Getty ImagesA study conducted in England and Wales suggested that there was a rise in the proportion of women seeking abortions despite using “natural” methods of contraception, such as fertility tracking apps.
Data published in BMJ Sexual and Reproductive Health, Researchers say the study shows a “shift” in contraceptive use in the past five years, from “more reliable” hormonal contraception such as the pill, to “fertility awareness-based methods.”
The percentage of use of hormonal methods, including the mini-pill, decreased from 19% in 2018 to 11% in 2023 among tens of thousands of women.
Meanwhile, the use of natural methods has risen from 0.4% to 2.5%, which is still a minority but a significant increase that “needs study,” experts say.
Fertility apps help track fertile days so a woman can know when she is most likely to get pregnant each month or each menstrual cycle.
They rely on measurements such as body temperature to predict ovulation (when an egg is released from the ovary).
The companies say they can be up to 93% reliable when used correctly.
However, it does ask people to take readings and control when they have sex, and to avoid intercourse on days when the app tells them they might be fertile.
The National Health Service in Britain says that if you do not follow the instructions carefully, the method is only 76% effective. This means that 24 out of every 100 women will get pregnant when their fertility is tracked for a year.
In comparisonBirth control pills and minipills are 91% effective with “typical use” and 99% effective with “ideal” use.
Hormonal coils or implants, which do not depend on the user remembering to take them, are 99% effective.
For the study, researchers from the University of Edinburgh compared data from the UK Pregnancy Advisory Service for the periods from January to June 2018 (33,495 women) and January to June 2023 (55,055 women) to see if contraceptive use had changed.
In addition to switching to natural methods, more women reported not using contraception at all in 2023 – 70% compared to 56% in 2018.
It’s impossible to pinpoint what’s driving these trends, but difficulty accessing sexual health services during the Covid pandemic may be a factor, the study’s authors say.
Lead researcher Dr Rosie Macnee told the BBC: ‘The thing that really needs scrutiny is the increase in the use of e-health, including fertility apps and menstrual trackers.’
“The market has exploded. There are hundreds of them and some are more reliable than others. Plus you don’t need a prescription, so you may not get all the information you need.”
MSI Reproductive Choices UK, which provides abortion services, told the BBC it had also seen more women using fertility awareness methods.
Contraception lead Tanya Lin explained: “This may be a result of the rise in popularity of social media platforms like TikTok, which has seen more people sharing their experiences… and creators undertaking paid partnerships with brands for fertility awareness methods which may have an impact on People to choose this option.
Long waits for appointments at GP and sexual health clinics may also be a factor.
“People are waiting months for appointments in some areas of the UK, especially for long-acting methods such as IUDs and implants.”
She said any woman considering switching to fertility tracking should talk to a medical professional.
“Dispel any myths and misconceptions and have a discussion about the risk of failure so you can make an informed decision,” she advised.
Paula Baraitser, medical director of NHS partner free sexual health provider SH:24, said there could be many reasons for women to switch, including concerns about future fertility and potential side effects.
Risks can range from mild side effects to rare but potentially serious complications.
She told the BBC: “A lot of people will use contraception for 30 years of their lives.
“People’s experience of hormonal contraception is highly variable, and ultimately we need a greater range of options to enable people to find a method that works for them.
“There have been only a few new contraceptive methods in the past 50 years, reflecting a lack of investment in research in this area.”
Sexual health charity Brooke said many women are using hormonal contraception not just to prevent pregnancy, but to manage menstrual health, to make their periods lighter and more predictable.
“These benefits should be part of a broader conversation about hormones,” said spokeswoman Lisa Hallgarten.