When considering birth control, many people typically think of the daily oral pill or the intrauterine device (IUD). Although these hormonal methods are some of the most well-known, they are just a part of the wider array of contraceptive choices. This blog will explore the evolution of "birth control" and emphasize the equally effective yet frequently overlooked non-hormonal options.
A Brief History of Birth Control
Understanding the history of contraception can provide perspective on how ideas about reproductive control have evolved and where biases and even misconceptions originated. Birth control methods have existed for millennia, shaped by cultural, scientific, and societal developments. Here are some noteworthy milestones:
Condoms: As far back as 3000 B.C., King Minos of Crete reportedly used goat bladders as a protective measure. Over centuries, condoms evolved from fish intestines and linen to vulcanized rubber (thanks to Charles Goodyear) in the 19th century and latex in the 1920s, becoming one of the modern barrier methods we recognize today (there are also non-latex and lamb skin options).
Spermicides: Ancient Egyptians used crocodile dung (I even read about elephant dung) and fermented dough around 1850 B.C. as a primitive spermicide. Aristotle later suggested ‘anointing the womb with oils, like cedar and olive, mixed with lead and frankincense as a form of contraception’. While these methods were innovative for their time, many carried significant risks. I think we can all agree that lead likely not only resulted in ineffective sperm but also potential death to the female thanks to lead poisoning (have you seen the series House of Dragon? Totally unrelated to fertility but spoiler alert the king killed himself from Iron poisoning from his own throne!)
Forced Sterilization: The history of birth control isn’t without its dark chapters. In the early 20th century, eugenics-driven sterilization laws targeted marginalized populations. By 1929, 30 U.S. states had enacted such laws, leaving a legacy of injustice in reproductive rights.
Modern Advocacy: The term “birth control” was actually coined in 1914 by public health nurse Margaret Sanger, who championed contraception as a way to empower women. She believed that “enforced motherhood is the most complete denial of a woman’s right to life and liberty,” laying the foundation for legal and accessible contraception today.
The above provide some examples of how far we've come in understanding reproductive health and highlights that we’re still evolving in our approaches today. Even with modern methods, ongoing research and education remain vital to ensure we make informed and thoughtful choices. This is why discussing the pros and cons of different birth control methods is crucial—it’s about balancing individual needs, safety, and effectiveness.
More Than Pregnancy Prevention: Why People Consider Birth Control
Before diving into non-hormonal options, let’s explore why someone might consider birth control in the first place. Yes, preventing pregnancy is a common reason. But it’s far from the only one and even that reason has layers.
We must mention that every reason on this list deserves an individualized discussion. Simply “turning off hormones” may sound straightforward, but nothing in the body operates in isolation. Your body is a connected, adaptive system, and interventions—no matter how small—have ripple effects.
Some Reasons Birth Control is Considered:
I have attempted to divide them in 3 main categories. This is not an exhaustive list.
Contraceptive Purposes
Prevention of Unintended Pregnancy
Avoiding pregnancy until ready or indefinitely.
Temporary contraception while pursuing education or career goals.
They are not in a safe environment
Spacing of Pregnancies
Allowing adequate time between pregnancies for recovery and planning.
Permanent Contraception (Long-term use)
As part of a long-term family planning strategy (e.g., IUD or sterilization)..
Medical Conditions and Management
It is important to clarify that the notion of hormonal birth control 'regulating' a menstrual cycle does not mean maintaining the communication between the brain and ovary that leads to ovulation and progesterone production.
Birth control is often prescribed to address or manage medical conditions, including:
Irregular Menstruation
HERE is a Great blog discussing abnormal menstrual cycles
Heavy Menstruation (Menorrhagia)
Reducing blood loss and anemia risk.
Painful Periods (Dysmenorrhea)
Alleviating cramps caused by excessive prostaglandin production.
Polycystic Ovary Syndrome (PCOS)
Managing irregular cycles (NOT making them regular ovulatory cycles), acne, and excess androgen-related symptoms.
Endometriosis
Reducing endometrial tissue growth and associated pain.
Hyperandrogenism (Excess Androgen Hormones)
Treating symptoms like hirsutism (excess hair: this is not a few coarse hairs on your check, upper lip, nor too much peach fuzz) or severe acne.
Uterine Fibroids
Managing heavy bleeding and pelvic pain.
Adenomyosis
Controlling heavy bleeding and uterine pain by suppressing ovulation.
Risk of Uncontrolled Bleeding in Specific Disorders
Managing conditions like von Willebrand disease or platelet dysfunctions.
Functional Hypothalamic Amenorrhea
Stimulating withdrawal bleeds in cases of amenorrhea to maintain uterine health.
Sarah wrote a GREAT blog HERE
Endometrial Cancer Risk Reduction
Progestin-containing methods may lower risks by thinning the uterine lining.
Chronic Anemia
Addressing heavy bleeding as a contributing factor.
Autoimmune Conditions
Reducing flare-ups associated with any hormonal shifts
Non-Medical or Social Reasons
Convenience
Skipping periods for personal reasons or convenience
Their friends are talking about birth control and it is now entering the conversation on if they should also start.
You may want to read THIS blog we wrote "Your Menstrual Cycle: Beyond Inconvenience"
Religious or Personal Beliefs About Family Planning
Adopting a contraception method aligned with values or life circumstances.
Sexual Freedom
Enabling intimacy without worry about unintended pregnancy.
Improving Athletic Performance
Avoid any ebb and flow that may affect mood, training or competition interference.
Workplace or Educational Commitments
Avoiding disruptions caused by severe menstrual symptoms. Which could result in missed days.
It’s crucial to recognize that not all individuals feel safe in their environments. This may be closer to home than most desire to recognize. In other regions, women's rights to autonomy are severely restricted. For these individuals, access to reliable contraception can be a lifeline, offering control over their futures.
Now that we have covered just some of the reasons that a female may open up the dialogue of birth control let’s dive into several several non-hormonal options that get forgotten about.
Non-Hormonal Contraceptive Options
Non-hormonal options have advanced significantly and can be as effective as hormonal methods when used correctly. Here are the most widely used options: (this is not an exhaustive list)
Copper IUD (Paragard)
Effectiveness: Over 99% effective.
Advantages: Long-term protection (up to 12 years) and can act as emergency contraception if inserted within five days of unprotected sex.
Considerations: May cause heavier periods initially.
Barrier Methods
Condoms (Male and Female options): Provide dual protection against pregnancy and STIs. With proper use, they are up to 98% effective.
Diaphragms and Cervical Caps: When paired with spermicide, these methods offer 86-87% effectiveness.
Fertility Awareness Methods (FAM)
Effectiveness: Ranges from 80-98%
Approach: Involves monitoring ovulation signs, such as basal body temperature (BBT) and cervical mucus, to predict fertile windows.
Here are several posts and a blog we made on just this topic
Phexxi Vaginal Gel Direct Link HERE
How It Works: Maintains an acidic vaginal pH to reduce sperm mobility.
Effectiveness: 86% with typical use.
Pros/Cons: Offers hormone-free contraception but doesn’t protect against STIs.
approved by the FDA in May 2020 and launched in the United States later that year. Its availability is currently limited to the U.S. and has not been introduced in other countries, including Canada. In the U.S., Phexxi is prescribed as a localized, non-hormonal option for contraception, particularly for women who prefer to avoid systemic hormonal birth control or for those with contraindications such as clotting disorders or certain cancers.
Phexxi is used within an hour before intercourse and works by maintaining an acidic vaginal pH, which inhibits sperm mobility. This makes it a viable alternative for women seeking flexibility and control over their contraception without hormonal side effects. However, it is not effective if applied after intercourse
Permanent Methods
Tubal Ligation/Bilateral Salpingectomy: Permanently closes or removes fallopian tubes.
Vasectomy: Blocks sperm from reaching semen. A vasectomy blocks or cuts each vas deferens tube, keeping sperm out of your semen. Sperm cells stay in your testicles and are absorbed by your body. Note: It is important to have semen retested 8-12 weeks post Vasectomy. It is “possible” to have the procedure undone. Vasectomies do not impact hormone levels, sex drive, or ability to get an erection.
The Importance of Empowering women through informed and thoughtful discussion
As you can see, the reasons for considering birth control and the options available are incredibly diverse. This underscores the importance of informed, educated discussions—not only between individuals and their healthcare providers but also within the broader scope of health coaching.
Birth control is not a one-size-fits-all solution. It is a deeply personal decision that benefits from a collaborative approach involving a supportive healthcare team, coaches, and trusted practitioners. Coaches have a unique opportunity to empower their clients by providing education, fostering meaningful dialogue, and ensuring clients feel confident exploring their options in alignment with their goals, values, and health priorities.
Creating a safe, nonjudgmental space for these conversations is pivotal. It opens the door to bigger dialogues about autonomy, body literacy, and how health decisions integrate with all aspects of life.
Understanding the full range of options—including hormonal and non-hormonal methods—enables women to make informed choices that best fit their individual needs and lifestyles. Non-hormonal options, when used correctly, can be just as reliable as hormonal ones, but selecting the right method often requires thoughtful discussions with a healthcare provider and even their trusted coach.
Ultimately, when we educate and empower women, we aren’t just making decisions about birth control—we’re fostering a culture of informed choice, mutual respect, and advocacy for whole-body health. These conversations have far-reaching implications, shaping not only immediate health decisions but also a lifetime of well-being and autonomy.