Natural Alternatives to Hormonal Contraceptives

Natural and safe alternatives to hormonal contraceptives Natural Alternatives to Hormonal Contraceptives

I realize I just crossed the line from fun posts about lotion bars or sea salt bath fizzies or how to eat liver without gagging and into serious territory…

I’ve gotten dozens of requests for natural alternatives to hormonal contraceptives, and while my naturally introverted nature tends to shy away from controversial topics, I decided it was time to tackle this one head on.

But… Why?

Personally, I have a plethora of non-medical reasons for avoiding contraceptives, but there are some solid medical/scientific reasons to make this decision as well.

Hormonal contraceptives are made from artificial hormone-like substances that attempt to mimic the effects of naturally occurring hormones in the body. Hormonal contraceptives work by:

  • Suppressing the release of hormones that trigger ovulation;
  • Stimulating production of thick cervical mucus, which prevents sperm survival and ability to travel to a ripe egg in the fallopian tube in the event that ovulation does occur;
  • Disrupting the ability of the cilia (whip-like cells that line the fallopian tube) to move a fertilized egg toward the uterus in the event that conception does occur;
  • Preventing buildup of the uterine lining, and thereby inhibiting implantation of a fertilized egg in the event that one arrives in the uterus. (source)

Personally, the mere possibility that conception could occur and then the fertilized egg could be prevented form implanting is enough to keep me from ever wanting to use hormonal contraceptives (along with a host of other reasons), but it turns out that artificial hormones aren’t good for mom either (or the water supply for that matter):

In The Breast Cancer Prevention Program, Sam Epstein, MD, writes,

“more than 20 well-controlled studies have demonstrated the clear risk of premenopausal breast cancer with the use of oral contraceptives. These estimates indicate that a young woman who uses oral contraceptives has up to ten times the risk for developing breast cancer as does a non-user, particularly if she uses the Pill during her teens or early twenties; if she uses the Pill for two years or more; if she uses the Pill before her first full-term pregnancy; if she has a family history of breast cancer.”

Thus, a woman who takes the Pill for two years before she’s 25 and before she’s had a pregnancy to term increases her risk of breast cancer tenfold.

A study conducted by the World Health Organization found that women who carry the human papilloma virus (HPV) and who have taken the Pill for five to nine years are nearly three times more likely than non-Pill users to develop cervical cancer.7 (HPV affects a third of all women in their twenties.) Women with HPV who’ve taken the Pill for more than ten years are four times more likely than non-users to develop the disease.

Women who have a history of migraine headaches and who take combined oral contraceptives are two to four times more likely to have a stroke than women who have migraines and don’t take the Pill.8

Women who use low-dose oral contraceptive pills have a two-fold increased risk of a fatal heart attack compared to non-users.9 Women who take oral contraceptives and smoke have a 12-fold increase in fatal heart attacks and a 3.1-fold increase in fatal brain hemorrhage.10 Women who use the Pill after the age of 45 have a 144 percent greater risk of developing breast cancer than women who have never used it.11

Because of blocked hormone production, women who take the Pill have decreased sensitivity to smell. Because sexual interest is communicated through smell, the Pill may decrease women’s sex drives.12

In Solved: The Riddle of Illness, Dr. Stephen Langer writes that “the Pill. . . can cause severe bodily damage in hypothyroidism.”

Oral contraceptives may aggravate insulin resistance and longterm risk of diabetes and heart disease.13″ (source and references here)

IUDs carry additional concerns:

“When conception occurs with an IUD in place, the IUD can prevent implantation, thus causing an early abortion.

[Additional risks]  include uterine perforation, which may lead to a hysterectomy, and infections, such as a pelvic or tubo-ovarian abscess. Use of all IUDs has been associated with an increased incidence of PID (Pelvic Inflammatory Disease). The IUD may occasionally result in pregnancy and if this were to occur, an ectopic pregnancy would be more likely to occur. An ectopic pregnancy is one in which the unborn child implants himself/ herself in a location other than in the mother’s uterus, usually in the fallopian tube. According to Rossing and Daling, two prominent researchers, women who had used an IUD for three or more years were more than twice as likely to have a tubal pregnancy as women who had never used an IUD even years after the IUD had been removed. Ectopic pregnancy remains the leading cause of maternal death in the United States. The IUD may also cause back aches, cramping, dyspareunia (painful intercourse), dysmenorrhea (painful menstrual cycles), and infertility.(source)

Even sterilization, which is becoming an increasingly popular option, has its risks:

“Tubal ligation does not always prevent conception. When conception does occur, it is associated with a much higher incidence of ectopic pregnancy, which, as was noted, is the leading cause of death in pregnant women. In addition, women who undergo the procedure may experience complications from the anesthesia or from surgery. Complications include bladder puncture, bleeding, and even cardiac arrest after inflation of the abdomen with carbon dioxide Some women who have undergone a tubal ligation experience a syndrome of intermittent vaginal bleeding associated with severe cramping pain in the lower abdomen.

About 50% of men who undergo a vasectomy will develop anti-sperm antibodies. In essence, their bodies will come to recognize their own sperm as “the enemy.” This could lead to a higher incidence of autoimmune disease. Several studies have noted that men who undergo a vasectomy have a higher incidence of developing prostate cancer, especially 15-20 years after their vasectomy, although one large study did not find a link. Also, some research evidence suggests that there is an association between vasectomy and a recently identified form of dementia, Primary Progressive Aphasia” (source)

Balancing Hormones?

I’m guessing that hormone imbalance is a widespread problem in today’s world, as my post on how to balance hormones naturally is consistently my most viewed posts.

Statistically, many people use hormonal contraceptives to help “balance hormones” or prevent acne, etc. The problem is that this is just treating the symptoms and not addressing the root cause. The body naturally moves toward balance so if hormones are out of whack, it is not from a contraceptive deficiency, but rater that the body is not producing the natural hormones optimally.

Treating some of the symptoms with hormonal contraceptives not only doesn’t fix the root of the problem, but it can lead to bigger problems in the future as the underlying imbalance can still be causing other problems in the body.

If skin issues are the problem, check out this post about oil cleansing, which has completely gotten rid of my acne.

If hormone balance is the goal, check out this post about many ways to balance hormones naturally. I’ve also found some supplements that help a lot (excerpt from the above post):

  • Maca- A tuber in the radish family that has a history of boosting hormone production and libido. Many women notice less PMS, increased fertility, and improved skin while men notice increased sperm production, libido and better sleep. Maca is also high in minerals and essential fatty acids, making it great for hormones.  It is available in powder form (least expensive option) or in capsules.
  • Magnesium- Magnesium supports hundreds of reactions in the body and often contributes to better sleep (which is great for hormones!). There are several effective forms of Magnesium: In powder form with a product like Natural Calm so that you can vary your dose and work up slowly,  ionic liquid form  can be added to food and drinks and dose can be worked up slowly,or  transdermal form by using Magnesium oil applied to skin. This is often the most effective option for those with damaged digestive tract or severe deficiency.
  • Vitamin D- A pre-hormone is supportive of hormone function. Best obtained from the sun if possible, or Fermented Cod Liver Oil.
  • Fermented Cod Liver Oil- Provides many of the necessary building blocks for hormone production including Vitamins A, D, and K. It also is a great source of Omega-3s and beneficial fats.
  • Gelatin is a great source of calcium, magnesium and phosphate. It supports hormone production and digestive health and helps sooth inflammation, especially in joints. We use Great Lakes Kosher as I was able to verify with the company that it is sourced from grass-fed, humanely raised cows, and as such is higher in nutrients.”

Natural Ways to Prevent/Delay Pregnancy:

Hopefully I’ve made a case for why taking artificial hormones aren’t the best option for delaying pregnancy, but if just balancing hormones isn’t the reason for taking hormonal contraceptives and there is the need to delay or prevent pregnancy, there are other options (that are much healthier).

I’ll address the methods I have tried so that  I can speak from experience:

Natural Family Planning (NFP) or Fertility Awareness Methods (FAM) are natural ways of preventing or achieving pregnancy based on the body’s natural hormonal cues. These methods carry no side effects and actually help women get to know their bodies better. I know of several cases of women who discovered problems (endometriosis, anovulation, etc) from practicing these methods since they were in touch with their hormonal cues.

While these methods get a bad rap, they have come a really long way from the Rhythm Methods of the past and many are now as effective as hormonal methods (and more effective than barrier methods) when used consistently. These methods can be used to delay or achieve pregnancy, so those who decide to conceive don’t have to worry about the risk of infertility, birth defects or delayed fertility after coming off of contraceptives.

The basic concept is using cues like Basal Body Temperature (BBT), mucus production, cervical position and other symptoms to effectively predict ovulation and avoid intercourse during this time.  There are classes teaching how to practice these methods in most areas, or for those who can’t find a class, there are websites like Fertility Friend (free website) that  allow users to chart symptoms and pinpoint ovulation. These websites now even have apps and mobile features for easy tracking.

High Tech NFP…

What I’ll be using personally to give myself a little space after this pregnancy, is a computer that does the tracking and calculation of NFP for me. Thanks to emerging technology, there are several great options available now (I might be using all of them…):

  • The Lady Comp Fertility Monitor- Considered the Cadillac of fertility/NFP computers, this model just requires a daily input of Basal Body Temp (BBT) and it gives easy to understand red light (high probability of fertility), yellow light (possible fertility), and green light (ovulation has passed=no fertility).  It works best with a cycle, though thanks to its knowledge of over 700,000 cycles, it is accurate even while breastfeeding (once cycle has returned or is about to), for irregular cycles and in pre-menopause. Click here for a ton of reviews and FAQs on this model. The price is the only downside, though in comparison to a lifetime of hormonal contraceptives (and any associated health problems) the cost is minimal. I know many people who have had great success both delaying and achieving with the LadyComp. There is also the more-expensive Baby Comp which helps predict gender for those who are trying to conceive, thought he Lady Comp can do this too (just time intercourse as close as possible to ovulation for a higher chance of a boy or a couple of days before for higher chance of a girl)
  • The OvaCue Fertility Monitor- “The OvaCue predicts ovulation using the patented Electrolyte Method™ – a technique that has been demonstrated to be 98.3% accurate in predicting ovulation in clinical studies overseen by the National Institute of Health. Here’s how it works: Throughout your monthly cycle, your body retains or discards varying amounts of minerals, such as sodium and potassium (electrolytes). The OvaCue tracks the changes in these electrolyte levels in your saliva over time and processes this information to precisely define your time of peak fertility.” I’ll be using this method before my cycle returns and then using both this and the LadyComp to track fertility signs.
  • If those options don’t seem like a good fit, NFP can be done without a computer with a simple Basal Thermometer and knowledge of the method.
  • Methods like ClearBlue monitors which measure Luteinizing Hormone and estrogen to pinpoint ovulation. Though cheaper upfront, these require the purchase of additional ovulation strips to use each day, so they can be more expensive in the long run.
  • OV-Watch – I don’t have personal experience with this one, but it claims to take computer readings every 30 minutes during sleep to accurately predict ovulation.
  • Fertile Focus- I haven’t used this one personally but have a friend who had success with it. It is also the least expensive option. The basic idea is that this microscope shows changes in the woman’s saliva before ovulation (the same changes the Ovacue can read) and that by examining saliva each day she can predict ovulation. Like I said, I haven’t tried it, but it is an option that is out there.

Why I Don’t Recommend Herb:

There are herbs that work as contraceptives, but I won’t list them or recommend them for several reasons:

  • Many have abortifacient properties that can lead to early miscarriage.
  • Most also impact the body in the same way that hormonal contraceptives do and cause similar problems for the mother as well. Herbs are highly effective and potent, and have to be used with care. Certain herbs should be avoided for these reasons.
  • None of the “contraceptive” herbs are completely effective, they do have side effects and many can cause birth defects if conception does occur.

Sources:

Larimore WL, Stanford JB. Postfertilization effects of oral contraceptives and their relationship to informed consent. Arch Fam Med.

International Agency for Research on Cancer, Combined estrogen-progestogen contraceptives and combined estrogen-progestogen menopausal therapy. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. 2007; Vol 91. available at http://monographs.iarc.fr/ENG/Monographs/vol91/mono91-6E.pdf

Kahlenborn C, et al. “Oral Contraceptive Use as a Risk Factor for Premenopausal Breast Cancer: A Meta-analysis” Mayo Clinic Proceedings. 2006: 81(10):1290-1302
The study re-enforces the classification of OCs as Type 1 carcinogens by the International Agency for Cancer Research (WHO).

Kahlenborn C. Breast Cancer, Its Link to Abortion and the Birth Control Pill, One More Soul. 2000, 229-231.

Hume K. Effects of contraceptive medication on the cervix. The Biology of the Cervix. Retrieved on Apr 11, 2008 from .

Overall cancer risk from several cancers due to oral contraceptive use: Kahlenborn C. Breast Cancer, Its Link to abortion and the Birth Control Pill, 2000. One More Soul, 2000, 228-229.

The Society of Obstetricians and Gynaecologists of Canada, Injection (Depo-Provera), retrieved from http://sexualityandu.ca/health-care-professionals/contraceptive-methods/injection-depo-provera September 27, 2008

Mia AR, et al. Effects of prolonged use of injectable hormonal contraceptive on serum lipid profile. Mymensingh Med J. 2005 Jan; 14(1):19-21.

Herrero R, et al. Injectable contraceptives and risk of invasive cervical cancer: evidence of an association. Int J Cancer. 1990; 46(1):5-7.

Rahwan R. Chemical Contraceptives, Interceptives and Abortifacients, 1995. College of Pharmacy, Ohio State University.

Klonoff-Cohen HS, et al. An epidemiologic study of contraception and preeclampsia. JAMA. 1989 Dec; 262(22):3143-3147.

Rosenberg L, et al. Vasectomy and the risk of prostate cancer. Am J Epidemiol. 1990; 132(6):1051-1055.

Giovannucci E, et al. A prospective cohort study of vasectomy and prostate cancer in US men. JAMA. 1993 Feb; 269(7):873-877.

John EM, et al. Vasectomy and prostate cancer: results from a multiethnic case-control study. J Natl Cancer Inst. 1995 May; 87:662-669.

Kahlenborn C. Breast Cancer, Its Link to Abortion and the Birth Control Pill. One More Soul. 2000; 12, 226.

Kippley JF, Kippley SK. The Art of Natural Family Planning (Fourth Edition). The Couple to Couple League. 2007; 245.

Mercola.com

Official Web Site for John R. Lee, M.D.

What do you think? Ever used natural methods for balancing hormones or delaying pregnancy? Have other suggestions? Share below!

You may also enjoy these posts...

Reader Comments

  1. Angela says

    Thank you for this post! Another great ‘high-tech’ method of NFP is the Creighton Model FertilityCare System and NaProTechnology (Natural Procreative Technology). Education and personal charting, paired with medical diagnosis and treatment for avoiding, achieving, health, monitoring, infertility, etc – in any reproductive category! Check out http://www.fertilitycare.org/ for more info, local teachers and doctors, and more.

    • patricia niles says

      I would like to know a little more about using coconut oil for vaginal dryness, could you tell me more. I am 68 and find sex hurtful because I am so dry.

  2. Sarah says

    Thanks for this honest and informative post. Way too many women these days are given misinformation about contraceptives or pressured into them as if they’re just part of womanhood. I know from personal experience the immence pressure women are placed under to use contraception…especially post partum! The nurses were flabbergasted that I said we wouldn’t be using any!

  3. Katharine McClellan says

    I have been considering going off bc for about three months now, at least trying to. I have tried quiting in the past, and orginally started due to intolerable cramping and a very heavy period, I have always gone back because I cannot function during that week. Do you have suggestions on how to herbally treat the side effects?

    • says

      Hey Katharine – I used to have the same symptoms. The main changes I made that helped me overcome these symptoms was adding lots of saturated fat and meats back into my diet and eating a lot of real food! I have also been taking maca powder for the past couple of months and it has almost eliminated my cramping and all the other symptoms I generally suffer from! I hope this helps.
      Sarah

    • Noelle says

      Katharine, I’d recommend reading the book, “Fertility, Cycles & Nutrition” which can help pinpoint your cycle irregularities and recommend dietary changes/nutritional supplements to help alleviate them. The book is meant for women who use NFP and want to treat menstrual issues naturally so I’d definitely recommend it for you!

      • Hana says

        Thanks for the recommendation as well, would love to read this!
        Been doing NFP for the past two years and love it. It has become second nature, but would love to have more bearable menstrual cycles.

    • Lauren Scalf says

      I agree with maca as mentioned previously. I went on bc for the same reason and taking maca and cod liver oil helped sooooo much. It was even better than the bc. Additionally, it also helped with my blue moods as well. I notice more and more that I wake up with a smile on my face lol. I have only been taking it for two months also!

  4. Fanny says

    Thank you for that article regarding birth control pills. I was previously told that these pills could cause a miscarriage/abortion. I wasn’t sure if this was true but felt the responsibility to stop taking the pills. Your article did confirm that the embryo could be aborted because of the pill. Knowing this fact, would make me responsible for the murder of my baby. I don’t think most women know this fact.

    • Mack says

      About 30% to 40% of fertilized eggs naturally fail to implant, even without artificial assistance. If you are responsible for “murder” by taking a pill, or an herb, are you also responsible for “murder” if you are stressed out or have been eating too much chocolate, or whatever it was that kept all those other eggs from implanting? If it hasn’t implanted, pregnancy has not been established, and therefore there can be no abortion, spontaneous (miscarriage) or otherwise. In fact, if you miss a period, come up positive, and take a Plan B, nothing will happen. You might feel ill, but your pregnancy will remain intact. Since Plan B is basically an overdose of birth control pills, and it won’t end a pregnancy, it is false to say that birth control pills are abortifacients. They prevent pregnancy, they don’t end it. This article would have been of more use if it had stuck to health issues and alternatives, and omitted the moralizing about “ending a life” when many people have differing beliefs about when life begins in the first place.

      • says

        I have to disagree… science has shown that a newly conceived embryo can fail to implant due to the effects of the contraceptives. In fact, there are studies backing that up in my sources. I understand that people have different opinions on “when life begins” but as this is my blog and I know that many of my readers share mine, I felt it important to include.

        • Mack says

          I’m not disputing that zygotes can fail to implant due to contraceptive pills – that is how many of them are supposed to work, others work primarily by suppressing ovulation. I was taking exception to the terminology used by Farm to Family, characterizing a failure to implant as a “miscarriage/abortion”. I thought it was important to point out the high percentage of fertilized eggs that never implant without any intervention whatsoever anyway. Stress or any number of other things (or complete happenstance) can likewise make the uterine environment inhospitable to implantation, and these are not called “murder”. If contraceptive pills were abortifacients, Plan B would end a pregnancy, but it is ineffective for that purpose. If one were calling RU-486 an abortifacient, one would be correct, but Plan B/contraceptive pills are not the same thing.

          • Cy says

            If we dump chemicals into the water we will potentially kill some cute baby sea turtles. However, since many cute baby sea turtles die before adulthood anyway it’s OK for us to dump the chemicals. Does this argument work? Discuss.

          • Noelle says

            The difference is that a newly conceived embryo that fails to implant due to happenstance or some other unknown cause to the mother is a miscarriage; a newly conceived embryo that is unable to implant because the mother took a drug that caused her endometrium (uterine lining that is meant to nurture the new embryo) to shed itself is abortion. Scientists have clearly shown that life begins at conception (not implantation), so the argument that pregnancy begins at implantation is not valid in defense of hormonal contraceptives that have the purpose of destroying a newly conceived life. One is intentional, the other is not.

          • Denise Ward says

            Why do women let scientists, or anyone else, decide when life begins? If something is connected to a person’s blood supply, that becomes a part of his/her body. Life begins at first breath. That is the only sane way to define life. Anything else becomes convoluted. It’s not so cut and dried, as we also don’t have a clear definition of when life ends.

          • Larissa says

            I think everyone is missing the point here. One uses birth control pills to prevent pregnancy. Whether that be through prevention of fertilization, travel, or implantation, the end result is the same: no pregnancy.
            A cell or two dying is not “murder” any more than scratching your arm is murder. Hundreds of cells die everyday as part of life. Your uterus is no different.

          • Noelle says

            You need to confront reality if you think life doesn’t begin until birth! Scientists don’t decide when life begins, they discovered it. That life begins at conception is a fact, not opinion. Also, the unborn baby’s blood supply never touches the mother’s – this is why you may have a different blood type than your mother’s. Furthermore, the unborn child also has it’s own unique set of DNA that are distinct from the mother’s. Yes, the unborn child is inside the mother and receives sustenance from her, but he or she is still a unique person capable of surviving outside the womb after 24 weeks. Based on your logic, a 24 week old fetus that was born prematurely would have his life begin 16 weeks earlier than most infants, while a full term baby’s life wouldn’t begin until he was born at 40 weeks. The only difference is geography.

  5. Tapes says

    Props to you, Wellness Mama, for having the courage to tackle such a controversial topic! I have been using the “low-dose” hormonal IUD (Mirena) for about 8 months now, and it’s horrible! I have been bleeding non-stop and my gynecologist says “there’s no way to know” when/if it will stop! They wanted to put me on strong antibiotics to see if that would help, but I cannot (due to breastfeeding) and will not take them for no reason! I am considering the copper IUD, as I just don’t think I or my husband could do ovulation prediction. The risk of becoming pregnant again isn’t one we are willing to take, and we certainly can’t afford any sort of devices or classes that might help us with natural birth control methods. :(

    • says

      In my experience it is not very expensive to find an NFP class. In fact, my husband and I took ours for free through our church before we got married. Ask at the local churches (especially Catholic) and you may be able to find a class for far less than it costs to be on birth control. :)

    • Cy says

      I’d second Elizabeth’s comment. I learned Creighton/NaPro for about $40 (and supposedly would need to continually buy stickers – but I started using an app instead).

    • Emma White says

      With the coil it can take up to a year for the bleeding to stop, it is quite common for woman to bleed heavily for up to a year! Be patient with it, and after a year if your symptoms persist definitely try the copper coil, as it doesn’t release hormones. Hope this was some help :)

    • Chris says

      Been there had the same thing bled for 6 months then it fell out, had to spend a lot of $ making sure it didn’t shift UP in my body with xrays and ultrasounds and now my cycle is extremely heavy where it was really light. I can’t afford anything else and really with all the side effects of everything I’m not doing another one.

  6. Elliot Love says

    No discussion of condoms (male and/or female condoms) or other barrier methods?

    Pulling out, where the male pulls out before he ejaculates, is also an excellent method of birth control. It has to be practiced consistently and reliably, of course, so it’s best for guys who are familiar with their body’s reactions and signals so they recognize when they need to pull out.

    • says

      Unfortunately, pulling out is not effective, because even the pre-ejaculatory fluid contains plenty of sperm to get the job done. And if you happen to be a Catholic who follows the Church teachings, it’s not a morally licit option, either, and neither are barrier methods.

      • Rob says

        Pre-ejaculatory fluid comes from the cowper’s gland. Not the testicles where sperm comes from. There is no way in that regard that pre-ejaculatory fluid could have sperm or impregnate your partner.

        Pre-ejaculatory fluid can have sperm in it IF the man ejaculated before engaging in intercourse and didn’t flush out the possible leftover sperm with urination. This is where misconception arises about pre-cum causing pregnancy or not.

    • says

      I was only talking about methods I’ve personally tried. As a Catholic, neither of those methods is morally permissible for me so I have no experience with them and can’t personally encourage them :-)

      • Rob Crampton says

        I’m curious. Why are condoms not morally permissable? At least with being a Catholic in your mind?

          • Clarissa says

            The 15% fail rate comes from user error. If used correctly, their fail rate is 2%. So the fail rate for condom use is 12-15% with typical use but with perfect use, it’s 2-3%. I’m a sex educator and I just had to point that out. ;) They’re a really great option for those looking to prevent sexually transmitted infections as well as pregnancy but they need to be stored and used correctly every time.

          • Clarissa says

            Rob, the Catholic faith believes that it is intrinsically wrong to use contraception to prevent new human beings from coming into the world. This includes sterilization, condoms and other barrier methods, spermicides, coitus interruptus (withdrawal method), the Pill, and all other such methods. Essentially, the Catholic church believes that contraception violates the design God built into the human race, often referred to as “natural law” and the natural law purpose of sex is procreation. Sexual pleasure and strengthening intimacy and marriage bonds are additional blessings from God. It’s pretty easy to educate yourself about other faiths via friends, the Church, or the Internet.
            Katie, totally. Condoms are a personal choice and can be a good option for people who are having sex outside of a monogamous and/or STI-free relationship. I was just correcting the numbers; trying to spread condom positivity for others. :-)

    • Virginia Miner says

      If you are using NFP, you can know when you need to use barriers etc. and when there is no physical possibility of pregnancy.

    • Chris says

      We’ve done this (po) a lot over the past 9 years and have never had a problem or unexpected preg. Occasionally we use condoms and once again never had a problem. Although we’d prefer neither.

      • Queenie says

        This really interests me. I guess I’m a little nervous to not use any type of contraception and to only rely on when I “think” I’m not ovulating. Especially because I’ve heard so many stories about women getting pregnant when they didn’t think they were ovulating. I’m curious, when you say you occasionally use condoms, is that often or more like once a month? Because if it’s more often then not, couldn’t it just be the condom preventing you from pregnancy and not really the NFP? I’m disputing anything, I’m just genuinely interested in the validity of NFP…is it worth the risk?

  7. says

    have been using NFP for 20 years and love it. However, I would never recommend the temp only method, simply because I have seen from personal experience that lots of things can affect temps, and alone, they have not been a totally reliable indicator for me. They have been great to confirm mucous observations. I strongly recommend going to an NFP practitioner to be trained in the method (we used the Napro-Technology method), because it can be tricky, especially when breastfeeding, and especially when you have irregular cycles or constant mucous.

  8. Jess says

    Great post! I agree with all the points you make. We have used NFP for 3 years and it has been a great. I think there needs to be more awareness of hormonal contraceptives. Thanks for bringing this to light.

  9. says

    Thanks for the post! I’d like to add candida overgrowth to the list of harmful side effects of hormonal BC (here’s a well documented article http://bodyecology.com/articles/pms-and-candida-overgrowth-the-dangers-of-estrogen-dominance#.UW85krWGCf0) and also offer another effective NFP method: Ecological Breastfeeding (not to be confused with what is considered normal nursing in the US) great book on the subject:
    The Seven Standards of Ecological Breastfeeding: The Frequency Factor (sorry for the big font! silly cut and paste…)

    • ALyssa says

      Yes!! Doctors will not admit that the pill causes yeast infections, but I have suffered through as many as two a month for two years. Finally told a DR I have this problem and he tests me for.. are you ready… HIV!!! Are You KIDDING?! Total BS. Went off the pill for a year and had no infection for a year… went back on for 1 month and got an infection right away… Yeah.

    • maree says

      Ecological Breastfeeding can be an excellent choice for many women, I’d definitely recommend the book, it isn’t expensive. I used this after our last child, it has worked for 13 months for us. Although I have started cycling now, but I got very sick for 10 days (tummy bug) and ran my milk supply down to basically nothing, otherwise it probably would have worked for longer. We will do a little bit of NFP (looking into LadyComp) as we would prefer a 2 year gap this time (last time without ecological breastfeeding or NFP the gap was 14 months between children). So a little more break would be nice :)

  10. Kristen says

    Thank you for this article. As a midwife and herbalist (and a Christian), I have shared the health risks (and possible abortifacient risks) of hormonal contraceptives with many women who have sought my counsel. I have shared this article on my business page, Whole Family Herbals!

  11. Meghan Mohler says

    I am and avid reader and this is my first comment. I have PCOS and my cycles were 40 to 50 days long. I started taking magnesium and maca and now my cycles are exactly 31 days. I refuse to take Bcp, against the advice of my doctor. I switched to the diaphragm and LOVE it. No hormones!

    • Sarah says

      Just a side note that doesn’t have anything to do with this post, but thank you for sharing what your cycle length was and how you fixed it. I’ve been freaking out because my cycle as of now is 40+ days and counting. I’ve definitely been putting the blame on being 18 and still having things figuring themselves out to put my mind to ease, but it is a very short term ease. Of course that could be part of it, but it’d be nice to get it somewhat regular.

  12. says

    Thank you Katie for writing such a wonderful, informative post! And not being afraid to offend people with such a controversial topic. Most women need to be better informed about the harmful effects of contraceptives, not to mention the moral implications. Thank you for being brave enough to speak the truth in your posts!

    • says

      One other thing – I was on the pill for 2 years in high school and 1 1/2 years in college to treat my PCOS. It only helped my problem while I was on it. Once I came off the medicine, my symptoms all eventually came back, sometimes even worse than before. Right before I got off the pill forever, I realize I did not feel like myself anymore – I was constantly moody and felt incredibly out of control. I decided then I needed to stop taking the pill. Since then I relied on alternative methods of treating my menstrual problems like acupuncture, herbs and eventually changing the way I ate. I never ate the SAD, but I grew up eating a lot of pasta. I discovered real food about 2 years ago and ever since then, my cycles have continued to improve and are almost normal, without symptoms! I am thankful to God for directing me towards a healthy lifestyle. ~Sarah

  13. natalie says

    My husband & I have used the withdrawl method effectively for 8 years. We have had two planned pregnancies. I also pay attention to my own body & know when I’m ovulating (more or less :)

  14. kiyah says

    I was using birth control in college but it made me nauseous but condoms worked fine and my husband and I use the pull out method now since we don’t have to be so cautious

  15. jennie says

    Congrats to y’all on the birth of your baby. :-) I, too, recently gave birth to our fifth baby. I read the website of ovacue and it says not to use it during the postpartum period as there is no ovulating, however you say you will be using it. Will you advise me as I would like to easily anticipate the return of my fertility. Thanks so much for your blog and all the information.

  16. Noelle says

    Thank you so much for this wonderful and informative post Katie! I completely agree that most women don’t know the many risks of hormonal contraceptives and that there is a natural alternative. For those women who aren’t sure, my husband and I have been using NFP successfully for the last 9 months of our marriage to postpone pregnancy, so I can vouch for its effectiveness. I use a free app on my phone called “Ovuview” where you input your symptoms (basal body temp & mucous observations are used, called the sympto-thermal method) and these predict what fertility phase you’re in, when you ovulate, and your next menstrual cycle using various methods. It’s really pretty neat and I’ve found it to be extremely accurate and super convenient since I travel a lot – no need to carry a paper chart around! We also supplement that with the clearblue fertility monitor, which as Wellness Mama mentioned can be expensive but it helps me know with a higher degree of certainty when I’ve ovulated. The fertility monitor is not meant to be used to prevent pregnancy, but using the Marquette Model of NFP it CAN be used (see http://nfp.marquette.edu/avoiding_pregnancy.php) and this has been great for us. Just wanted to throw out some other options! There are so many great resources out there and I learned a lot from this post and all the comments about even more options available so thank you again for sharing all this great information!

  17. says

    I used the LadyComp for 3 years before we stopped to have our son and LOVE it! It is expensive, but I feel like the cost is more than made up for over time, considering what you would spend on birth control pills (not to mention medical bills from the higher risk of cancer, which was a big factor for us). I didn’t know that it still worked while breastfeeding though so thanks for that info! I’ll be pulling it out again soon!

  18. Jane Romano says

    I love your site! I’m a conservative hippie Catholic Hippie Mama to 4…soon to be 5 ! I am about 12 weeks pregnant… We practice NFP and I charted while using the Lady Comp… We followed all the rules and this little bundle of joy was a major surprise. The Lady Comp miscalculated my day of ovulation by 4 days (according to my chart based on my early thermal shift). In addition to my early ovulation, my husband’s sperm had to live for at least 6 days… It’s no wonder… I was pumping him full of gelatin, liver and FCLO before he left for deployment… I guess we have no hope for a boy with this late conception…So far we’re blessed with 1 boy and three girls… Thoughts??

  19. Shannon Fossett says

    Thank you! I am saddened by the number of young women I know who have been taking artificial bc since their teens/early twenties without being informed about the serious risks, or aware of the effectiveness of alternatives such as NFP. Many in the medical community are part of the problem. I have encountered condescension and rudeness after stating that I do not use artifical bc. After the birth of my daughter, I was asked about my birth control plans, and I respondend: “I hope to have another child as soon as is healthy for me and my family.” Currently 36 weeks along with daughter #2!

  20. Johanna Lamb says

    Thank you for your thoughtful article on this heavy topic.

    It’s important to empower women with this information so that they can be in full control of their health. It’s sad that this information is not made more readily available.

    I was on hormonal contraceptives for 10 years to manage PCOS until I decided enough was enough. When I stopped taking the Pill it launched a physically and spiritually transforming journey that has allowed me to take back my health and I now enjoy a vibrancy to life that was unimaginable before. I find it interesting that the Pill is sold to woman as a panacea but science really is starting to show that it has important consequences to consider. (In more crass terms- you take the Pill so that you can have sex whenever you want, but it changes your body so much suddenly you don’t want to anymore!) Thanks for listing all your sources at the end.

    Love your blog!

  21. lyss says

    Totally agree. Natural methods are SO worth learning so you don’t have to take hormones!

    I have successfully prevented pregnancy with just keeping track of my mucus. Temperature taking seemed too variable to me(I read that you can’t get up at night and you have to wake at the same time each day…which would be nice, but not happening with babies and toddlers!). But I guess I can’t really have an opinion since I’ve never tried it.

    My only problem with my method is that it doesn’t work post-baby before the cycle returns. I got pregnant with my 2nd before I got my period (at 9 months), and I had no idea I had ovulated! After my 2nd baby, my period returned at 6 weeks, but if that doesn’t happen again, I’m unsure what I’ll do for preventing pregnancy postpartum next time around. Is there any reliable method for checking for ovulation before your period returns besides expensive devices? Actually, I just reread what you said about them, and sounds like they only work once you have your cycle.
    If anyone has suggestions for a natural method for post-baby contraceptive, I’d love to know…

    • Natalie Heskamp says

      I’m not sure if anyone answered your question in following posts, but being a certified NFP instructor, I couldn’t help chiming in here. While figuring our your fertility post partum can be super tricky, it can be done! It just requires even more diligence and being even more “conservative” with which days you use for intercourse. For instance, you might have 40 days in a row of “ambiguous” type mucus while breastfeeding, before your cycle has returned. Here’s where you have to decide, how serious are you about not getting pregnant? If very, you better abstain. Yes, for that long :-) Have you taken a class, or met with an instructor? If not, I would highly recommend doing so, as some of the “rules” can seem overwhelming. I’ve been practicing NFP for over 5 years now, and instructing for a couple of years, and I still have to keep going back and rereading my texts and double checking. We have 2 children, one on the way, all “planned” :-), if you will. I would be happy to chat more with you, or at least I encourage you to find a class in your area.
      Another important thing to remember (especially when trying to sell your OB on the effectiveness of NFP!!), is that there are “failures” with contraceptives, just as there are failures with NFP. The METHOD effectiveness rate (the method being used perfectly) of NFP is about 98%, the same as the METHOD effectiveness of the pill. So, if someone forgets to take there pill and gets pregnant, it’s the same as if someone made a mistake in their mucus charting and gets pregnant. No one one claim that the pill is ineffective, so we shouldn’t claim that NFP, when practiced well isn’t effective!
      Anyways, I hope this isn’t redundant or too preachy! Just thought I’d put in my two cents, hoping that it is helpful!
      Peace
      Natalie

      • says

        Hi Natalie… thanks for weighing in :-) I actually am a sympto-thermal isntructor myself and while we’ve gotten pregnant each time before my cycle returned, we weren’t that serious about preventing :-)

    • Zeni says

      I had this problem too. I was using NFP but post-partum ups and downs, irregular sleep patterns, and breastfeeding made it impossible to accurately chart any fertility signs…and I got pregnant when my baby was only 5 months old. My suggestion? Use condoms until you feel you can safely use NFP again.

  22. says

    I just recently stopped using the pill after having been on it for 10 years. I have been told that I have PCOS, and when I was in high school I was having my period every other week and I was an emotional wreck. The pill did straighten that out, but I finally just thought, why am I taking this crap when I have been eating so well and switching out my shampoo for more natural options, etc? The pills are terrible! So I stopped. I have been taking maca, and I’m going to get some chaste berry, as you recommended the other day. I’ve had a few weird mood swings, but other than that, I’m feeling pretty good physically. Suprisingly, my cycle has been pretty normal, and I’m actually looking forward to getting to know my body better.

  23. Kristin Spirek says

    I’m so glad you posted about this! I have been using both the Ovacue and Clearblue fertility monitors (love self-experimentation) for the past five months while exclusively breastfeeding. The Clearblue has gotten my fertile days right each cycle (that is, it agrees with my Ovacue and other symptoms), but the Ovacue has given me soooo much more information about my hormones. I thought my hormones were pretty well balanced, since I eat like you and have been cycling very regularly since 12 weeks postpartum after each my last two babies, but my “rocky-mountain” Ovagraph chart at 7 months postpartum (my first cycle using that device) showed me otherwise! The first thing I did was review your tips to balance hormones, and I started supplementing Maca, Vitex, FCLO and magnesium, and things have slowly improved. Five cycles later, my chart looks very close to a model chart… even though I’m still breastfeeding quite a lot! I will say that it seems most breastfeeding mothers on the Ovacue forums get multiple “cue peaks” in their saliva in each cycle, and so we can’t rely on the color coding and MUST use the vaginal sensor as well. I’ll be curious to see if you post a review of the Ovacue and especially using it before your cycle returns. I’m sure it’s possible and the company is just protecting itself by saying it can’t be used before the return of menstruation…

  24. Allie says

    Very nice post, thank you :) I have been using neem oil as a natural contraceptive. It is a tree from India and has a wide variety of uses and benefits. I use this because it’s what feels safest for my body and effective.

  25. Norma Oliver says

    I am SO in agreement with this article and glad to see someone taking the time to share this information. I’ve thought for years that there is a huge connection to synthetic hormones and the huge increases in breast and other female cancers. It’s funny how many are into eating healthier, going organic, non gmo etc, then flood their bodies repeatedly and regularly with synthetic hormones. :(http://articles.mercola.com/sites/articles/archive/2010/07/10/real-contraceptive-choices-alternatives-to-risky-hormone-pills-patches-and-shots.aspx

    http://articles.mercola.com/sites/articles/archive/2010/05/15/the-pill-at-50-sex-freedom-and-paradox.aspx

  26. Deb says

    I personally use the Lady Comp. Although I do highly recommend it ,you have to have a regular cycle. So until a regular cycle is achieved it will be futile. Also you have to put in about 6 cycles before it really startes to know your cycle. I started using this method after my husband and I were married. We tried birth control first because we did not want a child our first year of marriage and it was terrible! I was crying almost every other day (far from my norm). However, the the deciding factor to stop was that I developed 17 fibroid adenomas all since starting birth control. This resulted in a ton of Doctors appointments (many comments on how lumpy my breast were) and the result of no more BC ever.They are very painful and will not go away….ever. I stopped it, went on lady comp and its been a year and half with no babies. What is also good about this machine is if you wanna have babies you can reverse it and have sex on the “red” days.

  27. Jessica says

    I have used NFP in the past. My husband doesn’t trust it though, so I have the non hormonal IUD. It’s the most I’m willing to do. NFP also kind of sucks because its when I’m fertile that I’m the horniest! Lol.

  28. Nicolette H says

    Great post! Thank you for sharing;) Question for you…. I am 25 years old and have been told that I have high testosterone levels. Unfortunately, my husband and I have not had any luck with conceiving these past 2years. Is Maca effective in lowering testosterone/androgen levels in females? If it is, what is the dosage amount of it in powder form? What other supplement could I take that are effective in lowering testosterone levels?

    • says

      It should help, but using a natural progesterone cream in the second half of the cycle might also help. Fermented cod liver oil and magnesium would also be good pre=pregnancy…

  29. says

    I’ve used the Sympto-Thermal method of NFP, using basal body temp and cervical mucus observations. I’ve also used the Creighton Model with is super indepth. All these are free systems that you just need training on. Each woman’s cycle is different than anyone else’s and even her own, sometimes. Through charting, I learned that I have low progesterone, endometriosis and fibroids. I had 3 surgeries last year to remove the fibroids and endometriosis. I recommend NFP! I haven’t been able to get pregnant, due to my issues, but I’m working on it.

  30. Alexandra says

    Thank you for addressing the fact that hormonal contraceptives do not address the CAUSE. As a soon to be chiropractor, this is what I’ve been rediscovering… The nervous system is what controls your entire body, which is protected by the bones in your back. When there is a misalignment or interference to your nervous system, your body responds in many different ways, usually with a symptom like pain, but less obvious, hormonal imbalances can occur. Chiropractic allows for you to experience and express more life, we live through our nervous systems. I urge everyone who wants more life to seek out a chiropractor who sees you as a perfect being, who has perfectly adapted to the stresses you have undergone in life, not see that something is WRONG with you. I get checked several times a week and adjusted, because my nervous system controls my entire body and I want to function at my full potential, doesn’t matter if I’m experiencing health (symptoms) or not. A body without interference is better than a body with interference. Thanks a million!

  31. Laelle Martin says

    Thanks for this post! Used the LadyComp for 2-3 years before the birth of my first child and loved it. Did not ever get around to using it before this pregnancy since my cycle didn’t return for almost 2 1/2 years once I stopped all night nursing.

  32. says

    Thanks so much for posting! Birth control is definitely not good for the body. When I was younger my doctor recommended going on it to help ‘regulate’ my period and I chose to do so. Ten years later and now I’m working to reverse its devastating effects =/ After 1.5 years of bio-identical hormones and supplements and lots of money working with a holistic practitioner that actually knows what’s going on, I finally had a period! yay! Anyone thinking about getting off bc or starting, please find natural alternatives, it’s not worth it!

  33. says

    I started the pill when I was 13 and did not stop until I 26. The reason was because I suffered from severe cramps and the pill made them more manageable, but they never went away. I tried to get off of the pill several times do to bad circulation, low sex drive and hair thinning. Every time I tried to get off of them the pain would come back 10 fold. Growing up I loved milk and would drink several glasses of it everyday. It wasn’t until the last maybe 2 years I stopped and cut out all dairy except organic yogurt. I also eat all organic food now. I have been off the pill finally for over a year and no pain. As crazy as it sounds I believe it was the cows milk. I believe the hormones in it where not reacting well with my body. I was also suffering from endometrial hyperplasia which went away right after I stopped milk. I am 27 pill free and pain free. I love your site btw, I wish my mother would have been more into natural alternatives.

  34. says

    Yes, I love this! I got off my IUD due to terrible reactions with the hormones and my doctor wanted to put me on the pill. But I refused because of the aforementioned adverse reaction to hormones. So glad I found FAM – I’ve been using the LadyComp since last October and I love it.

  35. says

    I just want to say how refreshing it is to have so many people not blindly following what doctors tell them. my female problems started when I was 12 and I was put on birth control by the time I was 13. I was on the pill for more than six years before I decided to take myself off of it. after several surgeries my problems persisted. I wish I would have known about the possible long term side effects when I was just a teenager. but doctors never tell you about all of that. it’s so good to have people like you out there spreading this knowledge! after refusing doctors plans for me i started my own road to recovery through diet and lifestyle changes now have two beautiful children the doctors told me I would never have( and planning for more).

  36. Virginia Miner says

    I love NFP! I have weird cycles, so the mid wife’s due date calculator is worthless, but since I know my ovulation date, I know my due date! I recommend getting familiar with the method and then using one of the many smartphone symptom trackers out there (free!) to track once you know what to look for. It is awesome, and it really helps you to know what is going on with your body beyond just fertility.

  37. Amy Smellinger says

    I have 6 kids and my husband and I do not want any more. For that reason I have been using a Mirena IUD. 2 yrs ago I noticed swelling in my nether regions followed by intense itching that to this day really has only subsided a little. All tests for std’s and infections and yeasts came back negative. No cause found for intense itching. At the same time I started to gain weight (40 lbs in 6 months). I also cannot lose it no matter what I do. I am thinking the hormones in my IUD may be a culprit from what I have read so far. I will check into these methods since I am now opposed strongly to hormones from birth control. The accuracy rate you have stated has opened my mind to NFP. Thanks for this post.

  38. says

    At the moment I’m considering the copper IUD and/or my husband is getting a vasectomy. That info about IUDs is pretty scary though….I absolutely 100% can NOT get pregnant again (for health and financial reasons) so I don’t think nfp would be a long term solution. I’m 29 so I have quite a few years of fertility left. Anyone have experience with copper IUD?

    • Jenny says

      I realize you wrote this awhile ago, but I just got my copper IUD taken out. I had it almost three years and hated it every single month. The doctor really tried to convince me to use Mirena, but hormones get me so depressed that I would have to start anti-depressants………NOT OKAY. I thought copper would be better. I had three years of INTENSE cramps. I’m talking debilitating, couldn’t walk at times, couldn’t breathe at times kind of cramps. I kept going back to get it checked because I thought it was trying to exit my body. It stayed right where it was supposed to the whole time, strings always available. In short, it’s a foreign object, and my uterus hated it! I cannot recommend an IUD to anyone. We just started trying to get pregnant, but I plan on one of these natural methods post baby. The only cons I can see are going through the training, a high initial cost, and daily effort. The Lady Comp is $300 cheaper than my IUD was, so that’s not a concern. The training is just a small amount of time, and the daily effort is worth it for the peace of mind. I cannot express to you the importance of peace of mind. For three years I had no peace…..worrying about if my uterus was being perforated, dreading every single period, being useless at work because of the two days each month of intense pain, and so on. All my girlfriends have had theirs taken out as well due to pain. We’re all very relieved!

  39. Lindsay Maher says

    Great post! I have to echo Angela’s comments here as well. We have used Creighton Method for 4 years now, avoided pregnancy for 2 years, got pregnant when we decided to start trying, and are now using to avoid while still breastfeeding 8 months post-partum. The science behind this system and naprotechnology is what sold me on the method and they have done remarkable things for hundreds of families including my own sisters.

  40. Sara Stahlman says

    This article forgets the main side effect of these natural alternatives – unintended
    pregnancy. I fully agree that hormonal contraceptives as well as the non-hormonal copper IUD have side effects that
    make them not ideal. BUT – if the goal is to not get pregnant, any of
    those options are much more effective than these natural methods. I’m
    talking MUCH MORE EFFECTIVE – like from less that 1% chance of
    unintended pregnancy with an IUD to 25% chance of an unintended
    pregnancy using FAM or NFP. I get the desire to minimize hormones, but I
    also get the desire to plan when you want to be pregnant.

  41. Zeni says

    My thoughts exactly! Condoms have something like a 98% rate of preventing pregnancy (higher than any other contraceptive method), and have no side effects.

    • Rob says

      Actually, I was hoping condoms would have been discussed too. I would be willing to wager though there might be some side effects in relationship to the spermicides, latex vs. non-latex options, and lubricates that are used in condoms. As far as to the affect of this effects would be my interest. My partner and I are very particular about what goes inside her that isn’t natural. Like a foodie is to their pastured raised beef vs. CAFO options.

  42. Moriah Cameron says

    THANKS for this great post!! It was very timely as my teenage daughter was requesting to go on it for all her friends are on it to help control acne and painful periods. i knew better than to allow this but didn’t have any information to back up my convictions. What a blessing your words were to me and my family! :)

  43. claire says

    Thanks so much for this post!

    I’ve had a lot of success with the icyclebeads app. http://icyclebeads.com/ It’s over 95% effective and very economical ($2.99 from the app store).
    I get notifications before my fertility window and period, and I can check my phone at any time to find out where I am in my cycle.
    The only downside to this option is that your cycle has to be between 26 – 32 days, and not everyone’s is. For those of us whose cycles fit this length, however, this is another great natural tool in preventing or promoting pregnancy.

  44. Jessica says

    Maybe someone can help me. I got off of birth control after taking it for 15 years. I began getting cysts on my ovaries and the rupturing was very painful. My dr told me BC or pregnancy was the only way to stop the cysts. Are there any options because this is the ONLY reason I am on it.

  45. Jenny says

    Is there any way to promote longer periods of natural infertility after childbirth? I breastfed my daughter exclusively after she was born for almost 2 years, but my periods returned immediately after she was born. I had a copper IUD placed, and then had it removed so we could conceive again. I just had another baby a few months ago and immediately had a period after I finished my postpartum bleeding with him. Still exclusively breastfeeding. In fear of getting pregnant I had another copper IUD placed, but I really don’t want it. I haven’t had another period, just sporadic spotting. I just REALLY don’t want to get pregnant before he is at least a year old, maybe longer. Any suggestions?

  46. Angelina says

    Good article! Very informative!

    However, I take herbs for contraception, and they haven’t done me any harm.You have to respect the herb, people from many generations before us have taken herbs as contraceptives.

    Also, the male chooses the sex of the baby, not the female. It’s random.

  47. Bradu says

    i ABSOLUTLY looooooovvvvveee my lady comp. im am in my 20s an hav been married for a couple yrs. started out on the pill an soon decided i needed to find another way… a friend told me about lady comp an ive never regretted it 1 time.

  48. Casey Harris says

    Can Wellness Mama do a post on the Copper IUD? I would like to know if there are any negative side effects of the copper to the system that the medical field does not address. I am currently using the Nuvaring but have had progressively harder times coming on and off the hormones each month. We are still two years away from wanting to start a family but I would like to get off the hormones now and get my system balanced.

    • Eva Rinaldi says

      Check out IUD_Divas on Livejournal for women writing about their IUD experiences. For me the main side effect was that it was very painful to put in, and I had cramps for several days.

  49. Krystal Tornstrom says

    I have a question, but I hope I don’t come off the wrong way. I do not plan to have kids until I am married. I am on the pill right now and I have been wanting to go off it, but I do not know how effective NFP is, I know you Katie, have 5 kids and do use NFP, but did you not try but not really try to stop getting pregnant if that makes sense? Is there anyone who has tried NFP, and not gotten pregnant or at least for awhile.

  50. Kristina says

    Hi Katie. If you’re still responding to comments on posts this old, would you mind giving an update on how well these methods worked to track when your fertility returned after baby? I haven’t seen anything posted about baby #6, so I assume something worked :)
    I want to get off birth control and buy a fertility monitor to help prevent a baby for now, and help conceive quickly when we’re ready. I would also like to be able to use it to monitor when fertility returns between babies. I emailed both Lady Comp and OvaCue to ask how well their monitors work for tracking the return of fertility after baby (as a random side note, I was extremely impressed with the customer service from both companies – I received immediate responses from both). The Lady Comp people told me it can be used after baby but would show up as yellow until you’ve actually ovulated, which really won’t do you any good if you want to delay baby #2, and the OvaCue people said you can’t use their product until after you’ve had your first period after baby. I’m wondering if these responses are just some sort of legal obligation to respond in a certain way, and the products do actually work for that.

  51. Kristine says

    I am 8 weeks postpartum and seem to be having a period (emergency c section, 12 pound baby). How has the lady comp worked for you postpartum for birth control. I would like to switch to this method as we hate condoms.

  52. Kristyn-Kimberly says

    This is honestly the most eye opening thing I have read. I am 25 and I have been on birth control for over ten years. I am starting to see some major side effects from long term use. I didn’t even know there were things out there like the lady comp fertility monitor. I am stopping my pills immediately and getting myself one of these.

  53. Christina says

    What a great post! I use the rhythm method, since we have been married it helped us conceive three times, one ended in MC but we are due in April with our 3Rd. we use the my days app. It helps monitor your menstrual cycle too for women who may not always be regular.

  54. Steph says

    Thanks for this discussion. Another fertility tracker that I would recommend for its ease and convenience is the Selene app. (https://itunes.apple.com/us/app/selene-fertility-awareness/id562235219?mt=8) You input your BBT and other data right into your phone each morning. It collects a huge amount of information, provides accurate predications and has a beautiful interface. I switched to natural family planning after 10 years on oral contraceptives and only wish I had known about it sooner.

    • says

      I agree with many things that she ways, but she even admits that there is nothing wrong with supplements, just with an unhealthy dependence on them. Herbs also fit in to this category, and many herbs were used as medicine in Jesus’ time and are not new age at all.

  55. Jackie says

    Many years ago, I went off the pill because of the issues it caused me. I used the “rhythm Method”. Actually, I took my temp and all the other changes etc. It worked very well for me because I was extremely in tune with my body. It does require vigilance and a supportive partner probably would be helpful. We actually used condoms for unsafe times. No drugs was the best part, though simplicity was nice also. i fortunately knew EXACTLY the time of ovulation (due to the pain it caused) so I could stop marking any other changes. I only have 2 children, so it must have worked.

  56. Clarissa says

    Just curious, are there any women out there using NFP who are not mothers or already married? I’m a 26 year old graduate student with a big pile of student loan debt and a traveling itch. I have a wonderful partner whom I love but neither of us want children and we’ll probably separate after school when I move to a new state or country. I’ve been moving toward all natural and organic foods and body products but I also have the Mirena IUD. I had some initial yeast infections but now 7 months into it, I have no physically evident side effects. I plan on using NFP after I’ve met a person who I can settle down and raise children with but right now I’m not in a place where I can take any kind of risk for unintended pregnancy. Looking at the CDC and americanpregnancy.org it looks like with typical use, NFP has failure rates of 24-25% and with perfect use the failure rate is anywhere from 2-10% depending on which study and who funded it. I’m very interested in going off hormonal birth control, but I’m curious to hear if there are any other “single ladies” out there trying NFP and what their stories are. Thank you!

    • Ewa says

      The NFP methods are very effective and I don’t know if you have read Take Charge of Your Fertility by Toni Weschler – if no you will see how affective it could be – I’m happy user of NFP since the beginning of my marriage and it works perfectly for me, from 3 years I use Lady-Comp and I recommend it to ever woman as it is a great, integrated fertility management method…

      I also recommend to contact professional NFP adviser, as they might be a great support to you

    • Teresa says

      Amen sister! I’m a 21 year old undergrad student currently using the copper IUD. I’m working toward a more holistic lifestyle and I would love to be more in touch with my hormonal cycles and bodily processes. I’m interested in NFP but there’s not really info or support out there for young, unmarried, nonreligious women interested in using it as birth control. Most, if not all, of my friends assume NFP is only used by women trying to get pregnant, or who have the resources (emotional and otherwise) to care for an unexpected pregnancy. Abstaining from intercourse during ovulation also seems tortuous, as I don’t completely trust barrier methods’ efficacy nor enjoy buying and using condoms. I love being able to have relatively carefree, spontaneous sex with my partner but I’m concerned about copper toxicity, heavy & painful bleeding, and generally suspect that having a foreign object permanently placed inside an organ is energetically unhealthy. I’m kind of at a philosophical impasse comparing the benefits and disadvantages of an IUD or NFP… all I know for certain is that pregnancy is absolutely not an option for me right now. Would love to hear about your experiences since you posted!

    • Andrea says

      Hi Ladies!
      I am new to this blog, and I know that your posts have been around for a while, but I thought I would add my “two cents” anyway.

      I do not know any unmarried people who use NFP and are sexually active. I think that this is because NFP requires married-style trust between partners. It is a lifestyle choice that both the man and the woman must choose together, and they have to believe that their love can bring them through anything. An unplanned pregnancy could turn out to be something they could handle after all and even be profoundly grateful for

      Some thoughts for your consideration….. I think one of the biggest differences between NFP and contraceptives is not the effectiveness rate of the methods, but the way the effectiveness is perceived. Let me explain: when used properly, NFP methods compare pretty closely to artificial BC methods when it comes down to avoiding pregnancy. The truth is, all methods, natural or otherwise, include a low possibility of getting pregnant. However, if you use NFP, you think about that possibility every single cycle, so an unplanned pregnancy never catches you completely off guard. If you are using the pill or an IUD, the risk of getting pregnant is still very real, but you are probably not as cognizant of it.

      When it comes down to avoiding pregnancy, you’re looking at a matter of a few percentage points between methods. The only way to be 100% sure that you won’t get pregnant (without surgically removing body parts) is to not have sex.

      All the best to you! I am sure it must be a hard decision!!

  57. Taylor says

    I have a question about the NFP devices/apps to track ovulation. Do I have to go off birth control before I can begin tracking my ovulation, or can I start while I’m still on it, and then go off it?

  58. Stephanie says

    Thank you for this article. I have taken BC for 20+ years and all of a sudden had several health problems including migraines, high blood pressure and anxiety. My doctors just put me on more medicine to treat the symptoms. I didn’t feel good about it and come off of everything (including BC). My health started returning back to normal including my BP dropping back down. My doctor wanted me to go back on my BC and got upset when I said no I didn’t want to. Needless to say I switched doctors. My hormones are still imbalanced and I still get migraines once a month but I figure that might take a while to straighten out. I’m trying to eat better, take good vitamins, added light exercise, cut out some chemical exposure and have started taking vitex. I might need to also check out maca. Thanks again! Doctors won’t tell you everything you need to know and the risk with taking hormones.

    Oh and I also tried a IUD and instantly had health problems (aches and pains all over, swollen and sore glands in neck, hair falling out, etc..). I got it removed and felt better within about a week. Hormonal birth control can do really bad things to your body!!

  59. Jamie says

    Thanks for this thorough article Wellness Mama! I’ve used Sympto-thermal NFP from the beginning. I’ve been charting for 15 years now. In the beginning it helped me learn my cycles better and drove to to learn more about what we put in our bodies affects our health. I has some cysts burst in college, and had heavy bleeding and long cycles. Over the years I was able to shorten those cycles, as well as conceive and postpone pregnancy without issue or barriers and anything artificial or abortifacient ever. Like you, my Catholic faith is how I learned about NFP, and I am so very grateful because it sent be down an path of continually improving my physical health. (For my husband and I it also improved our relationship because we forced ourselves to really keep the topic of pregnancy up at the top, instead of just being surprised, and our relationship grew deeper when we had to communicate our love in other ways.) It moved us to teach Sympto thermal together for a time, though we have now retired. I have 4 children, all about 3 years a part each. I breastfed and had long months of absence of period, usually about 18-22 months. My youngest is now almost 4. We are not in a time right now that is ideal to welcome another child. If my faith had not moved me down this path, due to the severe allergies I encounter in my life, I am not sure what options I would have had without reactions. I can not even have an epidural during birth, And my midwives taught me how to hydrate well to avoid even having an IV because they have to give me benadryl for even that!
    My reasons to be natural go well beyond my faith, but I feel blessed that my faith helped not to have to learn and find these methods the hard way!

  60. Dawn says

    Great info as usual. I am so relived to be off of hormones for about three years, and I have never felt better. To add to the list of tracking devices, I use the Cyclotest. The monitor tracks my temperature automatically and I can also add when I notice ECM. The temperature plus mucus system is said to be 99% accurate at detecting ovulation so it is a pretty safe bet!

  61. Rachel L says

    Hi, Katie, and thanks so much for this post! I wish I’d read it before I went on the Depo-Provera birth control shot. I was engaged to be married in 3 months, was a virgin, and had never been to a OB-GYN before. I had done (what I thought to be!) LOTS of research online before I went to my appointment for B.C., and my lady doc even said that I impressed her with all my knowledge about my B.C. options.
    Never having taken B.C. before, I wanted something super convenient, so I chose the Depo-Provera shot, which you only have to get as an injection every 3 months. It sounded too good to be true! I lived in Cincinnati at the time, and had no idea there was any other way to prevent pregnancy besides condoms or B.C.
    My doc said that she herself was taking Depo, and she’d been on it for a couple years, and she liked it. She said she was a runner (so was I), but she looked a little overweight, so perhaps that should’ve been my first clue.
    So I went on Depo and for the first 6-7 months everything was normal enough. I gained a few pounds, but I was also running and lifting weights, so I thought maybe it was muscle weight. I also bled and spotted for over a year (which they kept saying was a normal side effect) until finally my period completely stopped (which apparently is also “normal” for Depo users). But until then had to wear a pad every single day b/c of the non-stop period I had. That alone was terrible, but it was about to get much worse.
    I started having depression, lack of motivation, sadness, severe blood sugar drops (I had to eat something substantial every 3 hours or I’d get shaky, tired, weak, and light-headed) and the worst: severe weight gain.
    I ate better and ran more, but I still gained 50 pounds in 2 years. I’ll say it again: the Depo made me gain 50 pounds (of fat) in 2 years. I was unable to lose weight, unable to gain muscle mass even though I lifted weights, and unable to improve my running stamina.
    I was stuck in a terrible rut with my weight and my life, and it was only after I’d been on the Depo for around 2.5 years that my husband & I finally faced the hard fact: I had to quit taking this monster drug ASAP. I could attribute every single ailment to the Depo. It had destroyed my body (and almost my life) in 2 short years, and I was a completely different person than I had been just 2 short years ago. Gone was the active, slender, joyful, optimistic 22 year old who got married; now here was the 205-pound shell of a 25 year old whose body had turned on her and who felt like she was 60 years old.
    It’s been about 2.5 years since I went off Depo for good, and I can tell my hormones are still out of whack: I’m still over 200 pounds, but I’ve been gaining muscle mass recently, so that’s a great start. I have stretch marks on my breasts, my upper thighs, my butt, and even the backs of my calves. I didn’t know you could get stretch marks on the backs of your calves!
    So my body is still mostly ruined, but at least I’m making some progress. My blood sugar doesn’t have severe drops every 3 hours anymore, I’m eating the healthiest I’ve ever eaten, and I power walk, job, and lift heavy weights several times a week.
    I also have a gluten intolerance that makes me so constipated I only go #2 a couple times a week, so I’ve been staying off gluten for a couple years.
    I know most people start eating healthier and cutting out gluten and they lose a bunch of weight, but not me. But I’m trying not to lose hope; it’s just been a horrible waiting game of waiting while the Depo slowly empties out of my body.
    I’ve heard that the Depo takes at least as long to leave your system as years that you were on it; so I was on it for 2.5 years, and it’s been 2.5 years since I’ve stopped taking it, and it’s still in my system, but I believe it to be finally leaving. My periods returned a while ago, but they’re still not to the pre-Depo severity they were (they used to be very heavy and long, and that was “normal” for me).
    So anyway, sorry for such a long post, but if I could scream from the rooftops and warn women of the vast and severe dangers of taking Depo, I would! It’s such an unnatural, high-powered drug that completely changes your body, and I had (and am still having) a ridiculously terrible reaction to it. And I’m sure my fertility is shot all to pieces, and who knows when it will return. (I’ve read fertility takes at least 2 years to return for long-term Depo users like me)
    I will NEVER again use hormonal birth control of any kind!
    So thanks, Katie, for informing women everywhere that there are plenty of other options out there! I would not wish what I’ve been going through even on my worst enemy.

  62. Aimee says

    Hi Katie,

    I’m incredibly grateful that you shared this info with all of us loyal readers. I used to be slim, healthy, very active, etc. Due to being pressured by my OBGYN, I began taking hormonal BC. I wish I hadn’t listened to her. In just two years, I’ve noticed a significant change in myself. Weight gain, lethargy, mood swings, severe headaches (the type that will drop you to your knees, in agony), aches and pains (all over), decrease in libido, etc. I have been so desperately wanting to quit taking it, but my partner and I can’t use condoms (I’m allergic to latex). I had considered herbal methods, but assumed it probably wouldn’t be the best choice (due to possible side effects). I’ve always been very in tune with my body, so NFP would most likely work for me. I appreciate your informative research into all of this. I cannot thank you enough for this post, it gave me hope. :)

    One question I have though is, are you aware of how long it takes to return to a normal cycle after taking hormonal BC? Is it different for all women? I’d rather not ask my OBGYN, I’m sure it won’t go over well, and I’ll probably receive false information anyhow.

    Thank you again Katie, you are certainly a blessing from heaven.

  63. Kathy says

    I recognize that you are a not a physician, but what would you suggest in place of the pill for cystic ovaries? My daughter has cystic ovaries with cysts that periodically would burst and cause extreme pain. Her physician put her on bc to reduce the cysts, stop new ones from forming and reduce scarring and further damage to her ovaries. She is young and unmarried so getting pregnant is not a remedy! ;0)

      • Kathy says

        Thank you! I had not considered a functional medicine doctor. When we visited our naturopath she didn’t indicate a different course other than following our primary care doctor’s prescription of b/c pills. Thanks, again.

  64. kenzie says

    You write about the pill and IUD’s, but what about implants? I have Nexplanon and chose it because it gives me the lowest dose of hormones possible while still being on hormonal birth control. Would all of the facts pertaining to the pill also pertain to implants? Thank you!

  65. Ewa says

    I want to come back to this very important issue mentioned here: many fertility experts (including doctors) are concerned about the fact that women often are not informed that the birth control pill can cause an chemical abortion as well as prevent pregnancy.

    Despite the hormones’ ability to prevent the release of eggs, sometimes a “breakthrough ovulation” takes place.

    A woman can still conceive an embryo (baby), who because of synthetic hormones cannot attach to the uterine lining and is aborted. The pill’s third mechanism is to change the lining of the endometrium, which creates a hostile environment for a newly created human life.

    The similar and even worse mechanism works in case of IUDs (coils), like Mirena, where one of the mechanisms incorporates a physical intrusion to prevent implantation of already conceived embryo.

    I use NFP methods since the beginning, currently Lady-Comp, which works great for me….

    Ewa

  66. Stacey says

    I wish this information had been available to me when I was younger! My aunt died of a “slow stroke” that we believe was due to long term use of birth control pills. I had to stop taking them because it raised my blood pressure so high and the doctor was afraid I would react the same way as my aunt. Over the years, I’ve also learned that some forms of contraceptives actually don’t block the conception of a life, they do the work after conception, which would have concerned me greatly had I known at the time. So, I couldn’t take birth control pills and then I had a very difficult high risk pregnancy and we did not want more children, so out of frustration, my husband had a vascectomy, which of course is very drastic and hard to reverse. This was in the early nineties and we had no computer or internet, so we were so uninformed! I really think all women should have access to this information above. I’ve seen many Christian women blog about trying to choose between no birth control or the pill and be torn due to their religious beliefs and likely think those are their only options. Thank you for putting this information out there!

    • Ewa says

      Hi Stacey – very good point…I’m also Christian (Catholic) and I’m very angry that I was not informed enough about natural methods of family planning (NFP) either classic (Billings, Rotzer, sympto-thermal) or the new NFP methods like, fertility monitors, which do all NFP, like Lady-Comp…every woman should have a right to be fully informed about anti-implantation mechanism of pills and IUDs (you mentioned their abortifacient mechanism) – regardless of a doctor’s personal opinions, few women are ever informed about this issue.

  67. Charity says

    Katie, I’m totally new to all of this and would love some insight. I have been taking the pill for 3 years now and a little over a year ago I started having a lot of pain from ovarian cysts. My OBGYN basically shrugged, said there was nothing they could do since I was already on the pill, and gave me some drugs to take for the pain. I have spoken with my husband and I am quitting the pill. We would like to avoid pregnancy, so I will be looking into NFP, but I’m nervous about the cysts. They have never gone away and I have had pain from them at least once a week. Is there a natural way to deal with those too?

    • Ewa says

      Hi Charity – congratulations on making the wide choice of quitting the pill – there are many NFP professional associations (like Billings, Couple to Couple League, etc) where you can get right advice – if you still afraid, add technology (like Lady-Comp fertility monitor for natural birth control – which works effectively with irregular cycles and can even identify hormonal imbalances) – so you have many choices and for sure it is good to contact NFP advisers also…and quitting the pill is the best choice you could make, not only because of your health, but because of ethical issues also: see my previous post about anti-implantation mechanism of the pills, causing embryonic abortion…

      Best

  68. Angela says

    Thank you so much for this discussion! We used the pull out method for 7 years with success. Then discovered I have PCOS and because of that my doctor pushed me into taking the pill as I felt like I had no other option. I was hospitalized twice in two years from major ovarian cyst ruptures. I didn’t know what was wrong and it seemed like it took a lot of money and testing to finally figure it out. Now I am having so many side effects from the pill that I just stopped taking it last week. I am actively looking for an alternative! I also have endometriosis caused from my first C-section. 2 kids = 2 C-sections. I usually have very painful cramps – when not on the pill. I am having anxiety attacks, weight gain, LOW libido from the pill. I called my OB a month ago and left a message for help and she has never called me back. I will check into the NFP option today. I would also like to know what I can do naturally to prevent the cysts and painful cramps from reoccurring? Help!

  69. Lenah says

    I am so glad you shared this with us all, I am so disappointed in my doctor for not telling me these things for the babies sake and my own health ;( it makes me so sad, and I’m really scared because when I was 18 I started birth control, I think it was nuvearing (pulled out during sex with hubby BC it hurt him and me and I forgot to put back in), and then depo provera shot (scared of needles, shots hurt, especially when your scared of them, then I didn’t have period forever and I had to pay for it and o thought its not healthy injecting your body with this unknown things, that could be doing any thing to my body and babies or future babies, when I got off that I thought I was going to die, cramp overload, period finally back, hardcore,,, then nuvearing (hubby didn’t like it neither did I, I was still not normal but getting there from depo withdrawal I guess.., then Nothing because we just wanted to put it in gods hands, and we had a home of our own (rented but Nice and we were happy) and I got pregnant some time later, healthy pregnancy and baby boy, as soon as he was born they were writing me out a prescription for mini pill because “breastfeeding wasn’t enough” and then upgrade to big pill, switched pills 2 years later and switched back to nuvea ring and I’m done with all this chemical horimone I
    Unbalancing crap, I want to take my birth control ring out right now and throw it in the trash, but I don’t know where to go from there, should I wait for this cycle, I’ll be calling my Dr on Monday,,, who can I talk to about natural family planning, (my husbands out of town a lot so we don’t have sex a lot.) But were not in a good spot to have another baby right now, but I would feel better leaving it in gods hands (if I get pregnant it was meant to be,..and ever since I started birth control at 18 my body and mind had gone down hill, everyday I hurt am depressed, lethargic (not me, the active girl) I do have PTSD and major depression from my childhood BUT before the birth control, I was WAY better off, everything is clicking in now, it seriously all
    Started or got 10* worse once I was on birth control…omgosh I’m so scared of during young BC I didn’t know better, I was young and dimn and.doing what I thought was right, if I knew what it does to the eggs etc I would never had done it ;( I’m so sad and mad at this world and drs and nurses and pharmacies and money makers who profit off this :) I am very thankful for you Katie and the work you right on, so very much any advice where to begin, what to do would be lovely, I am so new to natural family planning, I word love to have a note full of kids, but I don’t even have my own house now, and my hubbies never home so it would be hard to have lots of babies and kids running around, but oh do I wish for them;) I just turned 26…

    • Laura says

      Hi – I have been using LadyComp for almost 4 years now. I have 2 girls already and I am now planning for my next baby, which will hopefully be a girl since she would make the last addition to our family. I’m very comfortable with LadyComp and as a physician it is important to me not to harm my body unnecessarily with [the likes of] the pill [or other unnatural methods]. Lady-Comp is so easy to use and straight forward for natural birth control! and I’m hormone-free – so I really recommend you Lady-Comp or other fertility monitors like Wink for example

  70. Autumn says

    I would like to try the LadyComp or the OvaCue Fertility Monitor, but I have to work one night shift a week. I am afraid my results might not be accurate because of this. Would either one of these be an option for me. I was previously on the pill, but it gave me migraines.

    Thanks

    • says

      From what I can tell, it would still work if you could take the readings at the same time each day. The ovacue now has a mobile version that attaches to a phone, so it is easy to pack in a purse and bring along if needed, but you could probably schedule around your work hours too. http://wellnessmama.com/go/mobileovacue/ The mobile app is really user friendly and you could make notes on your night shift day and take that into account to be extra safe :-)

    • Eva says

      In relation to Lady-Comp and shift work, see FAQ section: In fact the new Chip III generation of Lady-Comp was designed especially for these types of women. Thanks to its very long measuring period of six hours, women who have to get up several times a night (e.g. mothers of babies or toddlers) can almost always take their temperature, either at their scheduled waking time or at night before taking care of the child (since reading takes only 30 seconds, this should not be a problem). If you are a shift worker or want to sleep in, you can change the measuring period at any time within a cycle by simply setting the alarm clock accordingly. That way you can take your temperature at 7 a.m. on one day and at 2 p.m. on the next, provided you had your sleep before that. This means that Lady-Comp can be customised to meet your requirements on a daily basis.

  71. Kelsey says

    I know this post is a couple years old but this is a subject I’ve had a really hard time finding good information about. I am 26 and have been on the Pill for I think 5 or 6 years now — I’m not sexually active and don’t plan to be until marriage, but I went on the Pill to regulate my terrible, terrible periods. They used to be extremely heavy, last at least 9 or 10 days, and caused debilitating cramps and horrible acne. I absolutely love being on the Pill — my skin has cleared up, I rarely get cramps, and my periods only come every 3 months and are super light and easy.

    That being said, I’m not comfortable being on the Pill long-term due to the risks you mentioned, and I’m looking for more natural ways to regulate my periods. I absolutely can’t go back to the way my periods used to be… They were nightmarish and debilitating. What supplements or steps would you recommend to regulate hormones for someone who is concerned only with the misery and general gross-ness of periods — heavy flow, cramps, breakouts, mood swings, etc. — and not at all with actual birth control? Every discussion I’ve seen on the topic gets wrapped up in the issue of fertility, but since I’m not sexually active, that is at the bottom of my list of concerns right now. :)

    Thanks! Love your site!

    • says

      Hi Kelsey, thanks for reading. I can sympathize. I had horrible periods when I was younger. Vitex, Maca and natural progesterone cream (second half of cycle only) were really helpful and I actually took the “after ease” tincture (you can probably find it on Amazon) during periods to help reduce them. I also noticed a big difference after switching to natural menstrual options (diva cup, cloth pads and sea sponges) instead of disposable. My body really disliked the chemicals in regular tampons and pads. My period got shorter and completely cramp free. Hope some of this helps!

      • Kelsey says

        Thanks so much for the tips! I don’t know if I could ever switch to reusable products since I find the whole period process to be revolting enough as it is without having to clean any… equipment. But I will definitely look into the other things you mentioned! Even if I can’t bring myself to ditch the tampons and pads, it will at least be a relief if I can get off the Pill. Thanks again!

Join the Conversation...

Please read my comment policy.