I'll take the pill that makes me fat and angry.
July 15, 2013 7:03 AM   Subscribe

Please help me alleviate my fears about going on hormonal birth control for the first time.

I a 31 year old female who is probably the only one on the planet to have never been on the pill. While I'm generally a very rationale, science based decision maker birth control just freaks me out and I have managed to avoid it like the plague except on a few occasions when I had to use the morning after pill when condoms broke.

Well now I've started dating a guy that HATES condoms and is begging me to go on the pill. Which honestly is probably good idea as I've had too many condoms break in my time and it would be more reliable.

That being said I am suspicious as hell of taking artificial hormones and I'm convinced (probably totally irrationally) that my total lack of lady related health problems that seem to plague many of my friends is due to the fact I haven't been messy with my hormones since I was 16. My period is very regular. I only get mild pms. So the pill could only mess things up, not make it better.

However my real concerns are weight gain, moodiness and my sex drive. I've always battled my weight and putting on even 5 lbs, let alone 20, upsets me greatly. I put on weight very easily so i havea a bad feeling I would put on weight. Also the few times I took the morning after pill I went into a deep funk for several days and remember feeling moody, numb and detached (and my then boyfriend said I was not fun to be around). I also have a high sex drive, which I don't really want to see killed just when I'm actually getting to have sex again.

My other option is paraguard/mirena, but that seems like something I should try if the hormonal birth control ends up not working out.

It's hard to get input from my friends because most of them have been on the pill for so long it's nearly impossible for them to say what its effects are anymore.

So am I being crazy and irrational? Or should I just bite the bullet and get a paraguard?
posted by anonymous to Health & Fitness (38 answers total) 4 users marked this as a favorite
My other option is paraguard/mirena, but that seems like something I should try if the hormonal birth control ends up not working out.

I don't see why. If you don't want to use hormones, you shouldn't feel like you have to! I have a paraguard and I totally recommend it.
posted by showbiz_liz at 7:05 AM on July 15, 2013 [3 favorites]

I lost weight on the pill (and kept it off for the four years I took it, and have gained a bit back after stopping last year). Not all women gain weight, many lose weight. And my breasts were about a cup size larger (they look fine now that I've stopped, though, just a bit smaller).

Sex without condoms IS way more fun.

I think it lowered my sex drive, but it's hard to say - that may have been a consequence of being in a relationship for 3+ years that wasn't really working out by the end : )

I don't think it made me moody at all - if anything, less so, because I didn't have monthly hormonal swings/PMS.
posted by amaire at 7:10 AM on July 15, 2013

Have you thought about female-led barrier methods, such as a diaphragm or a cervical cap or contraceptive sponges?

I'm not saying that hormonal birth control is unsafe. I've taken it on and off for 15 years, and my reproductive health is excellent, and other than one pill that made my boobs sore (and that went away when I switched to a different formulation), I've never had any side effects. But there are also hormonal methods, such as the IUD you mentioned or a vaginal ring where the hormones are much more localized if that makes you feel better.

The bottom line is that it's your body, and you have to do what makes you comfortable. Just like your guy is entitled to reject condoms, you're entitled to reject hormones. And just like you're not going to wheedle and cajole him into doing something he hates, if when you say he's "begging" you to go on the pill, you mean that he's badgering you after you've already said no, then he needs to cut that shit out. But I also think that you should talk to your gynecologist about all of your birth control options. Because the pill and condoms are not your only choices.
posted by decathecting at 7:15 AM on July 15, 2013 [6 favorites]

Don't forget mirena (recommended above) is a hormonal delivery device. That's pretty much at least one of the main ways it works. The copper IUD does not use hormones and may be an option you want to explore.

The hormonal idea behind the mirena is similar to the "mini pill" which uses a much lower dose of hormones to work--you might want to consider that too. My impression of all these hormonal contraceptives is that everyone is different--you may or may not have the side effects that others report, and really the only way to know is to try, and to remember that if you are unhappy/uncomfortable with the side effects, to stop. It's so easy to convince yourself that "you're fine" and the "side effects are due to something else"--this is what happened to me with the mirena--it made me bleed constantly and gave me abnormal paps, but I didn't really believe it was really the cause for more than a year; those side effects disappeared instantly when I got the thing taken out. Just remember everyone's personal experience is different.

Post-hoc mix up fixed--mirena is hormonal, paraguard not.
posted by gubenuj at 7:31 AM on July 15, 2013

I'm convinced (probably totally irrationally) that my total lack of lady related health problems that seem to plague many of my friends is due to the fact I haven't been messy with my hormones since I was 16. My period is very regular. I only get mild pms.

This describes me as well and I've been on the pill for 8 years. You hear more horror stories than non-horror stories online because nobody complains to all their friends when the pill works as advertised. Almost all my female peers are on the pill and seem happy about it.

It did kill my sex drive at first and made me really moody (although other stressful factors at the time may have contributed) but both side effects went away after a month or two.

Some people have major issues with artificial hormones (and you'll hear from them in this thread, no doubt). Many, many other people have no side effects at all other than not getting pregnant. You can't tell which group you're in until you try them out. Sometimes switching brands jumps you from one group to the other as well.
posted by randomnity at 7:34 AM on July 15, 2013 [3 favorites]

I was on Implanon for 10+ years. My period basically stopped while I was on it, and in the last couple of years I experienced some hairloss. I also lost a little weight. Sex drive was always really great, moods good, I was happy for my experience on it and also happy to come off it*.

IMHO, I've noticed a lot of backlash against hormonal birth control (HBC) lately that I don't believe is entirely warranted. Many women happily use HBC for long periods of time; they aren't dupes of evil pharma, or horribly 'out of touch' with their bodies, they just don't want to get pregnant. Many women also have negative experiences on HBC, because drugs have side effects. There's really only one way to find out which group you'll fall in to.

That said: if you are concerned - and you have every right to be - I'd look into Nuvaring, as Decathecting suggested, or Mirena.

* if you look through my history you'll learn that I stopped using Implanon and the pill because of the hair loss, and also because my partner and I are probably going to try for kids in the next few years. We're using condoms right now, and I even quit charting because charting was making me crazy - much crazier than the implant ever did.
posted by nerdfish at 7:35 AM on July 15, 2013 [1 favorite]

You'll never know until you give it a try. My GYN says it is sometimes a matter of finding the right pill. Supposedly pills with drospirenone have less impact on sex drive but honestly every pill I have researched has a zillion anecdotes every which a way about all of those side effects.

I always get the low dose BCP because the ones that change strength week to week make me KRAZY (with a K because that is how crazy I get). But this time around, I am going to seriously consider switching if it causes a dip in my sex drive (I hope it will at least remain the same minus pregnancy anxiety).

I am still toying around with mirena but have not really 100% gotten on board.

I agree with the decathecting, you need to look into ALL of your options and if your GYN is just into writing the same script over and over then find someone more accommodating. Also, don't be afraid to switch if it is not working out. Give it some time (3 months) and then reassess. Again, if you GYN finds this annoying then, get a new one. Your SO should be very supportive since you are trying to ditch the loathed condom.
posted by TheLibrarian at 7:36 AM on July 15, 2013

Reading internet opinions about hormonal BC can be scary, because it's rare for people to say, "I had few negative symptoms, if any", even thought that is the most common response to HBC - people who have bad symptoms are obviously more likely to report them. The other issue is that there are tons of formulations of HBC, some which work better with some women, and some gynecologists/G.P.s seem unwilling to help their patients experiment. Low-dose b.c. is a much, much, much lower dose of hormones than the morning-after-pill.

All that being said, if you're uncomfortable with the idea of HBC, there's no real reason not to explore other options first. I like the Planned Parenthood My Method quiz on that page, because it asks questions that most people probably don't consider when thinking about birth control.

(Personally, low-dose birth control didn't affect my weight at all, has significantly decreased my period with all the attendant mood swings, and seems to have increased my sex drive. But there was no real way to predict that in advance of trying it.)
posted by muddgirl at 7:37 AM on July 15, 2013

The weight gain thing is a non-issue. I know after I post this we're gonna get a bunch of people in here who gained 1000 lb on hormonal birth control and lost it all after they went off of it, but this has been studied pretty thoroughly and the link is just not there. Women tend to gain weight around the same times in their lives when they would start HBC (e.g. beginning of college).

Everyone wants to ascribe their good health to something they do instead of something they are (or dumb luck) because it gives us an illusion of control. Frankly, do you want to look in the eye of your friend with PCOS or painful periods or infertility and say "You did this to yourself by taking birth control pills"? Because... they didn't, and you won't either. There are risks associated with HBC just like everything else, but the idea that it's going to take away your perfect gynecological health is silly and irrational, so I hope that thought experiment helps you get over it.

Finally... in my experience, men who BEG to not use condoms are jerks. Get him tested if he hasn't already, because you can bet he's BEGGED to not use condoms many times in the past.
posted by telegraph at 7:39 AM on July 15, 2013 [13 favorites]

I've had big trouble with hormonal birth control, pretty much everything except weight gain (though getting off of it added pounds). I've had good luck with an IUD, but my husband has not (wires, ugh). Also, I found out years post-pill that migraine sufferers have to be extra careful with the hormones, which no one told me at the time. To be fair, I'm the only one of my cohort to have such difficulties with BC.
posted by eralclare at 7:42 AM on July 15, 2013

Oh, also, maybe this goes without saying, but you should each get a full battery of STD tests before ditching condoms. Even if you've been monogamous for a long time, and even if your last tests were clean, do it again, just to be safe. Condoms are the only method that is really even somewhat effective at preventing disease transmission, so make sure neither of you has any diseases to transmit.
posted by decathecting at 7:42 AM on July 15, 2013 [4 favorites]

I had what I think you call Paraguard over there - I'm in the UK. I stopped using it in the end for a variety of reasons, mainly the much heavier, more painful periods that were very disruptive and left me exhausted. So when I went to get something else, the FPC recommended Nexplanon. I was worried given the hormones - like you, I don't need the weight gain, and I have bipolar disorder so I don't want more things messing with my moods. However, it's been great so far. The only bad thing is suddenly getting spots in places where I never used to get them, like my chest and back. I have put some weight on, but then I'm on medication for my mental health that makes that happen, plus I haven't been as vigilant about eating well and exercising as I needed to be which I'm hoping to change. So it's hard to say whether it's the cause. The other good thing is that if it doesn't suit you and you get it removed, it takes only four days for your body to adjust, and it took me much longer on Depo-Provera.

I've never been on the Pill either, and my only pre-coil experience of contraception was Depo-Provera, which made me put weight on like woah and also made me pretty depressed toward the end of the dose. I wouldn't personally feel comfortable using condoms alone, and I found it a little anxiety-inducing until I knew there was something more permanent in place. That said, if this is a new guy please don't rush to ditch the condoms until you can be sure both of you are safe to have sex without a barrier method.
posted by mippy at 7:48 AM on July 15, 2013

I had problems before going on hormonal BC (and they were serious, painful problems!), and have never had any problems since. I am much less moody, actually, and though I've gained weight during the seven-ish years I've been on it, I'm not going to kid myself - that's a lot more to do with aging/tacos than the BC.

But yeah, uh, nthing everyone else - your big concern should be what this dude is potentially carrying. Do not stop using condoms unless you are confident he is disease-free, and do not start taking medications that make you uncomfortable to appease someone else's whining.
posted by goodbyewaffles at 7:48 AM on July 15, 2013 [2 favorites]

Your GYN will probably take a consultation appointment with you where you can go over these options in detail and get their opinion, too.

If your periods are light and fairly easy, I might seriously consider the Paraguard. It's non-hormonal but the major side effect (experienced by 33% of women who use it) is heavier, longer periods.

An IUD is much more effective than hormonal birth control. It is a "set it and forget it" form of birth control that is easily reversible. Also, hormonal IUDs use lower doses of hormones than the Pill, so the side effects from hormones might be less severe.

Many women with IUDs are positively evangelical about them (and this is for a reason). If you're comfortable, try asking some friends whether they have an IUD and talk with them about it. Given your question, it really does sound like a good option for you to consider.
posted by k8lin at 7:55 AM on July 15, 2013 [1 favorite]

The cochrane reports provides summaries of peer review research on any kind of medication. Birth control has higher risk for some than others, depending on other health issues, such as smoking.

Any use of any medication should be your choice.
posted by chapps at 8:00 AM on July 15, 2013

PS - It's also not like having an IUD or taking the Pill precludes using a condom. Your boyfriend and any future partners should always be tested and be willing to share their results with you before you stop using condoms. Using them along with another form of birth control is fine.

Oh, also, an IUD is more effective than condoms, too. Either of the options you are considering will prevent pregnancy better than a condom will. A condom offers additional protection against STDs, but it isn't as effective at preventing pregnancy as the other methods you're considering.

Good luck, and congrats on taking charge of your fertility.
posted by k8lin at 8:01 AM on July 15, 2013 [3 favorites]

I was on the Pill for nearly 30 years. It was GREAT!

One thing you can do is take them continually and not have a period. How bonus is THAT?

Being on the pill probably prevented the ovary damage that ovulation causes that is thought to be one cause of ovarian cancer (which my family is prone to.)

I felt great on the pill and once I went on, it helped a lot with cramps.
posted by Ruthless Bunny at 8:05 AM on July 15, 2013 [1 favorite]

I lost weight on HBC. I was on low-estrogen, more for PCOS than controlling fertility (although that was certainly a thing). While I did have a 6wk adjustment at first and each time I changed formulations (sometimes you need to change to get the right one for your physiology figured out), my hormone-based mood shift was way more dealable than when I wasn't on, and the predictability of my cycle was a huge plus. And it made my cycle easier to bear. The worst thing for me was acne when I first started, but even that got better quickly.

But...this hating condoms thing kind of makes me nervous for some reason. I don't know why. Maybe because my experiences and those of others around me have given me telegraph's perspective on men who are that way about them. I don't know. Probably nothing, but, yeah, I hope before y'all give up on condoms that testing happens.

I also feel bound to note that HBC isn't 100% effective versus successful implantation. And it is 0% effective against STI. Dual method is really the safest possible approach other than non-PIV or abstinence. Obviously, you're adults and know what it's all about, but you do seem concerned about potential pregnancy, and pill failure is way less obvious than broken condom.
posted by batmonkey at 8:09 AM on July 15, 2013 [2 favorites]

Well now I've started dating a guy that HATES condoms and is begging me to go on the pill.

Um, it sounds like you might be better off switching your boyfriend rather than your birth control.
posted by Asparagus at 8:26 AM on July 15, 2013 [7 favorites]

Once I found the right pill for me (it took a couple tries) I lost 15 pounds. After I went off the pill I gained them back. If weight gain anecdotes are scaring you, you can counter those with mine.
posted by purpleclover at 8:30 AM on July 15, 2013 [1 favorite]

I had a similar terror of Tamoxifen, the breast cancer drug, which I avoided like crazy due to all the horror stories about weight gain and depression. A light bulb went off when my doctor said, We're going to put you on a 90-day test packet and see how you do. It didn't have to be permanent! It was just a test packet!

I have been on it for three years with NOT ONE SINGLE SIDE EFFECT. And my doctor was b-s'ing -- she gave me a script for 90 days, just to get me to take 'em.
posted by thinkpiece at 8:40 AM on July 15, 2013 [1 favorite]

I was 31 when I first went on hormonal birth control. I did have concerns about becoming a moody wreck of adipose tissue and acne, but... nothing like that happened. The only side effect I encountered was that my menstrual cycle got super unpredictable. My period was never heavier or more painful than before, it just did things like not showing up for several weeks and then lasting for ten days.

I take progestin-only pills (aka the minipill) due to high blood pressure. They often have a lower chance of side effects - except for the wonky cycle thing, which is quite common. They also have a greater chance of failing if you don't take them at the same time every day, so they're often only recommended for people who can't take combined pills. But they are an option.

Honestly, though, if your relationship is new enough that you describe it as having "started dating," it's not time to discontinue condoms yet. Once you've got several months of committed monogamy under your belt and you've both been tested for STDs*, then consider non-barrier methods. He's asking you to put something in your body long-term so that he can avoid putting something on his body short-term. Hormonal birth control of any kind requires a commitment and does carry some risk of side effects, and it's reasonable to wait until you're sure this relationship is a long-term thing before making that transition.

*If he balks at the idea of getting tested, RUN.
posted by Metroid Baby at 8:42 AM on July 15, 2013 [8 favorites]

There are plenty of folks who have none of those symptoms on the pill (for the first few months I lost weight because I'd be mildly queasy if I ate withing a few hours of taking the pill, and weight after that was pretty consistent for the 12 years I was on it). It's not a thing I was constantly posting on the internet about because it was working for me. I have a Mirena right now--it does have hormones but a much lower dose, and I've found it pretty maintenance-free, and again not affecting much of anything negatively, and also making my already-pretty-easy periods even easier.

Agreed with the folks upthread that you and your partner should be tested for STD's and have some talks about monogamy before going condom-free.
posted by tchemgrrl at 8:46 AM on July 15, 2013

The mirena, amongst many other side effects, made me gain ten pounds. The nuvaring made me puke and killed my sex drive. The pill gave me constant cold sores.

Hormones and I... don't mix.

However, my periods? Are horrible. I have endometriosis and painful ovulation, so I have 7 days of bleeding, followed by 4 days of ovulation pain, followed by a week of relative awesomeness, and then 10 days of pms. Hormonal birth control took care of all of that, it didn't cause it.

The paraguard might be an option, if you want hands free birth control. If you are responsible and dedicated, the Fertility Awareness Method (FAM) really works too. You need to chart, and you need to be very, very much on top of things, and you either need to abstain or use condoms when you're fertile, but it is a pretty awesome non-hormonal birth control method.
posted by lydhre at 8:53 AM on July 15, 2013

Make sure the guy / relationship is worth this incredible bodily discomfort.

Do not take yazmin, it is the subject of a lawsuit because it has a higher risk for blood clots.

I loathe HBC and use Fertility Awareness Method instead.
posted by St. Peepsburg at 8:59 AM on July 15, 2013

If you can pay for Mirena easily, consider it. It seems to be safer than most of the available pills. (Or consider Paragard if you don't have period problems.) They are also more reliable than pills, since few humans can take a pill perfectly every single day.

I never had problems with weight gain or moodiness with any of the pills that I took. But the last brand that I took caused a significant health problem, and the part that kind of pisses me off is that nobody told me what symptoms to watch out for. The result is that, while I'm not opposed to BCP, I feel that doctors don't educate patients about things like, say, pulmonary embolisms nearly enough.

But seconding the things that people are saying about STDs and trust and concern for YOUR well-being (over his comfort!) and so on. I mean, BCP carries a more-than-zero risk.
posted by wintersweet at 9:01 AM on July 15, 2013 [2 favorites]

I'm on the pill and I like it. My skin is great, my period is regular, I'm not any moodier than normal, I have less PMS, and I haven't gained weight.
posted by queens86 at 9:18 AM on July 15, 2013

Some excellent advice upthread. FWIW, I've been using Implanon for 3 years and the only side-effect I've experienced is some slightly wacky periods (which makes going to the sexual health clinic pretty fun, I can tell you -- "when was your last period?" "Um, I had one in March, two in April, none in June.."). No weight gain, no mood swings.

This, though:

Well now I've started dating a guy that HATES condoms and is begging me to go on the pill.

I think you should sit yourself down for a moment and think about whether you're considering this because you really truly want to, or because this new guy has been whinging at you. Remember: this is your body. This is your choice. If you don't want to go on BC, it is totally OK. If he's pressuring you to do something that freaks you out, that is not OK, and you have my permission to kick his ass to the curb.
posted by fight or flight at 9:26 AM on July 15, 2013 [6 favorites]

Every time you take the morning after pill, you're taking an ultra-concentrated dose of the daily birth control pill.

Not only is there no difference, but depending on how often you have condom problems, you might actually be getting a higher dose of hormonal birth control the way you're currently doing things.

Just go on the pill. Millions and millions of women use hormonal birth control to no ill effects. Stories of weight gain, emotional overload, etc. are overblown. Keep in mind, too, that there are a lot of different types of hormonal birth control pills, and you can work with your doctor to find the one that's right for you.

Keep in mind, also, that if you try it, and you really hate it, you can stop. It's not poison.
posted by Sara C. at 9:29 AM on July 15, 2013 [4 favorites]

Just wanted to chime in that ParaGard (the only hormones-free IUD in existence) has been awesome for me. After being on the pill for a decade plus, I can tell you that it is much, much better (sex drive, hair, nails, convenience, etc). Memail me if you have specific questions.
posted by rada at 10:06 AM on July 15, 2013 [1 favorite]

Two things:

1. If hormonal birth control bothers you, look into a copper IUD. They work very well and you never have to think about it.

2. Your boyfriend is setting off my alarm bells.
posted by rhombus at 10:20 AM on July 15, 2013 [1 favorite]

As an aside- yes, absolutely don't do anything that makes you uncomfortable, and definitely get tested with the new guy. But he's allowed to make his sexual desires known, you know? That doesn't mean you have to accede to those desires, of course- it's your body and you have the final say. But I disagree with the people in this thread who think he's being creepy or inappropriate for asking not to use condoms. He's a partner in this sexual partnership and he gets to express his desires, even if your answer winds up being no.

(Now, if you say no and he keeps pushing it, feel free to kick his ass to the curb...)
posted by showbiz_liz at 10:49 AM on July 15, 2013

Diaphragm, cervical cap, IUD.

I'm 52, never used hormonal birth control, and am also the only person I know who's never had problems. My periods have always been barely noticeable in terms of cramps, PMS, etc. To me, the risks associated with hormonal methods have never been worth it, plus the risks are always downplayed by the companies making the stuff. My health is more important to me than putting $$$ in the pockets of big pharma companies.
posted by MexicanYenta at 10:50 AM on July 15, 2013

Before getting my IUD I scoured the forums at IUD Divas and found them to be a great source of real-world experiences. Everyone's body is different but I would highly recommend trying an IUD (although as you know, IUDs don't protect against STDs so if that's ever an issue you'd want to use a condom too). I love mine and because I have the copper kind I don't have to worry about any hormonal side effects.

Good luck!
posted by whenbynowandtreebyleaf at 10:56 AM on July 15, 2013

Just get a non-hormonal IUD. They're great.
posted by Jacqueline at 11:23 AM on July 15, 2013

If you do use it, any side effects will show up quite soon. There's no harm in trying it for a month or two and then discontinuing it if you don't like it. BUT of course if you feel at all uneasy, it's okay not to try it at all.

By the way, condoms are a lot more effective if you also use a contraceptive gel, the kind usually used with a diaphragm.
posted by wryly at 1:18 PM on July 15, 2013

I never had any real problems with hormonal birth control. I ended up going off it because I'm bad at schedules; I hadn't had any problems but I wanted to avoid them. It completely removed my PMS and my cramps but it made me slightly irregular in my cycle. I never noticed any weight gain other than the usual college amounts.
Depo gave me a constant low level bleeding which didn't stop until I did Depo AND HBC. Which was less than ideal.
Tried the patch, did not like the stickiness.
Nuvaring didn't fit well for me; it had issues with poking out. I'm small framed, which may be the reason for that.
I'm on an IUD now, Paragard and I absolutely adore it. I don't have to fuss with it until 2020. I do have PMS again and minor cramping. I may look into switching to a hormonal IUD when the Paragard is done, see if I can get rid of the PMS and cramping.

Whatever you try, feel free to switch it up whenever and however you want.
posted by stoneegg21 at 1:35 PM on July 15, 2013

Have your boyfriend try some different types of condoms first if you're not sure about playing with your own hormones!
posted by veids at 1:42 PM on July 15, 2013 [1 favorite]

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