Suggestions for side-effect-free contraceptives?
August 26, 2005 5:18 AM   Subscribe

What are some suggestions for side-effect-free(r) contraceptives? I've heard hormonal birth control can be personality-altering and have bad effects down the road. I'd really like that not to happen. We/She'll consult with a doctor as well, so no "honey and crocodile dung" suggestions please!

My girlfriend and I are in college, and we were high school sweethearts. We've been going out for 5 years, and we had vaginal sex for the first time last year. We used a condom. After a few times scattered over the next few months, I got freaked out about being a daddy, and we stopped having sex. We're still physically intimate, but we're thinking it might be time to go back to having sex.

At the risk of this being TMIfilter, my parents said to put her on the pill and shut up, and her parents are assuming she'll be a virgin til her wedding night.

I'd really like her to use a hormonal contraceptive, but I'd hate for the personality of the girl I love to be changed or for her to have health problems down the line just so we can have wild crazy teenager sex.
posted by anonymous to Health & Fitness (47 answers total) 2 users marked this as a favorite

People have been using birth-control pills for years. As long as she has regular checkups, and is aware of side-effects, it's reasonably safe. Sit down with a doctor and discuss the upside/downside.

Or you can get a vasectomy.
posted by jpburns at 5:48 AM on August 26, 2005

In my experience -- and this is not clinical information, so may be completely worthless -- personality changes are very rare. I have had a handful of partners go on and off the pill (and shots, and Norplant) over the years, and I've never seen personality effects. Long term use on the order of multiple years does have some common side effects, but nothing that should put you off having wild crazy teenager sex.

Hormonal birth control is a very safe and convenient contraceptive measure. Unless you're willing to undergo sterilization surgery, it's one of the better non-barrier options.

Having said that, I know (but have not been intimiate with) at least one person who had a negative reaction to hormonal birth control. It isn't always suitable for everyone.
posted by majick at 5:51 AM on August 26, 2005

I'm not exactly sure what you mean by "personality changes." As someone who has used birth control for a long time and has friends who all do the same, this is not a concern I've ever really heard. I'm sure that it does happen, but BCPs are not generally known for this--I've had other side effects, but not personality issues. In my case, I think it has helped stabilized my mood--rather than the natural "cycling" of my hormones, which makes for a week of PMS before the actual period, I have one quick and easy week with fewer PMS symptoms.

That said, your girlfriend will most likely have to try a couple different kinds to figure out what works best for her (some pills, I found, decreased my sex drive, or gave me a stomach ache). Find a trusted GYN who will work with her over a few months to find the best. I was lucky enough that my school had a great GYN at the health center, so appointments were free and contraceptives were really cheap--your gf might want to start there.

Finally, I'll put in my vote for the NuvaRing, which I think is the best out there. You only have to think about it twice a month (once to remove, then to re-insert), unlike the pill, and it doesn't have the weird sticky residue associated with the patch. And, I believe it is actually a lower hormone dosage than other forms. I've had fewer issues with it than with any other.
posted by CiaoMela at 6:07 AM on August 26, 2005

You could consider using a diaphragm - she'll have to ask her doctor. I wanted one, but the college clinic said I should use birth control instead, I've no idea why - easier for them, maybe, or just what they were used to college girls using. In retrospect I wish I'd held out for the diaphragm instead of going on the Pill. I don't think it was personality-altering or caused health problems, but I gained weight and a cup size - my figure was permanently altered - and I was super-draggy and nauseated for the first couple months I was on it.
posted by Melinika at 6:09 AM on August 26, 2005

Have her talk to her doctor. I've been on 4 different brands of birth control pills over the last few years, and never had a "personality change". Unless she's an extremely rare case, the worst that will happen to her personality is that she will be a little moody. If she doesn't like the side effects she can always try a different pill or stop taking them. But keep in mind that the birth control pills are not recommended for smokers, if she smokes.

And as for "bad effects down the road", the only one I've heard is that it sometimes takes women a while to get pregnant after stopping the pills if she's been on them for a really long time.
posted by geeky at 6:16 AM on August 26, 2005

My gyn refuses to prescribe the Pill to anyone with a history of depression. Negative mood effects are not unheard of. Your gf absolutely shouldn't take the Pill if she smokes cigarettes. I know someone who had a stroke at age 22 because she took the Pill and was a smoker.
For super semi-permanent convenience, there's the IUD. The catch: REALLY bad cramps, and it hurts like hell to have it put in. That was my experience. Also, some insurance doesn't cover IUDs.
posted by scratch at 6:20 AM on August 26, 2005

I use a cervical cap. (Talk about the TMIfilter!) I love it. I don't want to mess with my hormones, so I chose this route. I am happy with my decision.

The doctor who fitted me for it said that not many young women go this route and I asked why. She said it was because no one makes money from cervical caps (or diaphragms) and that a lot of the medical community don't want to trust young women to properly use a device like that.

I don't use it with spermicide, which is recommended, as I am allergic, so me and boypublisher double up on precaution by withdrawing (a method which is terribly ineffect on its own, duh).

Keep in mind, though, that the failure rate is lower with the BCP. Definitely a minus.
posted by girlpublisher at 6:24 AM on August 26, 2005

First of all, she should discuss this with a doctor. If her college has a health center, that is the best place to go. The visit and contraceptives will be less expensive there than anywhere else. She is legally an adult so there is no way her parents will find out that she has discussed this with a doctor/started taking contraceptives unless she tells them.

Like everyone else has said, she might have to try a lot of pills till she finds one that works for her. Yasmin (the site has plenty of info and will probably provide you with the answers to your questions about mood, etc.) has been the best for me, almost no side effects. On other pills, I experienced an assortment of side effects ( including decreased sex drive which seemed to be a rather ironic side effect). She'll probably want to stay away from the depo provera shot, while easy and cost effective, it is the worst when it comes to side effects: depression, moodiness, weight gain, you name it.
posted by necessitas at 6:32 AM on August 26, 2005

I'm going to vote for Depo Provera. As an extra bonus to not getting pregnant, she will also not have periods. I've been on this for 8 years with no side effects.
posted by pieoverdone at 6:33 AM on August 26, 2005

I think the side effects you're concerned about are associated more with the older, higher dose BCPs. Nowadays there are very low-dose pills that have way less side effects. I have been on the pill for years and I love it - less cramps, shorter length of period, extremely predictable arrival time. That being said, I had my period for the first three months I was on the pill - I guess that's a pretty inconvenient side effect, but bearable.
posted by amro at 6:48 AM on August 26, 2005

You know, condoms have no side effects and they're 90% effective. (why does the woman always have to fix the problem.... grumble, grumble...) But enough of that - I understand the fear of breakage, or wanting to really feel each other....blah, blah, blah.

I'd like to second everyone else and suggest she try taking the pill as well (unless she's a smoker). Start with Ortho Tri-Cyclin Lo - it has one of the lowest hormone levels out there, so the chances of it affecting her in any negative way are reduced.

I've heard from others that Depo is really good, but haven't tried it myself.

I also have a friend who is into natural cycling because her body can't handle the pill all that well. She bought this book and this book and swears by them. They rely on body temp, days since your last period, and possibly even measureable chemicals in the urine (though I could be wrong on that last bit). I think she also practices early withdraw as well, though, just in case. TMI, but my parents (Catholic) practiced that for 7 years before they decided it was time to have kids and it worked for them.
posted by Moral Animal at 7:02 AM on August 26, 2005

I think the side effects you're concerned about are associated more with the older, higher dose BCPs.

This is my impression as well. I was on BCPs 10-15 years ago and did have mood swings, irritability, weight gain, etc. The last time I was on them, more like 6-7 years ago, I had none of these problems. If you guys have sex fairly rarely, condoms might be the better way to go because you only need them when you need them, they're easier to hide from family if that's an issue, and if used properly they're pretty effective. They also require less in the way of constant vigilance [same with Depo but I have no personal knowledge of that] and as soon as you stop using them, you can try to get pregnant if that's your goal.
posted by jessamyn at 7:11 AM on August 26, 2005

I am not able to use oral contraceptive pills (bcp) because of personality changes. I tried for many years, and nearly every brand on the market (including many of the newer, low concentration BCPs and the triphasals). She'll never know if she is affected the same way until she tries, but be prepared to stop them RIGHT AWAY if either of you notice a change in personality.
posted by nprigoda at 7:18 AM on August 26, 2005

Sometimes the personality changes are slight and the taker has no idea while they are on it. After having been on ortho-tricyclen, I was on a progesterone-only pill while breastfeeding the kid, and had no idea that it was affecting me. It was only after I went off it that I could see how it had changed me.

What were these changes? Despite its vagueness, "crazy" is probably the most fitting word. I was very insecure and emotionally needy. Sure, post-partum issues or just who I was at the time might have played into it, but re-reading old journals revealed to me that the pill was changing me somehow.

Also, while some women enjoy not being burdened by their periods, I really feel that anything that stops women's monthly cycles is unhealthy. I know too many people who went on depo who developed some kind of fibroid issue for me to believe that it is okay for folks.

Me? I'm married. I don't have sex.

This isn't quite the answer for which you searched, nonny, but it's info that people don't always come across.
posted by frecklefaerie at 7:20 AM on August 26, 2005

I'm in a long-term, committed (live-in) relationship, and we use condoms. There was a discussion about them a while back, which led me to the prophylactic bliss of the Durex Avanti. They really are several orders of magnitude better than latex. Trojan makes a similar model, though I think Durex's are better. Never broken a condom.
posted by mkultra at 7:30 AM on August 26, 2005

I would suggest condoms. When you use them correctly they are very effective (I think more like 97%), and they are side-effect free. The fact that you describe being able to abstain from intercouse with each other leads me to believe that you are unlikely to get too carried away and 'forget' to put on a condom.
posted by OmieWise at 7:31 AM on August 26, 2005

Every woman's body is different, and each of us who replies can tell you horror stories about one pill and rave about another. Metafilter is not the place to decide which pill she should take -- she should talk to her doctor about that.

I'm concerned about this part: I'd really like her to use a hormonal contraceptive. Great buster, but what does she want? Has she been properly educated about all the contraceptive methods available to her? Or did life with parents who expect her to stay a virgin until her wedding night leave her woefully uninformed about available methods? It's her body, and her decision.

For 90% of women, the convenience factor of hormonal birth control outweighs any side effects. I, too, suffered from some depression while on certain brands -- Ortho Tri-Cyclen is known among women as a potential crazy-maker -- but a good doctor can make a calculated switch if side effects occur. What matters is whether your gf is comfortable with going through some trial and error.

Your job here, I think, is to encourage her to go talk to an OB-GYN. Is she getting regular pelvic exams? I bet she isn't -- and she should be,if she's sexually active. She needs to be prepared to ask questions about available forms of contraception, including the pill, the ring, cervical caps and the like, and to talk candidly about her sex life and contaceptive needs. Don't pressure her to choose a hormonal option; just encourage her to learn more and let her make an informed choice with the help of her doctor.
posted by junkbox at 7:32 AM on August 26, 2005

To add to the chorus: finding the right method will most likely take a few months. The risks of side effects will depend on the particulars of your girlfiriend's personal chemistry, but my sense is that a good place to start would be a low-dose oral contraceptive, such as OrthoTryCyclen and Yasmin, mentioned above.

Most of the women in my life have tried several brands of pills (there are more different kinds than you might ever imagine) as well as some of the other solutions discussed her, such as Depo-Provera and the cervical cap. The side effects seem to be entirely dependent on personal chemistry. Some friends who have no history of depression simply can't be on any kind of chemical contraceptive because they feel so terrible; others with lifetlong histories of depression find that the pills don't make a dent one way or another. Some who took one kind of birth control for years without any trouble suddenly experience depression or weight gain, since even slight hormonal changes (which women often experience through their 20s) can require a change in birth control.

So to add to the chorus even more: all of this is why you should sit down with a ob-gyn or np at the student clinic on your local Planned Parenthood. You hadn't mentioned if your grildfirend has ever had a pelvic exam, but this is a good time to start, particulalry since it will assure you that you are being attentive to every aspect of her reproductive health and ruling out any possible complications. Scheduling a pap smear also means you will have more time allotted for your appointment.

Make sure the practioner does a thorough work-up and takes a detailed medical history- including experiences (personal or familial) with depression, high blood pressure, etc. Walk them through your background, questions, fears and needs. Take the time you need to walk out of there with an option you feel comfortable trying. If the practitioner is harried or impatient, reschedule with another person until you find someone you trust and who understands that this deicsiion may take some time and that you will be back for follow-up visits. You have the right to be treated my someone who will not try to get you out the door with a one-size-fits-all solution for birth control, and who will treat you with patience and respect.
posted by foxy_hedgehog at 7:35 AM on August 26, 2005

I went with bcps and love them ... I'm on a low-progesterine pill called Alesse. I take it every morning before I brush my teeth (the routine is important to not forgetting) and forget about it. I gained about ten pounds on another pill and felt a little hormonal (I tended to get upset more easily), so switched. I've been on it for three years and have no complaints. Adjusting can be a little rocky, but if she sticks with it, she'll level out comfortably. Most of my female friends have no issues at all with their bc.

I want to put in a big plug for bcps at this point in your life: they're effective, inexpensive and safe. I had three condoms break in the three years I used them--each time it was terrifying, and complicated to get a hold of emergency contraception (our student clinic was closed on weekends, and of course it always happened on a Friday). No other form of bc is as effective, and it's amazingly easy.
posted by hamster at 7:35 AM on August 26, 2005

Just to toss in a few data points, I've known a number of women on the pill, the worst side "psychological" side effect that I was aware of was that one of my friends suffered (very minor) short term memory loss from one version of the pill (sorry, can't remember what kind). So she changed types and everything was fine.
posted by KirTakat at 7:41 AM on August 26, 2005

Obviously this should be something that she (and maybe you could go with her?) discusses with her doctor. But also remember that the OCP can help with the symptoms of PMS in a very positive way, if she gets bad cramps or whatever.

I myself am one of those women who were lucky enough to find a good pill the first time I tried one. So I've stuck with it since (12ish years) with little to no side effects (minor weight gain - but a similar proportion of people who gain weight on the pill also lose it).
posted by gaspode at 7:58 AM on August 26, 2005

I absolutely agree with junkbox. All this advice is really irrelevant in the face of what she and her doctor want. You can't really but your nose into what tests her doctor is doing.

Severe side effects from birth control are so rare that I have never even heard of them. Birth control, as I understand it, is one of the safest, and most important meds a woman can take (if she's sexually active). Usually birth control can affect the other meds one may be taking, so that would really be the only cause for concern. And birth control can helps reduce any risk of certain kinds of cancers as well. If she has any other medical problems, her doctor can figure out the right one.

I've been on the first one I ever tried, Ortho-tri/Tri-nessa, for years and years now. I've been on many meds, and birth control is by far the least invasive.
posted by scazza at 8:02 AM on August 26, 2005

I was on BCPs for about 15 years, with no problems. I just got tired of having to think about birth control and take a pill every day whether I was going to have sex or not. If you don't feel safe with just condoms, try condoms plus something else, like spermacide or a sponge.
posted by JanetLand at 8:07 AM on August 26, 2005

Condoms, the sponge, cervical caps, and diaphrams all work for side effect-free contraceptives.

I also suggest Durex Avanti. They're really the closest to bareback that you can get in a rubber. Mind you, they're not rated for prevention of STDs (although they seem to work just fine in lab trials). But, then, I started using them because I'm allergic to latex, so it's the only choice I have. Also, I guess that ya'll aren't out screwing around, so the STD protection is of low priority.

Personally, I'm with you. I really prefer that my female partners are on some sort of hormonal contraception. I don't like worrying about any of it... condoms put a huge damper on any sort of sex other than the stick-it-in-till-you-come style.

As my last girlfriend said, "It's kind of like having sex with a sandwich bag."

Now, before ya'll decide I'm some sort of pig who thinks it's all up to the woman, keep in mind that if some form of reversible hormonal or surgical birthcontrol were available for men, I'd most definitely be on it. However, the FDA hasn't approved any of the three or four methods available elsewhere in the world.
posted by Netzapper at 8:22 AM on August 26, 2005

I've never understood this 97% effective rate of condoms. If in a given year we have sex 100 times, will the condom "fail" 3 of those times? Is this considered effective?

FWIW, she's on the pill, no side effects.
posted by rschroed at 8:33 AM on August 26, 2005

Also, while some women enjoy not being burdened by their periods, I really feel that anything that stops women's monthly cycles is unhealthy. I know too many people who went on depo who developed some kind of fibroid issue for me to believe that it is okay for folks.

Actually, there have been studies suggesting that pills that suppress menstration can have positive benefits. In traditional cultures where women don't have access to birth control, they spend a much greater share of their time pregnant or breast feeding -- both suppress menstration. As a result, women in the industrialized world get a lot more periods on average than their ancestors did. During menstration, cell division is amped up in certain hormone-affected areas of the body, including the breasts. So early-state breast cancer is likely to multiply and grow more quickly in a woman who gets her period every month than in a woman who is pregnant and breastfeeding for a good share of her fertile life. This is one possible reason why certain cancers are much more prevalent in first world women than in the third world.

As far as birth control ... I love it. One thing for your girlfriend to look into: Is there any history or stroke or blood clotting in her family? If so, these are risk factors she should discuss with her doctor before going on the pill.

If you don't have good insurance, there are a lot of prescriptions out there that are now available in generic form. The generic form of Ortho TriCylin, for example is just over $20 per month right now. It was more than twice that a few years ago, when it was still on patent.

I love Ortho TriCyclin, because it's done away my cramps, shrunk my menstration to something much smaller than it once was, and cleared up my skin.

One reason birth control pills might not work for you: They have to be taken at roughly the same time every day to be effective. If your girlfriend is absent-minded or tends to forget things, there are other forms of hormonal birth control that might be better -- Depo Provera, the Ortho ring and the patch, as have been mentioned above.

By the way, I think it's awesome that you're involved in this decision making process. I disagree with posters who seem to think you're putting all of the burden of birth control on your girlfriend. You seem wonderfully involved.
posted by croutonsupafreak at 8:43 AM on August 26, 2005

rschroed: 97 percent effective means that if 100 hetero couples have sex regularly for a year using condoms, 3 couples will wind up pregnant.

This chart suggests that 14 out of 100 couples will get pregnant within a year whe using condoms as contraception, however. The 97 percent effective figure comes from ideal use, as opposed to real world use.

Without any form of birth control, 85 out of 100 couples will get pregnant within a year.

On most pills, 5 out of 100 couples will get pregnant.

With Depo Provera, 1 couple out of every 300 will wind up pregnant over the course of a year of regular sex.
posted by croutonsupafreak at 8:49 AM on August 26, 2005

If you don’t fancy a pill, I have found using a diaphragm and condoms (at different times) to be a good compromise. Diaphragm when you’re taking your time, condoms for the lady’s pleasure when you just want to go for it. Lady surprises gent with diaphragm already in for added spontaneity..The possibilities are endless!
posted by lunkfish at 8:50 AM on August 26, 2005

I'd say that those percentages are pretty hard to estimate though when you're dealing with such small numbers of failures.
posted by lunkfish at 8:54 AM on August 26, 2005

croutonsupafreak, thanks for the tidbit. I'd love for my g/f to get on Depo or something similar, but she immediately gets all "I don't want something messing with my natural cycles" on me.
posted by mkultra at 9:00 AM on August 26, 2005

for her

The pill or Depo will be the most reliable, but it will mean she'll have to step up on an exercise routine (walking or bicycling to work or to class are fine) if she wants to avoid the 10-20 lbs. mandatory weight gain (her body will think she's pregnant, which is why she won't ovulate).

When I first went on the pill at 15, for irregular cycles, I got suicidally depressed. This was on a regular pill; I was fine once they switched me to a mini-pill. The pills are even smaller dose now, but if your GF isn't a routine-based person, she will miss pills, and you'll have to use condoms for the rest of the month anyway.

Depo: I loved it. It didn't make me gain too much weight and didn't seem to aggravate the depression - although combined with other depressive aggravators, such as booze or ANY recreational drugs, it might do a number on her. (Drugs such as marijuana are system depressants similar to alcohol; stimulants, including Ecstasy, produce a depressive crash that Depo definitely aggravates.)

for you: Unless you are marrying this girl by the end of the year, stay in practice with condoms, regardless of what other method you choose. Actually, using condoms some of the time could become kind of a kink, or using condoms when she's in the off week on her pill could be kind of useful.

Why? Because if you want to get play in the future, with other girls, and not catch or spread anything nasty, including warts, yeast infections that you can keep giving to the same girl over and over, and herpes, condoms should be mandatory with new relationships until testing and monogamy are part of your relationship.

And if you don't stay in practice using condoms, your equipment may refuse to function just at the sight of one. When both partners want more than anything to just get on with it and fuck, but you can't because your erection won't let you put a condom on or won't let you put the erection in, well, you may not get laid.

That's if the girl has self respect, and you respect both her and yourself. Guessing she's clean because she says she is is not the same as playing it safe.

about condom safety
The last time I had a condom break was 1995, and I've had a lot of sex since then. The 97 percent rate is about the fact that many people don't put the condom on properly, leaving a reservoir at the tip to catch the explosion of spoo -- that's one way they break. Thinner ones like they have now are also less likely to break - those GOLD COINS broke all the time. They also felt like shite.

Another failure point in condoms: Putting it on inside out and then reversing it. This can catch pre-cum (or actual cum if you're going again) and then put it right on the tip of the condom to insert right where the sperm would be headed without the condom. Throw it away and try again.

condom brands
Get the variety pack from Good Vibes and think of it as a sex toy pack. Some of the new spiral varieties are loads of fun, no pun intended. A drop of lube on the inside of the condom makes it feel even thinner.

Safety third

I realize that you both may have been tested by now, but if you become sexually active with her again, she needs to visit the gyno anyway to talk about her options, and you should get tested for everything even if you don't have symptoms.

And if you have warts (I realize this is slightly OT but it's important, IMNSHO): They are not a pleasure increasing device. They are a deadly risk. ALL CERVICAL CANCER is linked to non-native HPV, almost always transferred to the woman by a past sexual partner. GET YOUR FAVORITE WARTS REMOVED for her sake.

Good luck to you, and good luck in choosing something that works well for both of you.
posted by tarintowers at 9:12 AM on August 26, 2005

This is one of those AskMeFi's that doesn't have an answer other than, consult a doctor and try what they recommend. There is such a range of reactions to all kinds of birth control (and there's a lot of options out there) that it's impossible to say what's best for her given her medical history. Great for being proactive about it, but she'll have to decide what works for her.
posted by agregoli at 9:28 AM on August 26, 2005

I and several of my friends went on Depo (also known as "the shot") when it first came on the market. Of 5 people I know that were on it (including myself), all of us gained large amounts of weight, although my doctor said the average gain was 7-10lbs, we all gained more, with one friend gaining about 50 lbs. All of us also had "personality changes," most notably depression (although I will admit that at least 2 had a previous history of depression before the shot). I personally also had severe anxiety attacks (as in, I froze in fear every time the phone rang). Add to that the insurance issues I had (you have to physically go to the doctor's office to get it, which may mean paying a higher co-pay than what you pay for pills at the pharmacy), and after 6 months (2 shots), I decided to go off it. But the problems didn't stop there. The longer you're on Depo, the longer it takes for your period to come back once you go off. One friend who had been on it for 5+ years had to wait a year for her period to come back. And since most other bcps require you to start the day/week after your period ends, it was confusing whether or not she could go on another hormonal bc pill during that time.

Having said all that, as one previous MeFite mentioned, you can look all over the web and find someone with 5 friends who had the exact opposite experience that we had. However, and this is my main point, yes, depression is a possible side effect of hormonal bcps. If you look at clinical trial data and the package insert (or any online PDR), depression is listed as a side effect. This doesn't mean that it will happen to everybody, but it will happen to some. Like other posters have repeated, she needs to talk with a doctor (Planned Parenthood is a good resource, and will charge on a sliding scale).

I'm currently on the patch, and I think it's great. I had a hard time remembering to take a pill at the same time every day. You only have to change the patch once a week. The sticky residue and slippage/sticking to clothes is occasionally annoying, but I've learned where to put it on my body to minimize that. A good friend of mine used the Nuva ring, but didn't like it because you had to take it out or put it in (I can't remember) while you were still on your period, which got messy. Again, YMMV.
posted by sarahnade at 9:32 AM on August 26, 2005

Also, while some women enjoy not being burdened by their periods, I really feel that anything that stops women's monthly cycles is unhealthy. I know too many people who went on depo who developed some kind of fibroid issue for me to believe that it is okay for folks.

You may want to be aware that despite the common perception that "it's more natural to have a period every month," there's been a bunch of research recently that suggests that it was by no means normal for women to have that many periods for most of human history. Between pregnancy and breastfeeding, women spent a not-insignificant chunk of their lives without menstruation. So while taking birth control pills isn't 'natural', and has the risk of some side effects, doing the 'natural' 12+ periods a year thing results in exposure to hormonal stresses that aren't 'natural' either. Taking birth control pills on the Seasonale schedule [four periods a year] may actually be closer to 'natural' for the body - not to mention more pleasant for the woman.

As everyone here has said: minimizing side effects may require some time, as she tries different methods. The vast majority of women can find a suitable and relatively side-effect-free birth control method if they have the time and money to try a few. However, everyone's body is a bit different, and what is side-effect-free for one woman may be awful for another. I know a few people on Nordette, and it seems to have worked for them [including someone who deals with chronic depression.] But seriously - the girl needs to talk to her gynecologist, who will be better able to choose a first method based on the girl's personal and family medical histories. Since you two have become sexually active, she should be making yearly trips to see her gynecologist anyway.
posted by ubersturm at 9:40 AM on August 26, 2005

Different things work for different people. I first went on the pill about a year ago, and it was fine until I had to come off it for a month due to high blood-pressure. It was only then that I realised that the fairly bad depression I had been experiencing disappeared as soon as I was off the pill.

Once I'd worked this out and my doctor had agreed with me, she prescribed me a different pill and it's been great. Not all pills have the same effect on the same people, and trying different ones until you find something that works for you is fairly common practice.
posted by Lotto at 10:04 AM on August 26, 2005

Oh yeah... I did fine on Depo, but a friend of mine had her hair fall out. All of it.
posted by tarintowers at 10:29 AM on August 26, 2005

Count me as a dissenter regarding Depo: for me it was bad, bad news. I got the shot just once, and it was one of the worst decisions I ever made. It's great birth control, because it turned me into such a raging bitch that my partner didn't want to have sex with me. Felt like going through puberty all over again.

In addition, Pieoverdone: you say you've been on Depo for 8 years. There are studies out now that show that extended use of Depo causes significant bone marrow loss, causing early onset of osteoporosis in many women. I've also heard that because of this, in the US it's illegal to prescribe it for more than five years in a row, though I can't find any links right now to support that. The good news is that the bone marrow loss is recoverable, but it's something I'd ask my doctor about if I were on it for multiple years.

As a followup, after trying Depo I was on bcp (Ortho-tricyclen) for seven years, and was fairly happy with it. When I stopped last winter though, I felt as though a layer had been removed between me and myself. In a good way.
posted by j3s at 10:39 AM on August 26, 2005

Condoms, of course. Isn't it the man's responsibility??? (LOL). Been using condoms with my now-husband (then HS sweetheart) since 1989--no breakage, no problems, no pregnancy scares, no health problems. (I refused to have sex unless he used a condom with nonoxynol 9--worked like a charm.) The only time we quit using condoms was to try for a baby in 1999. It took four months for me to get pregnant, which is an average amount of time.

In fact, a gyno told me once that condoms were the best choice because they didn't mess with your body. I prefer condom usage. *shrugs* YMMV.
posted by cass at 10:43 AM on August 26, 2005

Also, there are some disadvantages of birth control pills and antibiotics. For instance, I know someone who got pregnant after she took a course of antibiotics for an infection--the antibiotics interfered with the bcps and she got pregnant.

Even if she does end up going on Depo, or the Pill, you may still have to wear condoms until the hormones take effect.
posted by cass at 10:46 AM on August 26, 2005

There's no such thing as "side-effect free" hormonal contraception. It just does not exist.

If you don't want side effects, stick with condoms.
posted by grapefruitmoon at 11:26 AM on August 26, 2005

Yes, BCPs can affect mood for certain people. I had to discontinue because they were kicking off severe manic-depressive episodes. But they weren't the cause (long history of bipolar disorder), just a trigger. If she or close family members has any history of mental illness, it's definitely something to discuss with the doctor beforehand.

Condoms, when used properly and consistently, are highly effective. If you and she are concerned about hormonal birth control (BCPs, Depo), go down together to the univ health clinic or Planned Parenthood and get some advanced condom ed.
posted by nakedcodemonkey at 12:27 PM on August 26, 2005

She should decide if the pill is right for her--as someone already suggested. I've had bad luck with them and have a history of depression. Anyone out there toting that Yasmin is some sort of miracle drug is off their rocker, though--there is no such thing. And not only did it make me depressed and lethargic, it made my hair fall out after I stopped taking it, and made me completely lose my sex drive. If there's on side effect from the pill that doctors don't tell you about, it's that--and every single person I know who has been on the pill has had that side effect. We use condoms now, and they work just fine. Sure, it's more fun without them--but you couldn't talk me into trying another pill.
posted by fabesfaves at 12:41 PM on August 26, 2005

this is a very interesting thread, thanks everybody. (and "explosion of spoo" is really funny. to me at least. but then, I'm easily amused)
posted by matteo at 12:55 PM on August 26, 2005

We please to aim.
posted by tarintowers at 1:09 PM on August 26, 2005

One of my girlfriends went on the pill and it cleared up her lifelong acne. Another found that the first OCP she tried made her depressed, but a different one did not.

People vary a lot, is the upshot, but if your gf does this in conjunction with a knowledgable doc, she can probably find an OCP (oral contraceptive pill, not Robocop's parent company) that works well for her without the side effects you are worried about.

Certainly no one should tolerate personality or mood effects when the drug is supposed to be benign, no matter what drug it is; any doc would respond to this by trying to find a better alternative.
posted by ikkyu2 at 1:40 PM on August 26, 2005

I have been on the pill for over 10 years and have never had a problem. No weight gain or any of the other stuff. I realize everyone is different. There are low-dose options that are just as effective (Orto-TriCyclen Low). The pills I've been on are Ortho-TriCyclen and Trinessa, which is the generic equivalent.
posted by suchatreat at 7:10 PM on August 26, 2005

I have no history of any kind of depression, but the "newer" pills definitely affected my moods and personality. It took me a while to figure out what was going on, but I now avoid hormonal birth control like the plague. Just something to watch out for.
posted by walla at 6:15 AM on August 27, 2005

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