Why doesn't my b/c love me back?
June 8, 2007 11:29 AM   Subscribe

Hormonal Birth Control woes...

I'm going to try to keep this as coherent as possible:

22 years old and in a committed, loving relationship. On b/c for 5 years, NuvaRing for the last 9 months.

problem #1: No sex drive. Before birth control I was an uncontrollable 'nymphomaniac'. I rarely, if ever initiate sex anymore and it is not for lack of attraction or functionality of our relationship. I simply have no desire for sex until I'm actually doing it. Even then, I dry up easily despite plenty of desire to want sex.

problem #2: Onset of depression almost immediately after starting NuvaRing, with no other obvious trigger. Life was good, and since I became depressed I have felt basically disabled. My mood swings are awful. I scream and do things I would usually find completely unreasonable, torturing my boyfriend and roommates. Enough suicidal ideation often brought up by inconsequential difficulties and plenty of self destructive behaviour that leads to further depression.

problem #3: God-awful latex allergy, and a propensity to have an upset vaginal pH and subsequent infections.

So my question is: What are my options?!

I've skimmed through previous posts and found plenty of great advice, but none that really seemed to fit my needs.

Ideally I'd like to be off hormonal b/c as soon as possible. The implications of that move are a bit bothersome though:

- Non-latex condoms are awesome, but they are also relatively expensive. A pack of 5 runs about $18 at my local pharmacy. $15/mo for b/c is already stretching the budget, so I can't see me with increased libido buying all those condoms.
- Given my tendancy toward infection, I'm extremely wary about a copper IUD. I seriously don't want PID.
I also get enough cramps already, thanks.
- BBT charting was suggested in another thread, but while I'm in a stable relationship, we are by no means ready for an accident. I am thoroughly pro-choice, but have recently questioned my own ability to have an abortion. I'd rather not put us in that position.

So MeFites, is there any hope for me? Is there some miracle out there?

For the record, I have my annual exam with my GYN coming up, and I fully intend on bringing this up. I was just hoping I could get some anecdotal info before I go in. Thanks so much, and sorry for the length!
posted by sunshinesky to Health & Fitness (36 answers total) 2 users marked this as a favorite

Have these issues be with you since you started NuvaRing 9 months ago, or since you started BC five years ago?
posted by ALongDecember at 11:32 AM on June 8, 2007

Response by poster: Sex drive has been steadily declining for 5 years. I've been mood swingy for like... 10 years. I got on birth control just as my own teenaged rage was subsiding- There was some time off the mood swings just before I went on b/c.

The only thing new with the NuvaRing is the intensity of these side effects. Before I was moody, now I'm a downright asshole. I still initiated sex before NuvaRing, just less frequently than before b/c altogether.
posted by sunshinesky at 11:39 AM on June 8, 2007

If you are having suicidal thoughts, GO SEE SOMEONE. PLEASE. And STOP using the Nuvaring if you think this is causing them.

PIDs are most likely to occur at IUD insertion, and then mostly with women who already have a venereal disease. If you get tested (and then potentially treated) for diseases before IUD insertion, you should have a good idea of your risk for PID (which should approach zero). Talk to your obgyn. If the cramps are worse, you can get the IUD removed. For me, the cramps were only worse for a few months and treatable with a normal dose of motrin and staying away from caffeine for the first few days of my period (this really helps). Compared to hormonal birth control, its heaven.
posted by Eringatang at 11:47 AM on June 8, 2007

The only reason you don't want to go back to condoms is because they are expensive?? I would rethink that if I were you, since they sound like your best option. Split the cost with your s.o. - it sounds like the extra money would be well worth it to have your normal self back.

See also: buying your condoms online in bulk.
posted by infinityjinx at 11:49 AM on June 8, 2007 [1 favorite]

Suicide hotline: 1-800-273-TALK
posted by Eringatang at 11:52 AM on June 8, 2007

I think you need to switch birth control. See your gynecologist immediately.
posted by spec80 at 11:58 AM on June 8, 2007

there's a new IUD out that may work for you. my gyn said that they used to not prescribe them for women who still planned to have children, as there used to be a higher risk of contracting a pelvic infection, but that testing with newer models showed a reduced risk of infection as compared to women without it.

i opted against, for other reasons, but my friend has one and is really happy with it.
posted by thinkingwoman at 12:02 PM on June 8, 2007

Nuvaring made my depression worse. I had to stop using it. So, that is entirely possible that it is affecting you emotionally.
posted by jeanmari at 12:02 PM on June 8, 2007

some places will give you free birth control (including condoms) if you can find them. though the failure rate of condoms is still relatively high, so if you're willing to consider that, depending on which set of numbers you look at, BBT and related methods (FAM, etc) may have an equal or lower rate.
posted by lgyre at 12:05 PM on June 8, 2007

The pill could still be an option for you. Do you remember which brand you were on? A low- or variable dose birth control pill (I'm thinking of Yaz or OrthoTriCyclen) with a different dosage and variation of hormones than your old one might ease the mood swings and let you have your libido back. I have bad-ass depression, but the low-dose pills seem to not make things worse and they still let me be a sex fiend.
posted by foxy_hedgehog at 12:08 PM on June 8, 2007

Response by poster: yeah, cost is only one of the concerns I have with condoms. I have had a LOT of condoms break on me, and not for lack of lube. I'm just not into spending an arm and a leg for less piece of mind.
posted by sunshinesky at 12:08 PM on June 8, 2007

Response by poster: low-dose has been weird with me. NuvaRing is a low dose, which is why I switched to it.
On Alesse, I got awful breakthrough bleeding (read: a month of bleeding) if I missed pill-time by an hour.
On Demulen I had intense mood swings, but no depression.
On Ortho-TriCyclen I had more migraines.
On the patch, they tell me I was waiting for an aneurysm (I was a smoker).
Yasmin, migraines too.
posted by sunshinesky at 12:21 PM on June 8, 2007

Ask your doctor about a low dose b/c pill like Yaz. Or, maybe a mini-pill which contains only progesterone.
Other options could be a patch, or an injection.

Given your bout with depression (which may or may not be related to your b/c choice), your concerns about the cost of birth control, and your claim that neither your or your BF are ready to start a family right now, and abortion may not be an option for you, maybe you should think about abstaining for a while? Not the most fun choice, but better than an unplanned, unwanted pregnancy.
posted by socrateaser at 12:25 PM on June 8, 2007

Best answer: I have had horrendous depression exactly three times in my life - the 2 1-year periods when I was on the pill, and the 9 months that I used the Nuvaring.

I have had ob/gyns tell me it wasn't the pill, or that I must have already been depressed and the pill was just making it worse. I've been told the types of pills I was taking don't cause depression because [the type of hormone, low dose, etc.]. LIES.

You know yourself best. Get off that shit. In the meantime, use the condoms as you research.

I LOVE my copper IUD.
posted by peep at 12:29 PM on June 8, 2007

Best answer: I used to be on hormonal bc (Loestrin) for years without any problems, and then gradually found a variety of increasingly awful side effects creeping in. After trying a variety of different brands, including Nuvaring (which sparked a sudden crushing, nearly suicidal depression within a few days), I finally gave up on hormones altogether last year. It felt GREAT. Sex got better, and my moods steadily improved.

But then came the question: now what? I considered and decided against an IUD. The sponge sucked. I used to use a diaphragm and didn't like it. Non-latex condoms were preferable, but expensive.

Not so much of a miracle, but what's finally worked for my guy and me: a combo of BBT charting and condoms. With BBT, there is a set of rules that indicate your safe days, some of which are very easy, and some of which are more complicated (and, given my own particular physical patterns, more ambiguous).

So for now, we've chosen the conservative route of only considering myself "safe" during the easy-rule days and using condoms on the other days. That adds up to using condoms for about half my cycle, and going without for the other half (if I was using the more complex rules to extend my safe days a little longer into my cycle before ovulation, we'd probably get up to another 5-7 days of non-condom usage).

If you went a similar route, then at least you'd be going through condoms at about half the rate you're using them now. (And your boyfriend should be splitting the cost with you, anyway.)

On preview: I have had a LOT of condoms break on me, and not for lack of lube.

What kind of non-latex condoms are you using? I've never had lambskin break, but the other kinds have.
posted by scody at 12:32 PM on June 8, 2007

Response by poster: We don't currently used condoms (though we stay tested twice a year), but when we did it was the Durex Avanti.

I haven't had any luck finding sheepskin, any ideas in Canada? Otherwise, links appreciated.
posted by sunshinesky at 12:36 PM on June 8, 2007

I'm on the nuvaring and have had very similar symptoms. What really helped me was taking a B-complex vitamin and flax seed oil everyday. My doctor actually recommended trying B vitamins when I told her I wanted to switch from nuvaring to the IUD because of the side effects. It sounded silly at the time, but worked wonders for me.
posted by blueskiesinside at 12:38 PM on June 8, 2007

I think this chart may be helpful for you. It sucks having to bounce around until you find one that's right, and sucks even more that you can't get as much (or any) variety in other formats (ring)... when will the bc industry catch up?!
posted by anaelith at 12:41 PM on June 8, 2007

You can combine barrier/sperm killing types of methods (contraceptive sponge, spermicide, condoms) with fertility awareness (which involves a bit more than just BBT charting) to design a pretty foolproof program. For instance, you can use the cheaper sponges/spermicides during the low fertility periods of the month, and either reserve the more expensive condoms or practice non-penetrative sex/abstinance during the high fertility periods.

Some info about sponges and spermicides. You might also want to ask your doctor about a diaphragm.
posted by carmen at 12:42 PM on June 8, 2007

Another voice recommending the copper IUD.

I've been on hormonal birth control for the last 10 years, with a steadily decreasing sex drive. Started on Norplant. Liked that pretty well, but had to switch to the patch when my 5 year span was up and Norplant was no longer available. Was on the patch for a couple years but experienced some suspected blood clots in my calves. Swiched to Nuvaring for the next couple years. Calf pain went away, but what sex drive I had left pretty much shut down completely.

Had the copper IUD installed two months ago. My sex drive came back almost immediately, to nearly pre-b/c levels. I couldn't believe it.

First period was very heavy, second was heavy, but not as much as the first. I expect this trend to continue. Some cramping right at the beginning of the period, but easily controllable with advil. No cramping after the first day. Period seems as regular as clockwork, and I feel like I'm high school again. Well, the good parts, anyway. ;)
posted by Void_Ptr at 12:53 PM on June 8, 2007

Trojan Lambskin from drugstore.com -- they will ship outside the U.S., but I think it takes a few hoops to jump through. Is there an equivalent website for Canada? And yeah, they're pricy: more than US$30 for a box of 12. But if you and your guy split the cost and you use them only about a third to half the month (in conjunction with charting), it seems like it could be doable for your budget.

On preview: Carmen's link on the fertility awareness method is a good one. (And yes, she's correct to point out that it's about more than just BBT charting.) This is the FAM book I use after it had been recommended right here on AskMe a few times.

Carmen's link also brings up an important point: always have emergency birth control on hand, in case you do have a condom break/slip.
posted by scody at 12:56 PM on June 8, 2007

Response by poster: When we talk about heavy periods associated with the copper IUD, how heavy is it? Is it annoying or downright inconvenient?
posted by sunshinesky at 12:59 PM on June 8, 2007

Annoying AND they returned to normal after a few months for me.
posted by Eringatang at 1:02 PM on June 8, 2007

There's diaphrams and spermicide, but I can understand why you wouldn't want to use them long-term.

What about the hormonal IUD, Mirena? Its dose of hormones could be even lower than NuvaRing, and it is not supposed to be as irritating as the copper kind--in terms of cramps or anything else.
posted by Anonymous at 1:26 PM on June 8, 2007

I tried the copper IUD and there were no problems with cramping or infection, but I was continually spotting. The gynecologist told me that was normal and it would go away, but I gave up after 6 months and had it removed. I really wanted it to work--LOVED the idea of not having to think about birth control for the next 5 years--but it wasn't for me.
posted by happyturtle at 1:29 PM on June 8, 2007

I have no specific suggestions, but wanted to warn against the Depo shot for you. Its been known to cause crazy depression and mood swings in some people, and lasts for 3 months once you've gotten it. Works perfectly for me, but sounds like it might just amplify problems for you.
posted by wuzandfuzz at 1:33 PM on June 8, 2007

In addition to a literally never ending period that Nuvaring so kindly produced for me, I also went absolutely ape-shit bonkers emotionally. I used to love the ring before the changed the dose and what-all ever else they did to it, you couldn't pay me to ever use it again.
posted by goml at 1:41 PM on June 8, 2007

happyturtle, are you sure it was copper (Paragard) and not Mirena? Mirena can last 5 years, copper is 10.

sunshinesky, here's something I wrote previously. I think my periods on the IUD are the same or better than they were when I was not on any BC. They are heavier than the periods you would have while on the pill.

They do not interfere with my life, work, exercise routine, etc.
posted by peep at 1:52 PM on June 8, 2007

Best answer: It seems you have tried a plethora of oral contraceptives, and found all of them to have horrible side effects. I'm not convinced that switching to a different pill will make your life any better.
I have been on everything short of the implant, and fully endorse the IUD. I use the Mirena variety personally. I don't know if I would recommend you getting the hormonal type (Mirena) because you have had such negative reactions to it. I don't feel the same amount of side effects from having extra hormones in my body as I did with any of the other methods, but there still exists that risk.
PID with an IUD is only at an increased risk when you first have it inserted (for about thirty days). This risk can be negated if you are tested before insertion, and you are 100% sure your significant other is faithful. If you are still worried, get tested 30 days after insertion when you go in for a checkup just for your peace of mind.
The extra cramps and bleeding associated with the copper T IUD (Paragard) can be annoying, but are far less annoying than being pregnant. It is a wonderful form of birth control, and I've heard many sucess stories.

Finally, regarding the non-latex condoms, it is such a common problem, but people in the sexual-health industry seem so naive to it! My SO is allergic to latex as well, and we used Avantis. They are my personal favorite brand, mostly because I think sheepskin is gross (and I'm a vegetarian) and the Trojan polyurethane condoms are HUGE. I once ordered a gross of Avanti for a group that I worked for, and they still cost a US dollar a piece in bulk. Planned Parenthood (and my college campus sexual health services) do NOT carry polyurethane male condoms, which I think is a terrible crime against humanity. However, most of these people carry the odd female condom (Reality brand) which is polyurethane. Search around for free condom sources like Planned Parenthood and see what you can get. If they don't carry non-latex, raise a stink! Eventually, hopefully, we can make them change their ways.
Good luck, and my email is in my profile in case you have any questions you want to throw at a nurse-in-training.
posted by nursegracer at 2:08 PM on June 8, 2007

When we talk about heavy periods associated with the copper IUD, how heavy is it? Is it annoying or downright inconvenient?

On Paraguard my periods were ridiculously, insanely heavy. 9 days total with 3-5 days of bleeding through super-extra-ultra tampons every hour. It interfered with my work, it was that bad. I finally started bleeding all the time and had it removed after 5 months. Normally, I have very light periods and no cramping at all.

I tried the mini-pill (homicidal rage), Depo (one continuous 3-month period), regular pill (worked great but can't get it anymore due to family history of stroke) and now I'm using Nuva-Ring. So far, so good although my sex-drive is poor. If it doesn't come back I'm going to try the Mirena but Blue Cross doesn't cover it so it's a pricey little experiment at about $800.
posted by fshgrl at 2:25 PM on June 8, 2007

Blue Cross doesn't cover it so it's a pricey little experiment at about $800

Are you positive on this one? You may want to check back with your insurance company if you aren't, especially if you called a call center about it, some people aren't aware on how to quote benefits that specific.

If you need more info, email in profile, etc.
posted by gregschoen at 5:54 PM on June 8, 2007

1. See your doctor very soon. The depression and suicidal thoughts are something you need to figure out and address right away.

2. Another hormonal method might work for you, but it really depends on getting the right combination. For some women, it just seems like more of a crapshoot than for others.

I had something similar on Ortho-Evra as you are experiencing. I went into a 6+-month fog of depression, crying all day, super sensitive to everything, and all of my physical pain was heightened. I admire my boyfriend's patience with me during that time.

I found a low-dose (a generic for Lo-Ovral) that's working for me now. No more super periods, my boobs don't hurt every single day, and most importantly, I can get out of bed and I don't weep all day anymore.
posted by cmgonzalez at 8:53 PM on June 8, 2007

Absolutely positive that my Blue Cross doesn't cover it. they cover generic hormonal birth control only, so no IUDs and no name brands. So basically, it's useless.
posted by fshgrl at 12:12 AM on June 9, 2007

Do you want kids at some point? If not, tubes tied or vasectomy for your boyfriend are alternatives to look at.
posted by BrotherCaine at 3:57 AM on June 9, 2007

Response by poster: I admire my boyfriend's patience with me during that time.

My feelings exactly. He's been a saint, all things considered.

I'm going to ask about the copper IUD at my upcoming appointment. It's been brought up previously, so I'm sure it won't be too hard to convince them to let me try one out. It seems it's worth trying before condoms, at least.

Thanks for your great, varied advice and links- I have come to expect no less from you guys! I love you, MeFi!
posted by sunshinesky at 10:35 AM on June 9, 2007

When we talk about heavy periods associated with the copper IUD, how heavy is it? Is it annoying or downright inconvenient?

First period was inconvenient because I didn't know what to expect. Prior to Paragard, periods would last 5-7 days, 1 regular tampon every 8 hours. First period post-Paragard was 7 days, with the middle 3 days at superomgtampon levels every 4 hours (if that). Second period would qualify as merely annoying, clocking in at 6 days, and only 1 day of superomgtampon every 6 hours.
posted by Void_Ptr at 7:01 PM on June 14, 2007

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