Hormone Free Birth Control Basics

Photo by Amy Shamblen on Unsplash

Ah, hormonal birth control, such a contentious topic for such a small pill. It can help prevent pregnancy, regulate periods, and improve symptoms of hormonal imbalance.

It’s a useful tool, when used correctly and with understanding.

However, you’d be forgiven for thinking The Pill was actually called Google, because it sure has taken over the birth control game.



Hormonal Birth Control’s Rise to Stardom

Since the maiden voyage of the first hormonal birth control pill in the 1960’s, Enovid, the little white pills have dominated the birth control marketplace. It was the brainchild of Margaret Sanger, who was also the continuous driving force behind its physical creation and distribution. She wanted to empower women, and provide them with the ability to take charge of their own lives.

Hormonal birth control has saved countless lives, and liberated an entire generation of women and their descendants. What was once considered impossible for women, is now possible. It’s not all sunshine and daisies when it comes to hormonal birth control, it does have some pretty serious side effects, potential complications, and serious contraindications with other medications.

The Pill is still a medication, but it’s become so commonplace that it’s barely treated as one anymore. Taking any medication that you don’t fully understand is risky, more so if you’re taking it daily, sometimes for years without pause. Prescribing physicians rarely explain the full breadth of hormonal birth controls inherent risks. Pushing their patients out of the driver’s seat of their own bodies.


So while there are a variety of different methods of hormonal birth control, there are also non-hormonal methods available. It’s important to do your own research, be mindful of your personal circumstances, and choose what will work best for you. There is no one-size-fits-all when it comes to birth control. So what are the other options?


Fertility Awareness Method

Don’t confuse it with the ‘rhythm’ or ‘calender’ method of our crafty foremothers, this method is a lot more scientific. The Fertility Awareness Method (FAM)  relies on educating yourself about your body’s natural menstrual cycle, and avoiding ‘risky’ intercourse during your fertile window.

There are at least 10 different types of this method, but most rely on skills like tracking your Basal Body Temperature (BBT), cervical fluids, and the cervix itself. Some FAM methods use a combination of these fertility indicators, and some rely on just one factor. This method requires discipline, dedication, and a desire to learn about your body.


Use back up methods or abstinence around the fertile window to help avoid the risk of pregnancy. Sometimes the withdrawal method is used in conjunction with FAM. Efficacy rates very widely and are disagreed upon, as there is limited reliable testing being carried out. Reported rates are between 79-98% efficacy, and the difference between ‘typical’ and ‘perfect’ use is a big variable for this one.

When first hearing the efficacy rates of FAM, some of my clients are shocked. However, I like to remind them that the external condom is actually only 85% effective. FAM provides no STI protection, so other methods need to be used in conjunction if this is a concern.


Copper IUD

The copper IUD is a small device inserted into your uterus through your cervical opening. It can last up to 12 years and is 99%  effective. Their efficacy rate is also increased by the elimination of user error, as there is no participation from the user. Once placed, it can remain there untouched. The copper ions damage and kill sperm, so it essentially works as an internal spermicide. It also thickens the cervical fluid which helps prevent implantation on the off chance one rogue spermy boi managed to make it through.


As with all things that sound too good to be true, this is not a perfect method of birth control. You may get heavier and longer periods, which may or may not improve. Your period could disappear altogether. It also has a small risk of migrating and puncturing your uterus, which can end in an emergency hysterectomy in some cases.

Other side effects can include pelvic inflammatory disease, backache, pain during sex, fatigue, nausea, depression, irritability, cravings, mood swings, brain fog, and others. There are also concerns for potential copper toxicity. However, studies so far are either inconclusive or contradictory. As with any of the ‘newer’ methods of birth control, there just aren’t comprehensive enough studies on the long term effect. It also offers no STI protection, so you may want to use a barrier method.



The good old classic, a rubber, no glove no love, the helmet. Whatever you like to call it, the external condom is a staple for a reason. It’s the only non-hormonal birth control that reduces the risk of obtaining or spreading STI’s. Condoms can be made from latex (rubber), plastic (polyurethane, nitrile, or polyisoprene) or lambskin. It’s important to know that lambskin don’t offer any STI protection.

Condoms are 85% effective with typical use, and are a great tool as each party can visually confirm they are being used. They require a little know-how with how to put them on, but other than that, they are a fairly low maintenance method.

Internal condoms are very similar in material, they also offer some STI protection, and they have a 79% efficacy rate with perfect use. They provide vagina owners with the ability to take charge of their contraceptive in the heat of the moment.



Diaphragms are like shallow little cups made of soft silicone. They can be inserted into a vagina to cover the cervix, providing a barrier between a Romeo sperm and a Juliet egg. Most commonly combined with spermicide, and are 88% effective with typical use. They offer no protection against STI’s, and you must remember to use it every time.

They can take some getting used to, they must be fitted correctly, and some people have an adverse reaction to spermicide.


Cervical Cap

The Cervical Cap is pretty similar to the diaphragm. They are both made from soft silicone, but the cervical cap has a more rounded shape and is smaller. You can leave a cervical cap in longer than you can leave a diaphragm in, but are only 71-86% effective with typical use. 



Spermicide comes in a few different presentations: gel, cream, film, foam, and suppositories, so they have good variance and you can pick which works best for you. It’s a chemical that both blocks the cervical entrance and slows sperm down. So even if they get past the spermicide, they are hopefully too lethargic to reach their destination.


Use spermicide by itself, or combine it with other birth control methods. It affords no STI protection, so use condoms as well, if that’s a concern. Spermicide is 71% effective, but is boosted when combined with other methods such as condoms and the pull-out method. For some people, it can cause irritation to the tender tissues of the reproductive organs. This is not only uncomfortable, but also provides an increase in the risk of contracting HIV and other STI’s.


Withdrawal (Pull Out Method)

While this method works best when combined with other tools like FAM or condoms, it also works solo by keeping semen away from the cervix. It requires a high level of self-control and self-awareness from the penis owner. The pull-out method does not protect again STI’s, and is 78% effective. This useful tool is best combined with other methods, particularly because of its high user error risks.

Pull out method also requires the vagina owner to have a large amount of trust in the penis owner. It’s important to not just pull the penis out before ejaculation, but also to ejaculate away from the vulva. Semen are might little folks, and pregnancy can happen from even the tiniest bit of ejaculate.



The number one most effective form of hormone-free birth control, coming in at 100% efficacy. A little challenging if you like to have sex though, and we sure do like it!




Nope, don’t even get me started with this one. Its efficacy is based solely on your age and fertility factors. Vagina owners under thirty will have a roughly 20% efficacy in avoiding pregnancy, those in their thirties will have 40-50% efficacy. Once you get to your forties this method improves to 70% and upwards in efficacy. It’s important to note the efficacy of this is only defined by how fertile you and your partner are, not the method itself.



So which is the right birth control for you? That’s up to you to decide. Hopefully, this article helps you dip your toes into the world of non-hormonal birth control, but it’s up to you to figure out what works best for you.

Isabella Frappier is an Australian writer and a holistic Sexuality Doula, who specializes in body literacy and sexual sovereignty. She is also a host on the popular new Sex Magic Podcast. When she’s not busy championing her sex-positive agenda, she—oh wait—she’s always busy doing that. Follow her adventures on Instagram.
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