Stomach-safe Birth Control Pills?

March 19, 2007 7:58 PM

About six months ago, my girlfriend went on The Pill - first Yasmin, then Ortho Tri-Cyclen Lo. Both caused mood swings and significant intestinal distress, but her physicians (internist and OBGYN) thought that she'd be safe to stay on, if she could put up with the side effects. This month, as a test, she went off, and she feels hugely better. So, now, we're considering alternatives, and looking for anecdotal advice.

In particular, any ladies here experience stomach problems with the pill, then find greater success with Nuvaring, Progestin-only mini-pills, or something else? Similarly, anyone have to try a slew of different pills to find one they liked?

posted by thomascrown to health & fitness (37 comments total)

My anecdotal advice is that the mood swings level out after an adjustment period of 3-ish months. Can't comment on the intestinal distress. And I confess I am not thinking specifically of the medications you mention by name, but more generally about pills used by past partners of mine. Suddenly I feel like a bad boyfriend for never knowing the specific names.
posted by ahilal at 8:05 PM on March 19, 2007

I had similar problems. Perhaps an IUD would work for her.
posted by acoutu at 8:06 PM on March 19, 2007

I would suggest checking out the Copper IUD, Paragard. No hormones, very effective. Personally, I use the Mirena IUD (with hormones) and I've been extremely happy with the low amount of side effects associated with smaller, more localized hormone doses.
posted by nursegracer at 8:06 PM on March 19, 2007

They say Nuvaring is less hard on the stum because you don't actually run any unusual hormones through your intestinal tract. And for people who are prone to vomiting, bein gon the pill is bad because if you throw up right after a pill it's like you never took it. I have always had a somewhat temperamental stomach, BC or not, so I can't really speak to whether one pill or the other was better for me (in any case, doesn't help you and your girlfriend since these are very individualistic reactions).

However, I can say that Nuvaring is the fourth hormonal birth control method I've been on in three years (switched once because of sex drive/mood issues, once because my healthcare provider stopped carrying my pill, and once to move to the ring), and I like it much better than the others. After a couple of years, taking the pill every day stopped feeling like an "event" to the point where I often forgot for a few hours. Any stomach/mood problems I had were massively exacerbated by my timing irregularity - like, if I had two pills in twelve hours, forget digestion. Even a couple of hours made a difference. Nuvaring obviously gets around that problem handily.

I think most women look around a bit before settling on a hormonal birth control they like. Hell, I'm still pondering a switch to an IUD sometime in the future.
posted by crinklebat at 8:09 PM on March 19, 2007

Depending upon your girlfriend's age, an IUD may or may not be what she wants. I'm 27 and I have the Mirena and I love it. HMMV, of course. If you are college-aged, I would think that the nuvaring would be a good option. Good luck. This is a continuous bitch in any woman's life.
posted by Medieval Maven at 8:13 PM on March 19, 2007

I have had several partners who've been on the pill, and now two that have been on the Ring... and the Ring has by and far been the least disruptive.
posted by SpecialK at 8:31 PM on March 19, 2007

I would suggest non-hormonal options, if both Yasmin and Ortho Tri-Cyclen Lo didn't work out. I've tried several different brands of pill, depo-provera, and the patch, before settling on Yasmin for about 3 years. Unfortunately, Yasmin still caused problems despite the low dosage (nausea and lack of sex drive), and hubby and I have gone back to condoms for lack of a better option. Granted, I've never tried the Nuvaring, and have heard good reports from other women.

Echoing the IUD suggestion, too--my GYN suggested it for me, and assured me that modern IUDs are not the archaic torture devices our mothers had to choose from. If your girlfriend has serious menstrual cramps, it will almost certainly make them worse, but if she usually has light-to-moderate cramping, it could be a good non-hormonal option. (I would have tried one myself, but have a good deal of terror surrounding doctors touching my reproductive bits, as even a routine pap smear causes blinding pain and serious bleeding for me.)
posted by tomatofruit at 8:33 PM on March 19, 2007

Another happy Nuvaring girl here.
Yasmin and Ortho-Lo are not the lowest dose options available, even in Pill form.
posted by junkbox at 8:42 PM on March 19, 2007

Hey, it's my new friend tomatofruit! Hi, tomato friend!

I never had any stomach troubles, but I did have mood swings for ~3 months every time I switched methods (OTC to OTC-Lo back to OTC to generic-brand OTC). Except when I got my IUD, which hurt like a damn hell ass lot of hurting to get inserted, but has occasioned no side effects other than some cramping in the first few months.
I have the Mirena, which is very small localized amounts of hormones, because I was told that the copper one might increase flow and cramps, and I already had plenty of both so wasn't interested. If she very much wants to be off hormones, it might be worth trying the copper.
posted by librarina at 8:43 PM on March 19, 2007

I went off the pill a little while ago due to a sense of hormonal vertigo after taking it ceaselessly for oh, two years? That was on my doctor's recommendation, due to my intense hatred of my natural mood swings, and can I just say I thought it would just be a break. But I've been more libidinous since then and I'm pretty contented with creativity and lambskin comdoms. That plan, if not a permanent fix, is a good stop-gap and a little fun in and of itself.
posted by Ambrosia Voyeur at 9:12 PM on March 19, 2007

I was on both of those and in the end I switched to Depo provera which is an injection every three months. It's amazing, I'm so happy I found out about it. I don't even get a period with it so its pretty much 100% baby free. It will be ridiculously hard to go back to taking a pill every morning. Also, no periods = no mood swings or "that time of the month." I really recommend asking your doctor or obgyn about it.
posted by rubberkey at 9:14 PM on March 19, 2007

I have the same issues with birth control, and had IMMENSE problems with the Nuvaring, not to mention the added risk of vaginal infection. My doctor says that her patients have had so many problems with the ring she no longer offers it. I think the best thing to do is to try one out for a few months before making a decision though, and starting and stopping like that only messes your cycle up and makes it worse. Im finally ok with Yaz, (I was a mess on Yasmin) it took me about 4 months to get used to it and now I never even have mood swings.

Overall, any hormonal birth control isnt really good for you, and you are at risk for complications. If you cant adjust to one of the low dose BCs I suggest talking to your doctor about Paragard, not Mirena though, it has the same kind of hormones as Yasmin and will give you the same issues. BUT, as mentioned already, Paragard can cause alot of other problems.

Birth control is not for everyone, good luck finding one that works for you.
posted by trishthedish at 9:14 PM on March 19, 2007

Oh, and I did have to try a slew of pills, finally settling on Mircette, one of the very low dose pills. On a full stomach only. Also, a pharmacist advised me that a quarter dramamine would keep nausea at bay.
posted by Ambrosia Voyeur at 9:16 PM on March 19, 2007

I have heard good things about the ring also.
posted by jitterbug perfume at 9:19 PM on March 19, 2007

Consider a vasectomy. It's the simplest operation imaginable and you'll never have to worry about this again.
posted by phrontist at 9:52 PM on March 19, 2007

Everyone's heard of the "rhythm method" and it is justly derided in terms of effectiveness. But there's an updated version, much more effective, known as BBT, or "Basal Body Temperature" charting. A girl friend of mine (admittedly about 25 years ago) used it and was happy with it. It requires some discipline, but it doesn't require any hormones or strange objectss.

You have to plot the chart for three or four months in order to get an understanding of the pattern, and then you can use it to determine about one week per month when you have to use condoms. The rest of the time you don't need to bother.

I have no idea whether this is an appropriate answer for you, but I thought I'd suggest it as an alternative to consider.

The page I linked to talks about using BBT charting for people who are trying to conceive, but it can also be used for birth control.
posted by Steven C. Den Beste at 11:22 PM on March 19, 2007

Two points about vasectomies: first, don't do it if you think you might ever want to have children. It's possible in some cases to reverse it surgically, but there are no guarantees. Second, after a vasectomy you will still be fertile for several weeks, because of sperm cells already in the prostate when the vasectomy happens.
posted by Steven C. Den Beste at 11:24 PM on March 19, 2007

Mate, have the snip! Your girl will feel better, your girl's libido will be better, your sex life will be better, your pregnancy-worry-levels will be better. Get the girl off the chemicals!
posted by TiredStarling at 12:09 AM on March 20, 2007

I had tried just about every pill on the market -- and depo provera -- when my gyn recommended I see an endocrinologist. The endocrinologist took me off the pill altogether for a few months, and gave me small doses of pure hormones instead. Using just the hormones, he figured out what my ideal hormonal balance is. Because the hormones weren't tied to contraception, he could change my prescription as soon as we identified undesirable side effects. Once we got the hormonal balance right, the doc just looked for the birth control pill that most closely matched it. I've been on that pill for about 6 years now with no problems. I highly recommend it.
posted by nadise at 1:55 AM on March 20, 2007 [2 favorites has favorites]

For more information on the Basal Body Temperature method, you might want to check out Taking Charge of Your Fertility.
posted by somanyamys at 5:38 AM on March 20, 2007

A friend of mine also had stomach issues on the pill, switched to Nuvaring, and has been very happy with the results.
posted by thejanna at 5:47 AM on March 20, 2007

I was on both of those and in the end I switched to Depo provera which is an injection every three months. It's amazing, I'm so happy I found out about it. I don't even get a period with it so its pretty much 100% baby free. It will be ridiculously hard to go back to taking a pill every morning. Also, no periods = no mood swings or "that time of the month." I really recommend asking your doctor or obgyn about it.

oy. please do more research on depo provera. i was on it for several years as well and now i'm scared for what it has done to me, especially after reading reports like this one: ask mefi: i want my bones back
posted by infinityjinx at 7:02 AM on March 20, 2007

I struggled with this for years. I've read that by keeping track of your side effects with each type of hormonal birth control, you can work with your OB/GYN and find one that works for you, that supposedly there is one out there that will work for everyone. I tried that.

In my experience, though, the three-month trial doctors always talk about is not necessarily a reliable way to judge whether a hormonal method of birth control will work in the long run. I took Triphasil with no side effects for quite some time. Two years later I found myself feeling literally suicidally depressed with no idea why. I had nothing to be unhappy about, I just wanted to die. I considered therapy, because I knew something was very wrong. Luckily, I stopped taking the pill first. Within a week I felt happier than I ever have. It was alarming.

My gynecologist told me that some women are simply prone to depression, and are unlikely to find a hormonal birth control method that will not cause severe mood swings. And after a few years of switching methods and being vigilant, I felt exhausted in every way. I was driving my SO crazy with my hormonal roller coaster, and missing more work than I wanted to just dealing with difficult new side effects all the time and making appointments. I tried the mini-pill myself, and it worked fine the first couple of months, but then it gave me a period that literally did not end until I stopped taking it.

I gave up and got a tubal ligation last year. I am overjoyed that that misery is over, and so is my man. I'm so glad to be myself again.
posted by zebra3 at 7:17 AM on March 20, 2007

i had a terrible reaction to the ortho family of birth control and ended up switching back to a pill (alesse) that had the same type of synthetic hormone as the pills i originally began taking some 20 years ago. in my lay opinion it was not the dosage causing me the problem, but the kind of hormone. if she is truly all hormone sensitive, i would avoid any hormonal type of birth control. as for depo provera, most people i know have hated it. HATED it.
posted by domino at 7:29 AM on March 20, 2007

My sister has an extremely sensitive stomach and has tried several different pills, all of which made her vomit. A lot. She's now on Aviane (aka Alesse, Levlen, Levlite, Levora, Tri-Levlen, Triphasil, Triphasil-28, and Trivora) and here is a direct quote - "Aviane is the best shit ever."
posted by tatiana wishbone at 8:02 AM on March 20, 2007

the nausea from hormonal BC can be lessened by taking the pill with food and at the same time each day and if your GF ever forgets the pill she should make sure to space the pills out at least 12 hours (I had this problem twice and it turned me into a vomit comet, puked into the bushes in front of the chemistry department and again less than a minute later in the bathroom) and of course use a back up method for at least one week.
posted by estronaut at 8:19 AM on March 20, 2007

Run for your life before someone tries to stick a needle full of Depo Provera in you. That is the worst shit EVER for your body.
posted by trishthedish at 8:44 AM on March 20, 2007

Hated hated hated the Pill, though I only tried one version. Turned into a homicidal crying screaming wreck after about a year and a half; stopped it and the homicidal and the crying and the screaming went away immediately. I agree that three months does not end the side effects for everyone.

The copper IUD has been wonderful for me so far. I was so totally against hormones that I refused to consider the Mirena, but I think if I were to do it again, I might actually go with that.

But the nice thing about the copper IUD is that for $250, of which my insurance covered $230, I have 10 years of birth control that is more effective than a vasectomy. Which is mindblowingly amazing.
posted by occhiblu at 9:05 AM on March 20, 2007

My SO has been on the ring for a year+. She loves it, no side effects at all.
posted by Four Flavors at 9:41 AM on March 20, 2007

If she goes for the IUD (and, from everything I've ever heard or read, that is the way to go), ask her to ask her doc to cut the string short--in my experience, you will be able to feel it during intercourse, otherwise. Even if the string is short, you'll sometimes get poked a little. It's not the worst feeling in the world, but it can be a little uncomfortable.
posted by MrMoonPie at 9:59 AM on March 20, 2007

Birth control pills made me nauseous, but Depo Provera did not.
posted by ruff at 10:01 AM on March 20, 2007

I love my vasectomy
posted by thilmony at 10:37 AM on March 20, 2007

A year ago a friend's wife had a surprise pregnancy while using the IUD. Another friend's niece is what he calls a "vasectomy child" (wife still got pregnant long after the vasectomy - it apparently reversed itself). Nothing is 100% of course, but why not just use condoms? Seems like the least invasive, least chemical option.
posted by nomad73 at 11:08 AM on March 20, 2007

I like the Depo Provera too.
posted by clh at 12:09 PM on March 20, 2007

Just a comment about the Mirnena IUD - it does contain and release hormones, but they are a tiny dose and seem to have primarily local effects, i.e. in the uterus. The amount released into the bloodstream is tiny - about 1/10 the amount you get with Depo-Provera. And the hormone levels are stable, unlike with the pill.

I've been on Mirena myself for several months. I was a happy NuvaRing user before - only problem was some mood swings - but then I found out that my insurance would cover the IUD for 10 bucks. That was half of what I was paying each -month- for the NuvaRing, and it will last me 5 years. Hurt like hell to put it in, and I had some cramps for the first couple of weeks, but since then nothing. No mood swings, no period (only a bit of spotting), no nausea, generally bliss.
posted by wyzewoman at 1:00 PM on March 20, 2007

nomad73: A year ago a friend's wife had a surprise pregnancy while using the IUD.

Anecdotal, right? Well, of all the birth control methods we'd tried, my wife liked the IUD the most. Today we recommend it to friends with the disclaimer that we had only one side effect. His name is Alex, and boy is he cute.
posted by pzarquon at 1:40 PM on March 20, 2007

Hormonal birth control affects everyone differently, so you just have to keep looking until you find one that works for you or just give it up entirely.

Pills either made me crazy or killed my libido. The Patch caused migraines. I can't say enough good things about the NuvaRing; it's easy, I can't feel it, and I have no side effects as long as I follow the prescription of three-weeks-in, one-week-out. Some women can leave it in for four and skip periods that way but that makes me go batty.
posted by blackunicorn at 5:02 PM on March 20, 2007