People have been trying to prevent pregnancies since the beginning of humanity, using techniques like animal bladders as condoms and seeds as oral contraception. Methods have evolved in more recent years and with the emergence of technology into most of our daily tasks, it’s no shocker that companies are finding ways to infiltrate reproductive health spaces.

The Oura Ring first emerged on the market as a health and fitness tool, similar to an Apple Watch. It tracks heart rate, activity level and other determinants of health like sleep patterns through a compact and sleek piece of jewelry.

In partnership with the first FDA-approved birth control app Natural Cycles, Oura now says it can be used as a non-hormonal, natural birth control option.

This ring is a lot smaller and less invasive than traditional methods of birth control, like the NuvaRing. Can wearing it on your finger really prevent you from getting pregnant?

Oura offers one non-hormonal approach to birth control

Oral contraception, or the pill, gained FDA-approval and hit the market in the 1960′s. It is the most popular form of birth control today, after sterilization, with 25% of U.S. women between the ages of 15 to 44 on the pill.

Fertility awareness, or natural family planning, is a class of methods that use fertility signals from your body to either prevent or plan pregnancy. This can include measuring your basal body temperature, which increases slightly during ovulation, recording patterns in cervical mucus texture, and tracking your menstrual cycle to predict fertile days. Some methods combine multiple techniques, like the symptothermal method which combines basal body temperature and cervical mucus tracking, also using a hormonal fertility monitor to detect hormones in urine.

“It’s actually using two or three different signs and symptoms to make decisions. And what we find is that the more signs and symptoms that somebody is accounting for, usually there’s higher accuracy in how effective the methods are,” said Dr. Rachel Simmons, research assistant professor in the Department of Obstetrics and Gynecology at the University of Utah.

Additional estrogen or progesterone in the body is not an ideal option for everyone. Some common side effects associated with hormonal contraception are headaches, nausea, mood swings, spotting, vaginal yeast infections and more.

“I’ve never personally had a client report not having side effects during their time on hormonal birth control,” said Chanana McGarry, Fertility Awareness and Holistic Sexual Educator Womb Literacy in Mesa, AZ.

McGarry herself has never taken hormonal birth control, relying on barrier methods. She says she decided to pursue fertility awareness methods as a means to align with her holistic lifestyle.

“After having two unplanned pregnancies, I decided I needed something highly effective, that was also eco-friendly and free of side effects,” said McGarry.

The ease at which someone can incorporate these types of methods into their lives really depends on a ton of different factors. Kelly Brchta, a fertility awareness educator at Embodied Cycles in Boulder, CO points to learning style, underlying health conditions, having professional guidance, and whether someone is learning with a significant or sexual partner as a few things that come into play.

“Everyone is different, so it is important to consider your unique needs in order to feel supported incorporating a fertility awareness-based method into daily life,” said Brchta.

How Oura works

The ring measures basal body temperature through the skin, “every single minute,” according to the Oura. Traditionally, body basal temperature would be taken through the mouth, vaginally or rectally. Dr. Simmons says that there are a lot of limitations to this because factors like not getting enough sleep or not measuring consistently can provide inaccurate numbers. Wearables, like a ring or watch cut down on human error.

“They are able to take your basal body temperature without you needing to do anything. It takes it for you relatively accurately, and you don’t need to remember anything, it will automatically log it for you,” she explained.

While the temperature you receive from inside the mouth versus the skin’s surface could be a very different number, it’s the slight drops and rises in temperature that indicate fertility.

“You’re looking for a change in the temperature and both of them [wearables and traditional thermometers] can do that. So the Oura Ring can identify that shift from your follicular phase to your luteal phase that signals that you’ve ovulated,” said Dr. Simmons.

The information is then synced to the Natural Cycles app. The app uses information input like period patterns, past hormonal contraception usage and other input into its algorithm to calculate the user’s fertility window, assigning red, or fertile days, and green, non-fertile days, in which no additional protection is needed to prevent pregnancy.

The price of modernized birth control

Fertility awareness, or natural family planning, is typically inexpensive, requiring no prescription, medication or monthly cost. It only requires the one-time cost of a thermometer.

The Oura Ring itself starts at $299 depending on the style and color. The Horizon ring in the rose gold finish is the most expensive option, sitting at $549. Users must then pay a monthly membership fee of $5.99 which Oura says includes sleep analysis, personalized health insights, heart rate and temperature monitoring.

To pair with the Natural Cycles app, users must subscribe to a $14.99 monthly subscription or $119.99 annual fee.

Femtech is breaking barriers to healthcare, but it has its limitations

Femtech refers to tech-enabled consumer products that address women’s issues including maternal health, menstrual health, fertility and more. Apps like Flo period tracking app which caught fire for sharing users’ data with Facebook and Google, or Emm, the smart menstrual cup which tracks flow rate and period length to your phone, would fall under this category.

It is a gender-focused niche, in a male-dominated industry – which based on science – may be key in improving how women access healthcare.

The American medical field has been criticized for failing women. From misdiagnosing heart conditions in women to skyrocketing maternal mortality rates, women have worse health outcomes.

“Modern medicine was developed with the male anatomy as the default, shaping how doctors treat patients and resulting in misrepresentation of women in clinical trials,” said Sasha Pines, co-founder of Aspire to Her during a March 2023 LOWkeynotes presentation at Stanford Graduate School of Business.

Femtech aims to break these barriers by allowing women to care for themselves, self-managing things like temperature checks and symptom tracking then placing it in an app that stores and analyzes the data.

Some companies even cater specifically to marginalized groups like Folx Health, a gender-affirming care provider that celebrates diverse identities and Kasha, an e-commerce delivery service that brings pharmaceuticals and health products to low-income communities in Rwanda and Kenya.

The industry is estimated to be worth $1 trillion by 2027.

“One of the big valuable things that I think about femtech is that it’s answering a demand that traditional contraceptive development wasn’t answering,” said Dr. Simmons.

There aren’t many non-hormonal contraception options on the market. Leaving those forgoing “the pill,” limited options to protect against unwanted pregnancies. The Los Angeles Times reported that doctors in Arizona, North Carolina and Florida have all reported an increase in the number of sterilizations after the Dobbs decision.

“I also feel like some of the benefits to femtech is it’s kind of de-stigmatized women’s reproductive health,” said Dr. Simmons. “By integrating it into activity trackers and all of these other mechanisms, it just makes it a normal part of understanding your body and body literacy becomes kind of this norm and people can only benefit, really from having more information about what’s going on with them.”

Last year, period tracking apps Flo had 43 million active users, and Clue 12 million. These apps store intimate details and insight into their users’ reproductive health, raising privacy concerns as this information could be used to suggest whether or not someone had an abortion, according to NPR.

Dr. Simmons says that apps should provide be transparent about how they’re using data, with terms and conditions housed in the app, using language that is easy to understand

“If you can’t find that, that’s a bad sign,” said Dr. Simmons.

In McGarry’s practice, she’s found that apps are not always the most reliable, citing that illness or travel can delay or change ovulation.

“I do not personally recommend apps to my clients, even those with regular periods or those trying to conceive,” said McGarry. “No matter how advanced the algorithms are, they can never account fully for unexpected real life scenarios that can impact your cycle.”

Brichta says that she meets her clients where they’re at, because no cycle or method is one-size-fits-all.

“My aim is to meet people where they are at and find the method that works best for them. Sometimes, this involves recommending the use of apps and newer technology. Other times it means keeping it simple with a thermometer and paper charts.”