Contraception conundrum

April 26, 2013 1:38 AM

Long story short, I had a very bad experience with the Mirena iud and now considering the Nuvaring. Wondering if this is a bad idea....

I've searched on this topic and read about plenty women who were on Nuvaring unhappily that then changed to Mirena IUD and were delighted but nothing to be found on the reverse scenario.

With the Mirena I experienced 8 months of daily debilitating cramps, huge loss of libido and ho-lee shit wild mood swings that just wouldn't settle down . When I admitted defeat and requested a removal, it took doctors 4 separate (painful) appointments before they could successfully remove it, but the moment it was out of my body I started to feel normal again.

General mood improved *instantly* - walked out of the hospital on top of the world, the emotional volatility disappeared quickly and my libido returned with a vengeance. Which was great but quickly lead to an unexpected pregnancy.

So we are considering our contraceptive options again, seriously. Really don't want to get pregnant (not for another couple of years at least, maybe never) Wouldn't consider sterilisation. I don't want to take the contraceptive pill as I seem to be extremely sensitive to any type of hormonal imbalance. So Nuvaring is a bad idea right? It's a different type of hormone from the Mirena and again it's 'localised' so meant to have minimal impact but I obviously am having doubts about that after my previous experience..

I would just love to know if there is anyone out there who switched from Mirena after a bad experience to the Nuvaring with great results. Has this happened ever?

What about any other contraceptions ideas? Condoms are ok in the mean time but other than that? The copper coil is not an option for me as I already have painful periods and do not want to compound that problem. Open to any other suggestions though. I'm at a bit of a loss here! Thanks in advance for any input.
(Posting from UK if that makes a difference)

posted by kudra23 to Health & Fitness (27 answers total)

Best answer: Are your periods fairly regular? Fertility Awareness Method might be a good fit for you if they are. I successfully used FAM for about 5 years and am now (intentionally) pregnant. You can get a feel for it from the free online classes on Fertility Friend, which also is a place to track your cycles, but the best resource is the book Taking Charge of Your Fertility. My fertility signs are very clear and regular, so I was able to figure out my "safe" times pretty quickly and easily. I used condoms while getting used to tracking, and also if we wanted to have sex during my fertile window. I know FAM doesn't work for everyone, for lots of reasons, but it might be worth trying.

I am also extremely sensitive to hormonal birth control. I have never tried Mirena, but have used Nuvaring for a couple of 6-month+ stints. For me, the symptoms weren't as intense as when I was on various types of the pill, but I still had some and noticed a definite improvement once I stopped.
posted by apricot at 3:33 AM on April 26, 2013 [1 favorite]

I had a terrible experience on the nuvaring and a terrible, terrible, terrible experience in the Mirena. Terrible experience on the pill, too. Me and hormones just don't mix.

I use FAM, the fertility awareness method, and withdrawal. It has nothing to do with "regular" cycles as you track your basal body temperature every morning and that plus cervical fluid consistence can pretty much exactly pinpoint your fertile days. Also, used correctly and consistently, the withdrawal method has the same failure rate as condoms. We've never had an issue or a scare.

Get the book Taking Charge of Your Fertility by Toni Weschler and see if it's something you'd be comfortable with.
posted by lydhre at 4:14 AM on April 26, 2013 [1 favorite]

Though I don't have much to contribute, I wanted to say that I too have bad times with hormones, so I practice the same methods as the previous two posters. I feel like fertility awareness is not an option that many are made aware of, though it does require a lot of personal responsibility.

The Nuvaring wasn't as bad, initially, but eventually I started to feel like I had felt on BC pills: excessively emotional, irrational, angry.
posted by sibboleth at 4:34 AM on April 26, 2013 [1 favorite]

As far as other contraception ideas go, this chart from Planned Parenthood looks at the efficacy of bc methods. Each of the images on the chart is a link that leads to more info about that method. Some of the methods can be combined to lower the risk of pregnancy.
posted by amarynth at 5:10 AM on April 26, 2013 [1 favorite]

I have a Paraguard which has worked fine for me. It's copper, not hormone based.
posted by dawkins_7 at 5:23 AM on April 26, 2013

I had loss of libido on Nuvaring but it was otherwise ok for me. Now I'm on Paraguard, and it HAS made my periods worse so I don't think it's for you, unfortunately.

Have you considered a diaphragm or sponge? I know it sounds sort of... old-timey, but it seems like the last invasive non-hormonal solution, short of condoms.
posted by showbiz_liz at 5:51 AM on April 26, 2013 [1 favorite]

I had a terrible experience on the pill but the nuva ring has been a dream. I have no side effects and often forget it's in place, so I have to keep track of it on my calendar to know when to take it out.
posted by thank you silence at 5:53 AM on April 26, 2013

Best answer: Actually though... you might as well TRY the Nuvaring. Unlike the Mirena, it's not a big commitment- if you don't like it, you just remove it and that's that. I'd give it a shot, even though I didn't personally love it.
posted by showbiz_liz at 5:55 AM on April 26, 2013 [4 favorites]

I have the Nexplanon, after deciding not to replace my copper coil due to a couple of complications. I was wary of it as I have medical issues that make hormonal contraception a risky choice, but I've found it great so far. The only downside is a little weight gain but I'm working on that at the moment. I have bipolar disorder so I'm pretty sensitive to hormone changes but things have been stable - and the FPC (you have to get it fitted there rather than by the GP as far as I know) can remove it for you if it doesn't suit. They told me it works its way out of the system in four days. I've also gone from very heavy and debilitating periods with the copper coil to nothing at all, which has made a HUGE difference to my life.

My family is astonishingly fertile (my mum came off the Pill after ten years to get steralized, pregnant with me two weeks later; my sister was steralized at 25) and I find the idea of using condoms - or tracking my cycle - alone very anxiety inducing. I realise some other posters have had success with it but it's personally something which would make it very hard for me to relax. For that reason, the downsides of more permanent contraception make it worth it for me.
posted by mippy at 6:21 AM on April 26, 2013

I could not physically have an IUD, but it was my preferred choice before finding out that I couldn't have one. (Something with the size of my uterus being to small and the risk being to high for problems) so I went with the Nuvaring.

I've been using it for over a year, and I really like it. The only bad part, if any, is the process of taking it in and out can be weird, but thats a short thing in regards to the actual use. My husband says he doesn't really feel it.

The cost is another issue for me. I pay $60 a month for it! It's not covered under the new birth control laws. But, I can't take a pill for the life of me (just forgetfulness on my part). SO it's worth every dime and a hell of a lot cheaper than diapers, child care, formula, etc!
posted by AbsolutelyHonest at 6:24 AM on April 26, 2013

Best answer: I can't do any kind of hormones, so haven't tried the Nuvaring. However, my gyn explained that if you're diligent about its use, the diaphragm is actually as reliable as the pill, so that might be the way to go. You can put it in up to two hours in advance, so it's possible to preserve some degree of spontaneity. Honestly, it's not worth the hit to libido (and life outlook) to make a choice just because it saves you 30 seconds of interruption now and then.
posted by acm at 6:27 AM on April 26, 2013 [1 favorite]

I'm not sure how much this will help you, as I currently have (and love!) a Mirena (for me, it has meant no period, mood stabilization around what are typically hormonally-related peaks and valleys, and general ease of use). But before I moved to the Mirena I had (and loved!!!!!) Nuvoring. I would suggest giving it a shot - you can absolutely try it for just a month or two and see how it works for you.

Alternately, I went for the Mirena because I wanted the low dose hormones. But there are several copper IUDs on the market that have no hormones that might help you - I realize this is probably something you won't want to consider right now given how challenging things were getting your Mirena removed. The one I'm familiar with is Paragard, which my sister has, and is very satisfied with.
posted by arnicae at 6:54 AM on April 26, 2013

I am currently using the Nuvaring. So far so good, its super easy to put it once a month, and not worry about remembering to take a pill. Nuvaring is also super easy to use continuously- my doctor told me it has enough hormones for up to 35 days, but after 28 its likely to have break through bleeding. I tried Kariva before, another pill, but it totally killed my libido. So I think trying a different type of hormone would be worthwhile.
posted by florencetnoa at 6:58 AM on April 26, 2013

All those who are recommending copper IUDs - the OP mentions "the copper coil isn't an option for me". "Coil" is a UK name for an IUD.

I too have had problems with hormonal contraception (the pill, in my case) and we just relied on condoms alone for a good while. So I can't comment on the NuvaRing, but in your position I might be tempted to try it for a little while.
posted by altolinguistic at 7:00 AM on April 26, 2013 [1 favorite]

I'm one of those who had problems with the Nuvaring and then switched to a Mirena and had success.

It's certainly possible the Nuvaring will work out for you, because everyone responds differently to bc. However, given your susceptibility to hormones, it's not very likely to play well with your body. The least amount of hormones you can get is with the Mirena. The Nuvaring certainly is a low dose, but not as low as Mirena. BUT -- everyone responds differently, so it's worth a shot. It's extremely easy to insert and remove, so if you decide it's not for you, you can take it out immediately.

Really the best idea for you is a barrier method. This summarizes bc methods by effectiveness. The first non-permanent non-hormone-based methods come in at ~80% effective, but that gives you the available methods. It is also good to double-up on protection methods to increase effectiveness.
posted by DoubleLune at 7:27 AM on April 26, 2013 [1 favorite]

I had a terrible experience on Nuvaring - it gave me cystic acne, and not on my face. Thankfully, that cleared up within a week or so of removing it. However, I'd echo other commenters and tell you to give it a try. You never know how a particular method is going to affect you until you use it.
posted by sevensnowflakes at 8:11 AM on April 26, 2013

Response by poster: Thanks for all the input ladies. Lots of food for thought... Thinking diaphragm for the meantime, till I feel brave enough to try the ring - if ever! Definitely looking into natural methods too.
Still hoping to hear from any mirena to nuvaring transitioners if they're out there!
posted by kudra23 at 9:27 AM on April 26, 2013

I used a diaphragm for several years: it was simple, cheap, not very inconvenient, and turned out to be reliable. You do need to use it with spermicidal jelly or foam - I was recommended to use a jelly specifically made for diaphragms as it was thicker and thus more effective. There have been some rumblings that some spermicides may increase the risk of STDs; this may or may not be a concern for you.
posted by jb at 11:12 AM on April 26, 2013 [1 favorite]

I've never had an IUD but I used the nuvaring and loved it; however, the cost can be an inhibitor just like the hormones probably are for you. No one's mentioned vaginal contraceptive films - I don't know if they're common or even available for you but I've used them with absolutely no side effects; if you combined them with fertility awareness I think you'd be very well set up.
posted by lemniskate at 11:36 AM on April 26, 2013

Count me in as one of the FAM (Fertility Awareness Method) for birth control, been doing it for years, as other methods caused cramps or other weird reactions. And of course there's an app for that (but read the book first).
posted by St. Peepsburg at 11:38 AM on April 26, 2013

I don't want to take the contraceptive pill as I seem to be extremely sensitive to any type of hormonal imbalance.

What pills have you been on? Personally I take Cryselle or Low-Ogestrel. It is the same level of hormones for 3 weeks, then no hormones for your last week. It's amazing. I was on Ortho-Tri-Cyclin-Lo and I had CRAZY mood swings and still an awful period, but the pill with the same level of hormones squashed all that. I think it's worth a try.

Planned Parenthood is a good resource for types of contraception. You can even take a quiz to find your method. They also have a chart for how effective each kind is.

Some options for you may include:

Trying a new kind of pills
The Shot
The Patch
Cervical Cap/Diaphragm
Another type of IUD or an Arm Implant

However I am unsure how much you don't want to get pregnant. The chart shows that Fertility Awareness usually results in 25 pregnancies per 100 women per year. (Withdrawal is 15 to 24). If you are willing to change a baby at that percent, then go for it.
posted by Crystalinne at 12:02 PM on April 26, 2013

I would be wary of the shot - if you mean Depo-Provera. On the plus side, it's effective and you are very unlikely to get pregnant. On the minus side, you will more than likely gain weight - I went from a stone underweight to two stone overweight in six months (though some of this may be down to looking after myself a bit more) and I found that I had horrible mood swings just before the next shot was due.

You don't say how old you are, but if you're under 24 I'd highly recommend talking to someone at Brook Advisory Centre if you have one in your town. They are specialist sexual health doctors and were the first place I went to when I realised I needed something longer-term than condoms. If not, then it would be worth going to a drop-in appointment at your local Family Planning clinic - they may have an option you haven't considered, or will at least be able to give you information about the NuvaRing.
posted by mippy at 1:19 PM on April 26, 2013

however, the cost can be an inhibitor just like the hormones probably are for you

You don't need to pay for any form of contraception in the UK - save for condoms if you buy them from the chemist.
posted by mippy at 1:21 PM on April 26, 2013

Best answer: Depending on your comfort level (and your partner's abilities), you might consider the pull-out method. It sounds dumb, but it has approximately the same success level as condoms (96% successful when practiced perfectly, 73% when practiced imperfectly).

You could also combine a lo-fi FAM (keeping a calendar and checking your cervical mucus to determine the approximate week of ovulation) with condoms or the withdrawal method on fertile days.
posted by feets at 2:29 PM on April 26, 2013

The Ladycomp makes NFP really easy.
Although you can also download an app and use a thermometer to the same effect.
posted by tenaciousmoon at 4:53 PM on April 26, 2013 [1 favorite]

Just a caveat abou FAM. I switched to FAM after a long struggle (if you read through my history you'll see a particularly exasperated ask) after 10+ years on Implanon. I LOVED Implanon, but in the last few years it gave me hair loss (maybe in interaction with some arthritis meds), which is pretty good innings for a medication I'd been taking continuously for 10 years.

I'm mostly healthy, kinda young (just turned 30) and prone to self-quantification, so FAM was a fun hobby. Until i got my first annovulatory cycle. Then another. Then another. My cycles were literally all over the place, totally unreadable. Fortunately, my intention was to use FAM as a backup to condoms, so we never went without.

I took my charts to my dismissive Dutch huisarts, and bloodwork revealed a patchwork of endocrine dysfunction. I'm now trying to decide whether to go through the expense of an MRI and gynaecology workup.

So TL:DR; FAM is pretty great, but you might not have the kind of cycles that can be 'read.' Stock up on condoms.
posted by nerdfish at 1:01 AM on April 27, 2013

But, on retreading the thread, if you're interested Nuvaring sounds like its worth a shot. I loved my carefree Implanon days. If it works for you, awesome! Bone on! If it doesn't, you can just remove it yourself and explore other options.
posted by nerdfish at 1:04 AM on April 27, 2013