The FDA Just Approved The First Birth Control App As A Form Of Contraception, But It May Not Be For Everyone

Ashley Batz/Bustle

On August 10, the Food and Drug Administration (FDA) approved the U.S.’s first birth control app as a form of contraception, Natural Cycles. It’s only available in the U.S. and in Europe, and is also the only digital method of birth control. Instead of relying on a birth control pill, you can rely on your smartphone, and currently 800,000 women — and counting — are using it, according to the app.

Natural Cycles is in the fertility awareness family and works by learning your menstrual cycle and telling you when you're most fertile via an algorithm. So, as a result, you and your partner can decide whether to have sex, not have sex, or use contraception (like a condom).

Each day when you wake up, you take your body temperature orally, then enter it into the app. You’ll then get a red light if you’re more fertile and the green light, so to speak, if you’re less fertile. Of course, back-up contraception is suggested if there’s a red light, and Natural Cycles states that women tend to have about 10 red days per month. The app also gives users other information, including daily updates on where they are regarding their menstrual cycle, how their cycles work, and when they can expect PMS.

“We give red and green days and clear recommendations on which days to abstain and which days we consider the risk of pregnancy to be negligible,” Natural Cycles co-founder Raoul Scherwitzl told Business Insider. He said it’s like the pill in that the app’s reliability can decrease if women don’t use it the way it’s intended.

What Health Experts Think

Andrew Zaeh for Bustle

Dr. Sherry A. Ross, women’s health expert and author of she-ology. The Definitive Guide to Women's Intimate Health. Period., believes that the app combines a popular and natural way of family planning with a high-tech interface. “It allows women to prevent pregnancy or know when the best time is to conceive,” she tells Bustle. “The app improves your chances of not getting pregnant by monitoring your daily body temperature over time. It’s easy to use, less costly than traditional birth control, and has no hormonal effects on women, which can be a real plus.” She adds that modern technology has a useful place in improving birth control. “We’re only on the surface of understanding all the benefits,” she says.

In a statement from the FDA, Dr. Terri Cornelison, assistant director for the health of women in the FDA’s Center for Devices and Radiological Health, commented on the app, too. “Consumers are increasingly using digital health technologies to inform their everyday health decisions, and this new app can provide an effective method of contraception if it’s used carefully and correctly,” she said. “But women should know that no form of contraception works perfectly, so an unplanned pregnancy could still result from correct usage of this device,” she added.

How Natural Cycles Came To Be

Natural Cycles was founded by physicists Elina Berglund and Raoul Scherwitzl in Switzerland, though the company is now based in Sweden. The couple had initially created the algorithm for themselves — they used it for family planning, and it worked; according to their website, they got pregnant on the first try. They saw that the formula could benefit other women, too, so they created the app, which became the first of its kind in the world to get approval as a contraceptive in Europe.

How Effective Is The App?

Andrew Zaeh for Bustle

According to Natural Cycles, the app is for women 18 and older and only available as a method of birth control in the U.S. and Europe; otherwise, it’s considered to be a fertility monitoring tool. As for its effectiveness, clinical studies were conducted among 15,570 women who used the app for an average of eight months. Natural Cycles had a “perfect use” failure rate of 1.8 percent — aka 1.8 in 100 women will become pregnant due to either having unprotected sex on a day the app said they weren’t fertile or if their contraceptive method failed when they had sex on a fertile day.

For comparison’s sake, within the first 12 months of use, the IUD and implant have the lowest failure rates — 1 percent — when compared to all birth control methods, according to 2017 data from the Guttmacher Institute. Conversely, they found that condoms (13 percent) and the withdrawal method (20 percent) had the highest failure rates.

As for the new app’s “typical use” failure rate, aka when someone does not use the app perfectly (as directed) — i.e., they have unprotected sex on fertile days — the clinical studies found that 6.5 percent will become pregnant. In addition, back in January, news spread that 37 of 668 women in Sweden allegedly became pregnant while using Natural Cycles.

But It May Not Be The Best Choice For Everyone

Although Natural Cycles sounds promising, it doesn’t come without some things to keep in mind, such as safety, Dr. Michael Krychman, executive director of the Southern California Center for Sexual Health and Survivorship Medicine and co-author of The Sexual Spark: 20 Essential Exercises to Reignite the Passion, tells Bustle. He says that as technology continues to infiltrate almost every aspect of women’s health, both women who use birth control and health care professionals need to demand research for safety and efficacy before widespread implementation.

As for women who do not want to get pregnant or want to protect against STIs, Dr. Krychman warns that women should be cautious about relying solely on Natural Cycles, as failure rates have been reported. “In addition, women should be aware that STI risks may still be of concern, so condoms should be used, as well.”

In addition, Natural Cycles may not be well-suited for everybody. For instance, if a woman has irregular menstrual cycles — shorter than 21 days or longer than 35 days — it may not work well for them since they may see a lot of “red” days appear. A woman’s body temperature is another factor, too; if it changes a lot, it will affect how the fertility app works. Of course, you and your OB/GYN should discuss contraceptive options and which will suit you the best.

“Having an app to act as birth control is a step in the right direction for women’s contraceptive empowerment,” Dr. Krychman says. “Women should be empowered about their reproductive choices, whether it is in an app, making an appointment with their health care professional, and/or choosing a contraceptive choice which is right for her.”

As for the app’s cost, aside from having to purchase a two-decimal basal thermometer, the app is not free — except for the first 30 days. After that, it is either $9.99/month or $79.99/year.

You can find put more about Natural Cycles on iTunes. In any case, one thing’s for sure: It’ll revolutionize birth control methods as we know them.