For Those Who Have Considered Non-Hormonal Birth Control, When The Pill Isn’t Enough

Q. I have a birth control issue. I’ve gone through dozens of pills over the years and also tried the NuvaRing with no success; my usually-supercharged sex drive is always flipped on its ass, I become a mushy demon woman from hell, and the idea of being so much as touched by my s/o sounds abhorrent. It’s difficult for him to understand that he’s not at fault and frustrating because he’s”¦ well, primal, and needs to be sexed very regularly. Normally, that makes us perfect for one another, but it’s also why it makes this difficult.I’m also kind of just looking for options. I’m hoping there’s some form of birth control that won’t destroy my libido or a condom that isn’t disappointing (something that doesn’t smell nasty, is large enough for him, and allows him to feel enough where we can both climax, for instance). I thought about female condoms but I don’t know if that would be better or worse than the standard. I also have a prescription for a diaphragm that I’m about to fill to use in conjunction with spermicide/withdrawal, but that still feels dicey to me. Am I missing something? Can you offer some advice?

A. Them’s tough waters kid. I know, because about once a month, I always find myself and about three to six other women having a similar conversation. “I’m on Implanon because Yazmin made me bloated and cranky.” “I hate condoms because I feel like I’m having sex with a plastic bag, but I don’t know the person well enough to be on birth control.” “Oh my sister tried an IUD, but it embedded in her uterus and it hurt.” These are the stories of back rooms and experience: the business of being reproductive. Certainly such a power comes with its privileges and problems, but at the end of the day, I’d almost always choose what has been thrust on me in the genetic lottery.

Birth control is not the” one size fits all” option that it seems to have a reputation as being. Take my sister and myself. I cannot take hormonal birth control, though Lord knows I tried. Much like the square peg trying to force itself into the round hole, I attempted every hormonal birth control on the block, and within three months of each pill swallowed, I’d be crying hysterically, either losing or gaining ten pounds, having to worry about blood clots, and as always, my sex drive would drop to zero. Each time as I’d realize, “Oh, there’s nothing wrong with me, it is the birth control.” I’d have the second thought of, “Oh, that’s why they call it birth control,” as it seemed like the very last thing I would ever want to do in this state would be to get naked and have sex with someone. But for years, hormonal birth control was the only option, and try as I might, I never could convince a doctor to give me an IUD until I was in my mid-twenties, and it’s been smooth sailing ever since. However, on the other side of the coin, there is my sister. She has been able to take hormonal birth control without the bat of an eyelash. Maybe she would gain five pounds or so, but that was just about the only side effect she experienced. Two sisters, one gene pool, two very different spectrums of reacting to birth control. I will say it again with mighty gusto: birth control is not and never will be one size fits all.

So, what of you and your birth control situation? Condoms are meh and most hormonal pill packs put you somewhere in between the bell jar and the yellow wallpaper. Well, the good news is that Planned Parenthood is already one step ahead of me and is all about the My Method campaign. My Method emphasizes that dainty little factoid that seemed to be on repeat just a paragraph above. There is no such thing as one size fits all birth control. So what are your options other than condoms, hormonal birth control, and diaphragms?

Implanon: Implanon is a small, matchstick sized rod that is inserted into your arm to prevent pregnancy. It protects you for up to three years by releasing small amounts of progestin into your body. Progestin is a synthetic hormone that is not only used for birth control, but tends to have less side effects than estrogen. The hormonal levels are incredibly low and regulated, and since they are not absorbed directly into your body by digestion like the pill or straight into your reproductive organs like the ring, again, the side effects tend to be less extreme.The Implanon makes your cervical mucus thicker, keeps eggs from releasing once a month, and is super effective, citing only 1 out of 100 women becoming pregnant per year. Oh and a side note: One of my favorite graphic artists, Lucy Knisley, loved it so much, she created a comic ode to the Implanon at Oh Joy, Sex Toy, a comic strip by Erika Moen. To find out more on the Implanon, you can check it out here.

IUD: My personal favorite, and the birth control I rock, the IUD is a small “T” shaped device inserted into the uterus to prevent pregnancy. The IUD comes in two forms: the non-hormonal ParaGuard IUD, which contains copper and is effective for 12 years and the Mirena IUD, which releases a small amount of progestin, and is effective for five years. While different in their makeup, both IUDs work to prevent sperm from moving, blocking them from joining the egg. The ParaGuard works by repelling sperm because of its copper makeup (think the Death Star of your uterus) and the Mirena works similarly, but also by releasing small amounts of progestin which thickens cervical mucus and so blocks sperm. The IUD, much like the Implanon, is highly successful and only 1 out of a 100 women get pregnant per year. It also is extremely cost-effective costing an average of $500.00 that is spread over five to twelve years (and maybe less thanks to new measures under the Affordable Healthcare Act). Not too shabby. I’ll go one step further and personally recommend the ParaGuard myself, since I ‘m the proud owner of one. To find out more about the IUD, you can check it out here.

Sterilization: Definitely the more permanent solution, sterilization is not for anyone for whom birth control is a temporary solution until they want to have kids. Sterilization effectively closes up the fallopian tubes, usually with an electrical current, clamps, or clips. Scar tissue grows around the affected area, and the tubes are no longer in service. Since eggs cannot pass through the tubes for fertilization, pregnancy becomes null and void. Sterilization might not be the best option, since it isn’t clear whether you eventually want to have kids. While completely effective, it is a permanent birth control plan. To find out more on sterilization, you can check it out here.

Cervical Cap: The cap is a silicone cup inserted into the vagina that covers your cervix. While similar in function to the diaphragm, the cap is shaped differently, although spermicide is still recommended with its usage. Cervical caps have a lower rate of effectiveness; 14 out of 100 women end up pregnant, though those stats can be attributed to not using spermicide and the cap together all the time. Cervical caps last an average of two years and cost anywhere from $65 – $75 per cap, so it is financially beneficial. To find out more on cervical caps, you can check it out here.

As for the withdrawal method in tandem with the rhythm method and some spermicide? Let’s all take a deep sigh before we venture forward and realize that opinions are like assholes…and so on. I am not a supporter of the withdrawal method as full-time birth control. I know, I know, the male patriarchy of capitalist birth control is feeding us blah blah and feminism, personal choices, all that jazz. I’m biased towards it because even if you and your partner were always, always accurate about it, you are still playing a high risk game where the odds are not in your favor. Even if your partner pulls out in time, you can still get pregnant, due to pre-ejaculate. I’m not saying don’t do it. This is America and you can basically do whatever you want. In my professional naked lady on the internet giving sex advice opinion, I think you are going to add more unwanted stress to your sex life, which is not supposed to be stressful to begin with. The constant worries of pulling out in time, and is now the right time of the month and fear of pregnancy aren’t sexy. They’re stressful. I for one, am advocating for less stressful sex lives.

Now, in regards to the pending rumor of male birth control? First off, I’d like to say, it’s about fucking time. Second, I think there is still too much time before we’ll see it. It seems that every new blast about male birth control still indicates that we are aways away. Call me cynical, but I think most of the feet dragging comes from the idea of, “If it ain’t broke, don’t fix it.” Why pursue male birth control when women can take it? While that’s not entirely true, given that there is a male birth control in the works, it does explain the feeling of the hold up, in my humble opinion. So don’t rely on the rumor of male birth control next year, because it’s always coming out next year. You my dear, you don’t need next year. You need now. The only way to get now is to take it into your own hands.

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9 replies on “For Those Who Have Considered Non-Hormonal Birth Control, When The Pill Isn’t Enough”

If you’re considering a Mirena, I always recommend this post so that you know what to expect in the first six months or so:

Stats I’ve seen also say it’s actually more effective than the 1-in-100 figure in the post – about the same as being sterilised, but reversible.

“The first year failure rate for the hormonal IUD is 0.2% and the five year failure rate is 0.7%.[11] These rates are comparable to tubal sterilization, but the effects of the hormonal IUD are reversible.”

That’s a useful article. I did find I had a lot of bleeding for the first 6 months after I got the Mirena – very light, but almost continuous for the first several months. What really made that easier for me to cope with was having a menstrual cup. I have seen some people raise concerns about using a cup when you have an IUD, but my doctor advised me that once you get past the first week there’s really nothing to be concerned about (definitely not more than a tampon). Since cups are deal for those ‘maybe I’ll have my period, maybe not, maybe just some spotting’ (way more comfortable than a tampon in those circumstances) the irregular bleeding / spotting was not really much of a problem for me. Then eventually my period did disappear altogether (although that is a little weird at first when you’re used to seeing it as a ‘phew, not pregnant’ marker).

Another IUD fan here! I’ve tried both types. I loved the Mirena in terms of peace of mind and very very light periods (though I had about six months of very irregular bleeding with prolonged spotting before it settled down). Sadly it gave me mild acne, though – I’m acne prone anyway and taking the pill had always helped my acne, so if you’ve had acne problems in the past it’s a good idea to ask your doctor about this. When it ran out I switched to Paraguard which I also totally love. Now I am used to the IUD I can’t imagine relying on the Pill (which relies on my not-great memory!).

The advice about who can use them has definitely changed over the years – they used to want to give them only to women who had already had children but that’s no longer the case (though some doctors still think that way). I’m in the UK, and there is a campaign at the moment to encourage younger women to use LARCs (Long Acting Reversible Contraception) since they are so reliable and since by definition if you are young there is a higher chance you will want the contraception for the full five years. Also, when I got my Mirena I had to get the actual IUD from somewhere else (the Family Planning Clinic, maybe?) and then take it to my GP to get it fitted. I think this is something to do with how the costs of the device are allocated (because it’s a big upfront cost but in the UK it’s free to the patient) – it wasn’t a big deal but for ease of experience I’d recommend UK patients go directly via the Family Planning Clinic. (This is also a good idea because the tiny percentage of problems with IUD insertion are associated with practitioners who haven’t got much experience with them, so if you go somewhere they do it all the time you’re more likely to get someone experienced).

I’m also in the UK and have a Mirena. My GP wouldn’t fit it – they referred me to the local Sexual Health Clinic – but did do the pre-insertion STI test that the clinic required. Then I had to go back to the clinic for a ‘consent’ visit, then the actual fitting, then the six-week checkup. But all free!

I’ve been loving my Nuvaring but the IUD sounds fantastic. I really need to find a doctor who will do it; my primary care location won’t do IUDs, and my doctor said I was too young for one anyway (coughBScough). Anyone else run in to the issue of doctors refusing care for you because you’re young? I have a friend who is in her mid-30s and never wants kids – but no doc will tie her tubes because she “might” change her mind. Ugh.

Did we see the same doctor? I had a doc who tried desperately to talk me out of getting mine because he was convinced I was using it to avoid having kids and it was his duty to change my mind. Even claimed he had hormonal BC that would help me lose weight (he also took every moment he had to tell me how disgusting I was for being overweight). I didn’t know I could go to Planned Parenthood and this was the only doc covered under my insurance that inserted IUDs (which vexes me because why offer to give the procedure if you’re so against it?). So after I preach the gospel of IUDs, I immediately tell my flock to check out Planned Parenthood if their doc is feeding them a pack of lies about them.

Yikes! That’s a seriously bad experience! My primary care doc couldn’t insert one but she was all for it and recommended a gyno who was equally in favor me getting one. My primary care doc told me she keeps a list of IUD-friendly docs because she knows women have trouble getting access to them. She said that younger, female doctors tend to be more open to them. The doctor who inserted mine was super friendly and helpful and talked me through which option (Mirena or ParaGuard) that would be best for me.

Reading about y’alls experiences, I’m really glad I lucked out with such a good experience.

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