Good Contraceptive Approved/Not so Good Contraceptive App Exposed--UPDATED

Yesterday the U.S. Food and Drug Administration approved a new vaginal ring that provides a year of birth control for women who use it. The method was developed by the Population Council in New York City, and I first became aware of it eight years ago. The FDA describes it this way:

Annovera is a reusable donut-shaped (ring), non-biodegradable, flexible vaginal system that is placed in the vagina for three weeks followed by one week out of the vagina, at which time women may experience a period (a withdrawal bleed). This schedule is repeated every four weeks for one year (thirteen 28-day menstrual cycles).

The efficacy and safety of Annovera were studied in three, open label clinical trials with healthy women ranging from 18 to 40 years of age. Based on the results, about two to four women out of 100 women may get pregnant during the first year they use Annovera.

That is a very good use-effectiveness rate, as you can see if you look at Table 6.2 in my book. 

On the other hand, a widely used Swedish phone app called "Natural Cycles" designed to help women avoid pregnancy through fertility awareness methods (natural family planning) is not so good, as a recent story in The Guardian points out. Indeed, it is now being investigated in the UK by the Advertising Standards Authority:

The Advertising Standards Authority has launched a formal investigation into marketing for a Swedish app that claims to be an effective method of contraception, after reports that women have become pregnant while using it. An ASA spokesman said it had received three complaints about Natural Cycles and its paid advertising on Facebook, which describes the app as highly accurate contraception that has been clinically tested. “We would require robust substantiation from any company to support such a claim,” he said.

The app was developed by two scientists from Sweden and Austria: Elina Berglund, who worked at the Cern laboratory in Geneva on the discovery of the Higgs Boson particle, and Raoul Scherwitzl. The married couple originally devised the algorithm for their own family planning, and now both work full time for the company they founded. They claim to have 600,000 users worldwide, who pay an annual subscription.

Users monitor their fertility with the app by taking their temperature each morning. It tracks the results to detect ovulation, and advises which days are safe or unsafe to have unprotected sex without the risk of conception. The app relies on users taking their temperature at around the same time every morning, and cautions: “Remember that you must always measure as soon as you wake up before you snooze, sit/get up, or check your phone.”

Like all methods of natural family planning, there is a lot of room for error--which leads to unintended pregnancies and possibly then to abortions. 

UPDATE:

CNN today published an op-ed piece by Caroline Criado Perez that gives us more background into the Natural Cycles app, and how suspicious its claims are. She argues that since getting pregnant is one of the most dangerous things a woman can do in her life, governments should make it harder to market birth control methods that aren't very effective.