Birth Control
February 6, 2012 3:17 PM   Subscribe

Some questions about hormonal birth control.

I've been considering going on the pill instead of relying on condoms, but I have some major doubts about messing with my natural hormone cycle.

I don't have any of the problems that the pill is supposed to help with, like acne or heavy periods. I don't get cramps/pain/bloating, I don't have mood swings or experience PMS. My periods are short, light, and regular. I have a high sex drive and I'm concerned that would be affected by taking birth control. Vaginal dryness seems to be a particularly common side effect that I would hate having.

Since my body seems to be working perfectly right now, I am quite hesitant to introduce a new factor that will throw things out of balance. Is it really worth trying several different brands to find one with minimal side effects? Which brand do you recommend? Do the benefits of being on birth control make it worth dealing with even "minimal" side effects?

Also, what are my options as someone without health insurance? Should I just go to Planned Parenthood and ask there?
posted by lali to Health & Fitness (15 answers total) 1 user marked this as a favorite
FWIW, I am on the pill and I have no side effects, except for no more acne! It seems to vary quite a bit by person, though. I was nervous to go on it after reading all the horror stories here, but I don't regret it at all.
posted by queens86 at 3:27 PM on February 6, 2012 [1 favorite]

I think it's hard because people love to communicate horror stories, but rarely take the time to say that the pill is working great for them. Honestly, it works great for me. I've taken it for many years, I've never had an accidental pregnancy, it doesn't make me sick, etc etc. (My initial motivation for taking it was to deal with heavy periods, so that makes me a bit different from you, but still.)

I would encourage you to try it out. You can always quit it if you don't like it. And yes, Planned Parenthood is a great place to start if you don't have insurance.
posted by BlahLaLa at 3:31 PM on February 6, 2012

The only side effect I had with the pill was complete and utter lack of sex drive. Which certainly did keep me from getting pregnant, but yeah.
posted by mollymayhem at 3:31 PM on February 6, 2012 [1 favorite]

Unfortunately I have yet to find a good study on sexual side effects and birth control. Mood effects are not uncommon on birth control, but they are also not normative:
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.
Low-dose birth control (Loestrin 24 is the one I take, there is also Lo Loestrin) should have fewer side effects than higher-dose pills.

That being said, there are options other than condoms or hormonal birth control. Please do talk with someone at a clinic like Planned Parenthood. Since you don't have insurance, something like a copper IUD (which is expensive to insert but does not require a monthly payment) may actually work better for you, and does not have any hormones.

(since we're talking anecdotes, Loestrin 24 actually boosted my libido - your mileage will almost certainly vary)
posted by muddgirl at 3:34 PM on February 6, 2012

I was on the pill for most of my early twenties. It often made me feel queasy and wreaked havoc on my sex drive.

Then I switched to the NuvaRing, which didn't affect me quite as badly but was much more expensive.

I recently switched AGAIN to a hormonal IUD. Other than some pain from time to time, it's the best birth control I've had so far. And most women don't have nearly as many pain problems as I do, I just have crap luck.

All of that said, if you're comfortable using condoms and your partner doesn't mind them...? Don't change your BC unless you really want to. The side effects are hard to predict, and some can be really unpleasant.
posted by Narrative Priorities at 3:35 PM on February 6, 2012

I took the pill for years and years, with no side effects other than that my sometimes horrifically painful cramps lessened.

This is DEFINITELY on of those biased-data things -- people who have no problems on the pill don't usually go posting to internet forums about it. But it's hugely popular for a reason. Still, of course YMMV and you should keep an eye on your mood, sex drive, etc. when you start taking it.

Planned Parenthood seems like a good place to start, yes. There are generic bc pills, and I expect they aren't very expensive without insurance, but don't know for sure. I'd guess $20 a month, but that really is just a guess.
posted by kestrel251 at 3:59 PM on February 6, 2012

As others have said... I think it's totally unpredictable and varies from person to person, but many women don't notice any effects or even notice positive effects. Unlike an IUD, the nice thing about the pill is that it's easy to try it for a month or two and then stop or switch. (Easy except that you'll need to rely on other methods of birth control during transition periods.) I agree that Planned Parenthood seems like a good option, and they should be able to guide you to a type of pill that is likely to work for you.
posted by chickenmagazine at 4:06 PM on February 6, 2012

I've been taking HBC off and on for 15 years and never experienced a side effect. My mother blames it for weight gain in my mid-20s, but to be honest...that was a side effect of Doritos and Mountain Dew.
posted by ladygypsy at 4:09 PM on February 6, 2012 [1 favorite]

No problems here - I take it for heavy/long periods. In theory I may have slightly less acne, but I hardly had any before, so. Seriously, my only headache has been that when switching from the 4-week set to the 13-week set, my body has not wanted to grasp the "you only have to bleed every three months now, I swear" lesson. And upping my Vitamin C intake for a few days helps with that one, so.

Since you're without insurance, PP or your student health center (if applicable) is your best bet. According to my insurance company, my pills cost them $85 every three months, and they're somewhat fancier than your basic pill.

(You're going to want to have backup B/C on hand, BTW - I'm not sexually active, but they send me giant piles of "if you miss even one pill use a condom for like two weeks afterward" paperwork every time I get a refill. I admittedly don't actually read that stuff very closely. But using the pill doesn't really mean saying "good-bye" to condoms.)
posted by SMPA at 4:48 PM on February 6, 2012

I've been on 4 different HBC's, including NuvaRing. The first one gave me bad nausea (too much estrogen in it - this is common). The second was fine except that I kept forgetting to take it on time. When I complained about it my gynecologist recommended NuvaRing, which I used happily for several years. In the last year, I got a yeast infection that I just couldn't shake and finally realized it was NR's fault. I now take something called Aviane. I had very, very bad mood side effects for the first two months, but once I got past those it has been a fine experience. After I became less of a crazy person I realized that NR was really suppressing my sex drive compared to this new pill, which was an unexpected bonus to switching.

If you trust condoms, I see no reason to screw around with a formula that appears to be working for you.
posted by troublesome at 6:12 PM on February 6, 2012

There is no "the pill". There are many many formulations for hormonal bc, and a few different delivery mechanisms (patch, ring, pills, Depo-provera shot, Mirena IUD).

Also of course there are other barrier methods (diaphragms - I don't know about getting these though) and non-hormonal IUDs (copper).

IUD is one of the cheaper methods if you can afford to pay the cost up front-- lasts for 5 years. The insertion process is more difficult for women who haven't been pregnant and so you might be strongly encouraged to try something else first, but the option is there. Additionally it is a large charge up front, and you've still paid that charge if it gives you side effects you don't like.

Depo is great if you're forgetful-- but might really suck because the shot lasts for a few months and you can't untake it if you have bad side effects, you just have to wait.

There are so many options; I'd say esp. since you're insuranceless that Planned Parenthood is a great way to find out more about your options, their associated costs, and which formulations might be least like to cause the side effects you're most worried about.

Oh, lastly, especially if you don't go to PP, some pharmacies have discounts available for uninsured folk, and you should definitely look into these. Birth control not on sliding scale can be stupidly expensive, and if you don't have an insurance compnay making a deal for you you might pay even more. (Although of course BC is a lot cheaper than a kid!)
posted by nat at 6:18 PM on February 6, 2012

Just one little word of advice to add: If you happen to choose the patch, don't place it on your abdomen right on top of an ovary - really, don't place it on your abdomen at all. Put it on an arm or leg or on a big muscle or on your buttocks. Just a safer idea all the way around. Planned Parenthood can recommend the best HBC for you.
posted by aryma at 10:42 PM on February 6, 2012

I was on the pill for 12 years - started in my mid-teens, before I was having sex. I felt my sex drive increased once I stopped.

I am also a really busy and not very organised person - bad combo. This made taking the pill at the same time everyday pretty challenging for me. It did mean I was using condoms most of the time as a backup method anyway because I had recently missed a dose.
posted by peanut butter milkshake at 10:51 PM on February 6, 2012

Thanks for all the answers!
posted by lali at 9:28 AM on February 7, 2012

Have been on the same one (alesse) for about 7 years now, with a break of a few months several years ago. No side effects now (other than the usual good ones - light, regular periods; arguably less acne; no unwanted spawn), although they were pretty bad in the first few months including mood effects and I almost switched brands, but glad I didn't. I also switched to the generic (aviane) a few years ago with a different (suspected) annoying side effect that again went away after a few months.

brand completely depends on what works for you, but as a starting point I'd stay away from progesterone-only since they are much more demanding that you take them on time and therefore likely to be less reliable for most people (not sure if there's a difference with perfect use). They tend to have lower side effects though so they're a good option if several of the other pill types have a lot of side effects. There are a TON of different ingredients in various pills at different proportions and doses, though, so there's not really a general rule.
posted by randomnity at 10:33 AM on February 7, 2012

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