neither pregnancy or emotional instability appeal to me!
September 24, 2011 9:27 AM   Subscribe

The idea of going on the pill freaks me out-- am I being reasonable, metafilter?

I'm 23, I've never used anything besides condoms for birth control. I know you're not my doctor, and I understand that different kinds of oral contraceptives affect different people in different ways. But, I need help putting this in perspective.

I've always meant to start birth control, and recently I started having sex with someone I've been dating, which has really pushed it back into the front of my mind. Mainly because I'm absolutely terrified by the prospect of getting pregnant, and relying only on condoms makes me nervous (perhaps wrongly?).

But, the possible psychological/emotional side effects really freak me out. While I've never seen any kind of professional about it and most of the year I'm really optimistic and happy, I would say that I have had some problems with mild depression in the past (almost always in the winter), and I have some pretty bad mood swings and weepy, depressed days during my period. Both winter depression and pms depression always take me by surprise and the lack of control I have over my emotions during them honestly kind of scare me, so the thought of having hormonal mood side effects for months as I try to shop around for different pills and adjust to them makes me really nervous. I'm also not sure whether these things would piggy-back-- (i.e. if I generally get seasonal depression in the winter, would starting hormonal birth control on top of that potentially make it much worse and would I be better off waiting until the spring.)

To add to this, I just moved cross country to a new city and started a new job, and for purposes of making new friends and impressing new employer and getting my life together, I'd really like to be as emotionally stable as possible over the next few months. (This also means that I don't have a gyno that I already know in the area.)

So yeah, I understand that no one knows for sure, but I'd just like to hear about people's experiences and be directed to other sources that could help me think this through and decide whether I'm blowing the possibility of mood side effects out of proportion, or whether I should just stick with condoms at least until I get settled in here and the winter stops looming.

oh, and I'm pretty poor with crap health insurance, so I think an iud is off the table (right?).
posted by geegollygosh to Health & Fitness (38 answers total) 5 users marked this as a favorite
And IUD might be off the table, but it might not be. Under the student health insurance plan at the state university in my area (which is a good but not amazing plan), IUDs were FREE. It's definitely worth checking into. If you can get past the high up-front cost (either through health insurance or just through saving up and paying for it), they are long-lasting, highly effective, extremely low-maintenance form of birth control, and both hormonal and non-hormonal options are available.
posted by aka burlap at 9:31 AM on September 24, 2011 [1 favorite]

The pill is nice because it's relatively cheap and easy to get. However, after having been on it for years, I switched to the nuvaring and had FAR fewer problems with side effects. It was also about twice as expensive as the pill, but in my case it was worth it.

Currently I have an IUD, which is mostly great and very convenient, but you're right that they're super-expensive -- I think mine was something like $400 through Planned Parenthood. Cheaper over time than other methods, but a lot of cash up front.
posted by Narrative Priorities at 9:32 AM on September 24, 2011

Also, if you haven't already checked out this Planned Parenthood resource, it's a helpful source of info on the various options:
posted by aka burlap at 9:34 AM on September 24, 2011 [1 favorite]

This is purely anectodal evidence, but prior to going on the pill I had some pretty bad emotional symptoms during PMS, to the point where I was worried about hurting myself because my brain was just not functioning properly.

Going on the pill actually evened out my emotions and I stopped having those symptoms. When I switched over to an IUD, those symptoms did not return. They're only starting to now that my IUD is ready to come out (I have the Mirena, it has a hormonal core that dispenses over 5 years, it'll be dead in November and I am noticing the slow return of those emotional symptoms again).

What area did you just move to? It's possible that you can find a recommendation here on AskMe for a good gyno in your new area -- let us know where you are and we can start pointing you toward places.
posted by palomar at 9:35 AM on September 24, 2011 [1 favorite]

It's possible the pill may stabilize your hormones and reduce the mood swings during your period.

I've only ever used one brand of pills and had no negative side effects.
posted by sarae at 9:35 AM on September 24, 2011 [7 favorites]

Oh, and I had pretty crap health insurance when I got my IUD, and I only paid for the office visit (roughly $100, I think). So it's not entirely out of the realm of possibility -- apparently my insurance didn't mind footing most of the bill if it meant not paying out for pregnancy-related health care, but of course all insurance plans are different. You should definitely call the number printed on the back of your insurance card and ask them some questions about what your options are -- that's what I did.
posted by palomar at 9:38 AM on September 24, 2011 [1 favorite]

I took the pill in my late teens and early 20s and have a history of problems with depression (I am now 31 and have been off the pill for around 10 years). (My period, by the way, has been problematic ever since I stopped taking the pill.)

I had lots of problems on the pill, and I would not want to go back on it if I had a choice. If I were in your situation, I'd be particularly concerned (as you are) about making any kind of major chemical change in my body as I adjusted to my new circumstances. But I will say that if you know you are "freaked out," chances are you are not doing your highest-quality thinking in evaluating this decision. MANY women decide the pill is the best choice for them and it works out great. Others like me avoid hormonal birth control of any kind.

If you decide against the pill, you can use multiple methods to back up the condoms you're using -- spermicide, diaphragm, whatever. Also get a prescription for Plan B and have that ready to go in case your barrier method fails.

I second getting professional advice/opinions from your doctor, Planned Parenthood, etc.
posted by pupstocks at 9:39 AM on September 24, 2011 [1 favorite]

My experience: years and years of being on the pill with almost no side effects and no accidental pregnancy. PMS symptoms almost entirely disappeared, periods are nice and short (after being horrid, long and frequent when off the pill).

There are horror stories, but there are also lots and lots of people who never take the time to post on the internet, "Gee, I like being on the pill!"
posted by BlahLaLa at 9:39 AM on September 24, 2011 [14 favorites]

My mood situation before oral contraceptives sounds like it was exactly like yours: generally optimistic and upbeat, occasional moodiness, and some seasonal affective depression. I had been taking St. John's Wort which seemed to help a little, but had to stop that when going on the pill. The gyn warned me that if I had any depression at all, it was likely to get worse on the pill, but I had been on it in the past and figured that I could handle it... Long story short, it did affect my mood a great deal. I then went on antidepressants, which was a whole new can of worms, and three years later, I'm off of both the antidepressants and the birth control pills.

But I think it also depends on what type of birth control you go on and how you react to it. In my early twenties I was on a pill that was more estrogen-heavy. This last time I was on a pill that was more progesterone. And I read somewhere that there's a link between progesterone and depression. IANAD, but going to a doctor that will listen to your concerns (as they well should!) will make it much more likely that you'll be fine. Tons of women take the pill and don't freak out like I did, so there's that.
posted by poppyseed at 9:47 AM on September 24, 2011

I'm going to follow BlahLaLa's implicit advice and chime in to say "Gee, I like being on the pill!" I've been on it since I was 19, and I'm now 33, so I've been through at least 4 different brand changes as I've moved around, availability changed, etc. None of them have had negative side effects, not even as small as mild weight gain, and the positives have been huge.

Like other posters above, the pill shortened my period and made it a lot less painful; it meant that I always knew when the PMS (which for me is basically craving weird foods and feeling weepier than usual) was coming so I could recognize it for what it was and, in some measure, control it; and it meant far, far more peace of mind than a condom (which I have had break, fall off, all kinds of goofy stuff -- and to top it off you really need to rely on someone else. I've had, in one particularly bad case, a guy *take the condom off* midway through without telling me). i have never had a pregnancy scare, or actual pregnancy, while on the pill as my only form of BC.

These days I also use the pill, Seasonale-style, to reduce my period to a quarterly event. This might be the biggest benefit of all, and I highly recommend it. I basically have my period only when -- and whenever -- I want it. I travel a lot for work and am in an LDR, so this is really convenient.

It's been interesting to me to watch what I perceive as an upswing in negativity about the pill over the last 15 years -- my older sister was actually prescribed the pill to help with emotional imbalance, and now you've gotten from somewhere the idea that it will make emotional issues work. I suspect the proliferation of options has made negative claims more prevalent -- but in general, most of my female friends have been on the pill at some point in their lives, and I know no one personally who had a response so bad that they regretted it. Which is not at all to say that no one has issues; just that my small sample suggests that issues are statistically unlikely.
posted by obliquicity at 10:17 AM on September 24, 2011 [1 favorite]

I've been using hormonal BC for 13 years now, 7 on the pill and 6 using a contraceptive implant.

If anything, it seems to stabilise my moods; the pill reduced my periods from "horrific" to "manageable", and then on the implant they have gone to non-existent: no symptoms of any kind.
posted by emilyw at 10:29 AM on September 24, 2011

I've linked to this study on the pill's effect on mood before. The salient bits:
In the overall sample, 107 women (16.3%) noted worsening of their mood on oral contraceptive, 81 (12.3%) experienced mood improvement, and 470 (71.4%) had no change in their mood...

They noted that women who reported PMS and severe menstrual pain as a teenager were more likely to experience premenstrual mood improvement on the pill than those without these symptoms.Women with a history of depression were more likely to experience premenstrual mood worsening on the pill than those with no history of depression.
I fall into the first category - a low-dose pill has pretty much completely dampened the typical menstrual mood swing, but I don't have a history of depression so I can't personally speak to the second category.
posted by muddgirl at 10:31 AM on September 24, 2011

and relying only on condoms makes me nervous (perhaps wrongly?).

Not wrongly in the slightest. It is an unfortunate side-effect of the post-AIDS resurgence in the popularity of the condom that many folk forgot that the good old rubber is significantly less effective than the pill in preventing pregnancy. There are people who will try to deny this, but they're wrong. Just check the stats. Check the stats going back a long way. There are all sorts of reasons why the simple barrier method will never, ever be good enough by itself for people who really, really don't want to become pregnant or to cause a pregnancy.

I'm an old guy. I went to school when the worst STD you could get was syphilis, and that was rare, and curable. The teaching then was "Condoms are good, and a hell of a lot better than nothing, but the plain fact is that for various reasons they fail far, far more often than the pill does."

And that is correct. The pill was right up there amongst the most liberating things that ever happened for women. It gave them reliable control over their fertility. Let us never, ever forget that. Of course, there were problems but the plain fact is that by the seventies most women could get a pill to suit them. These days, unless you're unlucky, you really ought to be able to do this with even less trouble, or no trouble at all.

It may be hard for younger people to credit, but when I ventured into the lovely world of shagging, back in the late seventies, condoms were basically over. They were what your parents used. Girls took the pill. Older guys got vasectomised. Don't fear the pill. It is freedom.
posted by Decani at 10:45 AM on September 24, 2011 [3 favorites]

I'm another one who used to have depressive episodes during my period (hour-long bouts of crying and general feelings of hopelessness), and who found that cleared up once I started taking the pill. I take the pill right through with no week off (and therefore no bleeding) except a couple of times a year, but even before I started doing that, the hormonal depression seemed to be controlled by the pill. (As did other PMS-like side effects).

And you know you can stop taking the pill right away if you do have trouble, right? (Obviously while replacing it with another form of birth control). So you don't have a lot to lose by trying it out.
posted by lollusc at 10:51 AM on September 24, 2011 [1 favorite]

I've been on the pill since my teens and switched to a low-hormone pack in my early twenties. The only side effect I've ever noticed is that my period became extremely light (and convenient) as time went on. I actually went off the pill for almost a year after I'd been on it for over a decade (insurance reasons) and was concerned that I would learn that it's been regulating my moods or hormones drastically for years. Besides some irregular periods, I didn't notice a thing, and I went back on it without a second thought when the opportunity arose.

Don't be afraid to try it. Tell you doctor your concerns, keep a close eye on how you feel, and be prepared to give it (and any hormonal birth control) a few cycles before you decide whether to quit or switch.

That said, if you are completely consistent and correct with your condom use, and have no interest in discontinuing, then do some reading: condoms are very effective birth control when used correctly. But if you find you have a high level of anxiety about this, there is no rule saying you can't use both!
posted by juliplease at 10:53 AM on September 24, 2011

Best answer: Anecdata, but hopefully will give you something to think about:

I have a history of severe bipolar-related depression. After being put on psych meds (which are working well), I had a long discussion with my gyn regarding my birth control options. We decided, to start with, a low-estrogen, non-cyclic (meaning I get the same amount of hormones throughout the month, minus the "off" week) pill. The reasoning being that the low-estrogen would have less effect on my moods, and if there were any issues, it was easy to just stop taking them. Unlike other options which would require medical/doctor intervention to stop. The shot was *not* an option for me because the idea of hormones that I couldn't quit for three months (on top of bipolar + psych meds) terrified me.

I've been on the pill for a year now (in fact, my annual exam is scheduled for Monday) and I have nothing but happy to report. Periods are shorter, MUCH less severe. Before, I was on an unpredictable cycle of crippling cramps, really heavy flow and almost-suicidal PMS-depression. Now, my period is almost an after-thought, not much more than slightly-heavy spotting. Cramps are less, mood is mostly stable and it doesn't last but maybe 3 days at the most (usually 2). Also, I know exactly when it's coming by looking at the pack.

I will probably stay on the pill, for cost-related reasons, but I will be talking with my doctor about other low-hormone options, now that I know the small amount of hormones *isn't* going to drive me crazier.
posted by MuChao at 11:12 AM on September 24, 2011 [3 favorites]

I was on the pill very briefly in my early 20s, maybe 6 months at the most. Had been mildly depressed throughout my teens but nothing that required medication. Within maybe my first month or two on the pill, I was a complete wreck during the placebo/off week/whatever you call it, crying all the time. It got so bad I had to leave a meeting with someone so that I wouldn't start crying in his office, and then cried for hours and hours, over absolutely nothing. My doctor had to put me on Zoloft which I stayed on for a few years (buying it from New Zealand because I didn't have any insurance), eventually weaning myself off the Zoloft. I'd be really hesitant before starting the pill if I were you, with your history of depression. I personally would never again take the pill and my experience has scared me from ever going any hormonal birth control.
posted by jabes at 11:16 AM on September 24, 2011

Like obliquicity I've noticed a lot of negativity about the pill over the past decade, particularly in regards to the likelihood of it (and other forms of HBC) causing mood problems. But at the same time, the clinical studies seem to pretty much say what they've always said: most users don't experience any side effects, and only a small proportion experience negative mood changes.

I don't think you're being unreasonable in worrying about a side effect you've quite possibly heard is likely, especially when it's a side effect you really really don't want. But if you're going to make a decision based on the likelihood of that side-effect, your best bet is probably to go with the studies like the one muddgirl linked above, rather than what anecdotal evidence or commonly-accepted wisdom say.

That said: if you're not comfortable with the idea of going on the pill, don't go on the pill. 'It freaks me out' is all the reason you need, whatever the freaked-out-ness is based on. There are lots of other reliable forms of contraception out there, hormonal and non-hormonal, and one of those might well suit you better. People can get awfully preachy about contraceptive choices (I have one well-meaning friend who pretty much ordered me not to go on depo-provera because 'it messes with your hormones', but who also wouldn't accept that I wasn't going to get an IUD because even thinking of it made me feel all squeamish), but your reasons only have to work for you.
posted by Catseye at 11:16 AM on September 24, 2011 [1 favorite]

Response by poster: Hey everyone, thanks for your input.

I guess what I'm trying to get at is that I'm not really up for months of testing different birth controls which are having a serious effect on my mood while I'm also dealing with seasonal depression and getting settled in a new place/job. So if there is a significant chance that it would be like that, I'll wait to try it out.

I am aware that lots of people don't have any problems on the pill, and that it could actually make my pms better. I do know people personally who have had bad experiences with starting different kinds of birth control, so that's where I've "gotten the idea that it will make emotional issues worse." I'm confident that I'm not just making up my concerns completely, I'm just trying to weigh them against the peace of mind that I would get from having a lower chance of ending up with a beautiful baby boy or girl.
posted by geegollygosh at 11:17 AM on September 24, 2011 [1 favorite]

I was freaked out too, but in the end I've liked it so much I really don't want to go off of it. It is great for peace of mind, and for me has been great for softer skin, firmer boobs, lighter and more regular periods, and actually more stable mood if anything. Just 2c but I understand where you're coming from and am really glad it works so well for me.
posted by Miko at 11:22 AM on September 24, 2011 [1 favorite]

I think it's a reasonable concern that you'll have an emotional reaction, but the thing is that it's unknown until you try it what reaction that might be. The best way might be to ask your GYN for the type that has the smallest hormonal impact. I think this would be something like "OrthoTriCyclen Low," which has half the amount of hormones as most pills. Personally, I never had an emotional reaction to hormonal birth control, but I did have a sex drive so heavily diminished that I decided to stick to barrier methods for the time being.
posted by DoubleLune at 11:30 AM on September 24, 2011

Best answer: If what you'd like is some validation, I agree that your concerns are valid. I've used hormonal BC. One kind was not good for me, one was. If you're feeling vulnerable and unwilling to experiment now, that seems completely valid. Hormonal BC made a bad time worse for me (mid-morning crying jags 90 minutes after I took the pill three days in a row). I can't weigh the risk of experimenting against the anxiety you feel about condoms, because I don't know how much you worry about the condom issue. And one thing I will say is, if I remember correctly, the negative effects of the pill vanished quite quickly once I stopped taking it, so you might be able to recover quickly if problems arise.

But check out the comparison table here. The "perfect use" failure rate for condoms is 2%, which is good enough for me. Slippage and breakage are other factors, but you could use the morning-after pill if that occurred. The "perfect use" failure for most hormonal methods appears to be 0.3-0.5%, or 4-7 times safer, so if you want the utmost in safety, you might need to start using them at some point. Of course, the "typical use" numbers for both are way higher, 8%, 9%, 15%. So it might actually be more important to choose the method that you can come closer to applying in the "perfect use" manner. For me, since I hate pills, lose things, and have an unpredictable schedule with a lot of travel -- I'd be closer to the "typical" failure rate (or worse!) for pills, whereas I learned appropriate condom use in all those college seminars and have enough self-control to refrain if I don't have a condom with me.
posted by salvia at 11:37 AM on September 24, 2011

just to address birth control methods and anxiety about hormones;
If hormones freak you out (I understand!), at a minimum you can double-up on non-hormonal methods

first an aside: I peeked in your profile to see where you live - there's a planned parenthood in your city, assuming your location is up to date. As someone else mentioned above, in some states, Planned Parenthood has the funding to offer birth control for very, very cheap or even free, including expensive options like IUDs and vasectomies. The ParaGard is the non-hormonal IUD (the copper one) available in the US. Free clinics often do things like this, and in some areas the public health department still does things like family planning on top of STI treatment.
Also, I'm really, really sure that the company that manufactures ParaGard has a patient assistance program (so it's free!), but you have to pretty damn poor to qualify.

But - you can try adding something non-hormonal like withdrawal (if your partner is into it/aware enough of his ejaculations), fertility awareness methods, or potentially a diaphragm or cervical cap in the mix. You're supposed to use spermicides with diaphragms, which I should warn you can potentially give you vaginal irritation and pre-dispose you towards BV, yeast, UTIs (it kills sperm, and makes other cells unhappy in the process). So, then you have two barriers (condom + diaphragm) and spermicide. YMMV, some women do just awesomely with it. A diaphragm is an initial investment, the price of which I cannot think of off the top of my head, but a heck of a lot cheaper than an IUD. I got one years ago also from Planned Parenthood - you do need to go in and get fitted for it to make sure it'll cover your cervix and not dislodge.

These are not alone great ways to prevent pregnancy. But, add things together, and it helps knock the chances down further. If trying hormonal birth control is anxiety-producing right now ... don't do it until you feel more comfortable about it.
posted by circle_b at 11:45 AM on September 24, 2011

I don't think most people that go on the pill spend months switching around and trying to find one that works -- in contrast to anti-deppressants, where you hear similar "you just have to find what works for you" advice. I also don't think that you're likely to get the same low-level depression from the pill as from the seasonal depression so I don't think you'll be confusing the two. By far the most likely thing is that you'll go on and feel the same or better. If you do get crazy moody from the hormones, you'll recognize that, especially since you're looking out for it, but that's quite unlikely. Especially, I'm guessing, if you tell your doc about the PMS issues you already have; some pills (Yaz) are prescribed specifically to help with those.
posted by wyzewoman at 11:48 AM on September 24, 2011 [1 favorite]

I know you mentioned that your health insurance isn't very good, so an IUD is off the table, but it might be worth a few calls just to make sure (to your insurance company, as well as to Planned Parenthood and/or other health clinics in your area). I don't have an IUD, but have been considering going on one, so have been doing some reading online about them. The reviews I've read of the Mirena IUD are largely very positive, and because the hormone levels are much lower and more localized than the pill, the risk of side effects (including depression) is supposed to be much lower. The copper IUD (non-hormonal) might be another option, if you'd rather avoid hormones altogether (although reviews I've read indicate that the copper IUD can make periods longer and heavier, which is a dealbreaker for me!). Tl;dr if you think an IUD would be the ideal option for you (other than the cost), it might be worth a few calls to check how much it would cost you...
posted by UniversityNomad at 12:36 PM on September 24, 2011

I have a family history of depression (myself included). I have been on the pill for the last 6 years for purely birth control reasons, because the things I don't like about it are greatly outweighed by the desire not to make babies (I also use condoms). I've had *minor* issues and side effects, and am going to start looking into trying an IUD due to some of them.

But overall, totally worth it and not a huge deal.

I think you're likely to find something that works well enough on the first try (even if you do end up switching due to less serious side effects), but you should really talk to a doctor. Perhaps the reason it freaks you out is because you haven't talked to said professional?
posted by Zebulias at 1:34 PM on September 24, 2011

you say you don't want to try different types of birth control, but . . . that's kinda what you have to do, unfortunately. there are so many different kinds (including a wide variety among pills) and none of them are perfect. What affects you, what you can tolerate well- the only way to find out is to try it. Just because certain side effects may be common for a particular method, doesn't mean YOU will experience it the same way. You might get the side effect worse than other people do. Or not at all. You won't know unless you try it.

That said, I can understand not wanting to take hormones. I don't love doing it either. That's why I had a copper IUD for a while. It can be very cheap- I paid less than $200 for mine at Planned Parenthood. In the end I didn't tolerate it well and I don't have it anymore. But it was useful for me to have tried it- I've tried many different things now. Nuvaring, copper iud, the shot, and a few different types of pills. It's been helpful for me in prioritizing what side effects/ annoyances I'm the most and least willing to put up with. In any case, if it helps, after having tried all that my next move is going to try a Mirena (hormonal IUD.) Because the hormone is local (in your uterus) rather than systemic (going through your stomach, into your bloodstream, and throughout your body) the dose is much smaller and there should be less hormonal side effects than the pill. i've been waiting on that because it's expensive, but my gut feeling is that it's going to be worth it in the end.

anyway, it does seem like a bad idea to be sexually active and not on anything. i understand that picking a birth control is not necessarily a fun thing to do. but like . . . last time i had a conversation like this with someone, a friend who was in a new relationship but struggling with how she felt about birth control- well, i think it was about three years ago, and her daughter just turned two.

being on a birth control that gives you crappy side effects isn't going to kill you. worst case scenario is that you notice you're having side effects and decide to stop taking it. i don't know why but i think a lot of people just stick with what they're prescribed even if it sucks- you don't have to do that. if you don't like it, you can talk to your doctor and they'll recommend something else. that's their job.
posted by GastrocNemesis at 2:14 PM on September 24, 2011

I think you should get an IUD, it really puts your mind at ease. I think being able to relax and not worry about taking your pills, if your cold medicine or upset stomach will make them not work, etc makes sex and life in general a lot better. Planned parenthood has a sliding scale, takes most insurance, and might have payment plans. You can go home after getting one, but should probably do it on a Friday so you have the whole weekend to ache a bit and eat lots of ice cream and watch bad movies (if that helps you). Having it out is quick and pretty much painless. If the string is too long you can go get it trimmed, but you're probably okay unless you're dating a 7+ incher.
posted by meepmeow at 2:21 PM on September 24, 2011 [1 favorite]

I have a copper (nonhormonal) IUD and love it. A pain to get inserted, but no problems since. My insurance covered it completely--yours may, too. if not, try Planned Parenthood.
posted by thinkingwoman at 2:22 PM on September 24, 2011

I'm surprised that there aren't
More recommendations for the ring! It's not nearly as invasive as the iud, there's no cramping, and the hormones released hang out locally to your ladyparts instead of running the whole scenic route through your whole system before getting there.

Periods are shorter, lighter, and though they don't talk about it at the doc's, less frequent, since a ring can last 4+ weeks at a time, making for fully customizable period timing. Good for vacations and all manner of other timing-sensitive things. It leaves your brain alone.. I dig it.
posted by missy_b at 2:29 PM on September 24, 2011 [1 favorite]

One thing to keep in mind too is that a lot of women have a very hard time adjusting to a new pill. Once your body gets accustomed to it, you're fine and you forget how bad it was getting started. So you see a lot of women saying things like "I've been on the pill for a decade and every minute has been hunky-dory!" But I just switched pills two months ago and I spent the last two months being an utter fucking psychopath. I think I'm mostly back on an even keel now, but I'm not kidding that I really spent some interesting hours in August fearing for even my most basic sanity. If you are in a place where you need your faculties intact, giving a new pill a shot is kind of not a good idea, in my opinion.

I'm going to also put in a good word for Nuvaring. Because it sits around right next to your ovaries, the hormonal dose is low, and since it isn't processed through your digestive tract, there's no real reason for much hormone at all to actually make it up to your brain. However, since there's no generic ring, it can be costly, and you should probably look at the math between that and an IUD. I was on the ring for 5-6 years and sadly it stopped working with my body so that's over now, but I don't remember a tough adjustment period when I opposed to what happened with each of the three different pills I've been on in my life.
posted by troublesome at 2:49 PM on September 24, 2011 [1 favorite]

My ex went on the pill due to extremely painful, prolonged and heavy periods. She also had a history of depression (at any time) and severe mood swings (at that time of the month). Her experience was that it made her period light, mood swings go away almost entirely, and certainly didn't make her feel more depressed. The side effects she reported were weight gain and feeling dehydrated a lot. I have also spoken to friends who have had almost no side effects, and others who report everything already mentioned here.

My thoughts are (IANAD of course) that side effects are largely unpredictable. I think it's worth trying simply because you might turn out to be one of the people for whom it's all plus. If you can't deal with what happens, stop.
posted by fearnothing at 3:36 PM on September 24, 2011

I had super heavy periods that lasted for 7 or 8 days...on the pill, they're shorter and lighter. Plus, my skin looks better and my pre-period breakouts aren't nearly as bad. I would find a good ob/gyn, voice your concerns, and see what she has to say. Since my skin problems were an issue, she prescribed me a brand known to reduce breakouts. Unfortunately the only way to know how the pill will affect you is to go on it, and then stop if it causes problems.
posted by emd3737 at 5:27 PM on September 24, 2011 [1 favorite]

Personally, I had serious problems with all kinds of BC pills. Mini pills made my periods last nearly entire months. Regular pills made me gain weight and nauseous from time to time. After trying 6 different kinds (and getting pregnant WHILE TAKING one of them), I was able to get a free IUD through my local federally funded clinic. It was NOT a Planned Parenthood. I would check to see if your area had one of these income based clinics... I've had better luck with this clinic with yearly visits and whatnot then I did when I had insurance and went to a regular physician. I will warn you though... there will be some kind of wait list and they may haggle you if you've yet to have a child.
posted by camylanded at 7:06 PM on September 24, 2011

If I get you right, you don't want to get pregnant but you want a backup method to condoms. One thing that might help would be knowing when you're fertile. To learn about this, check out the amazing book Taking Charge of Your Fertility.

You are only likely to get pregnant on a few days out of each month, and once you know when they are, you can be triple-careful on those days (by using foam or a diaphragm with your condoms, by having outercourse, or by being abstinent). Good luck!
posted by hungrytiger at 9:21 PM on September 24, 2011 [1 favorite]

Go to Planned Parenthood if you don't have a local GYN yet. They're probably a better source for information regarding birth control than your average GYN is. They know every kind of birth control and what kind of side effects it has and they can recommend one for you that is least likely to aggravate your tendency toward depression. The fact is that most PMS-type mood swings and weepiness and such are vastly improved with birth control pills - they're actually prescribed for that purpose to women who aren't sexually active but do have hormonal peaks and troughs with their ovulatory cycles.

I'd give a couple of words of advice from an old lady, however:

1) Don't use the patch - the pills are much safer. But if you DO decide to try the patch, don't - DON'T - put it on your lower abdomen right on top of one of your ovaries. Please. And don't put it anywhere near your breasts or your neck - near your thyroid. The safety of the patch is still very much in question and it's just not worth the risks at this point.

2) There's a "new" type of pill now that allows a woman to go three months or so without a period. That sounds good in theory, but there's one problem that I see and it's a doozie. With the regular oral contraceptives, you get a period every month, meaning that if you should slip up and get pregnant anyway, you'll know it by the time you're 1-1/2 months pregnant, which means you're in the first trimester and you can immediately get on prenatal vitamins with folate and stop drinking and using meds or drugs that might be harmful to the fetus in the first trimester. Folate is a B vitamin that is increased in prenatal vitamins because it's found to be vitally important to the health of the baby's brain and spinal cord - it prevents many neurological problems - spina bifida, for instance - but that type of damage occurs during the first 10 weeks of pregnancy, and if you aren't expecting to have a period for three months you won't know you're pregnant until it might be too late to provide that protection to your baby. Odds are the baby will be fine without it, but there's a good reason that it's considered very important. Also, damage to the fetus from alcoholl and most drugs is most serious in the first 10 weeks, so that's another reason to know you're pregnant before it's too late to get a good start to a good pregnancy.

The old-time oral contraceptives were harsh and frequently caused all sorts of stuff like blood clots and breast pain and emotional episodes, but today's pills aren't even remotely similar. Talk to them at Planned Parenthood - birth control is all they do and they know what they're doing.

As for IUDs, I don't know about the new ones, but I had one many years ago which corkscrewed up into my cervix and had to be removed with great pain. I know they're better now, but I'd also ask PP their opinion on IUDs first.

And don't be "scared to death" to get pregnant, or you will, for sure - LOL.
posted by aryma at 9:31 PM on September 24, 2011

Another vote for the ring. It made my periods almost nonexistent, and eliminated the one problem I had with the pill - nausea if I took it without food.

Until you get some sort of back up method, you should research fertility awareness; Taking Charge of Your Fertility is the one book I know, but there may be others; but if you can use that to help set your mind at ease while you're still using just condoms it could help. (Not the rhythm method, charting and using other physical symptoms to keep track of ovulation.)
posted by lemniskate at 5:36 AM on September 25, 2011

Another vote here for doing more research on any and all options. My dermatologist put me on the pill at 18, long before dudes were even in the picture, and thanks to a very caring GP, I went through probably four or five types to figure out what was best. "Best" in this case was pretty relative-- i.e. pretty skin, much reduced cramps-- and I only ever had really bad side effects on Yaz, which tends to be a pretty hard-hitter. Also, TOTAL lack of babies, which is a plus.

Something to keep in mind is that you can't swap back and forth between generic/name brand pills, if money is an issue; I'm on Ortho now because the generic was definitely not working the same way, but I do pay probably fifteen bucks a month more. It's also a little hard to separate out crazy thoughts caused by pill vs. crazy thoughts by being 20 years old, but I think I'm actually on a more even keel with BC. I have reason to believe that an IUD would be a terrible choice for me, and my doctor wouldn't prescribe me the implant/ring/shot for reasons ranging from "risk of stroke" to "you're in weird countries on a regular basis" which is pretty fair. Some of them require more upkeep in terms of time than others, but you know your life better than we could.

Anyway, it's worth the time to find a medical professional in your city, either through your health insurance, a free clinic, or a PP, to really talk this through. If you do go on BC, it's nice to have a baseline of your stats like blood pressure and weight, in case something does change, and they'll be a resource for discussing more of these options in depth. I hope you find something that works really well for you, and that you enjoy your new city as well!
posted by jetlagaddict at 7:24 PM on September 25, 2011

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