Although she and husband, David, 26, would dearly love children one day, they are not quite ready yet. Instead, Emma is one of a soaring number of British women using a smartphone app as her main method of birth control, resolutely turning her back on the Pill and other hormonal contraception.
When Emma Everard wakes each morning, she reaches for her thermometer and takes her temperature. Thirty seconds later, the 23-year-old meticulously logs the result on her phone and continues with her day.
It may sound odd, but thousands of women struggling to conceive will be familiar with the ritual – body temperature rises by up to one degree just after ovulation, so tracking it offers a guide to when you might be likely to become pregnant. Emma, though, is doing it for the opposite reason.
‘I’d been on two types of Pill since I was 14 because I had really painful periods. While they helped with those, I was becoming increasingly concerned about putting artificial hormones in my body,’ says Emma, a professional musician who lives with David, a patent attorney, in East Hampshire.
Emma Everard, 23, began using an app on her smartphone as natural birth control after getting married earlier this year
‘My concerns began when I was 20, taking Yasmin [a newer so-called ‘third generation’ brand of Pill], and I developed really bad bruising on my legs. At that time, there was a lot of fear that Yasmin could cause blood clots, of which a symptom could be bruising. It looked as though I’d been beaten up, but my contraceptive nurse was blasé and said there was no link with the Pill. Even so, I switched to another brand, and the bruising cleared up.
‘More recently, my husband, who is finishing off a PhD in cardiovascular science alongside his day job, questioned whether it was sensible for me to be using it long-term. He’s read all the stories about the Pill having links with depression and breast cancer, but he also reads and understands the science behind them.
We had several debates about what the Pill might be doing to my body, whether it was affecting my mood or dampening my libido. The truth was we simply didn’t know because I’d been taking it for so long, but it was a concern.
‘After we married in May, I went online and did some research into fertility apps. I found one called Natural Cycles which we started using in July, and I came off the Pill. I have to log my temperature at the same time every morning, and the app will tell me if it’s a ‘red’ day, which means I could get pregnant, or a ‘green’ day, which means it’s safe.’
Women can get pregnant on a maximum of six days in any one monthly cycle. These are ‘fertile days’ around the time of ovulation, when an egg is released. During the menstrual cycle, your temperature rises and falls slightly as your hormones shift. By logging your temperature in the app, it can detect where you are in your cycle, when you will be ovulating and so which days you must avoid unprotected sex.
Emma adds: ‘I admit I’m slightly terrified that if I’m not consistent with the readings – being two hours out can apparently affect it – then I might get pregnant.
Eve Greenow, 23, stopped using the pill four years ago after side effects left her hospitalised
‘But I’m so much happier now I’m not putting hormones in my body. This feels so much more natural.’
Emma is not alone. Official NHS figures reveal that between 2011 and 2015, the number of women in England taking the Pill fell by almost a quarter, with many turning to fertility apps as an alternative. It follows similar NHS figures this year which showed that uptake of user-dependent contraception, including the Pill, dropped by more than 13 per cent in the decade up to 2015.
So what has happened? When the Pill arrived in Britain in 1961, it heralded the liberation of women from the fear of unwanted pregnancy. Early generations of women were only too happy to take it unquestioningly. But millennial women – those born between roughly 1982 and 1996 – appear to feel very differently.
Doctors don’t seem willing to tell you about all the terrible side-effects – Eve Greenow
Hollie Grigg Spall spent seven years researching and writing about the emotional and psychological side-effects of hormonal birth control for her book, Sweetening The Pill: Or How We Got Hooked On Hormonal Birth Control. She believes there are a number of reasons why younger women are less likely to pop the Pill.
‘The young women I speak to are often choosing apps and technology to control their fertility because they want more natural methods of contraception,’ she says.
‘This generation generally starts the Pill earlier than previous ones. By the time they’re in their early 20s, they have probably already been offered several types of Pill, the implant and so on. The dip in uptake is hardly surprising when you consider the sheer number of women who experience side-effects such as depression and low sex-drive. Many come about because of long-term use – vitamin deficiencies and hormonal imbalances that show up after years on the Pill.
‘Women want to be rid of these side-effects. They’re also more aware in general of what they’re putting into and on their bodies, from beauty products to food.’
Eve Greenow, a 23-year-old marketing manager and blogger from South London, gave up on the Pill four years ago because of horrendous side-effects that at one point saw her hospitalised.
May Hart, 33, advises women on contraceptives daily as part of her job. She encouraged her husband to have a vasectomy to avoid taking artificial hormones
‘I refuse ever to go back on hormonal contraceptives after what happened to me,’ says Eve, who is single after a recent break-up.
‘I know the Pill can work for lots of women, but it can turn the rest of us into monsters. Yet doctors don’t seem willing to tell you about all the terrible side-effects.
‘I started on the Pill when I was 17 and was reassured because I was put on the same brand my mother had used for 15 years without any problems. In fact, when I started feeling depressed, she encouraged me to persevere with the Pill because she thought I needed to give it more time.
‘Her generation used to take the Pill without questioning what it was doing to their bodies. My generation is less willing to do that.
‘But at the time, I was young and naïve and didn’t know what to ask. I turned from a happy confident person to someone who was crying all the time. My libido vanished. At 18, I told the GP I was unhappy and they put me on a different brand, but my depression got so bad I didn’t want to leave the house. I’d always been slim but piled on about 4st.’
Annelies Paris, 20, uses condoms as she believes you should keep your body as natural as possible
Eve was prescribed another Pill brand, Marvelon, but she says this made her vision blurry and gave her headaches.
Her GP then prescribed Cerazette, which contains only progesterone [most Pills contains both oestrogen and progesterone], but Eve found the side-effects even worse.
‘At one point, the headaches were so bad that I stopped taking the Pill altogether,’ she recalls. ‘I woke up with the most excruciating pain in my head and my left side had gone numb. I thought I was having a stroke. I was whisked to hospital where I was told I was having ophthalmic migraines – a type of migraine that can also cause visual disturbances.
‘I saw a neurologist, who said the hormone imbalance from changing my Pill so often had caused the problems.
‘It was really distressing. I remember once shopping in the supermarket and suddenly I couldn’t use my arm. The side of my face went numb and I couldn’t see. I had a massive panic attack because of it. I was terrified that it might happen to me when I was driving.
Emma Everard uses the Natural Cycles app to track her fertility as natural contraception
‘When I got back to university and went to see my GP, he asked me what contraceptive I was now on. When I said “nothing”, he said “Well, let’s put you on the Pill”. I burst into tears and walked out of the room. What shocked me most throughout all of this is that I was only ever offered Pill after Pill after Pill, never an alternative.’
Consultant obstetrician and gynaecologist Shazia Malik understands why so many women are turning their backs on the Pill. But she urges them to think twice before they do so. ‘There are benefits to taking the Pill.
‘It’s effective for alleviating painful periods and is fantastic for women who suffer from debilitating endometriosis. It has been proven to protect against bowel, ovarian and endometrial cancers and of course, it’s very effective as a contraceptive,’ she says.
‘It’s worth remembering that there are many different types of Pill and if one particular brand isn’t working for you, it’s imperative that you discuss it with your doctor as there are so many other alternatives. Apps do work, but they’re only as good as the people using them. I would only recommend them for women who are very aware of their own bodies, who are meticulous about following the app’s instructions and who wouldn’t be devastated about a surprise pregnancy.’
May Hart (pictured right with her husband) says she suffered from migraines, weight gain and bleeding whilst using some methods of contraception
However, many women remain unconvinced about the Pill’s benefits. Student and blogger Annelies Paris, 20, has been with her boyfriend, Fraser Donnelly, 21, also a student, for nearly four years, but has never used any form of hormonal contraception.
‘I wouldn’t say I’m particularly health-conscious, but I do believe that you should try to keep your body as natural as possible,’ says Annalies, from Bournemouth.
‘When I was younger, I had acne and my parents suggested the Pill might help. But I’d heard too many horror stories about it causing weight gain or making you irritable and moody. I don’t drink or smoke, and I try not to take painkillers, so I’d never consider taking something full of artificial hormones every day.
‘We’ll continue using condoms until we get to the point where we want to start a family, ideally in our mid-20s.’
May Hart, a 33-year-old nurse, specialises in contraception and sexual health and hands out advice daily to women about all different types of birth control, including the Pill.
Yet the mother-of-three reached a point where she is no longer comfortable putting hormones in her own body. As a result, she encouraged her husband Alex, 34, a landscape gardener, to have a vasectomy.
Eve Greenow (pictured left with her boyfriend) says she lost nearly 4st after she stopped using the pill
‘I’ve used several types of Pill and the contraceptive injection and implant, and while I’ve been fine on some, I’ve suffered side-effects such as weight gain, bleeding and migraines,’ says May.
‘About nine months ago I decided I didn’t want to put more hormones into my body. I eat healthily, exercise four times a week and work hard to keep slim. I don’t want to take a contraception that might have an impact on my weight. Originally, I wanted to be sterilised but at 33, the guidelines state that sterilisation is not recommended before I have tried alternative long-acting contraceptives such as the coil. So instead Alex has had a vasectomy.’
In her professional life, May has also noticed young women going off the Pill for another reason. ‘They forget to take it. I see young women coming in every couple of months requesting the morning-after pill or a referral for an abortion. So I understand why GPs encourage longer-term birth control such as the implant, where they don’t have to remember to take a tablet.
‘But women seem more educated and are resistant to hormonal contraception. One girl told me that she “didn’t want negative things” in her body.’
For those who forget to take the Pill, an app that requires following instructions to the letter doesn’t sound a sensible idea.
But for women such as Eve Greenow, who suffered such horrendous side-effects, there’s no going back to hormones.
‘In my recent long-term relationship, I just used the app as well as condoms,’ she says. ‘When I came off the Pill, I lost nearly 4st, and although I still have panic attacks, I feel much better. I’m against putting anything chemical in my body now and that’s not unusual in my generation.
‘You have only to look at social media and all the wellness bloggers to realise we’re trying to be as natural as possible. And that doesn’t involve taking the Pill.’