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Birth Control methods for hormone intolerant?
March 2, 2011 10:35 PM   Subscribe

I am in need of birth control but extremely intolerant to hormonal methods. I need something more reliable than just condoms. I've been on pretty much every brand of pill and any hormonal methods seem to give me unmanageable depression and yeast infections that never ever go away. I do not ever want kids and would get sterilized only I can't afford it. I have heard about copper IUDs but I've heard a lot of things about women have stupidly heavy flows and awful unmanegable cramps with them. I'm concerned about a heavier flow because I"m prone to anemia. Does anyone have any advice? Any expirience with the copper IUD's, or has had similar hormonal issues but found a brand of pill that works well with no side effects?
posted by RampantFerret to Health & Fitness (51 answers total) 11 users marked this as a favorite
 
I have a copper IUD. Yup, heavier flow than before, but my diva cup is still fantastic. I had cramps for a year or 2, but they seem to have gone away (fingers crossed!).

I can't express how much I love my IUD. A good friend called it "fire and forget" birth control. I still have to think about STD protection, but a broken condom is no longer an "OMG NO BABIES!!!!!!!!!" Plan B panic.
posted by mollymayhem at 10:59 PM on March 2, 2011 [1 favorite]


What about using two less-reliable methods together. E.g. condoms and the rhythm method. Or condoms and a diaphragm? (And also use spermicidal lube for extra back-up)?
posted by lollusc at 11:00 PM on March 2, 2011


I too can't take the pill (migraine, depression) so I tried the copper IUD a few years ago. I had exactly what you describe: very VERY heavy periods and painful cramps more than half the month, which makes it tough to get in the mood! Also, I'm anemic too so that was not good.

However, note that the copper IUD is recommended for women who have given birth (which I hadn't) and that there's a 5-year, plastic IUD, the Mirena. It's supposed to be easier to deal with but it does secrete a tiny amount of hormones so I wasn't willing to try it. YMMV.

Have you tried the Today sponge? It's not 100% but, fingers crossed, it's not failed me.
posted by hapax_legomenon at 11:04 PM on March 2, 2011


I've got a copper IUD a year and a half ago; it's great. I do have a heavier flow than before. I don't have anemia, but I have one of amenia's related disorders. I've held up ok though.

My cramps, which have been horrible throughout my life, and continued to be awful with the IUD, completely disappeared half a year ago.

Hooray for non-hormonal!
Also I can't believe no one has plugged IUD Divas yet
posted by The Biggest Dreamer at 11:11 PM on March 2, 2011


I have a copper IUD and I love it. I recommend that everyone try it because though it doesn't work for everyone, those of us for whom it does work tend to LOVE it. I'm nulliparous and have had a great experience (albeit with bad cramps and nausea every month, but it's still so worth it for me), so don't rule the IUD out if you haven't had kids yet. The cramps also get better with time.

(Also, though there's no doubt that the IUD can cause increased cramping, I do also sometimes think that some of the talk about the cramps come from women transitioning from being on hormonal birth control and having a withdrawal bleeding "period" to having a non-hormonally regulated full-on period. I know that going from hormonal birth control periods to the crampy assault of my regular period was a painful time for me, and for a lot of people the first few months of having the Paragard coincide with the first few months of having a cycle unmediated by artifical hormones. If you're already not using a hormonal method, that transition might be easier for you.)
posted by verbyournouns at 11:27 PM on March 2, 2011 [1 favorite]


Taking your Basal Body Temperature is a natural and highly effective method of predicting ovulation. I've tried every kind of hormonal method along with the copper IUD and the Mirena (hormonal) IUD, and none of them have been satisfactory. I've also tried the diaphragm and the rhythm method (which landed me a darling baby boy). Nothing works as well as tracking your own ovulation through meticulous temperature-taking, which you can augment by testing your cervical mucus. This may sound like a great deal of work (and, maybe, a little more information about your body than you'd like to have), but it is the most effective, inexpensive, sustainable and side-effect free method that exists.
posted by She Talks To Angels at 11:51 PM on March 2, 2011 [5 favorites]


I have the copper IUD and I love it. I agree with everyone else that you definitely get heavier periods and cramps for at least a year, but mine went away after about two years. verbyournouns might have a point about the transition period and cramps - I came to the copper IUD from an implant which had stopped my cycle altogether, so I imagine there was quite a bit of adjustment that had to go on down there! I'm on my fifth year now and have zero problems with cramping, excessive bleeding, or anything. I'm also midly anemic, by the way.
posted by ukdanae at 12:16 AM on March 3, 2011


Getting bad advice here could fuck you up forever. Doctor.

Sorry, what? Your comment adds nothing to this discussion. In what situation could the OP possibly get an IUD without seeing a doctor? Do you think they're being inserted by old ladies in backyard clinics? And no, if it doesn't work out it will not "fuck [her] up forever" - unless you're referring to an unplanned pregnancy, which is extraordinarily unlikely with a properly inserted IUD. Please go and dump your nonsense in some other thread.

OP: I'm in my 20s, have never had children, and have had a copper IUD for years. My flow is slightly heavier, and I do get cramps, but they tend to be pretty short-lived. As in, they come in waves, a few times a day, for about three or four days a month. When they come, I might have to sit down for a minute or two, but then they're completely gone and I can get on with my day.

By comparison, I used to suffer debilitating cramps from an untreated ovarian adhesion. That pain made life completely unbearable, and I wouldn't wish it on anyone. But the occasional pain I get from having an IUD is something I'm perfectly willing to live with. It's transient and tolerable, and in return I get hormone-free contraception I hardly have to think about. Having the risk of pregnancy mostly off my mind is a wonderful thing. I never realised how much head space I had devoted to worrying about it until I got the IUD and could finally relax. I mean, I do check the string a few times a month, but that's really all that's required.

Regarding your anaemia, what kind of anaemia are we talking about? Is it iron deficiency anaemia, caused by blood loss or poor diet, or is it pernicious anaemia, caused by malabsorbtion of B12? Or anaemia of some other kind? I know from experience that iron deficiency anaemia is easily treated with diet and supplements. I'm sure most other forms are treatable enough that the slight increase in blood loss from an IUD would not be an absolute dealbreaker. I think you should at least discuss your suitability for an IUD with your doctor, and see what they make of your concerns.

Incidentally, a poster up-thread mentioned the DivaCup. While the combination may be working fine for that person, DivaCup recommends caution because there's a risk of the string getting caught between the cup and the vaginal wall, potentially dislodging the IUD. It's not an impossible combination, but you would definitely need to be careful.

Feel free to memail me if you have more questions, I'm happy to help.
posted by embrangled at 1:42 AM on March 3, 2011 [5 favorites]


I’ve used the Nuva Ring for a couple of years now and have had none of the side effects (depression, anxiety, complete loss of interest in sex) that I had on any of the several pills I tried. I think that because it’s right there next to your uterus it needs a much smaller amount of hormones to do the job.

I also have terrible, debilitating period symptoms that used to keep me at home from work from 3-5 days per month minimum. I run my Nuva Rings together with the permission of my doctor, avoiding my period entirely, as I used to do with my pills. I had breakthrough bleeding at least once every three months with pills that wouldn’t stop until I stopped the pills for a few days to have a “period”, but I have not experienced this with the Nuva Ring. I still leave it out for a week every six months or so just to clear everything out, but I’m able to plan it and take time off work in advance.
posted by Wroksie at 2:45 AM on March 3, 2011 [3 favorites]


The Mirena might work. The hormones are very localized. Nuva Ring didn't give me the Crazies like the pill does, but it did kill my sex drive.
posted by the young rope-rider at 3:18 AM on March 3, 2011


Copper IUD for 2.5 years so far, no kids, love it. My experience has been the same as the previous posters' - my periods are a little heavier and more painful (one day of cramps + spotting followed by two days of gore, then three or so days of dregs), but have been absolutely regular as clockwork with the exception of last month when my body decided to give me a scare and have a six-week cycle.

I itched all over for about a week after having it put in, and I spotted pretty much constantly for about three months, but have had no issues since then and will never go back to hormonal BC.
posted by corvine at 3:39 AM on March 3, 2011


Every brand of pill? Have you tried the progesterone only pills? If not, it might be worth trying the Mirena. It's not only more localized than bc pills, it's also without estrogen. (It's also a much lower dose than the progesterone only pills, so some women do have better experiences with the mirena even if the pill didn't work for them).

I've had both the copper and the mirena. I originally went for the copper out of a general preference to avoid hormones. I loved it but eventually got sick of the loooong periods. They were heavier than my previous periods but my main gripe was how looooong it was. Now I'm on the mirena and have minimal undesirable side effects and am loving the near complete lack of bleeding.

You should checkout the LJ community IUD_divas. Women with lots of different experiences post there.

Telling women that they can't talk about birth control among themselves is absurd. Next you'll be telling us we can't talk about our periods. Or our marriage frustrations. We all saw how that worked out!

(Doctor *too* of course, and keep trying doctors until you get one that's good and supportive, because the degree is no guarantee).
posted by Salamandrous at 3:49 AM on March 3, 2011


I just noticed that you had more yeast infections while on the pill. I've never had one at all, but I have read that vaginitis and yeast infections can happen more often with the Nuvaring. Additionally, yeast infection creams or vaginal suppositories can make the Nuvaring release larger amounts of hormones than normal, so if you're really sensitive to the hormones you might want to take it out if you have a yeast infection requiring medication.
posted by Wroksie at 4:25 AM on March 3, 2011 [1 favorite]


Depending on where you are, and how informed your doctor is, the cervical cap is also an option.

The cervical cap is basically a more form-fitting diaphragm -- it's made of rubber and you put contraceptive goop in it, but it's designed to fit more snugly over the cervix and only the cervix. It can be slightly trickier to put on than the diaphragm -- but the advantages are that you do not have to wait until right before intercourse to put it in, and you don't have to take it out and re-apply more gel if you're going to have sex again. You can put it in even a few hours before sex and just leave it there, and have sex as many times as you want. (The only rules of thumb is that you shouldn't leave it in for more than 24 hours without taking it out and giving it a clean, you shouldn't leave it in for more than 48 hours without giving your cervix a rest -- it can give you a hickey on your cervix, basically -- and you should wait 7 -8 hours after a sex act before taking it out.)

I. Love. Mine. I've used it during two of the long-term mutually-monogamous relationships I've had, and it worked like a charm both times. The only complaints are that sometimes I get a little uncomfortable waiting that 7 hours to take it out for good, because it's so form-fitting that it's got a suction effect on my cervix and that can get uncomfortable sometimes. Not too much, though -- it just feels like I'm a tiny bit crampy. But it's well, well worth it.

The big problem you're going to face finding this is - while this is FDA approved, it is not really visible on the market any more, so you may have trouble finding a clinic that has even heard of it. And you do need to get yourself "fitted" for one first -- so you may have to visit a couple places looking for a clinic that would be able to do that, because some clinics may not even know what they are. But once you get one, they last a really long time -- I've had mine for nearly 15 years and it still works just fine. There's also the possibility that your cervix may not be "shaped right" -- your cervix has to be kind of sticky-outy for it to work, and some women's don't stick out enough.

But it is well worth the investigation.
posted by EmpressCallipygos at 4:48 AM on March 3, 2011 [2 favorites]


[few comments removed - metatalk is your option if you want to complain to/about other people]
posted by jessamyn at 5:17 AM on March 3, 2011


Look into the Mirena and see if its low levels might be okay for you. Because it is fantastic for me -- I actually get no periods and I just never have to worry about it. I had trouble with the Nuva ring but no trouble at all with the Mirena.
posted by theredpen at 5:30 AM on March 3, 2011


tubal implant methods such as Essure as supposedly much cheaper than tubal ligation and similarly permanent.
posted by ennui.bz at 6:01 AM on March 3, 2011 [1 favorite]


Since a few people are saying the Nuvaring went well for them, I just need to offer the other perspective - the pill made me depressed and cry all the time, and the Nuvaring did the same thing, except the Nuvaring also killed my libido and gave me worse insomnia.

I've heard really good things about the Mirena from friends, but after my bad experiences with every other form of hormonal birth control, I've been too scared to try it and am just using condoms nowadays.
posted by Eshkol at 6:04 AM on March 3, 2011


Essure and Adiana, which are similar procedures, are not similarly permanent. They are permanent. Because both procedures are so new, there is not yet research on the chances of successful reversal and the advice from both manufacturers is discuss this option only and ONLY if you are interested in permanent birth control and not having kids or any more kids.

If you ever some day would like kids or more kids, you don't want to even consider Essure or Adiana.
posted by zizzle at 6:17 AM on March 3, 2011


I've been on an estrogen-free mini pill (norethindrone) for almost a year now. I was also warned about the increased risk of migraines on pills containing estrogen. At first, I was convinced I wanted an IUD, but my doctor is terrible and told me I couldn't have one because I've never had children (not true, btw, and I'm switching doctors soon). I wanted something that was relatively low-risk and wouldn't make my migraines worse. On this pill, I still ovulate regularly and still get a regular period. My moods are stable, and my sex drive is still good. In fact, I haven't had any negative side effects. My migraines are exactly the same- no better, but also no worse. Plus I'm not pregnant, which is totally awesome. I was also scared as hell of hormonal bc pills, but this was a great option for me. If I had my way a year ago I would have a copper IUD, but failing that, the mini-pill has been excellent.
posted by kella at 6:41 AM on March 3, 2011


I was on the pill for years, and then the NuvaRing, and the latter was still too high a dose of hormones for me. I ended up getting Mirena a few months ago (a plastic IUD with a very low level of hormones) and although it's a little too early to say for sure if the side effects have disappeared completely, they've certainly diminished a great deal. I've also had light periods with normal amounts of cramping.

I'm very glad I switched to an IUD in the end. However, I would stress that having it put in was one of the most painful experiences of my adult life. It isn't nearly so bad for most people, but if you decide to have one inserted take your doctor's advice for how to prepare very seriously.
posted by Narrative Priorities at 6:50 AM on March 3, 2011


Natural Family Planning (as Catholics call it) was something we were skeptical of but worked very well for us. We didn't get pregnant using just it for years (until we decided we wanted to). It takes discipline to take and chart your temperature every morning, and it does take some willpower, as there will be several days a month you need to abstain. In my marriage I personally felt this added anticipation and excitement, but it also means you're subject to your body's clock, so Valentine's Day, anniversaries, etc. sometimes fall during ovulation. It's certainly not a method for everyone, but it is much more reliable than you might think and is based on the science of how your fertility works.
posted by davextreme at 6:52 AM on March 3, 2011 [1 favorite]


Love my copper IUD. It's about time to change it out (coming up on 10 years) and I will probably get another one to carry me through to menopause.
posted by catlet at 6:52 AM on March 3, 2011


I have a copper IUD. I love, love, LOVE it. They are not for everyone, of course, but they seem to be gaining wider acceptance in the U.S.

Re: the heavier bleeding thing. The nurse practitioner who inserted my ParaGuard tried (unsuccessfully) to convince me to get a Mirena because of the potentially-heavier-periods thing. I'm glad I wasn't swayed. They are heavier, yes... but they were super-light before, and now they're more like I imagine "normal" periods to be. It was NOT a horrible, drastic change for me, and it is NOT that way for all women.

Also: I've heard anecdotal evidence that the heavier periods some women experience are due to the IUD causing some uterine inflammation, and that this can be largely alleviated by taking NSAIDs immediately before and during one's period. Again, IANAOBGYN, but it's something you may wish to look into.
posted by julthumbscrew at 6:56 AM on March 3, 2011


I've had a good experience with the traditional T-shaped copper IUD, Paragard. After the first couple of months, my period was not noticeably different. However, if by chance you live in Europe, also look into the Gynefix brand IUD. It is also non-hormonal, but differs from Paragard by being much smaller and stays in place by being attached to the top of the uterus. This means it is less irritating and leads to less bleeding. It was no more uncomfortable to have put in or taken out than Paragard, but it does require an experienced OB-GYN, which can be tough to find. When I lived in the UK I got it at the Marie Stopes clinic. They are AWESOME.
posted by CruiseSavvy at 7:21 AM on March 3, 2011


When I was in Catholic high school, a teacher once asked all the kids who knew that they were the result of the failure of the rhythm method to raise their hands. Half the kids in the class raised their hands. My advice is to double up on your birth control, so condom + sponge or diaphragm.
posted by Sara Anne at 7:26 AM on March 3, 2011 [1 favorite]


Lady Comp allows you to track and record your basal temperature on one device and will tell you which days you're fertile and need to use backup birth control. It's not cheap at the outset, but different distributors often do payment plans. (Note: I do not work for the Lady Comp folks!)
posted by corey flood at 7:27 AM on March 3, 2011


I'd just like to state here that the Rhythm Method and Natural Family Planning are two completely different things, in case there's any confusion. The Rhythm Method involves not much more than calculating your fertility time based on your typical cycle length and the start of your most recent period. Some of us can feel ourselves becoming fertile, and that helps make the Rhythm Method useful. Natural Family Planning, on the other hand, involves taking and charting your Basal Body Temperature daily before you rise from bed, as well as checking the color and consistency of your cervical discharge. The second method is much more accurate and scientific.
Of course, it goes without saying that putting the two together paints a more complete picture of your fertility cycle.
posted by She Talks To Angels at 7:55 AM on March 3, 2011


I was also warned about the increased risk of migraines on pills containing estrogen.

I was told that it's actually an increased risk of stroke if you also have migranes with aura.
posted by you're a kitty! at 7:59 AM on March 3, 2011 [2 favorites]


I have a Paragard (the copper IUD) because I can't tolerate any type of hormones. I've never had kids, and never plan to. Insertion was really, really rough, and my periods for the first 18 months were insanely painful. Now I've had it for about 4 years, and I'm down to only about 2 days of pain per month.

But honestly, it's worth it. I treat the pain with heat pads and advil, and take a multivitamin to avoid becoming anemic. But I don't have to worry about birth control at all for 10 years. It's fantastic.
posted by lilac girl at 8:01 AM on March 3, 2011


I'm also going to suggest trying the Mirena IUD. I'm not supposed to take any hormonal birth control at all because of vascular issues in my brain (you know that risk of stroke they always talk about in the warnings? That's me). Anyway, my neuro and obgyn came to a compromise on the Mirena, because it's such a low dose of hormone (I've been told it's the equivilantof 1/10th of the low-dose pill) and it is so localized, the risk was minimal. I've had my Mirena in for almost 4 years, and I and love it so much. I'll be getting a second next year. No hormonal side effects (nor vascular issues), and very infrequent, light periods -- i wouldn't even call them periods, more like random spotting at times. Once you get it in, you really don't need to think about it for the next 5 years. Over the 5 years span the cost is cheaper than all the other forms of birth control, and the slight discomfort of having it put in wasn't really that bad, and it only happens every 5 years. I'd compare it to maybe 2 months worth of cramps in a single afternoon, which leaves the next 58 months cramp free :)
posted by cgg at 8:09 AM on March 3, 2011


I picked the Paragard for similar reasons--I didn't want to screw around with hormones, at all, due to potential medication interactions. I've have had it for two years now, and apart from six weeks or so of settling-in time (during which there was some spotting and cramping), it has been WONDERFUL. My periods are not noticeably heavier or longer, though I admit I'm probably an outlier on that one. As for insertion, it lasted only a moment and wasn't any more painful than a period cramp.

I love my little copper buddy, and I'll be getting another one in 2021, I'm sure.
posted by Vervain at 8:39 AM on March 3, 2011


Have you tried hormonal birth control that is not the pill? I didn't react well to the pill, but I am the Nuvaring's biggest fan.

To be honest with you, I find condoms to be perfectly reliable. Sure, there's a teensy ghost of a chance that something might go wrong someday, but I have a dose of the Morning After Pill in my medicine cabinet just in case.

One of my brothers was conceived with a copper IUD, for what it's worth. Which, in my own mind at least, places IUD's behind condoms in terms of reliability. (I don't know anyone who got pregnant when a condom was used correctly - the problem with condoms seems to be that a lot of people are quite literally Doin It Rong.)
posted by Sara C. at 8:54 AM on March 3, 2011


Another vote for Today Sponge. Easy to acquire and use and no hormones or mess. It can get pricey, though (I get it from my Walgreens for about $14 for a pack of three) and it should only be used if you're monogamous because it doesn't protect against STDs. Once I've had my fibroid surgery, I'll be moving to Mirena.
posted by notjustfoxybrown at 8:57 AM on March 3, 2011


I also can't use hormonal methods and have been using condoms for years, in conjunction with Natural Family Planning. Really, knowing when you're ovulating and most likely to conceive is incredibly useful both if you want to prevent pregnancy or if you want to actually get pregnant. Knowing (based on body temp/cervical mucus) exactly where I am in my cycle both helped me avoid getting pregnant until I was ready and made it possible for my husband and I to conceive on the first try when we decided it was baby time.

So, yeah, I've used condoms and selective abstinence for years very effectively. Of course, for me an unplanned pregnancy wouldn't have been a disaster, so it was indeed a risk I was willing to take. I'm just putting it out there that it can be done if you want to both not have children and not have hormonal birth control.

(And spermicidal condoms might be more effective, but they can also cause UTIs - as I found from painful, painful experience.)

(Also, I would just advocate for all women to know their fertility inside and out, it's just an incredibly useful thing to know about yourself and helps with things like "Oh, my cervical mucus looks like *this* so I'll be getting my period in three days. I guess I won't be wearing white pants!")
posted by sonika at 9:18 AM on March 3, 2011


I am just going to jump in and say something, because I know a lot of people (including some medical professionals) are going to recommend the Mirena: though the hormones are small, there is a progesterone effect. You can experience side effects. Though they will probably be minor, you don't have to feel like you're nuts if you experience some stuff, despite the fact that many nurses and users claim that you won't feel anything at all! because the dose is so low!

This is technically hearsay, of course, but this was confirmed to me by the head OBGYN at a hospital I went to last year for another procedure. She said she was a little surprised by how the Mirena is being marketed to the public, because there are genuine side effects you may have to deal with.

That said, I really like mine.
Then again: it actually made my periods longer. Much, much longer.

Just a thought.
posted by vivid postcard at 9:46 AM on March 3, 2011


If you are seriously sensitive to hormones, don't bother with the pill (I tried a very, very low dose pill and I seriously didn't stop bleeding for a long time. It was horrible. I know most women are encouraged to just bear that burden until it gets better (which can take an extremely long time) but if you don't want to, you don't have to.)

I listened to the advice of health professionals when choosing a pill and the NP was surprised that I didn't react well to the side effects. A lot of women are encouraged to stick with it, but I personally don't want to bleed out for months on end and I think that that's a good enough reason not to take the pill.

An NP at Planned Parenthood pretty much tried to shove Mirena down my throat, but I wasn't comfortable with hormonal birth control, full stop. Everybody downplays the pain, fact of bleeding for weeks on end (seriously uncomfortable and I don't think it's fair to expect me to just be okay with that especially since I effing hate my period anyway).

I was shocked and surprised at how many of my female friends thought I was a baby for not just spending six months in hopes that it would "kick in" eventually. Spermicide and the sponge caused problems.

Use thin condoms and withdrawal, but seriously search out a cervical cap or diaphragm. You don't have to just accept heavier cramping and pain because a doctor, NP, or your female friends are being dismissive.

Also, some people did great on Mircette. It was perfect for them. It wasn't perfect for me. Other people's experiences with birth control, what they mean when they say they love it (I personally was so effing pissed that someone recommended me a pill expecting me to wait many months until I stopped bleeding or one that gave me extremely intense cramps for even a day (I've had those and I would rather not spend eight to ten hours crying, curled up because it's too painful to walk around, and praying that taking eight Aleve a day wouldn't seriously damage my liver, and having to take a day off of work because I was in too much pain from my fricking period).

After those experiences, I just stopped listening to people's anecdotal advice on hormonal birth control. While their experiences were good, it didn't mean that my experience would be likely to be great.

If you want a recommendation, you should ask people of your ethnic group with similar endocrine histories.
posted by anniecat at 10:08 AM on March 3, 2011 [3 favorites]


Paragard took about 3 months to even out and 6 months to be close to what my normal periods were like. Taking NSAIDs before and during your period does help the length and flow in my experience. I was off the pill for 2 years before getting Paragard so I know what's normal for me and I do have more cramps/PMS than I did before Paragard but after the first 3 months it was tolerable and after 6 months it was totally acceptable. I expect it to continue to normalize over the next year.

She definitely didn't say she plans to get a black market IUD from Canada and insert it herself.
I actually ordered mine from Canada and had it inserted in the U.S. because it was about $400 cheaper. YMMV, shop around.

posted by Bunglegirl at 10:33 AM on March 3, 2011


A friend of mine with endometriosis has been pretty damn happy with her IUD.

Then again, she doesn't want kids, so she's also pretty excited about the tubal ligation she has scheduled next month (cheaper than you think with the right insurance, and pretty uninvasive if you can get the right kind of surgery)
posted by ivan ivanych samovar at 10:56 AM on March 3, 2011


I understand your reticence to go with hormonal methods. I, and many others, have been very happy with the Mirena IUD despite also dealing with depression or other mood disorders. Mirena has such a low dose that it's barely noticeable, but I'm told that it actually may help increase the efficacy of some antidepressants (or at the very least not make you crazy enough to need a higher dose). It is supposed to only have enough hormones to work in your uterus, but my face was a LOT clearer when I was on it.

Again, this is only anecdotal evidence, but I've heard from at least ten people who have depression and an IUD and been very happy with it. Absolutely nothing but good things. I can't say the same for a NuvaRing or any other type of hormonal birth control.

Believe me, I feel your pain. I had also had problems with the emotional rollercoaster of regular BCPs, and I was THRILLED with my IUD. (Too bad it expelled twice -- a very rare occurrence after a successful exam, but thankfully painless. That was likely due to some interference with my beloved Diva Cup.)

The most important thing for you, though, is that if you are willing to try this but are hesitant about its hormonal effects, they should stop right away if you take it out. The hormones from BCPs can stick around for quite a while, but I've known people who have gotten pregnant almost in the first week after getting the IUD removed. If you find that an IUD -- hormonal or not -- doesn't work for you, you should be able to get rid of it immediately and not worry about its effects lingering.
posted by Madamina at 11:43 AM on March 3, 2011


Also, if you're looking into the Fertility Awareness Method, Taking Charge of Your Fertility (and its companion site) is THE go-to reference. All you need is a decent basal thermometer and the willingness to swipe your fingers up there :)

I was really impressed by its matter-of-fact yet friendly presentation and how complete and clear it is. It's written in a way that can appeal to women from every background, not just those who want to get pregnant and not just those who might use this kind of method for religious reasons. (It barely touches on religion, as far as I can remember.) It also includes sections on several other topics in women's health, not just related to reproduction, so it's the kind of book that's just plain useful to have around.
posted by Madamina at 11:50 AM on March 3, 2011


After extensive research on Mirena (reading a TON of research from the Netherlands, where they do a lot of good work on hormones, and the lowdown from the World Health Organization), my hematologist and I concluded that it was safe due to its very specific hormone and its mechanism of delivery. I wasn't willing to mess with a copper IUD, either, but I can't use oral BCP, the patch, etc.

If you're just looking for birth control, maybe barrier devices and sponges are a better idea, though. Then there's not even a theoretical risk of the hormones causing issues. If you need something to control dysmenorrhea, etc., my conclusion was that Mirena was the safest option. It was a quality of life issue at that point...
posted by wintersweet at 1:58 PM on March 3, 2011


Other info from the OP here-
I never ever ever want kids. I don't want to start a big dramatic thing here, but I am not a caretaker type. I can't even handle a hamster, and I'm 27. I really hate babies. If i had one I would harm it, not because I wanted to but because they basically have the reverse effect on me than they do on other women. Instead of mothering it, i want it to be As Far Away As Possable. Neither I, my partner, nor the baby would be happy. Ever. I'm career focused not family focused. Also, my long term partner has mildly life threatening genetic conditions. He dosen't want to pass them on to a baby.

(I know you will all probably tell me to seek therapy because I don't like babies. Sorry, I just don't like them. I'm not going to harm someone else's or say they shouldn't have any. I'm glad others pick up the breeding slack because I don't want to. I don't feel I need therapy. I just need reliable birth control.)

I do not have any health insurance, otherwise I would get sterilized in a hot second. I am going through Planned Parenthood, so I basically need to be as informed as possable because i don't have any health care options at this point.

My Iron deficiancy is probably a combination of diet and b12 deficiancy but i've never had health insurance in my lifetime so I've been unable to figure it out further than iron suppliments make me bleed internally and I can't seem to get iron out of anything but meat, but eating a lot of red meat and a B complex basically takes care of it. It hasn't been a problem for years and years, just a thing I need to watch out for.

I have not tried a non-estrogen treatment and after reading this, am considering trying the Mirena.

The bio-cycles method is NOT FOR ME or my partner. We need to be as close to 100% sure we WILL NOT HAVE BABIES as we can. He wouldn't sleep with me if i was trying to rely on the rhythem method, and I wouldn't be comfortable with it even if he would.

Condoms aren't reliable enough. Even though we are... ahem.. well lubricated, often we are enthusiastic enough to break condoms. also, we want to be spontanious but often can not because no one thought to stuff a french letter in their wallet.
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posted by RampantFerret at 4:48 PM on March 3, 2011


You don't mention it, and I'm sure you've thought about this, but just in case you haven't - does your partner have health insurance? Would he consider a vasectomy? I believe in men they are reversible (but obviously that's not easy) in case he sometime in the future changes his mind.
posted by echo0720 at 5:58 PM on March 3, 2011


Planned Parenthood might provide Essure or other sterilization methods.

As far as reliability, IUDs are very reliable.

Abortion is always an option as well--early in the first trimester you wouldn't even have to take time off of work. Keep that in mind.

I commend you for being realistic about your own desires and limitations, and wish you a happy, baby-free life!
posted by the young rope-rider at 6:30 PM on March 3, 2011


If you want to be absolutely sure to never have kids, hormonal birth control isn't going to be enough either. I have no fewer than three friends who have gotten pregnant while on the pill - it totally happens.

What you really, really need to look into is a permanent sterilization method. Sure, it might be expensive but if you figure out how much it costs, you can start saving towards it or do it in the future when you do have insurance or whatever. In any case, a one time payment on sterilization will be worth it for peace of mind and also will probably be cheaper in the long run than a lifetime of birth control and stress - especially if the traditional hormonal methods aren't an option for you. If your partner doesn't want kids either and is up for it, a vasectomy might be easier to get than a tubal ligation - if only because OBs are often very hesitant to perform ligations even for women who have already had kids.

Nothing else is going to guarantee that you never get pregnant. Even then, I have a friend who got pregnant with a tubal ligation. The species, apparently, really *wants* to propagate itself.

(Yeah, yeah, "I have a friend" is not science, but considering I'm 29 and have about 10-15 friends with kids, the fact that a not in-significant portion of those pregnancies were on the more reliable forms of birth control speaks to the fact that it totally does happen.)
posted by sonika at 6:45 PM on March 3, 2011


(I know you will all probably tell me to seek therapy because I don't like babies. Sorry, I just don't like them. I'm not going to harm someone else's or say they shouldn't have any. I'm glad others pick up the breeding slack because I don't want to. I don't feel I need therapy. I just need reliable birth control.)

I'm wondering why you are so convinced that we're going to tell you to seek therapy for not wanting to have children? It ain't our place to judge!

Yeah, sterilization is the best option, but there are plenty of options for contraception, and you've gotten a lot of them in here. To get yourself totally covered, go for two -- and maybe look into why condoms are breaking on you so much so you can make that one of your options (and, if you'll forgive me for getting all "Mom" on you for a second -- it may be time to take on the responsibility to plan for spontaneousness by packing a condom in both your wallets all the time as well).
posted by EmpressCallipygos at 6:56 PM on March 3, 2011


I didn't want to be all TMI about why condoms are breaking... but I have a pretty good idea.

He is getting a vasectomy... eventually. But I feel like my choice to not have babies is somewhat independent of his choice not to have babies (we are close and long term but not married) and as such I want to take my own reproductive system in hand, not depend on him alone to make sure we don't breed.

And yeah, I'm here for un-scientific advice. I'm pretty much looking for "I had a friend..." or "this is how it worked for me..." stories, they've been really helpful. Before this, I was thinking of going copper IUD and I'm glad I didn't because now that I've read other people's expiriences I realize that a lower dose estrogen free method would probably work better for me than a copper IUD, and I've been able to develop more discussion points to talk with my doctor about.

As for the comment about therapy... i don't tell that many people IRL about how I feel about babies, and a lot seem to say that means there's "something wrong" with me. Didn't mean to get all defensive.
posted by RampantFerret at 7:43 PM on March 3, 2011


The Fertility Awareness Method is ABSOLUTELY not the same thing as the rhythm method. If done correctly (and you can easily do it correctly, by charting it), it has a similar level of efficacy as many other typical methods of birth control that people consider reliable.

So yes, I completely understand your reasons for not using a barrier-free method, but it's a lot more reliable than you might think.
posted by Madamina at 8:58 PM on March 3, 2011 [2 favorites]


Have a look at the actual scientific data for fertility awareness. It's better than artificial methods in many, many ways. Look for some actual scientific papers in non-partisan peer-reviewed journals.

http://en.wikipedia.org/wiki/Fertility_awareness#Effectiveness

You can contact some NFP teaching organisations and have a conversation about your needs with them for free.

Ultimately the only 100% guarantee not to get pregnant is indeed not to have marital relations.

You need to have an ongoing dialogue with your partner about these things - that's one thing that NFP encourages too.

Everything worthwhile takes time and effort.
posted by KMH at 1:35 AM on March 8, 2011


PS - here are 3 places to start:

http://www.billingslife.org/

http://www.ccli.org/

http://www.creightonmodel.com/
posted by KMH at 6:06 AM on March 8, 2011


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