Is the new digital contraseptive effective? Natural Cycles App explained

Dear Doctor,

I’ve heard of a new app that can be used in family planning. How effective is it?

Answer

In August this year, the US Food and Drug Administration gave the green light for a controversial mobile app to market itself as a form of digital contraception.

The app, named Natural Cycles, uses an algorithm that prompts you to enter the date your period starts and record daily temperatures every morning before getting out of bed.

It will tell you the ‘green’ days when you aren’t fertile, and ‘red’ days when you are fertile. You can have unprotected sex on green days, and abstain on red days. Or use additional contraception on the red days, like condoms or the emergency pill.

The creators of the app are marketing it as a contraceptive, but is it really? Clearly, it will come as a relief for those who detest pills, devices, sheaths, and all other traditional contraceptives.

It is yet another algorithmic application geared towards women’s health, or ‘femtech’ in digital jargon. The app is based on what has always been labelled as ‘natural family planning’.

A digital contraceptive immediately appeals to many. For starters, you can avoid synthetic hormones, and their sometimes unpleasant side effects.

Those who dislike contraceptive devices, like coils, also have an extra option. The app also helps you understand your body, by tracking your menstrual cycle and relating this to reproductive biology.

In addition, the app is equally appealing to those trying to conceive. It will alert you on the most fertile period when conception is most likely, paving the way for timed intercourse.

But there are concerns about the app’s ability to prevent unwanted pregnancies, when compared to modern highly effective contraceptives.

Preliminary data from early users appear to show disproportionately higher numbers of unintended pregnancies. Well, this is inherent in the way the app works, and how you respond to its prompts and alerts.

Those with irregular menstrual cycles should use the app with caution. If there’s an absolute medical reason to avoid pregnancy at all costs, other long term effective contraceptives should be used instead.

Many people think of contraception as a tangible object. It can now be viewed differently, and blended into an increasingly digitised world.

Some have raised concerns about replacing proven and effective contraceptives with an app, and how that may eventually translate into increasing failure rates.

But there is the desirable advantage of choice for women. Those highly attracted to digital devices, and bent on trying a different approach to their reproductive control, will find the app pretty appealing.

If interested in digital contraception, all you need is to go online and download the app. You will need a period of familiarising yourself with the app, and get used to entering data and interpret prompts and alerts.

The app will quickly learn your cycle over a few months, and automatically give you accurate predictions each day. Remember the app is an aid to being in control of your reproduction, it doesn’t prevent sexually transmitted infections.    

Dr Alfred Murage is a Consultant Gynaecologist and Fertility Specialist. Reach him on [email protected]

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