Fertility AwarenessvsPill

A side-by-side comparison of two birth control methods — efficacy, cost, how they work, and who shouldn't use them.

Side-by-side comparison

Method
Fertility Awareness

Fertility Awareness

Tracking body signs like temperature and cervical mucus to identify fertile days and avoid unprotected sex then.
Pill

Pill

No non-hormonal birth control pill is FDA-approved in the US. Ormeloxifene (centchroman) is approved and used in India.
EfficacyLeast effective see details

Least effective: under 90 out of 100 people successfully prevent pregnancy per year.

Limited evidence see details

Limited evidence: no verifiable efficacy data available.

Cost$0–$100 /monthly

Insurance: Varies

Contact provider

Insurance: Varies

DurationOngoing daily trackingWeekly pill (ongoing)
ReversibilityReversibleReversible
STI ProtectionNoNo
How it works

Track basal body temperature, cervical mucus, and cycle length to identify the fertile window. Avoid unprotected sex or use backup contraception on fertile days.

Ormeloxifene (centchroman) is a selective estrogen receptor modulator (SERM) that prevents pregnancy by inhibiting implantation of a fertilized egg in the endometrium. It does not suppress ovulation and does not contain estrogen or progestin. It is not FDA-approved in the US.

PrescriptionOTC No prescription / OTCRequired Prescription required
Side effectsNone reported
  • Menstrual irregularities (delayed or altered periods; rates varied widely across studies, up to about 12%)
  • Headache
  • Nausea
  • Abdominal discomfort
  • Breast tenderness
Who shouldn't use this
  • Irregular cycles that make fertile window prediction unreliable
  • Inability to track consistently
  • Recent childbirth, breastfeeding, or perimenopause (cycles unstable)
  • Polycystic ovarian disease (PCOS)
  • Recent history of jaundice or hepatic impairment
  • Renal impairment
  • Cervical hyperplasia or chronic cervicitis
  • Pregnancy
  • Hypersensitivity to ormeloxifene

Key differences

Fertility Awareness duration: Ongoing daily tracking. Pill duration: Weekly pill (ongoing). Pill requires a prescription; Fertility Awareness does not. Fertility Awareness: costs $0–$100 monthly. Pill: Contact provider.