Low to no medicine birth control options

July 4, 2012 2:06 PM

please advise on birth control options particularly if you have experience with low-medicine or no-medicine methods.

I really HATE the idea of taking medicines on a routine basis.

What is your experience with the fertility awareness method? Please tell me about this if you have personal experiences or close friends with personal experiences- I'm less interested in rants against it that lack personal experience. If you give me an anecdote about someone you know, including yourself, got pregnant doing this please let me know if you aware of whether this was due to having sex on one of the no-go days, or if it happened when they had sex and it was a day it was supposed to be ok.

What are my other options that are low to no medicine? no vasectomies or tube-tying.

There are two stages I see: Stage 1 is not wanting to get pregnant at all since the next year will be exceptionally bad timing so a low-medicine solution is probably better than fertility awareness method. Stage 2, after next year, still not wanting to get pregnant but if it happens it will be less of a problem so maybe condoms/fertility awareness method will be more ok. also eventually after a couple of kids one of us will get a surgery so it's not like we plan to pop out a dozen babies.

No I have no experience with any methods of birth control so far.

My issue isn't a moral one- I'm pro-choice and family planning methods generally. I am however, a strong proponent of avoiding regular use of medicines where possible. Maybe you can suggest some very low-dose low-side effect stuff?

Please help! The sooner I figure it out the sooner the fun begins.

posted by saraindc to health & fitness (37 answers total)

Have you considered an IUD? They come with and without hormones, depending on how far your "no medicine" policy goes, but they're highly effective and generally very well-tolerated by users.
posted by decathecting at 2:08 PM on July 4, 2012 [6 favorites]

Condoms are an awesome way to go - don't rule them out until you try.
posted by dbmcd at 2:12 PM on July 4, 2012 [3 favorites]

I have a copper IUD, and so does one of my friends. MANY of my other friends have a hormonal IUD. We're all happy, and none of us have experienced scary side effects. My period was heavier for a while, but it went back to normal. My gyno is an enthusiastic proponent of IUDS, because they're very effective and reversible. And none of us have regretted our IUDS for one single second. There you go, some anecdotes!
posted by Coatlicue at 2:15 PM on July 4, 2012 [2 favorites]

also should mention: STDs are not a consideration in this question. we would probably want to get pregnant in a couple of years so longish solutions aren't ideal.

thanks again!
posted by saraindc at 2:15 PM on July 4, 2012

I am a flake: My first child is the result of using astrology to determine the timing thing. Not recommending it as a method. :-P

I have used condoms, sponges (cross between a barrier method and spermicidal method), spermicidal foam, birth control pills and my ex had a vasectomy later in the marriage. I liked the sponge reasonably well. Spermicidal foam began bothering me with regular use, though it was okay for a time.
posted by Michele in California at 2:15 PM on July 4, 2012

Why would you not use condoms 100% of the time? They are really, really effective when used correctly (no withdrawal!) and in the event one breaks (which is rare) you have the option of Plan B.
posted by DarlingBri at 2:16 PM on July 4, 2012 [1 favorite]

Non medical methods
- Cervical cap (not as prominent as a diaphram, works very very well)
- Sponge - don't feel it
- Rhythm method - works surprisingly well
posted by zia at 2:25 PM on July 4, 2012

Condoms are going to be your best option if you are not inclined to go on hormonal birth control or use an IUD. I would recommend Babeland's condoms as they are very comfortable and come pre-lubricated with lube that doesn't have glycerin in them, making them awesome for your lady parts and for your partner.

Have you considered visiting a local Planned Parenthood clinic for an advising session?
posted by Hello Darling at 2:27 PM on July 4, 2012

IUD! So nice, so easy, no hormones, never have to think about it. Had a couple heavy periods at the start, but otherwise smooth sailing.

Yes, they do last 10 years-ish (the copper ones without hormones), but that doesn't mean you can't take it out beforehand (well, your doctor will take it out). And the beauty is that you're ready to start trying to get pregnant immediately - you don't have to wait for hormones.

Costs may or may not be an issue: it was about $350 for the IUD and placement. It was a super simple doctor visit to take it out - so I'm guessing about whatever your Gyn charges for a routine visit. So if you said $500 for both in and out, and you need 2 years of control, that's about $21 a month. I have no idea how that compares to the cost of condoms or other methods.
posted by agentmitten at 2:32 PM on July 4, 2012 [1 favorite]

Wish I had more of an anecdote to offer you. We do the coitus interruptus thing (or finish with a condom if it's an ovulation week) unless there's menstruation involved. No problems thusfar, we both look forward to it.
posted by sibboleth at 2:37 PM on July 4, 2012

I was happy on my low-dose BCP (Tricyclen Lo) for a long time, but I've been using FAM+condoms for about 6 months now and it's nice to not have to take a pill every night. I'm not quite ready to get pregnant yet, so I'm very careful about avoiding the days around ovulation. I would only use FAM if I were ok with getting pregnant accidentally and I pretty much am -- personally, I wouldn't do it without feeling that way because it's just a bit too scary for risk-adverse me.

I track my temperature daily using an app on my phone, which is fantastic (it's called Lily). I've found that if I sleep in and don't take my temperature at the same time every day, my temperature levels get screwy. I'm very regular with my periods so I can pretty much anticipate when I'm ovulating and when my periods about to start, especially after charting for a few months, but if you have an unpredictable cycle, FAM might not be best for you. Read Taking Charge of Your Fertility before you start and keep it as a reference guide.
posted by pised at 2:44 PM on July 4, 2012

Mirena is a 5-year IUD, so depending on the cost, it wouldn't be totally unreasonable for you to get it now and get it taken out in a couple of years, depending on how much of it is covered by your insurance. It was about $400 for the device and office visit for me, I think (which was still more cost-effective for me than the Nuvaring, which I had been using until then), and free for my friend with better insurance.

Mirena was explained to me by my gyno as having only local hormones, unlike the copper IUDs, which last longer and are totally hormone-free. Both the copper IUD and Mirena, to my understanding, mostly function by signaling to your body that there is something in your uterus, but the low dose of local hormones addresses some minor side effects of the copper IUDs. I lost some of the benefits I got from using a hormonal bc method (e.g., I broke out for the first time since I went on hormonal bc), but I experienced some benefits to the IUD that led me to not really care about this (read: NO PERIODS). IANAD and YMMV, obviously.
posted by quiet coyote at 2:46 PM on July 4, 2012

I've successfully used FAM + occasional condoms. Don't knock condoms -- they can be lots of fun! You have to be really consistent with FAM, and make sure you follow as many of the symptoms as possible. It can be a lot of work.

Most of my female friends have IUDs, of varying kinds, and they all love them. Those who have had anxiety/libido/weight problems with the Pill don't have them with their IUDs. I'm planning to get one when I next need long-term birth control.
posted by linettasky at 2:55 PM on July 4, 2012

I love my IUD. I also know several people who used FAM to avoid pregnancy extremely successfully, as in "no oopses no scares" for years. However, none of them would have been destroyed a pregnancy; I would not use FAM as my primary method of birth control if a pregnancy would be a disaster. I only used FAM to get pregnant, but I was surprised at how clear my fertility signs were.
posted by KathrynT at 3:06 PM on July 4, 2012

I used FAM and occasionally condoms for 17 years, with two (wonderful and welcome) "accidents". First time, it was a condom that broke and it was before the "morning-after" pill. Second time, we knew well I could get pregnant, but took a chance since we were OK with the idea of a new baby. All along it's been easy to keep up with the different signs, I've never been in doubt. But I have become wary of condoms after the first baby, and never taken chances even using a condom until I was ready for another baby.
After number two, I've used a copper IUD. No problems at all.
posted by mumimor at 3:11 PM on July 4, 2012

I have had excellent luck using a Lady-Comp to track the days when I am able to get pregnant so I can act accordingly on those days. It's a combination thermometer/computer that tracks your ovulation cycle, which is good for the disorganized among us (me) who are not bloody likely to do any graphing or calculation on our own and for the mistrustful (also me) who are unwilling to leave potentially life-altering data collection to a $3.99 thermometer. While it is not a cheap investment initially, I have found it to be worth every penny. YMMV.
posted by corey flood at 3:33 PM on July 4, 2012

I love my copper IUD. I work in family planning and every woman I work with (nationally recognized experts in family planning) love their IUDs. I recommend you look into an IUD (copper or levonorgestrel). You can reverse it whenever,

FAM can be great too IF you are dedicated and down for study. In my nonprofessional opinion, though, you should look into an IUD.
posted by c'mon sea legs at 3:36 PM on July 4, 2012

lots of helpful answers- thank you :) after reading these i'm leaning towards condoms and FAM while maybe using some gadget like the lady-comp (thanks corey). also will look further into the copper IUD. cost of less than a thousand for a long term (but undoable) option is not a huge problem.

thank you all :) looking forward to reading more answers if there are any :)
posted by saraindc at 4:05 PM on July 4, 2012

I used FAM to get pregnant (but could just as easily have used it to NOT get pregnant -- it was that apparent once I'd been charting for a few months when I was fertile). You do need to take your temperature at the same time daily, and be aware that things like having a drink the night before (or more than one drink), getting less sleep than you usually do, having a cold, getting up to pee in the middle of the night (&c., &c.) can affect your temperature the next day, so I'd definitely be sure to use a FAM method that combines temperature charting with some other physical indicator -- cervical mucus, cervical position, etc. I used Fertility Friend for tracking (whatever you do, keep away from the boards there -- I only ever used the charting tool). It's definitely geared more towards those charting to GET pregnant, but there's no reason you can't use it for avoiding pregnancy, either.

Since I had my baby, I've had the Mirena IUD, and I love it -- no periods, as others have said, and no hormonal side effects like I had on the pill. For me, the small dose of hormones is worth it, given the reduced likelihood of heavier periods, etc., that come along with the copper IUD.

Be aware that some doctors won't insert an IUD in a woman who's never had kids, so be sure to ask your doctor and be willing to shop for a new one if that's the way you decide to go. There are no additional risks for a nulliparous woman but insertion is likely to be more uncomfortable than if you had given birth.
posted by devinemissk at 4:36 PM on July 4, 2012

You've gotten lots of great comments already, but I feel I should mention nonetheless: I have four different friends who have had surprise pregnancies while using FAM. I've never pressed for the details, so I'm sorry I don't have more to report on whether they were knowingly or unknowingly off-schedule, tracking their ovulations carefully or (probably?) not. Nonetheless, my mini-statistic seems worth mentioning here, as a reminder that you probably can't be too careful or precise when using FAM. And, like Kathryn T, I also don't think I would rely solely on FAM unless I felt that getting pregnant would be an ok outcome.

While I'm typing, I'll put in yet another positive for condoms - and yes, using the right brand makes a world of difference. For what it's worth, my partner and I use Crown - a million times better than your standard drugstore brands. Of course everyone is different - definitely try some different brands...
posted by marlys at 4:51 PM on July 4, 2012

I've been using a diaphragm combined with spermicide for a year or so, and no surprises thus far, thank god. It's not the sexiest thing in the world, but hormones make me crazy so 30 seconds of mild awkwardness is well worth it. (My partner and I don't really like the feel of condoms, YMMV.)

He can feel it sometimes in certain positions, but it doesn't seem to really affect the experience. And, it's pretty cheap--I think the diaphragm itself was..$50? They last for years. You do have to use it with spermicide though, which can be a little pricey (and some people are allergic too, though I haven't had that problem.)

Just thought I'd throw that out there.
posted by dysh at 6:18 PM on July 4, 2012 [1 favorite]

I am also interested in the answers to this question as I am adverse to hormonal BC due to side effects and potential risk factors regarding strokes. I have irregular periods that I track on the iPeriod app and a general knowledge and use of FAM (and am aware of its limitations in my irregular situation). I have not had the opportunity to really test it out since getting the app and learning about FAM, as I don't have partner, but I am occasionally sexually active and haven't gotten pregnant in the meantime (2 years). So, I guess I can't really advise beyond that fact that since I have started tracking symptoms on the app, I am way more aware of my body's cues and when it's a risky time of month to hook up.

I also wanted to comment to offer a dissenting voice regarding IUDs. In my social circle I know of at least two IUD mishaps, one of which involved a punctured uterus (shiver) and I think the other one involved a lot of pain. Of course that is very anecdotal and I do also have at least two friends who have IUDs and like them. I personally don't want one because I already have very painful periods, and the thought of a pointy thing in my softest of places makes me very uncomfortable.

I think when I get a regular partner, I will use the FAM plus a diaphram or cervical cap. The sponge interests me, but I have never tried it and don't know how widely available it is.
posted by smartypantz at 6:20 PM on July 4, 2012

The sponge interests me, but I have never tried it and don't know how widely available it is.

Are you in the US? Widely available. They are good for 24 hours and multi-packs are about 70% cheaper.
posted by DarlingBri at 6:50 PM on July 4, 2012

Also consider non-penetrative sex. It can be still just as fun (in my case, even more so) without penises having to enter vaginas.
posted by divabat at 7:07 PM on July 4, 2012

oooh sponge looks so expensive- more than 20 bucks for three days of protection? is this only a good idea for occasional sex?
posted by saraindc at 7:34 PM on July 4, 2012

The sponge interests me, but I have never tried it and don't know how widely available it is.
Are you in the US? Widely available. They are good for 24 hours and multi-packs are about 70% cheaper.
posted by DarlingBri at 6:50 PM on July 4 [+] [!]

I'm in Canada. I just asked at a fairly big drugstore and the pharmacist looked kind of confused and said to try online. I then looked online and the Today sponge website says Shopper's Drug Mart carries them in Canada, but when I called the Shopper's pharmacist said he's pulled them from the shelves at his store because nobody buys them and they just expire. He claimed women don't use them because they aren't as reliable as other methods and he suggests the diaphragm for a barrier method.

Today Sponge website says the effectiveness rate is 89-91%. I'm thinking maybe it would be ok to use in my situation combined with the FAM to cover those extra days that I'm not sure about due to the varying cycles.

saraindc - The price I see online is $14 for 3, which is still steep, but is totally reasonable for my situation of occasional sexual encounters.
posted by smartypantz at 7:55 PM on July 4, 2012

smartypantz- I see darlingbri's comment to you but I was asking in the context of my post. hope the advice you see helps you too though.
posted by saraindc at 8:08 PM on July 4, 2012

Just an anecdotal FYI about the diaphragm - not only did I find it really challenging to learn how to put it in (I shouldn't have tried using it the first time right before I wanted to have sex), but it gave me the worst raging UTI I have ever experienced.

I also did FAM for something like seven years, using the TCOYF software, and using condoms on high risk days, and never even had a pregnancy scare (although I've never gotten pregnant even once in twenty years of sexual activity with occasionally inconsistent birth control, so it makes me wonder if I'm infertile.)
posted by Neely O'Hara at 10:06 PM on July 4, 2012

Diaphragms! They run about 70 bucks but last for a couple of years if you take good care of them, waaay cheaper than pills/condoms/whatever. Tubes of spermicide seem to only come in GIANT sizes so they last forever too.

I've used mine for 12 years with no accidents. Because pills give me The Crazy and I am a chickenshit about having an IUD installed in my body.

It's not as spontaneous, but you get very adept at putting it in quickly after the first few times, and of course if you know fun times are going to happen later, you can put it in up to 6 hours ahead of time.

I personally have enough trouble making time for sex without having to consult charts or take my temperature every morning, so we never tried that method.
posted by emjaybee at 10:07 PM on July 4, 2012 [1 favorite]

I have extremely erratic periods, and a history of 'stealth' pregnancies in my family (including continuing to get light periods/spotting), so FAM was never an option for me. Even without that, I knew I would find logging/tracking/taking temperatures etc each day, as annoying as taking the pill each day.

The hormones on the pill affected me subtly, but badly. Not an option.


I had an copper IUD before that, put in by an experienced Dr at FPA and that was really good, did increase my (previous light) periods slightly, but otherwise completely trouble-free.
And more than that, I didn't have to pay it any attention whatsoever, and had peace of mind. Better actual-use success rates than pill, condoms, or FAM, no morning-after worries, and if I ever didn't want it? 15 minute appointment to come out.

Now? Now Mirena (IUD), is the best ever. It has about a tenth the hormones of the lowest dose pill, and unlike the pill, which you take orally, so it'll change your blood levels, so that *some* of it will hit your girly parts (and the rest of it your brain etc :P), it just releases a little, by the walls of your uterus, so that your body doesn't build up so much lining in your uterus, which equals lighter or no periods. Haven't had any problems like I did on the pill, and just get really light spotting instead of periods. Win!
(Also, I usually had light periods with no pain, but maybe once a year previously, I would have the most godawful, crippling, cramping, migrainy, I can't walk or talk for 30 seconds at a time, please give me a hysterectomy, pain. No more of those, either)


Oh, and between the pill & IUD, I spent a few years using condoms. Might be good for Stage 2 (Although, really - how bout just stopping using contraceptives altogether if you think you are ready? It's a good feeling knowing you've made the choice. Often takes quite a few months anyway...). Reason being, I think I had about a 1-2% breakage rate. And well, that meant taking the morning after pill about 3 times a year? And that suuuuuuuccked.
The first time wasn't so bad, but it seemed to get worse.
That's what had me fed up, and going for the IUD, and then later the Mirena when I was able to get it funded. Really nice not having to worry about it, at all.
The Mirena is actually more effective than a vasectomy/sterilization, because those surgeries both have a failure rate. So, for anyone militantly childfree, I usually recommend it to them. Effective, and reversible!


On a sidetrack:
Oddly, Mirena might be healthier for you than going au-naturelle, because well, women's bodies aren't designed for monthly periods for the extended time we have them in modern times. Between late onset of periods (13 now versus 18-20 100 years ago), frequent pregnancy, and breastfeeding for a couple of years at a time, women in pre-contraceptive cultures appear to only have a few periods between children. This leads to higher rates of cervical cancers, etc.
From section two onwards, here: http://www.gladwell.com/2000/2000_03_10_a_rock.htm
posted by Elysum at 10:15 PM on July 4, 2012

Sorry, I rearranged my post so it would be in order - the copper IUD was AFTER the pill & condoms, the 'before that' was in regards to the Mirena.
posted by Elysum at 10:19 PM on July 4, 2012

The Red Thoughts Consort and I have used condoms for a decade. Never had a problem, no drug-based birth control involved.
posted by His thoughts were red thoughts at 10:20 PM on July 4, 2012

Re: the sponge - Yeah I guess it would be pricey if you had a steady partner and sex most days. It does say you can leave it in for 24 hours and have sex multiple times, but that still makes it at least $5/day.
posted by smartypantz at 10:32 PM on July 4, 2012

Be aware that some doctors won't insert an IUD in a woman who's never had kids, so be sure to ask your doctor and be willing to shop for a new one if that's the way you decide to go. There are no additional risks for a nulliparous woman but insertion is likely to be more uncomfortable than if you had given birth.

This always comes up. I have no kids. No problem. No crazy pain. Just find an educated doctor and you're golden.
posted by Bunglegirl at 10:47 PM on July 4, 2012

You want to be looking hard at effectiveness statistics, not andecdotes on the internet!

Here is a handy chart from PP.

Personally, to me, an effectiveness rate anywhere below the high 90s would never have been acceptable. That rules out FAM, the sponge, condoms, and the diaphragm.

For you, it sees like a Paraguard IUD would be the ideal solution!

A word about FAM: I think the problem with FAM is that it is not a technological method, but rather a behavioral method. It's going to take you quite a while to get up to speed and get confident with it. For that reason, it's really not a good short-term solution for a healthy young woman having a lot of sex. One of the key signs used in FAM is cervical mucus, which young women produce more of naturally, and if you're having a lot of sex that makes things more confusing too. Couple this with your naturally high fertility ... no, I would not use FAM.

At the same time, using FAM to start to learn about your cycles now is a great idea. You may come to the point in several years where you're ok with a lower effectiveness rate, or you want to use it to get pregnant. I used FAM this way for many years, and I was able to get pregnant on the first try thanks to really understanding my cycles!
posted by mrs. sock at 6:50 AM on July 5, 2012

I use condoms exclusively with my boyfriend with the backup of Plan B when required. We've been having sex for about a year now with two scares -- in both cases I took Plan B. I much much prefer it to either birth control pills (which I have taken in the past -- I found that I really hated my mood when on it) and IUDs (I have a very low pain threshold and don't want to deal with the pain of an insertion).

I think you need to be a bit more alert when using condoms than with non-barrier methods i.e. always check for leakages at the end, make sure that the condom didn't slip etc. but as long as you're careful it's very effective. Note that with perfect use, 2 % of women using condoms exclusively will get pregnant in a year, and 15 % with typical use. I think that 15 % can be brought down significantly with careful monitoring, fertility awareness and Plan B when you have any doubts at all. If you are in a place with access to Plan B and RU 486, that is something I am willing to live with in exchange for not using steroid hormones (whose effects are still poorly understood) every day.

The key thing with this is to get your partner on board. He needs to be an equal partner in the goal of not getting you pregnant. It's easy to get carried away during sex so both of you need to be completely committed to having safe sex. Experiment with different condoms so you can find the ones that give you and him the best sensations. It might take you a little while to get into the groove of things -- our mistakes all happened in the first month or so, while we were still getting the hang of things. I think there was even a study that I recall reading where they said that most pregnancies that happened when a condom was used happened when the couple was unused to using condoms as birth control. Finally, I remember that I told the nurse practitioner who prescribed me my birth control that I was going off it and that I was going to use condoms exclusively. I asked if she was concerned by that and she just shrugged and said that she had been using them in her marriage for 17 years and had not had any problems.
posted by peacheater at 8:57 AM on July 5, 2012

Oh and incidentally my parents too used condoms exclusively for their marriage of more than 33 years. Both of them have said that it was not a problem at all.
posted by peacheater at 9:05 AM on July 5, 2012