According to the government of Canada, oral contraceptives are the most frequently used form of reversible contraception, and around 75% of women will use these pills at some point in their life (Rotermann, Dunn, and Black, 2015). Despite common usage, the birth control pill puts users at increased risk of serious medical conditions, including strokes, heart attacks, and blood clots (Rotermann, Dunn, and Black, 2015). In addition to this, women frequently cite other unwanted side effects, including weight gain and mood changes, which negatively impact their lives (Littlejohn, 2013). Other types of birth control can be used, including the condom and intrauterine device (US Department of Health and Human Services, 2020); however, a novel form of birth control has been tested, and it’s as simple as opening an app on your phone! This sounds a lot more convenient than typical forms of contraception, but can an app really be a reliable method of pregnancy prevention?
Mobile apps that claim to prevent pregnancy rely on what are known as “Fertility Awareness-Based Methods”. These methods encourage women to hone in on physical symptoms they experience as a result of hormonal changes throughout their menstrual cycle (Manhart et al., 2013). These physical signs are said to be a good indicator of when a woman is fertile so that she can work to prevent pregnancy (Manhart et al., 2013).
Two apps in particular, called Natural Cycles and Dot, have become particularly notable for using these methods to prevent pregnancy. A 2016 study performed an analysis of Natural Cycles, an application where users input their menstruation days and daily basal body temperature (Scherwitzl et al., 2016), as shown in Figure 1.
The app then performs a statistical analysis that gives users either a green (safe) or red (unsafe) score for each day. Red days indicate when the user is most fertile, and the algorithm is designed to give more red days around the ovulation window then are expected for a woman with a regular 28 day cycle (Scherwitzl et al., 2016). In their analysis, researchers found that using data from over 4000 women, only ten pregnancies were due to the app indicating that the user was infertile, when she was actually within her fertile window (Scherwitzl et al., 2016).
The DOT app works on similar principles as Natural Cycles by encouraging women to enter in the dates that they menstruate (Jennings et al., 2019). From this data, the app then generates high, medium, and low risk days, as shown in Figure 2. A thirteen cycle study found that the perfect use rate for the mobile app was 1% (Jennings et al., 2019), which is higher than the perfect use rate for condoms, and nearly equivalent to the perfect use rate of the oral contraceptive pill (Cooper and Mahdy, 2019; Majra, 2010).
While this data indicates that fertility apps may be an effective substitute for oral contraceptives, there are still a few remaining considerations. It is important to remember that many factors may influence a woman’s natural cycle, including weight fluctuations, stress, and smoking (Bae, Park, and Kwon, 2018), and the algorithm may not detect these changes. Further, the literature shows that many other fertility based apps marketed to avoid pregnancy do not yet use reliable methods, and could actually contribute to unintended pregnancy (Duane et al., 2016; Mangone, Lebrun, and Muessig, 2016) .
Perfect use rates show that apps like Dot and Natural Cycles could be a way to protect against unintended pregnancy, but external factors may make it a risk to rely on your phone for contraceptive advice. However, with a world that is becoming increasingly digital, it is important to keep these apps in mind as the potential future of birth control.
References:
Bae, J., Park, S. and Kwon, J.-W., 2018. Factors associated with menstrual cycle irregularity and menopause. BMC Women’s Health, 18(1), p.36.
Cooper, D.B. and Mahdy, H., 2019. Oral Contraceptive Pills. In: StatPearls. [online] Treasure Island (FL): StatPearls Publishing. Available at: <http://www.ncbi.nlm.nih.gov/books/NBK430882/> [Accessed 28 Feb. 2020].
Duane, M., Contreras, A., Jensen, E.T. and White, A., 2016. The Performance of Fertility Awareness-based Method Apps Marketed to Avoid Pregnancy. The Journal of the American Board of Family Medicine, 29(4), pp.508–511.
ISL, 2015. Introducing Dot — A Period and Fertility Tracking App for the iPhone. [online] ISL. Available at: <https://isl.co/2015/08/introducing-dot-a-period-and-fertility-tracking-app-for-the-iphone/> [Accessed 27 Feb. 2020].
Jennings, V., Haile, L.T., Simmons, R.G., Spieler, J. and Shattuck, D., 2019. Perfect- and typical-use effectiveness of the Dot fertility app over 13 cycles: results from a prospective contraceptive effectiveness trial. The European Journal of Contraception & Reproductive Health Care, 24(2), pp.148–153.
Littlejohn, K.E., 2013. “It’s those Pills that are Ruining Me”: Gender and the Social Meanings of Hormonal Contraceptive Side Effects. Gender & Society, 27(6), pp.843–863.
Majra, J., 2010. Use of Condoms: Clarifying the Message. Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine, 35(2), p.362.
Mangone, E.R., Lebrun, V. and Muessig, K.E., 2016. Mobile Phone Apps for the Prevention of Unintended Pregnancy: A Systematic Review and Content Analysis. JMIR mHealth and uHealth, 4(1), p.e6.
Manhart, M.D., Duane, M., Lind, A., Sinai, I. and Golden-Tevald, J., 2013. Fertility awareness-based methods of family planning: A review of effectiveness for avoiding pregnancy using SORT. Osteopathic Family Physician, 5(1), pp.2–8.
Mira, 2019. Everything You Need To Know About Fertility Awareness Method. Mira Fertility Tracker. Available at: <https://www.miracare.com/blog/everything-you-need-to-know-about-fertility-awareness-method/> [Accessed 27 Feb. 2020].
Rotermann, M., Dunn, S., and Black, A., 2015. Oral contraceptive use among women aged 15 to 49: Results from the Canadian Health Measures Survey. [online] Available at: <https://www150.statcan.gc.ca/n1/pub/82-003-x/2015010/article/14222-eng.htm> [Accessed 27 Feb. 2020].
Scherwitzl, E.B., Danielsson, K.G., Sellberg, J.A. and Scherwitzl, R., 2016. Fertility awareness-based mobile application for contraception. The European Journal of Contraception & Reproductive Health Care, 21(3), pp.234–241.
US Department of Health and Human Services, 2020. Birth Control Methods | HHS.gov. [online] Available at: <https://www.hhs.gov/opa/pregnancy-prevention/birth-control-methods/index.html> [Accessed 27 Feb. 2020].
Comments
13 Responses to “Can a mobile app replace your birth control pill?”
Hi guys!
I chose this topic because birth control methods are something we’re currently talking about in my reproductive endocrinology class! While studying, I came across an article stating that mobile apps may be just as effective as the pill to prevent pregnancy, and I wanted to investigate this further! I tried to incorporate biology, endocrinology, and lots of science literacy to evaluate these claims. I look forward to reading your comments on my post!
Disclaimer: Please don’t take this as actual medical advice, I just thought it would be a cool topic!
Caitlin
Hi Caitlin,
This is a really well-written blog post! All your grammar is correct, and the topic is very interesting! It’ll be interesting to see how women use the app, like for medium and high risk days, will they abstain, or use another form of birth control, or just risk it? The only thing I would double check is when you’re using multiple citations for one sentence; they might need to be connected by a semicolon within the parentheses (though I’m not certain) and arranged by date and/or name. I can’t remember the rules exactly, so it’d be a good idea to check!
All in all, great blog post!
-Juliette
Hi Juliette,
Thanks for taking the time to leave a comment on my blog post! You are correct about the in-text referencing, so I will fix that in my final version!
Caitlin
Hi Caitlin,
This was a very interesting post and I really enjoyed reading it. The premise of this app seems very applicable in today’s society and this post definitely showcases this. Here are a few suggestions:
1. In paragraph 1, remove the word “the” before “birth control pills”
2. In the same paragraph, change the word “cite” to “experience”
3. It would be beneficial to indicate how exactly the apps work as a contraceptive, I am assuming it indicates the optimal time to have intercourse to prevent pregnancy, but it would be helpful to directly state that.
Overall, very well written and it was very readable. Well done!
Best,
Joey
Hi Joey,
Thank you for leaving a comment on my blog post!
I will be making the two grammatical changes you suggested.
I feel as though I have explained well how the apps work, and dedicated a paragraph to talking about fertility awareness based methods, so I will be leaving that part as is.
Thanks again,
Caitlin
Hi Caitlin,
This was a really interesting topic! The introduction, in particular, was attention-grabbing. It’s interesting to think about how digital apps are now being used as contraceptive methods.
-I would rephrase the third sentence in the first paragraph to say “In addition to this, women frequently cite other unwanted side effects, including weight gain and mood changes, which negatively impact their lives (Littlejohn, 2013).” This makes a stronger point.
-The fourth sentence of the introduction paragraph could be split into two sentences such as: “Other types of birth control can be used, including the condom and intrauterine device (US Department of Health and Human Services, 2020). Recently, a novel form of birth control has been tested, and it’s as simple as opening an app on your phone!”
-The first sentence of the third paragraph should have a comma after “Dot,” and the word “notoriety” could be replaced with “success”: “Two apps in particular, called Natural Cycles and Dot, have gained success for this purpose.”
-The first sentence of the conclusion paragraph could be rephrased to say “Perfect use rates show that apps like Dot and Natural Cycles could be a way of protecting against unintended pregnancy, but external factors may make it a risk to rely on your phone for contraceptive advice.”
Overall, great topic! I hope you find my suggestions helpful.
Happy editing,
Keshikaa
Thanks for the feedback Keshikaa!
I will be making many of the changes that you suggested and found them very helpful. The only one I will not be implementing is replacing “notoriety” with “success,” as I feel like this sounds awkward. As Kate mentioned however, there is likely a better word choice, so I will be replacing the word notoriety with something else!
Caitlin
Hi Caitlin,
I really enjoyed reading your blog post, as it was extremely well-written and very informative. I had no idea about this birth control method before reading this, so I’m glad I read it because it seems like it will increase in popularity as time goes on and more people test it out. The blog was structure very well and each sentence was easy to read and understand. If anything were to be edited, I would suggest adding a statistic indicating the percent of females with a normal menstrual cycle that don’t take birth control. I think it would further indicate the viability of this birth control option as I know that many females take birth control to regulate their periods, so it makes me think that this method wouldn’t be very reliable if most women’s menstrual cycles are irregular.
Great job,
Shania 🙂
Hi Shania,
Thanks for taking the time to leave a comment on my blog post! I do agree that would be a very cool statistic to include, and I actually originally had it in there when I was drafting my post. However, the word count does not allow for any extra content to be added, so I will be keeping that statistic out of my post.
Thanks again!
Caitlin
Hi Caitlin,
I really enjoyed reading this post. I just have a couple of suggestions:
In your first paragraph is may flow better to say “…condoms and intrauterine devices (IUD), however…”
In the third paragraph you write they these two apps have gained “notoriety” which usually means being well known for bad reasons, however you the discuss how accurate these particular apps are. You could clarify this sentence, or change the word use.
Overall I really enjoyed this post. It very interesting to see that natural family planning practices are now more accessible by letting you track through your phone!
Happy editing,
Kate J
Hi Kate,
Thank you for taking the time to leave a comment on my post! I will be making all of the changes you suggested, and found them to be incredibly helpful.
Caitlin
Hi Caitlin,
This was a really interesting topic and I enjoyed reading your post! It’s definitely relevant to a lot of people, too. Here are a few suggestions for your editing:
– In your fourth paragraph, you state, “In their analysis, researchers found that using data from over 4000 women, only ten pregnancies were due to the app indicating that the user was infertile, when she was actually within her fertile window,” but this makes it seem like there may have been other pregnancies due to other reasons. It might be helpful to clarify if these were the only pregnancies.
– The last sentence of your first paragraph could be reworded to “This sounds a lot more convenient than typical forms of contraception, but can an app really be a reliable method of pregnancy prevention?” or “While this sounds a lot more convenient than typical forms of contraception, there is still some debate as to whether or not an app can really be a reliable method of pregnancy prevention.”
Overall, great job! Good luck editing!
-Gemma
Gemma,
Thanks for your feedback! I will be making the change you suggested about the phrasing of my first paragraph.
You are correct that there were pregnancies due to other reasons in this study, for factors ranging from not following the app’s instructions, to deciding not to abstain or use protection on fertile days, etc. While I wanted to mention this, I did not have the word count to do so. Owing to this, I decided just to put the one statistic in, since it was the most relevant to my post.
Caitlin