A new study published in BMJ Sexual & Reproductive Health reveals a significant shift in contraceptive practices among UK women, with a growing number moving away from traditional hormonal options, such as the Pill, in favor of fertility awareness-based methods (FABMs), also referred to as natural contraceptive methods. This change has been most pronounced over the past five years, with notable trends emerging from data provided by the British Pregnancy Advisory Service (BPAS).
The study compared two distinct periods—January to June 2018, which involved 33,495 women, and the same months in 2023, with a larger sample of 55,055 women. The results highlight an increasing use of FABMs, from just 0.4% in 2018 to 2.5% in 2023, a trend experts suggest warrants further investigation. The shift also reflects a younger demographic adopting these methods, with the average age of users dropping from nearly 30 to 27.
At the same time, the use of hormonal contraceptives has declined, with only 11% of women in 2023 reporting their use, down from 19% in 2018. This marks a stark contrast to 2010, when approximately half of women of reproductive age in the UK used the Pill, indicating a broad decline in reliance on hormonal methods.
Alongside this, the proportion of women attending BPAS who reported using no contraception at the time of conception has increased from 56% to nearly 70% over the same five-year period. The research also showed a significant drop in the use of long-acting reversible contraceptives (LARCs), such as implants, which fell from 3% to 0.6% between 2018 and 2023.
Researchers noted that this shift could be partly attributed to the increasing popularity of fertility apps and period trackers, especially those available without a prescription. While these tools offer an easy, accessible alternative, experts caution that their reliability can vary, and some may not provide comprehensive information about effective contraceptive choices.
Lead researcher Dr. Rosie McNee emphasized that the COVID-19 pandemic has played a role in restricting access to more effective contraceptive methods. “In the aftermath of the pandemic, there has been a reported difficulty in accessing primary care and sexual health services, contributing to an uptick in the use of less effective forms of contraception,” she noted.
Social media platforms, particularly TikTok, are also influencing public attitudes towards contraception. With increasing discussions around “hormone-free” methods, content creators and paid partnerships promoting fertility apps may sway women towards natural methods. However, experts like Dr. Patricia Lohr from BPAS have raised concerns about the effectiveness of these methods. “While fertility awareness methods may work well for some, they generally have higher failure rates compared to hormonal options,” she explained. The typical failure rate for FABMs can range from 2% to 23%, depending on the method and user adherence, whereas hormonal methods, such as the Pill, have a failure rate of about 7%, and long-acting options like the coil are more than 99% effective with perfect use.
Miss Meg Wilson, a consultant gynecologist, pointed out that the appeal of natural methods lies in their “no side effects” nature, with many women seeking alternatives to hormonal contraception. However, she emphasized the importance of a consistent routine and understanding the nuances of fertility tracking for these methods to be truly effective.
As the study suggests, while fertility awareness methods may appeal to a segment of the population seeking more natural, hormone-free options, they may not be the most reliable choice for everyone. Dr. Lohr and other experts call for a broader range of contraceptive options to be available, ensuring women can make informed choices based on the efficacy and practicality of each method.
Researchers conclude that more research is needed to understand the reasons behind the growing use of FABMs and the rise in abortion rates. The study underscores the necessity of providing women with clear, evidence-based information on the effectiveness of all contraceptive methods, enabling them to make choices that align with their individual needs.
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