“Natural” birth-control app dogged by unwanted pregnancies gets FDA approval
arstechnica.com
arstechnica.com
I understand most reporters are going to bring an existing set of political beliefs to the table, but I wish they felt a higher duty to present an objective account. (Like a judge.) This doesn't mean pretending there's no fact of the matter and all sides must be given equal time uncritically, but cooly assessing arguments is different than weaponizing the words on the page.
Personally, I would never recommend this to my minor daughter, sexual partner or frankly anyone who wants actual control in their "birth-control."
The best use case is for someone who would prefer to have like 5 kids over 20 years rather than 10 kids.
I also think people really underestimate differences in fertility at different ages. An 18 year old is way more likely to get pregnant than a 35 year old. I'd bet if a 35 year old woman was reasonably careful with natural planning, she could avoid getting pregnant until menopause, but I think there's no chance that an 18 year old with average fertility could make it to 25 without having at least one pregnancy.
Yea, and I would have agreed with that usage! Indeed, the author could have said explicitly something like "it's called "birth-control", but the inherent imprecision of the method means it's more aptly described as "birth-partial-hindrance".
And for that matter many other methods are a lot higher than many would guess
That's on par with condoms, which per Planned Parenthood have an effective annual failure rate of 15%[0]. Oddly, folks don't eye talk of condoms with suspicion.
0: https://www.plannedparenthood.org/learn/birth-control/condom...
This just shows that condoms have a UI problem.
Right, so the author is suggesting something is inaccurate about the word "natural" (in the specific sense that if you quote the word in this context, it means you are disavowing its correctness and attributing it to someone else) -- even though it's not -- simply because the author disagrees with the other persons conclusions, politics, or methods. But the author does this in a way that isn't technically disputing the word usage, so that if they are challenged they can always back track. (See "motte and bailey": slatestarcodex.com/2014/11/03/all-in-all-another-brick-in-the-motte/ ) This is a textbook example of a dark-side persuasion techniques rather than honestly engaging with arguments.
Would it be more accurate if the title were - natural “birth control” app...?
Because it is “natural”, the argument is it actually “birth control” since it doesn’t work.
source: https://academic.oup.com/humrep/article/22/5/131/2914315
The religious organizations you mention (like the couple to couple league, the largest provider of fertility awareness education in the united states) have never taught the rhythm method. The rhythm method was used before the 1950s, but we've had significantly better methods since then. In fact, the Billings method has -- in the pas at least -- been endorsed by the government of china as a way to enforce the one-child policy.
The main failure from these apps is lack of education. Most people using them have never had a formal education in them, despite such things being available. My wife and I are glad at having taken an actual course, rather than learning from an app or book. Our experience has been perfectly acceptable
Taking temp at the same part of your daily schedule, e.g., on awakening, will still show substantial variation based on just waking up earlier/later, or if something skews your sleep cycle -- and by substantial, I'm talking about >1.2°C.
Take temp at different times of day, and you're looking at >2°C normal variance between early morning low and mid-afternoon high.
Source: while training & competing at an international level, I took resting Temp/HR/BP readings 2x per day to regulate the training intensity schedule (unusual increases in resting values provided early warning for overtraining or illness, so could back off a smaller amount earlier rather than being forced to a larger rest later). What I found was that the temp numbers were extremely sensitive to the huge daily temp cycle, and that I had to constantly compensate reading that value.
It's really interesting, but unless you're very consistent and understand the daily cycle and variability, really hard to base anything on it (and I'm not even considering the F hormone cycle which is what they're apparently trying to measure).
Likewise, if I use sophisticated ML techniques to identify young students who have attention problems, but then the actual treatment is 1-on-1 tutoring (rather than, say, drugs), this is still a natural intervention. And it is reasonable to suspect that it has fewer side-effects on account of being natural, which must be traded off against it's lower effectiveness.
Personally, I generally find the distinction between natural and unnatural interventions mostly unhelpful (since there are plenty of natural ways to hurt yourself), but it's a meaningful distinction and one that can plausibly provide useful guidance to someone who is very risk adverse.
No, it specifically isn't abstinence. It's a combination of mostly non-abstinence with a window of abstinence timed with a thermometer.
A method can be called "natural" if it could successfully be practiced by cavemen. Selective abstinence based on counting days since menstruation could be called natural; cavemen could conceivably figure that out.
Needless to say, total abstinence is also natural.
The scare-quotes should actually be around the term "birth-control" since this app clearly has no solid supporting evidence from unbiased 3rd party researchers.
So it's not really birth-control, it's "birth-control."
You just end up with 6 kids instead of 18.
The temporary 'vasectomy' based on injecting a gel seems promising but needs more study and hasn't yet been approved in the US to my knowledge.
Given all this there's a reason natural methods like the rhythm method and withdrawal are still used despite lower than desirable effectiveness. People often talk like contraception is a solved problem when it's really not for many couples. Maybe this app is not as effective as would be desired but if it's improving on the unaided rhythm method it's still valuable.
Given that bodybuilders/"neurohackers" arrange for group buys of pretty complex peptides and steroids this one should be relatively easy
Since failure rates are typically stated as odds of getting pregnant within an entire year of usage, combining two methods that each have only 90% effectiveness can potentially yield an extremely high level of effectiveness: it's already unlikely that both methods will fail in the same year, but when you consider that both have to fail at the same time in the same year then the odds start to look pretty good, despite neither method being that great on its own.
These apps are popular among certain religous groups as well where sex is viewed as some sort of necessary evil solely for procreation. Something to be minimized.
The usefulness of NFP depends on your perspective. If you require a 100% childless life, you're going to see it as useless. For faithful Catholics, using NFP with random failures can mean 3-5 kids instead of 8-12 kids. That's a huge difference.
I’m not talking about some misinterpretation of Catholic views, but a view that actual people hold. No need for the indirection of trying to pin this on a label. That’s another convesation. But you are underestimating the level of sexual repression in the States.
Let alone the rest of the religious world, and even non-religious people can be puritanical about sex
Accurate fertility tracking requires multiple signals. When we were trying to get pregnant, my wife used body temperature, ferning, timing of her period, and the viscosity of her discharge all together. Combining the signals gives a remarkably clear picture, but temperature alone has a lot of noise.
Our charting tool also had a slot for logging sex, too. Most of the userbase we had contact with were actively trying to get pregnant and many had difficulty doing so. Being able to track past history allows you to phase-shift sexy time against the cycle to try and get the timing just right. I should mention that for couples who are trying to get pregnant unsuccessfully, the entire process can be extremely stressful. So while trying to shoot a perfect timing bullseye doesn't make a whole lot of sense physiologically, desperate people will try to tease out any signal they can for explaining why they can't get pregnant.
FTA:
> but 54 percent of those women dropped out within the first year,
That's not at all surprising. Rhythm method charting takes a fair amount of work and regularity that makes it something of a pain. There's also better tools for it than this app. Their target userbase seems to be couples that are both dedicated anti-contraceptionists and ~~lazy~~ less than fully vigilant.
I suspect the reality is that many users were trying it out just to learn about their own bodies, but were otherwise relying on other contraceptive methods. Once the curiosity wore off, they stopped using it.
Clinical studies have shown that Natural Cycles is 93% effective.* * Even with using the app perfectly, you can still have an unintended pregnancy. Natural Cycles is 93% effective under typical use, which means that 7 women out of 100 get pregnant during one year of use. With using the app perfectly, i.e. if you never have unprotected intercourse on red days, Natural Cycles is 99% effective, which means 1 woman out of 100 get pregnant during one year of use
Should a vocabulary memorization app require FDA approval? Memory is biological.
Quite plausibly so; if you have unusual trouble remembering even modest quantities of vocab, that could be a brain problem.
Not if you're not pregnant, unless 1) you would like some non-over-the-counter birth control method or 2) you're trying to get pregnant and it's not working as it should be (biology is failing).
It's when you introduce some means of manipulating your biological functions (either through behavioral changes or the consumption of external substances) for the sake of your health that something becomes "medical".
Your comparison breaks down: memory is a biological function, but the implements used to help one memorize stuff aren't being sold under the premise that it'll have any impact on the recipients health.
With unwanted pregnancy you have the possibility of psychological trauma and physical complications -- and as with any pregnancy, risk of death.
If we look at the app as just giving a rough idea of when one is ovulating, then it seems ridiculous to have the FDA involved. However, the FDA knows that people will be using this not purely out of curiosity in some biological attribute -- the app users will almost certainly be using it to choose when to have condom-less sex to not get pregnant. If the app is ineffective, it could do a lot of harm.
If humans had evolved in such a way that we risked severe physical and/or psychological trauma in the pursuit of expanding our vocabulary, you can safely bet the FDA would be involved there, too.
s/pregnancy //
If someone were to release an insulin measurement app that guessed your insulin by analysing selfies and wasn't reliable, then diabetics relied upon its results, it's easy to see how injury or death could occur. Birth control is a medical issue, and therefore, similarly, if an app makes claims of predicting fertility, it requires regulation to prevent unsuspecting members of the public relying upon an unreliable product.
This is in addition any normal claim of false advertising if they overstate their abilities.
For about a decade, my wife and I were fine with the lower effectiveness of the rhythm method. We were smart about it and had no issues, but if she'd gotten pregnant during that time it wouldn't have been a huge problem. In our case we based it on the date of menstruation, and giving enough of a buffer to feel comfortable. It worked. We've had two children, both of which were planned, and both of which were conceived within a month of our decision to do so.
Like most things, it's a tradeoff. We didn't want to have a child at that particular moment, but weren't willing to completely abstain to ensure that. It didn't make sense for us to use condoms, oral contraception, or an IUD at the time either for various reasons. We were willing to accept the risk, so it wasn't a problem.
This app isn't safe or effective.