Help me figure out my birth control
May 16, 2011 4:26 PM   Subscribe

Please tell me your experiences with the birth control implant. Plus other birth control questions. I know YANMD.

After many years happily using Depo-Provera, it was recommended that I take a break from it. So I got the implant (Nexplanon) put in on March 17th of this year.

So far I have had one period which seemed LONG (although it was probably not more than ten days tops) and one episode of spotting. I have also had worse acne, not as much on my face, though that has increased, but down onto my neck as well.

I did really well on Depo. I stopped having periods all together for years. I also had no acne. I was on it for a good ten years, and maybe a few more. I was definitely on it for about the past six or seven years continually and then a few years in my late teens, early twenties and sporadically afterwards (as I was in and out of relationships). I am now 35. I have also in the past been on the pill, the patch and the nuvaring.

I love the implant because it is zero maintenence. But if I'm going to continue to have acne, I may seriously need to reconsider. I don't really love the pill, because I hate taking pills every day. It might be a bit more tolerable if I didn't have to take the pill at the exact same time every day, which I can never remember. It should be said that, in general, the less I have to remember taking, changing or getting something, the better (though I could make myself do it if I had to). I also REALLY like (love) not having a period.

I would love to go back on Depo, but I know there are some concerns about bone density. I have also considered the IUDs (coil and mirena) but I don't think I'd do well with the pain of insertion (the scraping of the cervix during a routine pap smear makes me queasy).

What I'm wondering is: has anyone here ever had the implants and had the acne clear up? Have I just not given it enough time? Also, is a "break" from depo-provera enough? Meaning, does my body sort of "re-set" so I can go back on it after a certain amount of time off of it? I should say that I have always tolerated all previous forms of birth control well. Both depo and the pill made my skin clearer. I kind of assumed that the implant would do the same since that's how my body seems react to birth control in general.

As far as importance, I would have to say clear skin and ease of use are my number one priorities for birth control. Not having a period is a huge benefit, but I wouldn't mind it if I found something that checked the other two boxes. Any advice you could give is much appreciated, thanks.
posted by triggerfinger to Health & Fitness (12 answers total)
Maybe give a little more thought to the IUD options. Although the pain of insertion is worse than your yearly pap test, you can cut that with drugs taken beforehand. The doctor should be able to write you a scrip for the insertion if the initial consultation indicates that you are a good candidate. Since you seem to tolerate hormones decently well, the Mirena might be a good pick. A friend loves hers.
posted by amber_dale at 4:36 PM on May 16, 2011 [1 favorite]

I could barely love my Mirena more. It hasn't done anything for my acne because the hormonal dose is so low, but I've had no side-effects from it except that my period has pretty much disappeared - yay! It did hurt on insertion (I haven't had kids), but if you have a doctor who knows what she's doing it'll just feel like a really, really bad cramp. Ouch, OUCH, FUCKIN' OWW! and it's over. I can handle brief pain if I know it's not actually damaging my body, and I get major long-term benefits from it. You should only have to do it every five years, which is a pretty awesome cost/benefit ratio if you ask me. Plus some people don't really seem to have any trouble with insertion, and as mentioned above, there are some good drug options to help out.
posted by you're a kitty! at 4:43 PM on May 16, 2011

Best answer: IANAD(Y), but having just had a discussion about this topic today, here's what the experts have to say about Depo-Provera and bone loss:

"The American College of Obstetricians and Gynecologists, the Society for Adolescent Medicine, the World Health Organization, and the Society of Obstetricians and Gynaecologists of Canada believe that the advantages of DMPA [Depot medroyprogesterone acetate] use as a contraceptive generally outweigh the theoretical concerns regarding skeletal harm. Accordingly, skeletal health concerns should not restrict initiation or continuation of DMPA in adolescent girls, women 18 to 45 years of age, or older reproductive age women (age more than 45 years)."

There's also the option of taking some supplemental estrogen if your bone status is that concerning... Out of curiosity, was it your doctor that recommended stopping Depo or someone else?
posted by greatgefilte at 4:48 PM on May 16, 2011 [1 favorite]

If you go for an IUD (I love my non-hormonal Paragard despite an insertion that left me crying and blacking out from pain), you can ask your gynecologist for numbing lidocaine spray. It stings a but while it takes effect, but everything afterward is easy-breezy – unfortunately, I didn't know that when I got my IUD, but other procedures have been completely painless since.
posted by halogen at 5:19 PM on May 16, 2011

Best answer: From what my doctor told me about the various hormonal methods is that it takes about 3 months to adjust properly, and that was the case with me. I would ride it out another month and if you're still getting the acne, then re-evaluate.

For what it's worth, I got my implant a year ago, and I love it. I had a few mood swings and a week and a half long period in the first 3 months but I've been happy ever since (and no periods to speak of either!). Being able to freak people out with the bar in my arm is an added bonus ;)
posted by daysocks at 5:30 PM on May 16, 2011

Another happy IUD customer (Mirena). I don't remember it being too painful in terms of insertion, though I had just had my son a couple of months before, so maybe that had something to do with my relative pain scale at the time. I think I also had some kind of topical numbing, but it was really quick and no pain after that. It's otherwise been great! No side effects, fewer and much lighter periods
posted by goggie at 5:35 PM on May 16, 2011

I'm not on an IUD, but I did just have the essure procedure done a few months ago (insertion of coils to block up the fallopian tubes for permanent infertility, yay!). And yeah, it hurt. LOTS. (They have to stretch your cervix to get the equipment in there, and I haven't had kids.) However, it is going to be *such* a relief when I go in for the follow-up test and get told I am done having to worry about birth control. They gave me drugs. I went home and slept the rest of the day and cramped a bit for a few days more, but it was absolutely worth it.

I mention this because if I hadn't finally found a doctor who was willing to tie my tubes, my plan was to go for Mirena next. I don't know if the pain would be similar or the same, but I can definitely say that for five years of maintenance-free, non-Pill birth control, that amount of temporary discomfort would still have seemed like a pretty good deal. And from what I hear about IUD insertion, it's not as unpleasant for most people as the essure was for me. I think it sounds like a pretty awesome option.
posted by Because at 6:01 PM on May 16, 2011

You can read lots of IUD insertion stories on the IUD Divas LJ Community. Sorry if it seems like the IUD proponents are ganging up on you, but it's a 5 minute procedure and then you don't have to worry about anything else for 5-10 years, depending on which IUD you get! What could be simpler? Many people with the Mirena don't get periods anymore, too.
posted by Addlepated at 7:21 PM on May 16, 2011

I hate to rain on the pro-Mirena parade, but I tried to have one inserted and it was the most painful thing I've ever felt in my life. And I say this after breaking two bones and having jaw surgery where my mouth was wired shut for a month afterwards. Nurses have been shocked at my high pain threshold. So my advice is that if you do decide to go with the Mirena, find a doctor that does them frequently and read up on the pre-insertion advice.
To actually answer your question, I was on the Nuvaring for three years and I loved it. You can skip your periods on it by changing rings after three weeks instead of doing a ring free week. In my experience, you might spot for a month, but after that, it works fine.
posted by blueskiesinside at 8:07 PM on May 16, 2011

Best answer: I have an Implanon implant (same thing as Nexplanon, I think) which was inserted in September 2010. For the first three or four months I also experienced breakouts (which is annoying because I've always had clear skin) but it has really cleared up in the past few weeks.

I, too, was considering getting it taken out because I was experiencing frequent spotting along with my mild acne. I stuck with it a few more months and my symptoms tapered off. My guess is that my body took a few months to adjust to the hormones.

Since you've had it for just two months, I'd wait a few more weeks to see if your acne gets any better. I also love how low-maintenance it is, and I really hope it works out for you!
posted by elerina at 2:40 AM on May 17, 2011

Best answer: Even though I had my Mirena expel twice (which is almost unheard of after a successful checkup and did not hurt at all), I am still a huge advocate for it. It was pretty much the best thing ever. It was painful on insertion, sure, and it kept hurting through the weekend, but it wasn't unbearable by any means. The second time was easier by far, so I have to imagine that every insertion is different. I hadn't had a kid before, but I had had elbow surgery, and... eh. Pain was manageable.

Aside from the barrier-free sex, the skin and mood effects were absolutely perfect for me and totally ruled. I had had many issues with hormonal BC in the past, especially since I am on an antidepressant, but it was nearly undetectable except for the fact that my skin looked fa-a-a-abulous. Now that I haven't been on it, my skin looks like crap. BOOOOOO. These effects have been pretty common to everyone I know who has had Mirena.

I still had periods, but they were very light. Many (most) people I know do not have periods.
posted by Madamina at 9:56 AM on May 17, 2011

Response by poster: Thanks everyone.

As Elerina mentioned, I think I'll give it another few months before I make a decision. If I decide to switch I will definitely give the IUD another consideration. I still think I would not do well at all with the pain (I have never had children), and this causes me all kinds of anxiety around the issue, but I will look into pain relief options. I also may consider going back on Depo, if, as greatgefilte pointed out, world health officials are not concerned enough to recommend discontinuing use. I'll have to research that one a bit more.

Oh, and to answer your question greatgefilte, I wasn't actually told I should stop. It was an issue I brought up every once in a while and the last time I was in to get a shot, the doctor or nurse I was with (can't remember) said that we don't know anything for sure, but that it wouldn't hurt to switch to something else if I wanted to do so. Given that I had been on it for SO long, it was always a nagging concern in the back of my head, so the decision was basically my own. But, that said, if health officials came out tomorrow and said there is no concern whatsoever about bone density, I would most likely go right back on it.

Thanks again everyone for your help.
posted by triggerfinger at 5:34 PM on May 17, 2011

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