The Controversial Birth Control Method That's on the Rise

Yahoo

20-10-2024

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There's no denying the popularity of the Oura Ring — over two and a half million of these little wearables have been sold worldwide, according to the company. In fact, the Gen3 model was named the best overall smart ring by our tech experts in the Good Housekeeping Institute.
For the uninitiated, the Oura is a health and fitness tracker — just slide it on your finger, and it monitors 20 specific biometrics that affect different aspects of your health. Fans say they love that the Oura Ring and its app deliver real-time data analysis, offering an up-to-the-second snapshot of how your body is functioning. For example, the Oura app provides "readiness" and "sleep" scores, which you can check first thing in the morning to assess the quality of your rest. Throughout the day, you can also monitor stress levels, track your activity to evaluate workout performance and identify optimal moments for a mindful break.
'A bunch of my friends have gotten Oura Rings and have stopped using birth control,' one GH staffer reported. 'It's pretty concerning to me because I know they don't want babies right now.'
The trend is a big deal on TikTok and there is much discussion about it across social media. But is it a good idea? And does the Oura Ring actually work as birth control? and there are methods (including nonhormonal ones) with better success rates. The upshot is that the track record of the method women are using when they employ the Oura Ring as part of their birth control isn't great, even if it is much better than the same method practiced without the Oura Ring.
Oura partners with an outside app called Natural Cycles, which cites a 98% effectiveness rate at preventing pregnancy "with perfect use." This app, which is powered by the data Oura collects (it also works with Apple Watch and other devices), is FDA-cleared, . Natural Cycles works by "analyzing body temperature and other key fertility indicators to determine your daily fertility status." Natural Cycles' website slogan is "Birth control built around you."
While it's not known how many young women use the Oura combined with Natural Cycles as their sole form of contraception — or whether they were actually trying to conceive, rather than prevent pregnancy or are simply curious about their cycles — it is a popular feature: As of June 2024, , says Neta Gotlieb, Ph.D., a senior product manager for women's health at Oura.
That said, Gotlieb emphasizes.
How women are using it
Regardless, women are using the Oura Ring (in conjunction with the app) as their main birth control method. It works like this: People wear the ring to sleep, and during the night it measures body temperature, which varies slightly through a person's menstrual cycle. That data is then sent to the Natural Cycles app, which gives you a readout on your phone indicating your current level of fertility. If the app tells you it's a 'Green Day' according to your temperature, it indicates you aren't fertile that day. If the app says it's a 'Red Day,' you definitely need to use protection if you have sex.
What does body temperature have to do with fertility? There are slight variations in your body temperature throughout your cycle. The rise in progesterone after ovulation, for example, raises temperature, and if you take your temperature, it will show as slightly higher around this time. The idea is that if you've just ovulated, it's a fertile period (although you may also be also fertile before this time.) 'If you're experiencing a surge in the luteinizing hormone, or LH, that's when you're most likely to get pregnant," says Susan Mitchell-Derenkski, APRN, WHNP-BC, a nurse practitioner and OB/GYN specialist at Washington University School of Medicine's Contraceptive Choice Center in St. Louis.
The way Oura and Natural Cycles work together is essentially a new way to practice a fertility awareness-based method of birth control that has been around forever, and historically has not been very effective. 'Basal body temperature measurements have been used for decades to help women optimize the timing of intercourse during a fertile window,' according to an article in the National Library of Medicine at the National Institutes of Health (NIH). 'This unique methodology was also prevalent before the invention of oral contraception pills, as it aided women in an attempt to avoid fertilization during a fertile period.'
One difference between the way the Basal Body Temperature (BBT) method has been used by most women and is being used now with Oura Ring and Natural Cycles: Women have traditionally taken their temperature with an oral thermometer first thing in the morning and compared it to the previous days' measurements; this measures core (or basal) body temperature, or your temperature inside after a period of rest, rather than on the surface, as the ring on your finger does. One study found that measuring shell temperature throughout the night (as Oura Ring does) was slightly more sensitive than core temperature in detecting ovulation.
Are Oura Rings effective at predicting fertility?
The best answer we have to that is, paired with the Natural Cycles app, it is pretty likely to be accurate — but .
Let us explain: The ring itself does a great job measuring shell temperature, boasting a 99% lab accuracy rate and that using shell temperature instead of basal or core temperature provides more detail. Citing research, Oura says that shell temperature can even carry more information than core temperature due to the fact that your body serves as insulation. This means that your core temperature can only change in only a limited way. 'Your shell exhibits frequent, and more significant, changes in your skin temperature, while core changes can be more muffled,' the website states. Still, whether that extra detail helps pinpoint fertility is not clear. 'Overnight tracking is not necessarily more accurate than morning temperature tracking, but it is a convenient way to measure temperature if you are practicing the basal body temperature (BBT) method,' Gotlieb explains. 'Your basal body temperature is your body's temperature at complete rest or your lowest temperature. If you're using the BBT method to chart your fertility, you have to take your temperature first thing in the morning before getting out of bed, as moving around, talking, or even being awake for several minutes can affect your results.'
Presumably having Oura measure temperature at night and getting an average transmitted to your app means less human error, since if you forget to take it or jump out of bed to pee before taking your temperature, you still have accurate data. Plus, Natural Cycles says that their algorithm further reduces the chance of error. "The app has a unique and certified algorithm that adapts to each user's cycle, detecting the fertile window more accurately and removing a lot of the human error that comes with other FABMs," says Kerry Krauss, M.D., board-certified OB-GYN and Medical Director at Natural Cycles.
But how effective is the body temperature method?
It depends how you measure your temperature, but not as effective as other forms of birth control, and the reasons mostly boil down to the fact that nobody's perfect and the body isn't always predictable.
A big reason: The increase in body temperature happens after you've ovulated. "The most fertile days are the 2 to 3 days before this increase in temperature," The American College of Obstetrics and Gynecologists (ACOG) reports. A body temperature method "shows only when ovulation has already occurred, not when it is going to occur." Even though Natural Cycle's algorithm will adjust to your cycle when used over time, you may not be aware that you're fertile if your temperature hasn't yet gone up.
According to the ACOG, BBT results in one to five pregnancy out of one hundred in the first year,. This means you check your temperature every single morning at the same time when you wake up, compare it to previous days, and you are strict about not having sex at likely fertile times without a barrier method such as a condom. Natural Cycles cites a 98% effectiveness rate when used perfectly every time.
Many of us don't or can't practice this method perfectly. Even if you're using Oura Ring and you get your temperature reading automatically, you still have to remember to check the app to be sure it's a "green" day, which may not be the first thing on your mind in the throes of passion. It can also be really hard for some to forgo spontaneous sex even if you know it's risky. (And women in coercive sexual relationships with men may have even less control over when they have intercourse.)
These reasons mean that , according to ACOG. There are also reasons beyond your control: 'What if you get sick, or you become dehydrated?' says Mitchell-Derenski. 'Your temperature can be affected by these things.' Stress, smoking, drinking alcohol, having jet lag or even using an electric blanket can cause temperature changes that could throw off your result, according to Planned Parenthood.
The Natural Cycles app is better: It has been found to be 93% effective when practiced "typically," a.k.a. imperfectly. The reason it is more accurate, says Dr. Krauss, is that the algorithm becomes more accurate as it learns from your data over time, and that it errs on the side of caution. "For example, the algorithm will exclude a temperature if it detects a significant change," she says, perhaps from a night of drinking or a fever, so it doesn't factor in to the app's fertility conclusion. "It will also always err on the side of caution and give users a Red Day," indicating fertility when the data isn't clear. Because Oura also measures heart rate, says Dr. Krauss, the finding of an abnormally high heart rate, along with a higher temperature, may indicate that there are other reasons besides ovulation causing your higher body temperature.
That said, some studies have predicted that basal body temperature is only about 22% accurate in detecting ovulation. And while that one study found that using shell temperature might be slightly more accurate, we don't know how that affects the outcome. (By contrast, an IUD or implant result in less than 1% of women getting pregnant in a year.) An independent study from Sweden and Norway, found that the data Natural Cycles provides its users is sometimes not enough to prevent pregnancy, because, again, a woman has to use the app perfectly, and her timing of intercourse must also be perfect.
Lastly, it's women with very predictable cycles who do best with cycle tracking methods, she says. If you don't, it is much harder to predict ovulation.
That's what Olivia Lipski, the Good Housekeeping Institute's senior reviews writer and analyst, did in her use of the Oura Ring for almost three years. She used it initially for help growing her family, not to avoid pregnancy. 'I quickly realized how useful the ring could be,' says Lipski. 'I started digging into my Cycle Insights to get a better understanding of which phase of my cycle I was in that month, and then I paid much closer attention to the ring's body temperature tracking."
Lipski also used a separate period tracking app. "That information paired with insights into my body temperature allowed me to figure out exactly when I had ovulated — when I noticed the spike in temperature between my follicular and luteal phase that indicated ovulation had occurred, I knew I was likely fertile even if the Oura Ring didn't spell it out for me specifically,' she explains. By continuing to track her temperature after ovulation, Lipski had a happy non-surprise. 'Long story short, I knew I was pregnant before I even took a pregnancy test thanks to my Oura Ring," she says.
'You need to say, 'This is the method we are using.' Your partner must be involved in the process,' stresses Mitchell-Derenski. If you like your spontaneity and/or you and your partner want to have sex all the time, you're better off with a standard birth control method so there's no need to skip days.
This is where you check your vagina for clear mucus secretions every day after your period stops, and only have sex when you see no mucus. 'Checking for mucus can make using an Oura Ring more accurate,' says Mitchell-Derenski,
Using the Oura Ring along with Natural Cycles is not a failsafe, and to be fair, neither are some other methods (nine percent of women on the Pill will get pregnant in a year, for instance, according to ACOG, in part because they also don't use it perfectly).
To be clear, , including an IUD or an implant. In areas where access to an abortion is restricted, using only a body temperature method for birth control, unless you want a baby, can result in dire consequences.
The best thing you can do is have a chat with your healthcare provider before using any fertility tracking method.
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