TikTok Told Me…How I Learned About FABMs
By: Emmalee Sullivan, DO
Director’s Note: This patient interview conducted by Dr. Emmalee Sullivan, a former FACTS elective participant, highlights the rise in natural or fertility awareness-based methods (FABMs) use as a result of social media promotion and a growing dissatisfaction with birth control side effects. It also illustrates some challenges associated with these methods — including abstaining during the fertile window when a woman’s libido is highest. At FACTS, we remain committed to providing you with accurate, evidence-based information about the applications of these methods for family planning and the management of common reproductive health concerns. Please take a few minutes to complete this communications survey to let us know how we can best share the latest information with you. We will randomly select 5 people to receive a free CME webinar of your choice if you complete the survey by November 1st.
In recent years, natural or fertility awareness-based methods (FABMs) of family planning have gained significant traction across social media platforms. The Natural Cycles app and devices like the Oura ring are examples of the tools attracting growing numbers of women to explore FABMs. Despite this, physicians have been slow to embrace these methods, perhaps due to limited knowledge or misconceptions regarding their efficacy. However, there are strong research studies supporting the effectiveness of modern FABMs, which are proven to be suitable alternatives to hormonal methods, such as oral contraceptive pills (OCPs), intrauterine devices (IUDs), and implantable devices like the Nexplanon.
“There are strong research studies supporting the effectiveness of modern FABMs, which are proven to be suitable alternatives to hormonal methods, such as oral contraceptive pills (OCPs)”
Riley,* a 25-year-old woman, was introduced to FABMs through a TikTok video about how the Natural Cycles app could be used for pregnancy prevention. Riley had used OCPs since her freshman year of college; this was the first she had heard of a nonhormonal approach. Although she never experienced side effects with OCPs, she decided to switch to the Nexplanon device after several years. She then began to suffer from irregular and frequent bleeding, various gastrointestinal (GI) complaints, and significant weight loss. She had the Nexplanon removed a year after insertion and returned to using birth control pills. However, her GI symptoms persisted.
After learning about Natural Cycles on TikTok, Riley decided to do more research. Despite initial reservations about the complexity and time commitment that FABMs might require, she ultimately decided to try the Marquette Method. She was drawn to its dual monitoring of cervical mucus and urinary hormones.
Riley has successfully used the Marquette Method to prevent pregnancy for around six months. She said she was surprised how quickly she caught on: After just two to three cycles, it became almost second nature to check her secretions daily and use the charting system. Charting has also been an empowering experience, she said, as she feels in tune with her cycle and body. Additionally, observing and understanding her daily secretions removed some of the stigma and embarrassment regarding this unknown discharge she noticed over the years.
“She said she was surprised how quickly she caught on: after just two to three cycles, it became almost second nature to check her secretions daily and … it has also been an empowering experience.”
Still, FABMs have their challenges. Riley found that her libido peaks during her fertile window, making it more challenging to abstain from sex. On top of that, she also experienced a sense of guilt for having to abstain during this time. Lastly, Riley said she has had mixed experiences with FABM instructors. The first instructor she met with nearly discouraged her from even trying the method. In her first meeting with the instructor, Riley felt that the advantages of FABMs were presented through a religious lens rather than a scientific one, with FABMs being presented as the more ethical option compared to forms of hormonal birth control. As a former user of hormonal birth control herself, as well as a registered nurse, she felt judged because of her own prior choices. However, still interested in finding a non-hormonal option without side effects, she recommitted to learning the method with another instructor.
After successfully using the Marquette Method for pregnancy prevention, Riley is now using the method to try to achieve pregnancy. She has been trying for about three months and feels confident that she better understands many aspects of her fertility. She is also confident that if problems were to arise, her charting would allow her to work with a medical professional to manage them effectively.
“Riley’s perseverance underscores the importance of access to unbiased information and support regarding the full spectrum of options for family planning and pregnancy prevention.”
Riley’s journey exemplifies a broader shift in attitudes toward FABMs. Her dissatisfaction with hormonal contraception led her to explore alternative methods, eventually finding success and empowerment with the Marquette Method. While these natural methods do have their challenges, Riley’s perseverance underscores the importance of access to unbiased information and support regarding the full spectrum of options for family planning and pregnancy prevention. Now, as she transitions from preventing pregnancy to actively seeking it, Riley’s confidence in the Marquette Method highlights its versatility and value for comprehensive family planning. With ongoing research and advocacy, FABMs have the potential to become mainstream options for individuals like Riley, offering a holistic approach to reproductive health.
*Names have been changed to respect the privacy of the interviewee. All information is shared with permission.
ABOUT THE AUTHOR
Emmalee Sullivan, DO
Emmalee Sullivan, DO is a recent graduate of the Ohio University Heritage College of Osteopathic Medicine. She completed her undergraduate education at The College of Wooster in Wooster, Ohio. She plans to do her residency in Obstetrics and Gynecology and is interested in rural medicine. She enrolled in the FACTs elective to gain a better understanding of natural family planning methods to provide holistic options to reproductive health.
