Need effective birth control

September 13, 2005 5:18 PM

Help me bonk my wife. We're at our wits' end with birth control.

* The pill - serious emotional and physical side effects.
* Condom - she has a latex allergy. (This would presumably affect diaphragms as well, though we haven't tried.)
* Nonlatex condom - broke the first time we tried.
* Kids - absolutely not.
* Vasectomy - I'm all for it, and we're not interested in having biological children, but it may be that we're too young (20s) to make such a decision (though I hear reversability technologies are getting better.)

So are we doomed to a life of rhythm/withdrawl? Are some of the newer contraceptives (depo/patch) more tolerable for people with reactions to the pill? Is that spermicide goo reliable enough when used alone with the rhythm method?

posted by anonymous to human relations (51 comments total)

Try Avanti condoms. I've never had a breakage in like 8 years of use and have only heard of one or two ever breaking in user reviews.
posted by mathowie at 5:20 PM on September 13, 2005

Has she tried getting a diaphragm? That might be good.
posted by ThePinkSuperhero at 5:23 PM on September 13, 2005 [1 favorite]

What kind of nonlatex condom? Sheepskin condoms are very nice, if expensive.
posted by neckro23 at 5:26 PM on September 13, 2005

I believe the Nuva ring works like the Pill, but gives a lower dose.
posted by callmejay at 5:28 PM on September 13, 2005

depo has been upgraded from temporary calcium loss to some permanent calcium loss. Therefore no depo for me, and I don't recommend it to your wife either.

Maybe she could try those vaginally-inserted birth control methods. I understand they get less hormones into the blood stream. Then again, they're new which generally means untested and slightly dangerous in the birth control world.

Cultivating a sense of "a thing growing inside me against my will is gross and must be exterminated immediately" can help with any mistakes. Horrible thing to deal with, but if kids are a NO then you should both be mentally prepared ahead of time to deal with abortion.
posted by lorrer at 5:28 PM on September 13, 2005

(And second on the Avanti.)
posted by callmejay at 5:28 PM on September 13, 2005

ugh, by "vaginally insterted" i was extremely vague - I meant the nuva ring.
posted by lorrer at 5:37 PM on September 13, 2005

I believe that the NuvaRing is supposed to be less invasive than other forms of hormonal birth control--it has a lower dose of hormones and delivers them consistently rather than in bursts. (I promise, I don't work for them, I just like the product.)

Of course, your wife will have to discuss this with her gyn, to see if it's different enough not to cause problems for her.
posted by CiaoMela at 5:44 PM on September 13, 2005

There's the natural planning method where the cervical mucus is checked every day for signs of ovulation. I never tried it but apparently there are a lot of Catholics-and others- who find success with the method. If you google it I am sure you could find info or classes on it.
posted by konolia at 5:46 PM on September 13, 2005

Has your wife considered using and I.U.D?
posted by Radio7 at 5:51 PM on September 13, 2005

I am not a doctor, but I have read that there are some new IUDs out there that are supposed to be safer than the old ones. I don't know if doctors will prescribe them for young women who have never had children though. Might be worth looking into at least.
posted by awegz at 5:53 PM on September 13, 2005

* Vasectomy - I'm all for it, and we're not interested in having biological children, but it may be that we're too young (20s) to make such a decision (though I hear reversability technologies are getting better.)

I got one four months ago - at 24 - and it has been an absolute godsend. The urologist was pretty set against it at first, but the words 'mental illness' and 'I'd adopt anyway' changed his mind.

I can't stress this enough, though: make absolutely certain you're sure before you go through with it, because despite reversability getting better, there's a very very good chance you're slamming the door shut behind you.
posted by Ryvar at 6:12 PM on September 13, 2005

How about the contraceptive sponge? (Contains spermicide, although extra probably wouldn't hurt).

Male Contraceptives is an entertaining site.
posted by digitalis at 6:23 PM on September 13, 2005

Ditto success with Avanti. If that's what you had break, I'd recommend more lube.

Also ditto on the lambskin condoms, assuming you're neither vegan nor worried about getting HIV.

In addition to diaphragm, there's also the possibilyt of a cervical cap.

And as a last resort, there's oral sex.
posted by alms at 6:28 PM on September 13, 2005

When we were using birth control, we finally settled on FAM - fertility awareness method. It's described in Taking Charge of Your Fertility by Toni Weschler. Similar to rhythm, but more effective. So probably not good if you're tired of all the "work" of rhythm. IUDs are perfectly safe but not generally given to women who haven't given birth. And they exacerbate cramps and cause heavier periods.

A note about NuvaRing: I took it for 10 months. I had no emotional side effects, and I say this as a person who was literally suicidal while on the Pill. (That's a whole story in itself - no history of depression whatsoever, I just CANNOT tolerate the pill.) However, the Ring is not perfect. For me, it caused excruciating breast tenderness, breakthrough bleeding, vaginal dryness, and terrible cramps that I would describe as "feeling like my uterus was being pulled out." I kept at it because I wanted to be sure I was giving my body time to adjust, but the side effects just didn't abate. Oh, and I gained 15 pounds. Some may say there is no evidence that hormonal birth control actually causes weight gain. These people are not women. Best of luck to you - I know how hard it is to find a good method.
posted by peep at 6:50 PM on September 13, 2005

How much is a vasectomy these days in the U.S. anyway? Like, a round-figure range? Hundreds? Thousands?
posted by davy at 6:59 PM on September 13, 2005

I cannot tolerate oral contraceptives, and for me, NuvaRing was no better. A lot of women love NuvaRing- I'm not one of them.

You might have checked the Ask MeFi archives, because a very similar question has been asked before.
posted by elisabeth r at 7:07 PM on September 13, 2005

An IUD is definitely a great option, and though they've got a bad rap left over from the 1970s, they're quite safe now..

There's the natural planning method where the cervical mucus is checked every day for signs of ovulation. I never tried it but apparently there are a lot of Catholics-and others- who find success with the method. If you google it I am sure you could find info or classes on it.

This is called the Fertility Awareness Method, and it's not just for Catholics. It requires more committment than taking a pill or wearing a condom, so it isn't for everyone, but even if you don't use it, it's a fantastic way for women to become more aware of their/our bodies & hormonal shifts.

There are typically three parts to FAM: first, take your resting/basal body temperature [orally] every day before you get out of bed using a basal thermometer (which measures to the hundredth degree). Depending on where you are in your cycle, your temperature-at-rest changes as your hormones change, and typically there's a very clear/noticible shift you learn to recognize after several months. Many people combine this with looking at cervical fluid, which changes consistency (before ovulation it's stickier/gooier, which helps the sperm have something to hang on to) throughout your cycle. You can also buy a speculum and look at cervical position (something I've never done). For FAM to work you have to be totally committed to either abstaining or using a barrier method (condom/diaphragm) during fertile periods (typically the week before ovulation), and you have to spend your first one or two cycles tracking your body's hormonal patterns before you can totally rely on it (though that takes a while it's still comparable to the pill needing a whole cycle to kick in). Even still, like with every birth control method, there's a risk of pregnancy (essentially, used correctly, the risk is almost nothing, but if you're staunchly pro-life and don't want kids this is probably not a good choice; but in that case being sexually active isn't a good choice, period).

There's a fantastic book on FAM called Taking Charge of Your Fertility by Toni Weschler that you can probably get from the public library.

If you're interested in this, also check out the [very 1999-esque website] sisterzeus.com (click on "next" by the guestbook link), or look over archives of the FertilityAwareness yahoogroup.
posted by soviet sleepover at 7:07 PM on September 13, 2005

I second (third?) the IUD. Much safer than those of yore, and nothing to remember, no nasty side effects. I got it despite not having had any children, but YMMV, doctor-wise.
posted by airgirl at 7:09 PM on September 13, 2005

There's the natural planning method where the cervical mucus is checked every day for signs of ovulation. I never tried it but apparently there are a lot of Catholics-and others- who find success with the method. If you google it I am sure you could find info or classes on it.


This is big for Catholics and is commonly referred to as Natural Family Planning, or NFP, for us Catholics. It somewhat popular as it allows y'all to have natural sex with the basic assumption of abstinence while she's fertile for the month. For what it's worth, those who are on NFP claim that it has brought the two a lot closer together as it opens up channels of communication that might not normally be there.
posted by jmd82 at 7:16 PM on September 13, 2005

For you guys, IUD! Safe, effective, no muss at critical times, no allergies, not permanent.

I would hesitate to cut your cords, either of you, at this point. Who knows what you will want in the future. You are very young yet.
posted by caddis at 7:43 PM on September 13, 2005

Pssst. IUD. The new ones don't suck.
posted by ifjuly at 8:00 PM on September 13, 2005

Diaphrams are, as far as I know, usually made of silicon, not latex. Your wife may not react to a diaphram. Ask your doctor about this.

They are effective birth control, more convenient than condoms, with a similar safety.

Diaphrams are not expensive, though your wife will need to go to a clinic or her doctor to have it fitted for the first time, to make sure she has the right size.
posted by jb at 8:02 PM on September 13, 2005

You have to pay for a vasectomy? WTF? Surely they're covered by whatever medical insurance one has down there, and all the more so if one can't afford medical insurance ('cause denying vasectomies to the poor would be beknightedly stupid.)
posted by five fresh fish at 8:11 PM on September 13, 2005

I never tried {NFP} but apparently there are a lot of Catholics-and others- who find success with the method.

Of course, all the Catholic families I know have 4 or 5 children, too, so YMMV.
posted by ThePinkSuperhero at 8:13 PM on September 13, 2005 [1 favorite]

Planned Parenthood's birth control pages are always an excellent source for BC info. Everything mentioned in this thread is discussed there in great detail.
posted by climalene at 8:22 PM on September 13, 2005

IUD all the way or NuvaRing.. Both good options in your case.. talk to your doctor.

Also the rhythm method or it's cuter kid brother, this FAM business, is dodgy at best in its efficacy. The latter requiring significant amounts of effort and still yielding mixed results in many cases.
posted by drpynchon at 8:57 PM on September 13, 2005

For the women who got IUDs before having any kids, how did you talk your doctor into it? Did you get the copper kind, or the hormone kind?
posted by footnote at 9:09 PM on September 13, 2005

I was just about to say something similar to footnote's comment - I was told within the past four years that I could not have an IUD because I'd never been pregnant.

How about the contraceptive sponge? (Contains spermicide, although extra probably wouldn't hurt).

I said this in another post here recently, and I'll repeat it here:

"This is just an anecdote, but in my life I have known four women who became pregnant while using birth control.

All four used the sponge."
posted by anastasiav at 9:22 PM on September 13, 2005

Another anecdote: we used the NFP or FAM or PDQMRTZX or whatever you'd like to call it successfully for three years. Our youngest child is a direct result of that technique. Old joke: "What do you call people who use the Rhythm method? Parents."

Don't have any specific advice (although I'd second the Planned Parenthood page.)

five fresh fish: Yeah, we have to pay for our own medical care that's not covered by (1) insurance or (2) limited government programs like Medicaid or Medicare. And "denying vasectomies to the poor" may be "beknightedly stupid," but looked at from another perspective, sterilizing the disadvantaged could very easily be seen as less than democratic. Orwellian, maybe even. Not to derail, or anything. :P
posted by ZakDaddy at 9:47 PM on September 13, 2005

Nonlatex condom - broke the first time we tried.

I don't know what kind you tried but these are worth more than one attempt. I have used Avanti non-latex quite a bit, and not because of any allergy. Their texture and heat transfer are excellent and provide good sensation (not to mention a welcome change in sensation from latex - cariety is good). They don't have a long shelf-life, but they really are the second coming of non-latex condoms. If you've not tried the brand, you should. Still, condoms are not a great way of avoiding pregnancy over time. Or that much fun.

IUDs are way, way safer than in the past and got a pretty bad rap to begin with anyway. Why people flock to the pill and avoid the IUD like the plague is beyond me. Given your list, it seems like the best choice. Very effective, too.
posted by scarabic at 9:57 PM on September 13, 2005

that's "variety"
posted by scarabic at 9:57 PM on September 13, 2005

everybody and their sister seems to be using the NUVA ring as of late, in my experience


there are a lot of Catholics-and others- who find success with the method.

success = kids!


broke the first time we tried.

get a more expensive one, and Astroglide. it won't break then. Astroglide is your friend
posted by matteo at 10:14 PM on September 13, 2005

The sponge isn't cheap (about $3 each) but they're good for 24 hours of bonking, so you can at least have fun trying to get the most, um, "bang" for your buck.

They aren't as effective as hormone-based birth control, though. I do know one woman who got pregnant while using the sponge, but she used it incorrectly (she took it out immediately after sex instead of waiting 6 hours).

On the plus side (in addition to the 24-hour sex-fests) sponges are easy to use and neither of you will notice when you're using one.

On preview: scarabic, IUDs aren't recommended for women who haven't had children, or who aren't in a committed relationship; by the time you're eligible for one, you've probably already found a birth control method you like.
posted by stefanie at 10:58 PM on September 13, 2005

matteo >>> "get a more expensive one, and Astroglide. it won't break then. Astroglide is your friend"


Oh hell no. Astroglide is, hands down, the worst lube I have ever used. You want something like Trojan Liquid Satin, Wet Light, or Wet Platinum (which is silicone-based, and slippery as all fuck. Don't use with silicone toys or apparatus, though).
posted by dirtynumbangelboy at 12:11 AM on September 14, 2005

dirtynumb - What, no handy links to your favorite products? *grumblegrumble* *opens Google*
posted by ZakDaddy at 12:20 AM on September 14, 2005

What's the word on spermicide + "pulling out"? I've never heard it mentioned anywhere.
posted by redteam at 1:19 AM on September 14, 2005

I also had problems with BCPs, and I am using a copper IUD for now. The newer IUDs release hormones.

A woman who has never given birth has more of a chance of expelling an IUD. My doctor told me to use a backup method, and she checked the placement of the IUD after a month to make sure it was still in place. One should periodically check to make sure it is still there. They have a trailing "string" that can be felt.

I initially told my doctor I wanted a tubal ligation, and she suggested an IUD. The copper IUD is effective for 10 years, and she said if I still didn't want to have children in 10 years I could get another IUD inserted and after that I wouldn't need an operation. One would need to consider the risk of having an operation vs. the risk of complications from an IUD.

The copper IUD has caused me to have longer periods with heavier bleeding. About as bad as when I was a teenager.

aside: the female condom is non-latex. We had trouble with the Avanti condom being hard to put on. It seemed to be smaller than latex condoms.
posted by furvyn at 1:22 AM on September 14, 2005

lorrer - Do you have a link on the Depo information? I've been on it for nearly four years now and I absolutely love it, so I'm gonna be pissed if I have to change to something different...

Calcium issues aside, I much prefer Depo to the Pill. No weird side effects for me, and I've even managed to lose weight on it. I also don't have any period at all, which has been my dearest dream since the time I hit puberty.
posted by web-goddess at 2:32 AM on September 14, 2005

What's the rationale for not getting an IUD if you haven't had children?
posted by Saucy Intruder at 5:09 AM on September 14, 2005

lorrer - Do you have a link on the Depo information? I've been on it for nearly four years now and I absolutely love it, so I'm gonna be pissed if I have to change to something different...

An article on the black box warning:
Injectable contraceptive can weaken bones, company warns

I freaked out about the black box warning on Depo Provera too, but I'm still on it, partially because of these articles:
Depo Provera's Bone Loss Reversible
Reproductive Health Technologies on Depo (see: What is a "black box" warning and why was it applied to Depo Provera?)

That, and my doctor was also unconcerned about it, just suggested that I start taking a calcium supplement.
posted by heatherann at 5:17 AM on September 14, 2005

Avanti. Seriously.
posted by Pericles at 5:40 AM on September 14, 2005

A doctor can prescribe an IUD if you've had documented problems with the pill, such as being at risk for blood clots. It's pretty much the best thing going--all the midwives I know have them, and they're a pretty educated bunch.
posted by MrMoonPie at 9:22 AM on September 14, 2005

I had a vasectomy some years ago. It was $600, of which I paid $120, IIRC (I basically have catastrophic insurance, FWIW). If you know you don't want kids, ever, it's the route to go. Much less of an ordeal than a tubal ligation (took about 15 minutes).
posted by adamrice at 9:50 AM on September 14, 2005

I eleventh or twelfth the IUD. I gotta say, though: I'm a bit surprised at some of the comments here--I never experienced any reticence from my ob-gyn when I told him I wanted an IUD. I've never had kids and I was in my mid-20s when I got it. There's so many myths surrounding IUDs but any moderately enlightened doctor should be willing to at least *discuss* it with you.
posted by veronica sawyer at 11:03 AM on September 14, 2005

What's the rationale for not getting an IUD if you haven't had children?
According to my OBGYN, women who haven't had children are more likely to expel the IUD or experience more pain/bleeding after it's been inserted
posted by darsh at 12:02 PM on September 14, 2005

ha, I just started sleeping with a girl with a latex allergy. Of the four avanti we used, one broke. Probably wouldn't be an issue with enough lube though. And yeah, definitely not as good as latex
posted by slapshot57 at 12:48 PM on September 14, 2005

Depo nearly killed my fiancee. For the people it works for, it's great, but in her it induced a horrible, black depression that was fueled further by severe weight gain. It made her physically ill, and I feel terribly lucky that we figured it out and got her off that poison.

She's never had kids, and now she has an IUD that releases hormones. We like it.
posted by rocketman at 1:03 PM on September 14, 2005

The vasectomy option sounds great, however I personally know 2 kids who were conceived post operation (or the moms were sleeping around). It is definatly safer/less invasive than the tubal, and there's nothing to remember like with most of the BC methods.

I also back Wet as a great brand of lube. Not only does it work well, I also like the bottle design, easy to open and easy to hang on to. I find the "Light" to be the best for vaginal sex.

I hope the two of you have talked and have a game plan if/when the birthcontrol fails. That is not something you want to discuss for the first time when she's 8 weeks along.
posted by nadawi at 8:38 AM on September 15, 2005

What's the word on spermicide + "pulling out"?
The word is "daddy".

My wife and I were in a nearly identical situation to anonymous. IUD, all the way; godsend. (Nobody told us she couldn't have one despite not having had any kids previously, or if they did I never heard about it.) She had some cramping for the first couple of weeks, but after that, it's all good.
posted by ook at 10:03 AM on September 15, 2005

There are diaphragms and cervical caps made of silicone or other non-latex materials, and there are also some newer silicone barrier products like Lea's Shield, but do keep in mind that diaphragms have higher failure rates than many other methods (though I believe diaphragm failure rates are lower in women who have never given birth than in those who have).
posted by needs more cowbell at 8:58 PM on September 17, 2005