Trying to decide if I should stay on birth-control pills or not.

December 9, 2008 8:58 AM

Trying to decide if I should stay on birth-control pills or not. Please help.

I'm taking pills called Gynovin, composed of 20 mg ethinylestradiol and 75 mg gestoden. Some googling tells me those are very small amounts of hormones, which apparently "provides great acceptance in women and a high tolerance".

I started taking the pills about 8 months ago, two months before I got married. I don't think I've had any physical adverse effects except maybe feeling tired a lot, but that could be caused by other stuff. What makes me ask this question is that recently I've began to think that a lot of my emotional problems could be caused by the pills, but I'm not sure, as there's also been a lot going on in my life.

Some "symptoms":
-complete loss of libido, (which is funny, since we waited for sex until we got married, and I DID have a pretty fine libido before)
-I feel angry all the time, plus, I get very explosive
-I've been feeling "randomly" depressed sometimes during the last few months, watching tv for hours or feeling ignored and unappreciated

Things going on in my life right now:
-I'm a high school teacher with a lot of work (4 groups with a total of 118 students)
-I'm studying my master's degree online (almost all the work is done in teams)
-my husband are in the last stages of building a house, with lots of details to oversee and lots of people and suppliers to supervise
-generally adapting to married life (has been mostly easier than I thought)

So, sorry for all the info, but I really don't want to spend my first year of marriage angry all the time and having no fun with sex. It's no fair for me, OR my husband, who I really love, and has been getting most of the second-hand effects of my emotional craziness. Yet, I don't know if I should blame the pills or if I should just blame life. I've always been prone to feeling emotionally stressed and anxious, but the thing that makes me most unsure is the complete loss of any sexual desire (or enjoyment). I'm considering going off the pills and maybe using some of the natural methods, which mean a lot of work, but no hormones.

I know this isn't really a concrete questions, but I know there's a lot of Mefites out there with a lot more experience with birth contro. Help me figure this out, please.

posted by CrazyLemonade to health & fitness (30 comments total)

Try different methods, like Nuva Ring. Different methods, even if they involve hormones, cause different reactions in people. You should definitely talk to your doctor, too.
posted by bolognius maximus at 9:05 AM on December 9, 2008

Try the diaphragm. Seriously - hormones are hormones. I have not had luck with any type of hormonal birth control as I'm very sensitive to how they change my emotional status/libido/etc. YMMV but the diaphragm with loads of spermicidal jelly and used correctly should keep you covered.
posted by citystalk at 9:14 AM on December 9, 2008

Your description is pretty much what hormones did to me, among other things. I did not find any option that did not do these things to me.

If you can handle alternate birth control methods, going off hormones for 3 months or so would probably answer the question of whether it was the meds or just life.
posted by Lyn Never at 9:20 AM on December 9, 2008

Talk to your doctor -- It will be a quick visit, and you may just be able to describe your symptoms over the phone without an office visit. I personally went through 3 different types of BC pills before settling on one that worked -- my main issue was breakthrough bleeding about a week before I was supposed to have my period. I actually used to be very emotional just before my period, and I think hormonal BC has helped to temper that. I have had other friends experience a lot of headaches, but switching the type of pills fixed that and now they are doing well. It may be true that hormonal BC is "not for you" but there are a lot of different types out there (including a lot of different types of pills), and trying something else first may get you on the right track.
posted by sararah at 9:22 AM on December 9, 2008 [1 favorite]

I agree with citystalk - try the diaphragm, or any non-hormal BC for several months and see how you feel. If you then feel it's the hormones, get a Paragard IUD (copper, no hormones).

Count me as another who is sensitive to birth control hormones. I could not use Nuva Ring. You can search my ask.metafilter activity for several other comments about this issue. There are quite a few threads about this topic.
posted by peep at 9:23 AM on December 9, 2008

I would try a different brand of birth control before giving up completely. I was an emotional wreck on yasmin--the emotional side effects were essentially what you describe here--but I've been fine and dandy for three years on Portia. If that doesn't help, consider non-hormonal options.

Whatever the outcome, know it's not all in your head. Birth control definitely does have emotional side effects for many women.
posted by PhoBWanKenobi at 9:40 AM on December 9, 2008

Oh, you might also consider a low-hormone or non-hormonal IUD.
posted by PhoBWanKenobi at 9:41 AM on December 9, 2008 [1 favorite]

I would talk to your doctor before switching to other methods (which you'd have to do anyway to get a new RX). Don't think your only options are that pill or using a calendar. You may have to try a few to find what works best for you.
posted by purpletangerine at 9:41 AM on December 9, 2008

Another voice chiming in to say you may want to try other forms of the pill before switching to other methods. Different pills effect people differently. Perfect example, unlike PhoBWanKenobi, Yasmin has been awesome for me and without side effects at all, other ones not so much. Birth control certainly can lower or kill your libido altogether. The anger and depression may be related to the pill as well, or you might just be understandably stressed out and depressed. Your doc is the best place to start and good luck!
posted by katemcd at 9:56 AM on December 9, 2008

I am going to nth that it's the pills. i tried b'control some 5 or 6 years ago to regulate my wildly varying cycle and couldn't figure out why i kept crying all the time and felt nauseated everyday around noon ...until a friend told me she had had a similar reaction to birth control and hadn't realised it was so bad until her husband offered to (jokingly) leave her unless she went off them ("I don't care if we never have sex again!" says he). Unfortunately I can't remember the brand, but I was told these were a "very, very low estrogen" pill.

when did condoms become so unpopular? doesn't anyone remember the 90s...
posted by tamarack at 10:02 AM on December 9, 2008

I totally disagree with citystalk. Surely some users will find that any hormonal birth control causes them emotional problems, but many will find that a particular pill or formulation works for them.

I used to be on Ortho-Tricyclen, but after a while started getting severe mood swings and some other issues (it was several years before this really became a problem). Now I'm on Nuvaring and for me it is the best ever, but clearly that isn't everyone's experience.

Of course it's tough to isolate what's causing the problem (external stress, this particular pill, hormones in general). Docs have statistics on how many patients experience various side effects on a given pill, so tell your doc the problem and they should be able to pick out a new pill less likely to cause these issues. Then try out the new formulation for a few months. You might have to repeat the process a few times, and of course it's possible you might be one of those unlucky few (a la citystalk, peep, or Lyn Never) who can't find any hormonal option that works. But give it a try first, eh?
posted by nat at 10:07 AM on December 9, 2008

If you end up going off the pills, I vote for the Mirena IUD, which is basically the best thing that ever happened to me. I started having freaky emotional symptoms on all BC pills I tried; the Mirena is a local dose of hormones and I don't have any of the freaky crazy up/down BS I did before.
posted by Medieval Maven at 10:08 AM on December 9, 2008

Another vote for trying different bills or non-hormonal methods. I spent 10 years trying different pills before finally giving up on finding "the one" and getting myself a Paraguard (no hormones) IUD. No more synthetic hormone-fueled moodswings or libido loss. The IUD has its own side-effects, but I feel better knowing I no longer have chemicals in my system and my period related ups and down are my own.

I did a lot of pill research in those 10 yrs and each time I switched to a new pill I was making an informed decision. Some pills made me crazy or sad or angry, some made me break out (pills that have high androgens tend to make acne worse if that's an issue for you), some made me gain weight etc etc... Not only are all pills varying levels of hormones, the hormones themselves are different. Not only THAT, but there are monophasic (same hormone level in each pill) and triphasic (different levels in each pill to more closely mimic your bodies natural hormone production during your cycle) pills.

A lot also depends on your doctor and whether they're actively listening to you. Even my best doctors brushed off bc pill side-effects as "something I would get used to". This frustrated me.

Long story short - there are a ton of different bc pills out there and there might be one that's best for you, there may not be. Each and every woman has different reactions so what's perfect for your best friend may turn you into a raving harpy. You can definitely try out different pills, but you should give each one at least 3-6 months to really know how your body reacts to it.
posted by Constant Reader at 10:10 AM on December 9, 2008

Pills are awful. Patches are awful. Nuvarings are awful. All have side effects. There is no conclusive long-term research about what life-threatening effects or permanent damage they may cause. Do your body a favor and don't rely on artificial hormones. Use condoms. If it breaks, take the morning-after pill. The few times you may end up doing this (very unlikely if you use condoms correctly) will still be less harmful than taking hormones on a regular basis.
posted by bondgirl53001 at 10:24 AM on December 9, 2008

I concur with trying a few other brands before giving up on hormonal birth control. not all will cause negative side-effects, some will have positive ones (lighter period, less cramps, less pms, clear skin etc.,)
posted by supermedusa at 10:24 AM on December 9, 2008

You've gotten a lot of wise advice both for and against pills. Those who say that trying another formula may help are right, and those who say that none of them could be good for you are also right. It depends on what kind of trial-and-error you want to engage in (and alas, this is a trial-and-error thing that you and your doctor will have to get in on together).

Personally, even though I've only tried the pills once, and only a couple formulas, I gave them up anyway because I had become personal-ethicswise uncomfortable with tinkering with my body chemistry (I was in a very back-to-nature phase then, which may also account for it). So that is what motivated my decision to give them up.

But what I REALLY wanted to talk about is an alternative barrier method -- others have suggested the diaphragm and the IUD, but I'm in love with the cervical cap, which my doctor gave me in 1997. LOVE THAT THING. It's the same principle as the diaphragm, but more "form-fitting" over the cervix, and you don't need to take it out and put it back in every time you have sex over the course of 24 hours -- you can just pop it in and you're good to go for a whole day.

It may be tricky to find -- it doesn't fit well for every woman (variations in a woman's, er, anotomical design may make it not a good fit for some), and so it doesn't really enjoy much popularity in the U.S.. Some doctors' offices may not have even heard of it (I brought my old one in to my new doctor to have her check if it was still good, and none of the nurses knew what the hell I was talking about, even when I got it out of my pocket and showed them). But it is approved of by the FDA, so it is legal for you to get it -- it's another alternative to consider.
posted by EmpressCallipygos at 10:25 AM on December 9, 2008

every hormonal birth control method i've tried (several kinds of pills, nuva ring, Mirena (hormonal) IUD) made me depressed. The Mirena IUD is supposed to be local, but small amounts of the hormone do get into your blood stream. I had the Mirena for a year and a half before giving up on it and getting the non-hormonal Paraguard IUD.

The depression didn't entirely go away, however, until my doctor diagnosed me with PMDD and prescribed Zoloft. She said it was entirely likely that the Mirena was to blame for the PMDD. Apparently, for a very small percentage of women, the synthetic hormone in BC causes an increase in the amount of a chemical in the brain that degrades seratonin -- so it operates exactly oppositely of an anti-depressant. We are hoping that a year on an SSRI will reset what my brain thinks is the normal amount of seratonin.

my advice to you is stop taking the pill now and use condoms for a few months to see how your mood changes. if it improves, consider trying a few other hormonal methods if you want or, if you know you don't want kids for a few years, get a Paraguard IUD. If your mood does not improve, go talk to your doctor!
posted by argylekneesocks at 11:24 AM on December 9, 2008

I would like to chime in that some people and doctor's will tell you that you just have to experiment or give birth control a few months to find one that works for you. Trust yourself. If you don't want to gamble with your mental health, look into the options mentioned above. It's your health, not theirs.

I regret my time on hormonal BC, and resent the encouragement I got to give it a try (against my gut feelings). I wish I had listened to my misgivings and went straight to an IUD. I had very similar symptoms to you (anxiety, anger depression) as a bonus I had almost constant cold sores (really sexy and convenient!).

I would go off them (you can understand my bias). What's the harm in going off and seeing if you improve? There is little risk to stopping BC (as long as you use a barrier method to replace). A doctor advised me that the hormones would be out of my system within days and I felt better almost immediately.
posted by Gor-ella at 11:53 AM on December 9, 2008

I got so crazy on bc pills that I didn't even realize the pills could be the cause. I was depressed and irritable for two weeks out of four and cried all the time for no reason. My boyfriend suggested I try ditching the pills, and little by little I started to feel better.

I would second the recommendation to give your body a break from hormones for awhile and see how it feels. You might try a different brand in the future and it might be better, but I think you will be in a better position to make that decision once you are able to compare how you feel off the pills.

For myself personally, there is no way I would ever go back to a hormonal BC method, because the depression it caused was so insidious. It crept up on my until I gradually became a different person, but it was hard to even realize it was happening. I never want to feel that way again.
posted by mai at 12:09 PM on December 9, 2008

There is no conclusive long-term research about what life-threatening effects or permanent damage they may cause.

Not true. Women have been using hormonal birth control for thirty or forty years by now and it has been very well followed and studied all that time. The long term risks and benefits are well known and the studies continue. The statistics and information is readily available both to doctors and in the general medical literature. This myth makes me mad. Of course it's been studied, for this and al other types of medication. Pharmaceutical companies don't just make a pill to sell then forget about it, they care about tracking efficacy and side effects and health risks and long term issues and about just generally making sure that things are working correctly and not hurting any one. So does the FDA and equivalents. Hormonal birth control is not some newfangled experimental invention.

OP: there is no reason why you shouldn't try a different birth control method, hormonal or otherwise. Keep in mind the inevitable bias in answers to questions like these, where those who have something against hormonal bc are attracted and give a disproportionate amount of answers. While all the answers given here are valid (except that little urban legend I just refuted) the ratios for and against does not reflect the general population where many more people take the pill or whatever without trouble. This makes sense. My telling you I took a high dose hormonal birth control pill for five years without a single issue doesn't really answer your question or help you so of course those answers are missing. I only stopped taking it because I kept forgetting and we've been using condoms for over nine years, again without a single issue.

It may be that none of your problems are to do with the pill you're taking. Loss of libido is also a symptom of low grade depression and your life is pretty stressful. At the same time you can clearly see that your problems could possibly be caused by the pills based on other's experiences. Either way, you've got nothing to lose by talking with a doctor and trying something else. There are loads of options available to you. Your contraception cover should be just as good (make sure you talk percentages with the doctor though so you're aware of the risk for each version) and you shouldn't be any worse off even taking another type of hormonal pill. Your doctor also knows you and your medical history and can give you actual informed advice about what your options are. Plus their advice won't be biased in the same way that these answers are (hopefully it will be biased by statistics and facts instead).
posted by shelleycat at 1:03 PM on December 9, 2008 [2 favorites]

I had many side effects with systemic BCP, but nuvaring, which is all local, has been pretty great for me. Still, everyone's different. Try another one. These hormonal methods are terrible. You may just want to use condoms, unfortunately, until the MALE BIRTH CONTROL PILL COMES OUT! (Wet dreaming)
posted by namesarehard at 1:09 PM on December 9, 2008

I was on them in the 80s. Stopped. Started again in the 90s for medical reasons, got off them as soon as I could. When I went into a LTR, I thought it would be great, so i tried them again.

I wanted to throw myself out the window.

I tried talking to the doctor about it and they just wanted to put me on other pills. and they may not have been as bad, but you're supposed to take them for THREE MONTHS in order to find out. i got all sorts of lectures about this. i wanted to get my tubes tied - i do not want children and neither does my SO - and all i get about that is lectures.

there is no way i'm going to make myself feel bad every single minute of every single day for three months... for an activity i'm not engaging in every single minute of every single day. and i can't stop thinking about how women who use hormonal bc are all one giant health experiment and that if we were men, there would be birth control that had no side effects and it would be free for every single person who needed it. (so would tampons, but i digress)

it is okay to want to take the pill.
but it is also okay to not want to take the pill.

for now i'd urge you to give yourself a break. and then make a decision.
posted by micawber at 1:31 PM on December 9, 2008

I, like nat above, was on Ortho-Tricyclen for a couple of years when I first noticed that I was having incredible mood swings. Nth-ing that you should talk to your Gyn about other pill options available before giving up. I am now on Estrotep and find it to be much better, so there can be a happy medium. Good luck finding what works best for you!
posted by harrumph at 2:32 PM on December 9, 2008

I said there's no conclusive long-term research. You will find that there is an abundance of inconclusive long-term research, all of it contradictory in its findings. I don't want to be a human guinea pig, but others may not mind.
posted by bondgirl53001 at 2:33 PM on December 9, 2008

sounds like hormones to me--you will probably have to experiment a bit with your progesterones before you find something you like. i've had wildly different experiences, and finally found one i like. but you might prefer a non-hormonal option instead, like an iud (yes, you can get one if you are planning to have children--there is an old stigma about them because first generation ones raised your chance of getting pelvic inflammatory disease, which can lead to infertility, but newer ones do not have that risk).
posted by thinkingwoman at 3:03 PM on December 9, 2008

I was on Ortho-Tricyclen for years. It was fine. I asked my doctor about switching to Seasonale. I've been on it for 2 years and it's been great. No monthly cycle of any sort is what I prefer and now I have it. Just wanted to provide a data point that not everybody experiences soul crushing awfulness with BC.
posted by hydropsyche at 3:37 PM on December 9, 2008

I had all those symptoms you're talking about, plus major mood swings & crying jags, diagnosed depression and possible manic episodes. Tried 4 different anti-depressants with no improvement. Went on the pill (started with Yaz, switched to Seasonique) and now I feel great. Granted, it's wreaked havok on my skin but I no longer want to kill anyone because of it.
My point, and I swear that I do have one, is that you may not be on the right pill for you, or you might not want to be on one at all...there are a lot of different pills because we're all so different. Talk to your doctor and try a few things, you have a lot of options.
posted by kattyann at 7:24 PM on December 9, 2008

Logistically, it's not a huge deal to take a break from the pill and try something else (or a couple something elses if you would like to be very careful). It just takes a few weeks. So why not try something else and see what happens to your symptoms? That will answer the most important question. Should you experience a change in your symptoms, then you can decide whether it's worth trying another formulation of the pill or not. If you don't, then your question is answered and you can direct your efforts to stress reduction or the like.

The pill totally killed my libido, not to mention my complexion, so I haven't taken it for years.
posted by Herkimer at 8:08 PM on December 9, 2008

I want to highlight my very positive experiences with oral contraception...I was on a variety of triphasic regimens in the past, until Mr Pocahontas got a vasectomy.

Unlike others, the oral contraceptives actually *smoothed out* my PMS mood swings, and it's something I actually considered going back on for the mood-stabilizing effect! And, I didn't breakout when it was PMS week, either.

So, don't let the "negative" anecdotes point you in a particular direction; because that's why they are: testimonials, anecdotes.
posted by Pocahontas at 8:43 PM on December 9, 2008

Thanks everyone for all the answers, I think I'll talk to my doctor and go off pills for a while, to see if that changes anything, and then maybe try some new pills.
posted by CrazyLemonade at 6:37 PM on December 10, 2008