Your mission-Pick a bc method for me!
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| Sat, 08-21-2004 - 1:14am |
VITAL STATS:
I am a 29-year-old woman in a long-term monogamous relationship. We don't have children yet, but hope to in about 3-4 years. I am not concerned about STD prevention. I need to get back on some reliable method of b.c. because condoms stink and my libido is through the roof since I got the pill's hormones out of my system!!
I have had many problems over the past few years with the pill (possibly longer, but I only realized it 3 years ago). I'll include more specific info. below for those of you who want the whole scoop, but the skinny is that most of the pills I've been on cause me to have moderate to severe mood swings and dampen my sex drive. Some cause migraines, others do not.
Here's what I want from a b.c. method:
1) No hormones and/or hormones that are not likely to cause mood disorders (i.e. do the hormone levels in NuvaRing have as much chance of causing depression as the ones in the pill?)
2) No condoms-my b.f. is completely unable to have an orgasm with a condom. He's nice about it, but it sucks.
3) No methods that require us to stop the spontaneity to insert, add spermicide, etc. I do not generally know we're going to have sex 6 hours ahead of time. I am not opposed to inserting something as long as it can be done in one step and quickly (maybe the Sponge?)
4) Must be highly effective (one thing that freaks me out about the Sponge is that it's only 90% effective). What if I combined something like that with fertility timing? How hard is that?
5) Should not have counterindications for childless women who want children in the future. I'd love to use the IUD, but my doctor won't recommend it. While I know I could get someone to give me one, if I had problems conceiving in the future I would blame myself and be devastated. (Yes, I know unknown fertility problems could already exist, but that's completely beyond my control. If I chose an IUD against doctor's advice, I would fault myself for doing so).
Okay, I know I'm being demanding. But this is my wish list and maybe you can suggest something that would made all my reproductive dreams come true! If not, maybe you can come up with the best possible option out there. Please put your noggins to work for the very worthy cause of my happy sex life (god this was so easy before the pill started messing with my head!)
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If you want more specific info. on my hormonal problems on the pill, here's my b.c. history:
20 y.o. - 27 y.o.: TRIPHASIL b.c. pill
Quit this pill because I realized it was making me moderately depressed, moderate to severe mood swings and general inability to make decisions due to my feelings changing so much from day to day (or even within 6 hour periods). I finally realized this was a problem because after a year I still couldn't figure out if I wanted to be with my b.f. forever, or break up with him IMMEDIATELY. I bit frustrating for us both. I also couldn't decide where I wanted to live, work, eat, etc. Granted I had some other stuff going on in my head, but this made it 10x worse. I think it's possible that this pill had been giving me problems for a few years, but I didn't figure it out because I had been on it for a long time. FRIENDLY ADVICE FOR ALL: Try to "re-evaluate" your b.c. method every year and decide if you would choose it today. Don't just use it because it's what you've been using.
27 y.o. - 27 1/2 y.o.: LOESTRIN b.c. pill
At the time I liked this pill quite a bit. The moodiness went away, things were going very well. I was able to feel consistently positive about my relationship with my b.f.
UNTIL I thought I was pregnant! I missed my period & freaked out. Took a preg, test and was negative. Then I missed the next month. My gyno told me it wasn't a big deal...just happening because the estrogen levels were so low. After 4-6 months I decided the stress of thinking I was pregnant every month was too much, and I thought I had PLENTY of other options. How little I knew!!
27 1/2 y.o. - 28 y.o.: ORTHO TRICYCLEN
Okay, the doctor should have known not to put me on a triphasic since I told them I was having mood issues on the pill. BUT, as I now know, many/most doctors have no idea how these chemicals affect your mind/mood. After 6 months on this, I missed a pill. The next day, I decided to just stop taking it for a while to see how my mood was. After a few weeks, I felt like I was on top of the world. I hadn't even realized how "swingy" I had gotten again. I stayed off the pill for a year, fell heads over heels in love with my b.f. again and now KNOW that if I'm having "doubts" it's probably hormones and not really about him at all.
28 y.o. - 29 y.o.: CONDOMS
Let's just say we weren't having much sex. While my libido goes sky high when I'm off the pill, my b.f. just cannot have an orgasm with a condom. He's very understanding and wants me to do what's best for my health, mental & physical, but no orgasm means he's not as interested in sex and I feel bad that I'm the only one truly enjoying sex with a condom.
29 y.o. - 29 1/2 y.o.: SEASONALE
Pretty good. Relatively even temperment, fewer migraines than normal. Libido down a bit, weight up a bit. My insurance made me pay three $40 copays for each pack, so it was pretty expensive.
29 1/2 y.o.: LOESTRIN (continuously)
I decided to use a cheaper b.c. pill and take it *like* Seasonale. I chose Loestrin since I had been on it before. Instead of taking the sugar pills during week 4, I start a new pack.
I started getting migraines like CRAZY which is interesting because this didn't happen the first time I was on Loestrin. I stopped taking the pills 3 weeks ago, so now I'm on nothing again. My libido is SKY HIGH, so I really should get back on something other than condoms! (Why is it that when I'm not on b.c. and shouldn't be having sex, it's all I want to do?!?)

As you already know, there are going to be tradeoffs. You are going to have to make choices but I’ll mention some things you might want to think about or try:
1) No hormones and/or hormones that are not likely to cause mood disorders (i.e. do the hormone levels in NuvaRing have as much chance of causing depression as the ones in the pill?)
Hormones: We are all different so no one can say for sure how you will react to a given method until you try it. If I ever go back on hormones I would try NuvaRing first! You don’t mention having tried progestin methods. I don’t care for them but am mentioning the possibilities for your consideration. I wouldn’t recommend a progestin only pill as you have to be very, very consistent in taking it at the same time every day and it stops ovulation in only about 50% of users. I wouldn’t use Depo either, but it works well for a lot of women and it might for you. The down side of Depo is that weight gain, irregular bleeding and moodiness are common side effects. There is a delay (12-18 months) in the return to fertility of some women after stopping Depo but fertility does eventually return.
2) No condoms-my b.f. is completely unable to have an orgasm with a condom. He's nice about it, but it sucks.
Condoms: Have you tried Reality, the female condom? It’s slightly less effective than male condoms but if bf’s problem is with a snug sheath, then Reality might work well. The reduction in effectiveness is due primarily to the fact that if he slipped out it is easy for him to reinsert outside the sheath. That can be remedied by making sure you guide his reentry so that you know he is safely inside and you are still protected. You could try inserting a sponge before the condom for added protection. The condom-sponge may not work well depending on your anatomies (with a sponge, FC and penis in a small vagina it could get crowded) but it’s a possibility. I know you don’t want anything interrupting the spontaneity, but…
3) No methods that require us to stop the spontaneity to insert, add spermicide, etc. I do not generally know we're going to have sex 6 hours ahead of time. I am not opposed to inserting something as long as it can be done in one step and quickly (maybe the Sponge?)
Vaginal Barriers: The sponge is a spermicide delivery device and not a true barrier. A diaphragm can be worn continuously for 24 hours but does require additional applicator of spermicide before each act of IC. A cervical cap might fit your requirements if you can be fitted. There are a limited range of sizes (22mm – 31mm) depending on the type and they can be left in place for 48-72 hours without additional spermicide. I use a cervical cap and am very happy with how well it works for me! You do have to be fitted and need the discipline to use them correctly and consistently. If you are interested there is more about diaphragms and caps in the FAQs at the top of the board.
4) Must be highly effective (one thing that freaks me out about the Sponge is that it's only 90% effective). What if I combined something like that with fertility timing? How hard is that?
The Fertility Awareness Method (FAM – uses barriers during your fertile times) and Natural Family Planning (NFP – uses abstinence during your fertile times) are very effective methods if all the rules are followed all the time. However, to use a FAM/NFP you have to have a stable schedule and chart your fertile signs. It takes discipline to use correctly and the method is unforgiving of errors and risk taking. A wonderful book on FAM is Toni Weschler’s ‘Taking Charge of your Fertility’.
The biggest reason for unintended pregnancies with any method is user failure. That’s why low maintenance methods, such as the ring, patch and shot are popular, they take less discipline to use correctly thus significantly reducing the likelihood of user failure.
5) Should not have counterindications for childless women who want children in the future. I'd love to use the IUD, but my doctor won't recommend it. While I know I could get someone to give me one, if I had problems conceiving in the future I would blame myself and be devastated. (Yes, I know unknown fertility problems could already exist, but that's completely beyond my control. If I chose an IUD against doctor's advice, I would fault myself for doing so).
The IUD is very safe but still under a cloud created by the Dalkon Shield, a poorly designed IUD that caused infertility problems in the 1970s. However, the wearer should be in a monogamous relationship as there is a greater risk of infection if she or her partner have multiple sexual partners.
I hope you van find an effective method (or combination of methods) that work well for you. You’ll let us know what you decide, right?
Good luck,
Jill
hope this was helpful!
I have terrible problems on every brand of pills I tried until I got on the mini pill, and then all the depression went away.
Three things concern me about the mini-pill.
First, when I've been on the lower estrogen pills I, quite frankly, lose lubrication.
Also, the lower estrogen pill (Loestrin) is what gave me massive migraines for the last two months...I would assume a no-estrogen pill might do the same? Maybe not, I don't quite know what combination of hormones is better or worse.
And, since my sleep schedule on the weekends is somewhat different than during the week, I've never been great about taking the pill exactly on time. I generally remember within a 3 hour span, but from what I've heard that's not enough with the mini-pill. Is this correct?
Thanks for the info.
I've always heard estrogen causes moodiness and mood swings, and it's the progesterone that causes depression. I don't know what the difference is between moodiness, mood swings, and depression, they all seem pretty much the same thing to me. The mini pill doesn't have estrogen, and while it does have progesterone in it, it's a far lower dose than any combination pill has.
Everyone is different of course, but I've always had problems with lubrication on any combination pill. That problem went away once I got off them and tried the mini pill for a while, although now I'm using the Mirena IUD. The mini pill basically brought me back to completely normal, including my sex drive. All the little side effects from all the pills I tried were gone completely.
If you can't take them on time, then mini pills aren't as effective. Anything more than three hours difference counts as being late and requires a backup method for two days. So this may make them not a good method for you.