What does hormone-free contraception mean?
Many couples are looking for alternative methods of contraception because of concerns about complications from hormonal contraceptives or personal rejection of them. There is a wide range of options, with most contraceptive methods involving the woman herself. The advantage of hormone-free methods is that they do not interfere with the natural female cycle.
Many non-hormonal contraceptive methods offer good pregnancy protection when used correctly, but often require some practice and patience. A medical consultation may therefore be advisable. The conventional condom and vasectomy, i.e. surgical sterilization of the man, are ways for the partner to prevent pregnancy.
What hormone-free contraceptive methods are available?
There are numerous contraceptive methods that do not require external hormonal supply. These are also very safe in many cases, whereby the right protection is always associated with correct handling:
- Symptothermal method: With the help of the symptothermal method, the fertile days can be determined by means of the basal temperature and the consistency of the cervical mucus.
- Contraception computers: Similarly, the contraception computers take the readings themselves, record the monthly cycle and display in color when unprotected intercourse can occur. Some contraception computers also include the consistency of the cervical mucus in their analyses.
- Billing method: Within the framework of the so-called billing method, the woman can also examine the consistency of her mucus herself and thus determine whether she is currently fertile or not.
- Barrier methods: In addition, there are so-called barrier methods that prevent seminal fluid from entering the uterus.
These include the conventional condom, the female condom, the diaphragm and the cervical cap.
The condom is the only contraceptive that offers protection against both pregnancy and sexually transmitted diseases. This applies to both the male and female versions. The condom is a barrier method of contraception.
It prevents sperm from entering the vagina and uterus of the woman. A condom is usually made of wafer-thin latex, although products made of polyurethane are also available for allergies. If the man is not circumcised, the foreskin must first be retracted before the condom is put on.
The condom is then rolled over the erect penis, taking care to leave the small prefabricated tip of the condom free at the tip and not to pull it over the penis as well. This tip serves as a reservoir for the seminal fluid that is released during orgasm and is therefore important to prevent the condom from bursting due to lack of space. After sexual intercourse, the condom is removed from the still stiff penis.
This should be done after the penis has been pulled out of the vagina. This prevents the seminal fluid inside the condom from escaping into the vagina. Due to the thin nature of condoms, they are usually hardly noticeable during sexual intercourse.
However, a prerequisite for this is that the condom must fit perfectly, which is why the correct size must be chosen when buying it, according to the length and thickness of the limb. The safety of the product can be severely compromised when using oils or fatty creams as lubricants, as the condom material can become porous and tear more easily. Therefore, if necessary, only lubricants that are designed for use with condoms should be used.
A female condom serves as a mechanical barrier to penetrating sperm. It is used to trap the sperm before it reaches the uterus. A female condom consists of a thin plastic sheath with one open and one closed end.
The ends are stabilized by flexible rings. This is to prevent the tube-like female condom, which is closed on one side, from collapsing and slipping in its seat. The correct way to use the condom is to insert it into the vagina with the closed side first so deep that the cervix is covered.
Lubricant can be helpful here. The open end of the female condom protrudes from the vaginal canal and covers the outer labia.On the one hand, this guarantees easier insertion of the male genitalia and, on the other hand, prevents the condom from slipping into the vagina. After sexual intercourse, the female condom can be removed from the vagina with a twisting motion.
The rotation closes the condom, preventing sperm from escaping. When used properly, the female condom, like the condom for men, is a fairly safe contraceptive method. It can also prevent the transmission of sexually transmitted diseases.
The correct placement of the female condom in front of the cervix is important for the safety of the contraceptive method, which is why its use requires some practice. The application and mode of action of the copper chain, trade name Gynefix ®, is similar to the copper coil. The copper chain is also one of the intrauterine devices.
These contraceptives are small copper tubes strung together like a chain on a flexible thread. The length of the chain and the number of copper elements depends on the size of the uterus. It is usually inserted into the uterus by the gynaecologist during menstruation and is fixed there with a knot if it fits correctly.
The effect of the copper chain is based on the fact that the mobility of the sperm is reduced by the emission of copper ions, which usually causes them to disappear. This reduces the probability that the sperm are able to fertilise the egg. If fertilisation could still take place, the chain also acts as a foreign body in the uterine cavity, which makes it difficult for the egg to implant into the uterine wall.
In some cases, this mechanism is also used in emergency contraception, when the copper chain is inserted as soon as possible after unprotected sexual intercourse, thus preventing implantation. The copper chain thus has two pregnancy-preventing active principles. As a rule, the chain can remain in the body for up to five years and is removed from the uterus via the return thread after this period or earlier if desired.
As the copper chain is still a relatively new procedure, not all gynaecologists are familiar with the correct handling and are more likely to be able to insert the copper spiral. Therefore, information should be obtained beforehand about which gynaecologist in the vicinity will perform this type of procedure. The coil as a contraceptive method is available in two forms, with a distinction being made between the hormonal and the non-hormonal variant.
The coil is one of the intrauterine devices. The hormone-free method is the copper spiral: it consists of two short and one longer plastic rods, the shape of which is reminiscent of the letter T. The longer plastic rod is wrapped around the name-giving copper wire like a spiral. A return thread is also attached for later removal of the spiral.
The gynecologist inserts the copper spiral into the uterus through the cervix, usually during menstruation, in order to use the natural easy opening of the cervix during menstruation for the procedure. In the uterus, the spiral has an immobilizing effect on penetrating sperm, making it difficult for them to reach the egg. In addition, if the egg is fertilised, it is prevented from implanting in the uterus.
This is due to the fact that the coil exerts a foreign body stimulus and also represents a mechanical obstacle to implantation. The IUD can remain in the uterus for up to five years or can be removed by a doctor earlier if desired or if complications arise. In addition, the position of the copper coil should be checked at regular intervals by ultrasound examinations, usually every six months.
The temperature method is a natural form of both contraception and family planning. The woman’s fertile days are determined by means of the morning waking temperature, the so-called basal body temperature. Only those thermometers with at least two decimal places are suitable for this, as the hormonally controlled temperature changes are very small.
In addition, the measurement must be taken at the same time and in the same part of the body in order not to falsify the results. About one to two days after ovulation, the basal body temperature rises by a few tenths of a degree, at least by the value 0.2, due to the influence of the hormone progesterone.If the values remain elevated for at least three days compared to the temperature of the previous six days, the infertile phase begins in the monthly cycle and pregnancy is unlikely to occur until the beginning of the period. From the beginning of menstruation until the temperature has risen again for at least three days, either sexual intercourse should be avoided or alternative methods of contraception, such as condoms, should be used.
The temperature method can be a fairly reliable means of contraception when used correctly. However, the temperature should be recorded in writing for a few cycles to determine the individual cycle duration. During this time additional contraceptive measures are recommended.
In addition, several factors can influence the measurement result. These include: Some women combine the temperature measurement with the assessment of the cervical mucus, the so-called Billings method, to increase the safety of the contraceptive method. Both methods combined are also known as the symptothermal method.
- Alcohol consumption,
- Lack of sleep and
- Disturbed sleep patterns due to jet lag or shift work.
The billing method is a natural method of contraception and family planning. To determine the fertile days, the consistency of the cervical mucus is compared every single day, as it is subject to hormonal influences. After ovulation, the mucus becomes thicker and more viscous.
It forms a regular plug in the cervix to trap rising sperm. This is the infertile phase in which sexual intercourse is unlikely to result in pregnancy. As the mucus becomes more liquid again and reaches a “spinnable” state shortly before ovulation, i.e. it forms threads between the fingers during a spreading movement.
If the cervical mucus is thin, additional contraception should be used. On its own, the billing method is not very reliable. In combination with basal body temperature measurement, the reliability of contraception can be significantly increased.
It is then the so-called symptothermal method. Nowadays, many manufacturers offer contraception computers which, based on the measurement of body signals, can calculate when the risk of pregnancy is increased by unprotected sexual intercourse, or when the probability of this is low. The underlying principle of contraception computers is usually similar to the basal body temperature method or the symptothermal method.
This means that both the basal body temperature and, in some models, the composition of the cervical mucus are measured. However, this is not determined manually and by thermometer as in the classic application principle, but the device takes over the task independently. Some models include ovulation tests, i.e. testing the time of ovulation, in their calculations instead of the cervical mucus.
By evaluating and collating the measurement results, a cycle-dependent release of infertile days takes place, which are often shown in green on the computer, on which unprotected sexual intercourse can take place without the risk of pregnancy. Conversely, the fertile days are usually marked in red, on which either sex is not necessary or alternative contraceptive methods should be used. The Persona Contraception Monitor is one of the hormone-free contraceptive methods.
It is a set consisting of a touch screen monitor and urine measuring sticks. On the first day of your period, a new cycle is set up on the monitor, in which the time of your period is entered. In addition, the woman can independently set an individual six-hour time window in which the regular measurements are taken on the following test days.
When the device is used for the first time, more frequent measurements must be taken, usually sixteen, so that the measuring device can learn about the woman’s cycle. In the following months, eight measurements per cycle are sufficient. Days on which the measurements should be taken are shown in orange on the monitor.
The result of the measurement then determines whether unprotected sexual intercourse can or should be contracted on the day of measurement. To perform the measurement, the test strip must be held in the urine stream for three seconds or in a container filled with urine for fifteen seconds. Morning urine is most meaningful.After the test strip is saturated with urine, it is inserted into the test slot of the monitor.
This calculates the levels of the hormones estrogen and luteinizing hormone (LH). A signal is given after the analysis. The days on which unprotected sexual intercourse can take place are then marked green on the monitor, whereas the time during which additional contraceptive measures should be taken to avoid pregnancy is shown in red.
The prerequisite for safe contraception with the Persona Contraception Monitor is a regular cycle, which must not be shorter than 23 days and not longer than 35 days. In addition, the individual suitability for using the Persona Contraception Monitor should be checked beforehand by consulting a physician or obtaining product information. There are several factors that can influence the reliability of the method and should therefore be excluded beforehand.
Lea is one of the barrier methods of contraception that prevents sperm from entering the uterus and thus prevents the subsequent fertilization of the egg. The Lea contraceptive is a silicone cap of uniform size with a handle, which is inserted deep into the vagina and placed over the cervix. When used correctly, the cap is sucked into the vagina by the creation of negative pressure, which prevents the Lea contraceptive from slipping during sexual intercourse.
To increase the reliability of the method, the silicone product is coated with a spermicidal agent. In 2014 the product was taken off the German market. Contraceptive methods with a similar mode of action include the diaphragm and the FemCap®, a further development of the cervical caps formerly available.
The shape of the diaphragm is similar to a cap, as it is a round or oval spring ring covered with silicone. It is also inserted deeply into the vagina and should sit in front of the cervix, completely covering it. In contrast to the Lea contraceptive, there are several available sizes which must be adapted to the individual female anatomy in order to prevent slippage during intercourse.
It is therefore recommended to have the size adjustment carried out by a specialist. The correct use of the FemCap® also depends on the choice of the correct size. The FemCap® is a dome-shaped cap with a handle for removal after intercourse.
It is placed over the cervix and adheres there like the Lea contraceptive by means of negative pressure. Both the diaphragm and the FemCap® should always be used in conjunction with a gel which on the one hand reduces sperm motility and on the other hand forms an additional mechanical barrier. NFP stands for Natural Family Planning and comprises those methods that determine a woman’s fertile days via the body’s own signals and changes.
This knowledge can then be used either for planning pregnancy or for contraception by timing sexual intercourse to coincide with the results. On the fertile days, if contraception is desired, sexual intercourse is either avoided or additional contraception is used. One of the methods used in NRPs is the temperature method, also known as the basal body temperature method.
If this is combined with the billing method, which also belongs to the NRP and observes the composition of the cervical mucus, it is called the symptothermal method. Depending on the definition, this may also include manual palpation of the consistency of the cervix, which is subject to cyclical fluctuations. The methods of NFP can reliably prevent pregnancies if used correctly.
They offer a completely side-effect free option of anti-conception. However, some interfering factors can influence the natural rhythm of the body and thus affect the accuracy of the measured values. Furthermore, all methods of NRP require practice and should be performed over several monthly cycles before reliable results can be obtained.
Only when you know exactly what your own cycle is and how to use it correctly can you do without additional contraception for the infertile days determined. Coitus interruptus, i.e. interrupted sexual intercourse, is a very unreliable and therefore not recommendable form of contraception.In this procedure, the penis is pulled out of the vagina just before the man’s orgasm, which causes ejaculation to take place outside the vagina. Although the majority of sperm do not enter the woman’s body when this method is used correctly, small amounts of semen can be released before the actual climax and thus reach the uterus. In addition, coitus interruptus requires a good knowledge of the body and strict self-control on the part of the man to pull the penis out of the vagina at the right moment before orgasm. This may not always succeed and the semen reaches the uterus unhindered.
