Alice Greczyn

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What Works For My Body, Part Two: Birth Control

Disclaimers: As I said in my other post on birth control, I recognize that not all women use hormonal contraceptives exclusively to prevent pregnancy. Some women are on the pill for other reasons, like endometriosis and anemia, and I don't endorse ceasing to take any necessary medications without the advice of your doctor. The post you’re about to read is meant to address the women—and men—who are only looking to avoid pregnancy. The method I describe below is not a condom substitute to prevent STDs. Finally, this method probably works best in a sexually monogamous relationship.

The last time I blogged about this topic, I wrote about the various forms of contraception out there and how I was trying to find alternatives to hormonal birth control. The hormones in various birth control pills—and in their cousins, the shot, the ring, and the patch—have never agreed with my body. I was comforted to find that I wasn't alone. A lot of you ladies have experienced the same horrible side effects I did, and worse. Strides are being made in male contraceptives, but these are not yet available outside of clinical trials. Even if they were, I personally couldn’t ask my partner to tamper with his body’s hormone levels any more than I’ve wanted to tamper with mine. These limitations leave many of us searching for an effective, hormone-free way to be able to have sex without having a baby. I’ve found a method that has been working for me and I’m pleased to share it with you.

My current method of birth control, which I have been using successfully for the past two years, boils down to ovulation tracking and withdrawal. Before I get into exactly how I track my ovulation, bear with me through a little sex-ed refresher...

A woman can’t get pregnant until she ovulates. Ovulation occurs when one of her ovaries releases an egg to be fertilized, and this usually happens once a month, about halfway through her menstrual cycle. The egg, once released, has a lifespan of 12-24 hours. As we all hopefully know by now, this egg can only turn into an embryo if it's fertilized by a man's sperm. Sperm can live inside a woman's cervix, uterus, and fallopian tubes for 5-6 days. This means that if a woman has sex on, say, May 1st, and her partner ejaculates in her, she could still become pregnant if she ovulates on May 7th—even if she doesn't have sex again during that six day window. Therefore, she may be considered fertile from May 1st - May 8th.

Still with me? A woman can track her ovulation for birth control purposes and avoid intercourse during the week that she is fertile, or use condoms that week if she does have sex. Keep in mind that even if a man pulls out, there can still be sperm in his pre-cum. We all hear that pregnancy by pre-cum is rare, but ask yourself if it's worth the risk. Since many women don’t have clockwork-like periods (myself included), diligent steps need to be taken to ensure when exactly a woman is ovulating if she is to use ovulation tracking as a method to prevent pregnancy.

I started with the symptothermal method. The symptothermal method is a classic way to naturally monitor one’s fertility, but it’s not easy. I tried it for a while, but it was hard to remember to take my temperature every day immediately upon waking (a woman’s temperature rises a couple of decimal notches right after ovulation, best verified before she even sits up in her bed). I analyzed my cervical mucus/discharge, but it was too messy and too laborious for my time-pressed life (vaginal secretions should be clear and stretchy when ovulation occurs, like a raw egg white). I also tried to feel the position of my cervix with my finger, but I couldn’t gauge its subtle shifts in a way that I found definitive (as a woman’s body prepares for ovulation, her cervix opens upward and becomes softer, then firms and drops when she’s nearing her period).

I looked into a slew of fertility tracking monitors, but all of them were extremely pricey. Then I remembered that I live in the modern age of apps. I found a free app on my iPhone called Pink Pad that helped me keep track of my symptoms ranging from my mood to the tenderness of my breasts. This app became essential to me.

With practice and education, I gained an animal-like awareness of my fertility. I can now feel the slightest twinges of my ovaries when they release an egg, and I notice changes throughout my cycle that manifest from my wardrobe (women are known to dress more provocatively around ovulation) to my voice (women unconsciously tend to use a higher pitch when they ovulate, as it sounds more feminine and therefore more attractive to a potential mate).

But I’m a science gal. I like to see technology validating my observations.

Clearblue Ovulation Test

Insert the Clearblue Digital Ovulation Test. You can find it in the feminine care aisle of any drug store, next to the pregnancy tests. Like a pregnancy test, it involves peeing on a stick. Unlike a pregnancy test, which detects human chorionic gonadotropin (hCG), the hormone indicative of pregnancy, an ovulation test picks up on a different hormone in the urine called lutropin (LH), which is released 24-36 hours before a woman ovulates. I first found these nifty test sticks at Target, but they’re cheaper to buy on Amazon--$30 for a month or two's supply, which is about the same price for a monthly NuvaRing.

Now that I’ve given you a brief history of my fertility schooling, here’s what I do…

Smiley = Fertile

Blank circle = Not Fertile

After the last day of my period, I pee on one of the test sticks every morning (when urine is the most concentrated) until it reads positive for the month. When the result is positive, usually two to three weeks after my last period ended, there will be a smiley face in the digital window. This means that I am officially fertile. (These tests are marketed to women who want to have a baby, so the smiley face is supposed to tell you, “Go find your partner and have sex now!”) When the test result is negative, which is the rest of the time, there will be a blank circle in the digital window. This means that my body isn't quite near ovulation yet. I keep peeing on these sticks once a day until the result is positive. Then I know I'm ovulating at some point in the next 36 hours, and I know that I should avoid condom-less sex for the next five days. I don't need to pee on any more sticks until I finish my next period.

Now remember: sperm can live inside a woman for up to six days. The digital ovulation test only give you a one to three day heads up. I don't like to do math, either. That's where the Pink Pad app comes in handy.

Screenshot of my Pink Pad calendar.

Instead of recording every minute detail of my fertility awareness into my Pink Pad app, now I just enter the date of a positive ovulation test result into its calendar. Pink Pad automatically tells me when my next period will be by the depiction of red droplets. Pink Pad also predicts what week I’ll be fertile in the next month if I don’t conceive, as illustrated by the day-by-day blossoming of a cartoon flower. After a few months' worth of input, this app knows my menstrual/ovulation cycle, since it does the math for me and finds my average cycle length. Ergo, during the week that the app's calendar says I'll be ovulating—regardless of whether or not my ovulation test has given me a positive result yet—I use condoms if I have sex.

I cannot emphasize enough that these test sticks and the Pink Pad app alone are not a 100% reliable form of birth control. Again, and I'm sorry to keep drilling it over and over, but it's important: sperm can live inside a woman for up to six days. The ovulation test only gives you a one-to-three-day warning. That means you could get pregnant if any sperm is inside you when you ovulate, even if the sperm is almost a week old. (I know, ew.) This is why, even if I have a regular sex partner, I never, ever let a guy ejaculate in me. And again, for additional protection, I use condoms to protect against any pre-cum if I want to have sex during the week Pink Pad tells me I’ll be ovulating.

There you have it. That’s my hormone-free method of birth control. Of course it’s not foolproof, but so far the combination of test sticks, calendar tracking, withdrawal, and weeklong condom use once a month has been working for me.

I must say, I wouldn't advise this method to every woman. It takes a lot of discipline, bodily awareness, and a trustworthy partner(s). The latter is of utmost importance. Ladies, if you’re not taking a hormonal contraceptive and/or you are not using an intrauterine device (IUD); and if you are having sex with a man who has anything less than excellent self-control, use a condom. Obviously don't continue to sleep with anyone who doesn't respect you enough to pull out. (See the movie Blue Valentine to watch why. Plus, it's got Ryan Gosling.) Know yourself, and encourage your partner to know himself. I think if one doesn't have the self-awareness, time, or means necessary to track one's ovulation, condoms and/or synthetic hormones are the best way to go. That said, I encourage all girls to begin learning to track their ovulation as soon as they get their periods. Hopefully the next generation will be less inclined to go the hormonal birth control route, which means fewer women will have to battle the crazy cons that go with it.

Part Three: UTIs. Fun!