I don’t want to take hormonal birth control. What are my options?

Women who seek non-hormonal options for birth control are frequently frustrated by their efforts to seek alternatives.

If you are looking for a birth control method that is highly effective, cheap, easy to use, side-effect and risk-free, and convenient all at once, you are likely to be disappointed, as there is no perfect contraceptive method out there. However, there are some options which come close to fitting the bill, and knowing your personal priorities can help you to land on a birth control option that feels right for you, is in alignment with your personal values, and has drawbacks you can live with.

Here is a quick overview of our favourite non-hormonal options. We have included efficacy ranges using information from the most highly regarded research to date that can be found in Contraceptive Technology (see reference at end of blog). Efficacy rates are presented as a range, with “perfect use” as the highest level, and “typical use” as the lowest level. Typical use refers to rates that include the results of a device failing (e.g., a condom breaking) or improper use of a method by the user (e.g., not leaving a diaphragm or cervical cap in for the required amount of time after sexual activity).

Condoms: Aside from protecting against STIs, condoms continue to provide one of the best non-hormonal birth control options on the market. They are relatively inexpensive, easily available, and relatively high on the effectiveness spectrum (82-98% effective). The most obvious drawbacks that couples experience are reduced sensation and inconvenience. If you run out during a moment of passion it can be rather frustrating. And since they are one-time use they are not ideal for the environment.

FemCap & Diaphragm: Barrier methods that cover a woman’s cervix are among the oldest known approaches to birth control, dating back thousands of years. Modern diaphragms and cervical caps like the FemCap are intended to work primarily as spermicide holders. Until recently, most spermicides contained toxic chemicals like nonoxyl-9. However, you can now purchase a product called Contragel for use in these products. The advantages to them are that they are reusable, don’t hinder sensation and give the woman control. The cons are that they need to be inserted prior to intercourse (which can be a challenge for spontaneity) and have lower perfect use efficacy rates than condoms (88-94%).

IUD: While the most commonly prescribed IUD these days has hormones in it (Mirena), you do have the option of requesting a copper IUD. Copper has been used as a contraceptive since Egyptian times. The advantages to the copper IUD are that it is effective, long-lasting, and convenient (once inserted it doesn’t require any “work”). It is also a more environmentally sound choice. The drawbacks to IUDs are that they can be painful to have inserted and can worsen menstrual cramps if you are already susceptible to them. They can become dislodged, puncturing the uterine walls, although this is very uncommon. IUDs can lead to spotting and irregular cycles, especially in the first six months after insertion. Despite these drawbacks, the copper IUD does provide the most effective reversible form of non-hormonal birth control (99.3%) aside from Fertility Awareness (see below) and is an extremely cost effective option ($50 for five years).

Withdrawal: While withdrawal is probably the cheapest, easiest and most commonly used birth control method worldwide, the challenge is that its efficacy depends almost entirely on a man’s level of ability to anticipate his orgasm and take action prior to ejaculation. As a result, some women are not comfortable relying on withdrawal, particularly because they have little way of knowing whether it has worked. Men who have excellent control can achieve efficacy rates as high as condoms (up to 96%) but rates can be much lower for men who don’t have high levels of control (78%).

Fertility Awareness: This is our preferred approach to birth control as it can enhance the efficacy of any of the above methods while also providing a whole host of other benefits. Because a woman is only capable of conceiving on one day of each menstrual cycle, Fertility Awareness Methods (FAM) – not to beconfused with the much less effective rhythm method, aim to teach women how to read their physiological signs of fertility in order to track her days of fertility with impeccable accuracy. When done correctly and with support, the method is 99.6% effective. At Red Tent Sisters we teach the Justisse Method of Fertility Management, which is a Canadian, pro-choice, pro-woman, body literacy approach to Fertility Awareness. FAM puts the control into women’s hands, but can also be used by couples to share the responsibility of birth control. Unlike most methods it is environmentally-friendly, body safe, and highly effective when done correctly. For information about instruction in the Justisse Method of Fertility Management please check out our signature programs or send us an email on the “Contact Us” page.

To read more about the health and environmental risks of the birth control pill and other hormonal contraceptives, we invite you to read our report “5 Reasons to ditch the pill & reclaim your health, happiness & future fertility.”

Kim & Amy Sedgwick love to discuss sex, periods, and all the other things we’re not supposed to talk about. The co-founders of Red Tent Sisters and ecosex.ca, they’ve been featured in every major Canadian news outlet and have become a trusted resource for women seeking natural (effective!) birth control, a more joyful sex life, and an empowered journey to motherhood.

Want more inspiration from the sisters? Join our mailing list for updates, articles, and special offers. Or, join the conversation on Facebook &Twitter.

*Trussell, James (2007). "Contraceptive Efficacy". In Hatcher, Robert A.; Trussell, James; Nelson, Anita L. Contraceptive Technology (19th ed.). New York: Ardent Media.