages such as added health benefits and the disadvantages as well as possible side effects.

Please see our position statement on the Pill.

Comparison to other commonly used short and long-acting contraceptive methods

 

Contraceptive Method% of women experiencing
an unintended pregnancy
within the first year of use
Protection against
STIs
User-dependentPotential non-
contraceptive
benefits
Potential side effects
Typical usePerfect use
Natural Cycles¹71NoYesYes⁴No
Copper IUD²0.80.6NoNoNoYes⁵
Hormonal IUS²0.20.2NoNoYesYes, hormone-related
Traditional³ fertility
awareness-based
methods²
240.4-5NoYesYes⁴No
Male condom²182YesYesNoNo
Combined pill and
progestin-only pill²
90.3NoYesYesYes, hormone-related

¹Berglund Scherwitzl E, Lundberg O, Kopp Kallner H, Gemzell Danielsson K, Trussell J, Scherwitzl R. Perfect-use and typical-use Pearl Index of a contraceptive mobile app. Contraception. 2017;96(6):420-425.
²Trussell J. Contraceptive failure in the United States. Contraception. 2011;83(5):397-404
³Non-digital, without the help of a personalised algorithm
4Hatcher R. Contraceptive technology. 20th ed. [New York, N.Y.]: Ardent Media; 2011.
5E.g. Cramps, pelvic infections, heavier periods, ectopic pregnancies

Natural Cycles’ effectiveness is based on clinical research, please see the results of our clinical studies and peer-reviewed publications.

 

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