Elina Berglund’s app will be the first in the world to be government approved as a contraceptive, putting it alongside the pill, IUDs, and condoms — in Europe, at least.
“It feels incredibly exciting that there is now an approved alternative to conventional pregnancy prevention methods, and that it’s possible to replace medication with technology,” Berglund, a Swedish physicist who co-founded the Natural Cycles fertility-tracking app with her husband Raoul Scherwizl, told Business Insider Nordic.
But not so fast. The app, which has not yet launched in the US, may never be capable of replacing medication for many people. Here’s what you should know about the Natural Cycles birth control app, which claims to be “as good as the pill” at preventing pregnancy.
1. The app works by counting the time since your last period and monitoring your body temperature.
Around the time you ovulate, your body temperature rises slightly (about 0.3℃) and remains slightly elevated throughout the rest of your cycle.
Your ova (female eggs) only live for about a day. That means that if you were to have sex with a man for a window of time after ovulation, you cannot get pregnant. If you have sex with a man before you ovulate, on the other hand, you can get pregnant — sperm can stay alive in your uterus for close to a week.
The app uses an algorithm that takes into account your temperature and many other factors like sperm survival, temperature fluctuations, and cycle irregularities. That way, it can detect ovulation and fertility as well as the different stages of your cycle.
And it’s far more accurate than other similar methods of fertility tracking.
2. Fancy schmancy app, meet your great-great-great-great grandmother.
Still, aside from Natural Cycle’s proprietary algorithm — which, again, is what makes it far more accurate than other similar methods — the app is grounded in science that has been around for centuries.
For thousands of years, it formed the basics of birth control. Since as early as 300 AD, the idea went, someone who wanted to either avoid pregnancy (or get pregnant) kept track of when she was the most fertile. If you want to avoid pregnancy, you don’t have sex on those days. If you want to get pregnant, you do. Simple.
Simple, but not perfect.
3. “Fertility awareness-based” methods of birth control are hard work.
Today, so-called “fertility awareness-based” methods of birth control can include everything from marking up a calendar to paying detailed attention to your vaginal discharge to taking your temperature every morning. Problem is, they aren’t always reliable, because our bodies aren’t always reliable.
The length of your cycle can vary for several reasons, including stress. For many women, this variability is the only constant thing about their periods. In this case, fertility awareness-based methods are generally a bad option, according to Planned Parenthood.
Fertility awareness methods also aren’t advisable for women who have a sexually-transmitted infection (STI). And Planned Parenthood suggests these methods “may not work” for women who have any of the following: more than one sex partner; a sex partner who “isn’t as committed to fertility awareness-based methods as you are;” trouble keeping close track of your “safe days;” trouble abstaining or using another method for at least 10 “unsafe days” during each cycle; or for women who take medicine that may affect reading any of the signs of these methods.
4. This is where the app comes in.
Natural Cycles, however, is the first of these apps to be certified as a medical device and officially approved by a European health agency. So where does that “as effective as the contraceptive pill” come in? Co-founders Raoul and Elina point to a recent clinical study of more than 4,000 women between the ages of 18 and 45 published in the peer-reviewed European Journal of Contraception and Reproductive Health Care.
The study found that the app’s failure rate for “typical use” (a term used to refer to how most people use a form of contraception) was 7%. Or, for every 100 women who used the app in a “typical” way (meaning certain common slip-ups are accounted for), seven got pregnant each year. In comparison, the “typical use” failure rate for the pill is about 9%, according to the CDC. For injectable birth control, it’s 6%; for an IUD, it’s 0.2% – 0.8%.
For “perfect use,” the app was also found to be fairly similar to the pill in terms of effectiveness — among those women who used the app perfectly, about five out of every 1,000 got pregnant (a 0.5% failure rate). Among women who use the pill perfectly, about three out of every 1,000 get pregnant (a 0.3% failure rate).
That’s way better than traditional fertility-based awareness methods, which have an average failure rate of 24%, according to the CDC.
With that in mind, Natural Cycles is inarguably one of the best forms of fertility-based awareness birth control that exists. Its low failure rates are multitudes better than other traditional fertility-based awareness methods, thanks to all of the data the company has crunched (it probably helps that its creators are both physicists with extensive science and maths backgrounds).
“A lot of other apps track fertility indicators and then the focus is on the women to do it on their own,” co-founder Raoul Scherwizl told me. “We want to make planning easy for everyone. Temperature data fluctuates a lot. This makes it easier and ensures a certain safety.”
5. Natural Cycles, there’s a small elephant in the room.
Still, Natural Cycles is a fertility-based awareness method of contraception.
That means that for certain people, the app can work wonders. These people will likely have, in addition to a clean sexual bill of health, one or all of the following: A predictable sex schedule; regular periods; the time and ability to abstain from sexual activity on certain precise, consecutive days every month.
“In the end, what we want to do is add a new method of contraception that women can choose from without side effects,” Scherwizl told me. “I think there are many women who this will be great for.”
But not everyone falls into this category. It’s worth noting, for example, that the same study which found that Natural Cycles had an encouragingly low failure rate for typical use also found that more than half of the women who did get pregnant recorded having unprotected sex during their fertile period, Susan Walker, a professor of sexual health at Anglia Ruskin University, pointed out in a recent post for The Conversation. This doesn’t mean the app was providing inaccurate data.
Quite the contrary, in fact: It suggests that women were still having sex on the days when the app was telling them not to.
That’s an important finding, too. We know an app can’t keep people from having sex. But depending on your current situation in life, consistently and reliably abstaining from sex for several days at a time during a precise and sometimes variable window each month may be easier said than done. In these situations, medication may be your best option.