Help me avoid unnecessary hormones
February 11, 2013 11:08 PM   Subscribe

What are my best options for hormone-free or low-hormone birth control?

My SO and I would like to stop using condoms... but after my last experience with hormonal birth control in a previous relationship, I'm a little nervous to go back. I was on the NuvaRing for about 2.5 years, which is supposed to be low-dose, and to this day, I'm not positive whether my severe mood swings were a side effect of the ring or a symptom of my relationship at the time, which I realized, in retrospect, was quite dysfunctional. Maybe it was both. Either way, I've felt a lot happier and more stable since ending that relationship -- which, coincidentally (or not?), I broke off about 6 months after ditching the NuvaRing.

I felt the most angry, depressed, clingy, and crazy during that time period than I've ever felt in my life, and now that I'm in a very satisfying, peaceful relationship, I'm anxious that hormonal birth control will rock the boat somehow. I like the way that I feel sans hormones, but at the same time, I'd like a more reliable birth control method than just condoms. (And obviously, my partner would prefer no condoms as well.)

What are the chances that I'd be able to get a copper IUD without having had any kids? (I'm in my early twenties.) Are there any other options? What have your individual experiences been with finding a quality long-term birth control option, and how were you able to tell which feelings or problems were caused by the hormones and which weren't?
posted by happyjuice to Health & Fitness (18 answers total)
What are the chances that I'd be able to get a copper IUD without having had any kids? (I'm in my early twenties.)

My GF has one and she has no kids and is in her early 20s. The doctor didn't mention that being a problem to her, i don't think.
posted by empath at 11:11 PM on February 11, 2013

My partner got a copper IUD when she was 18, no kids.
posted by Jairus at 11:18 PM on February 11, 2013

You can get an IUD. It might require a little wrangling, but you can do it. Check out the Livejournal community IUD_divas -- they can give you a lot of advice about it.

Other options: fertility awareness, diaphragms, cervical caps, and pull-out (which supposedly rival condoms in effectiveness.
posted by feets at 12:04 AM on February 12, 2013

Planned Parenthood (even in Arkansas!) will give copper IUDs to nulliparous 20-somethings. When you call to make your initial appointment, mention your circumstances. If they are unwilling, try another location.
posted by amber_dale at 4:50 AM on February 12, 2013

Maybe you'll find something interesting here

As a follow-up to that question, tried Nuvaring and felt like it ruined me. Now we're just using condoms- not what you want, but maybe you'll try another suggestion from that link and have some luck.
posted by saraindc at 5:41 AM on February 12, 2013

N'thing IUD. I would even suggest looking into the Mirena, even though it's hormone-based. I don't know how it compares to nuvaring in terms of amount of hormones dispensed, but they're different in type: I believe nuvaring has both estrogen and progesterone, and mirena just progesterone.

For me, when I stopped taking the pill and got the IUD put in, some useful pill related side effects (namely: less body hair and acne) unfortunately went away. But my period also appears to have tailed off and stopped, which is a pretty significant bonus. This also means that I don't get any PMS symptoms, or if I do, I don't notice because I have no clue what time of the month it is. I can still be in an irrationally crabby mood sometimes, though. So there you go.
posted by quaking fajita at 5:46 AM on February 12, 2013

I'll just link to one of my own raves about the cervical cap here.

It is not for everyone - your cervix needs to be sufficiently sticky-outy enough to put it on, and not everyone can manage the necessary insertion-of-hands-inside-your-own-junk required to properly put it in - but I love mine to the point that it's actually a bit embarrassing. (Condoms are actually what I use most often, but two of the three times I've been in a monogamous enough arrangement to ditch them, I've gone with this, and never been pregnant in my life.)
posted by EmpressCallipygos at 5:46 AM on February 12, 2013

I love my copper IUD. I got it in September, and now five months later my periods are almost back to normal. And yeah, I'm 25 and never had kids, and they didn't bat an eye when I asked for it. More doctors these days know that the new IUDs are safe for young women with no kids.
posted by showbiz_liz at 5:50 AM on February 12, 2013

A copper IUD can be a great birth control solution: it's much cheaper and lasts longer than an IUS (like Mirena). However, it can also increase cramping and the amount of blood released in your period. If you have heavy periods and/or cramping, a copper IUD is not a good idea.

Personally, I found the hormone levels in the Mirena/IUS to be negligible - I had reacted badly to pills and the NuvoRing, but didn't notice the hormones in the Mirena except that my cramps had disappeared and my periods were much lighter.

You should go somewhere like a dedicated birth control clinic where they can discuss the pros and cons for your specific needs.
posted by jb at 5:58 AM on February 12, 2013

You can get an IUD if it fits. But they don't know if it fits until they measure the depth of your uterus, which for the sake of efficiency they do right before insertion. If you're of average weight and BMI, have hips, you have a decent chance of it fitting. The reason it used to be mainly limited to post-pregnacy ladies is that the uterus stretches, and it fits more people. But I've never been pregnant and had no trouble getting mine.

I also do recommend you to take a look at the Mirena. I struggled with the decision between that and a copper IUD, because I also had mood swings and such on other supposedly low-dose bc (including the NuvaRing), and eventually I opted for the Mirena because of the period issue. I grew up with heavy-normal periods, and I just couldn't bear the thought of having even heavier periods. The Mirena has all but stopped my periods (I get occasional spotting), and honestly, that's the part of it that I love most.
posted by DoubleLune at 6:42 AM on February 12, 2013

I would nth an IUD and also encourage you to at least consider Mirena. When I was on pills, no matter what kind, I ended up on a crazy rollercoaster of emotions, bad enough that my dad called me out on having PMS. (Dick move...)

But Mirena was absolutely perfect. Despite my history of mood disorders, I never experienced anything with Mirena... except for beautifully clear skin. Sigh. Mine expelled twice, which is VERY rare (not painful, though), and sure enough my skin went back to crap. As anecdata, I know of several other women who had the same experience re: emotions (history of mood issues but did fine).

But do stick with whatever feels right for you.
posted by Madamina at 6:44 AM on February 12, 2013

Joining the chorus to praise the IUD. I got my Mirena about a month and a half ago and love it. Like you, I was a wreck on the pills and Nuvaring. The only side effect I've noticed on the Mirena is a slight decrease in libido (which actually makes me feel normal now) and clearer skin. The first week after insertion was cramp-central, but nothing a few ibuprofen a day didn't take care of.

I was also seriously considering a cervical cap, but since I don't plan to have children any time soon I opted for a long term, hassle free solution (and because the Planned Parenthood in my area offers free services to low-income individuals, so the whole thing didn't cost me anything).
posted by E3 at 8:23 AM on February 12, 2013

To answer your question about determining which feelings were hormonal and which were circumstantial, I noticed a trend with the different types I was trying and they were all the same no matter what my life situation was at the time. I think it depends on the person and I'm generally a positive, self aware person, but on BC I felt hopeless, heavy, tired, loss of interest in doing ANYthing, and random things would bring me to tears. Usually when I start feeling down, I'm able to turn my thoughts around and focus on other things, but on BC it was really, really difficult. It was like a physical reaction, not just mental. Everything just felt wrong.

Once I stopped taking it, it took a couple days for that haze to lift and then it was like night and day.
posted by E3 at 9:00 AM on February 12, 2013

Here's a link to a comment I made about specific levels of hormones in the blood with Mirena vs NuvaRing in case it helps.

And as for anecdata: I had a horrible time on the NuvaRing. I seem to be doing fine with the Mirena.
posted by Katine at 10:04 AM on February 12, 2013

Here to sing the praises of the unsung copper IUD.

(I'm wondering where the IUD got such a terrible reputation... maybe the Dalkon Shield?)

Copper IUDs work just fine and almost any healthy woman of reproductive age can use one. There can be some cramping after insertion, but it passes soon enough. I've had a couple of partners with garden-variety copper IUDs, and they were both very happy with them (though this is by no means a sufficiently large sample, there were no reports of heavier periods here in either case :) )

Doctors in my part of Canada don't hesitate to give young women an IUD, especially if she has had problems with hormonal birth control in the past.
posted by rhombus at 10:51 AM on February 12, 2013

If you haven't had a pregnancy, inserting the IUD can be very painful (a short-lived pain!) as they have to open up the cervix. This might be why some doctors are reluctant to fit them.

I had no problem getting one without having had children (though I'm in the UK). However, I did experience very heavy periods on them which became disruptive. After having the IUD out, I recently tried the contraceptive implant as it was more effective and would lessen the chance of affecting my bipolar disorder/medication compared with the Pill. I've been fine with it so far, bar some increased breakouts. I've been on Depo-Provera before so I *know* hormonal contraceptive disruption, and I was very wary, but so far it's working for me.
posted by mippy at 1:12 PM on February 12, 2013

I stopped using birth control pills because they were making me suicidally depressed. I now have a Paragard copper-T and I love it (LOVE IT LOVE IT LOVE IT). I've commented about it previously. This one has another four or five years left, at which point I intend to have the docs pull it and replace it with another, which with luck will take me through menopause.

FWIW, a friend at work had a Mirena and found that even that low level of hormones was enough to cause problems for her. She reports being much happier since having it removed.
posted by Lexica at 8:14 PM on February 12, 2013

If Mirena or Paragard doesn't fit, the FDA just approved a new IUD, called "Skyla." It only lasts for three years but has been designed for nulliparous women. It still has hormones, but I think they it has the same amount as Mirena.
posted by obviousresistance at 9:43 PM on February 12, 2013

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